Peroneal tendon injuries are not uncommon, but they can be very painful and damaging. Knowing how injuries are usually caused and how to treat them can be helpful for active people hoping for a quick and full recovery.

What Are the Peroneal Tendons?

The peroneal tendons are the tissues that run along the outside of the ankle behind the fibula bone. These tendons serve as a connection between muscle and bone that allow for smooth movements. Each foot has two peroneal tendons—one is attached to the outer portion of the middle of the foot while the other one stretches under the foot and ends at the arch. The job of these tissues is to stabilize the foot and support the ankle. There are several different types of injuries that can involve peroneal tendons and prevent them from functioning properly.

Types of Peroneal Tendon Injuries

A few different types of peroneal tendon injuries include:

Peroneal Tendonitis

An injury involving inflammation, peroneal tendonitis can affect one or both of the tendons. This injury usually occurs with chronic overuse from repetitive exercise, or sudden trauma like a sprained ankle or serious fall. Swelling and redness are the main symptoms of peroneal tendonitis, as well as pain that is difficult to ignore. The injured region may also be warm to the touch.

Acute Tears

Just like tendonitis, acute tears are also caused by repetitive stress or trauma. A tear can be partial or full, and can affect one or both tendons. If you have an acute tear, you will feel sharp, stabbing pains, and have visible swelling. The foot and/or ankle will feel very unstable, and if left untreated, the shape of your foot and arch may change.

Degenerative Tears

Unlike an acute tear that happens rather suddenly, degenerative tears are gradual. Also known as tendinosis, the tendons tear slowly over years as the tissues become thinner and more fragile. Common symptoms of degenerative tears include increased arch height, ankle instability, and pain that comes in periodic intervals instead of consistently affecting the foot.


Tendons can sometimes be affected by subluxation. This condition occurs when one of the peroneal tendons slips out of place. Outside of their normal position, this can become a serious structural issue. This may occur at birth or be a result of sudden trauma. Symptoms of subluxation include ankle weakness, persistent pain and a sensation of “snapping” whenever one walks on the affected foot.

Causes of and Treatment for Peroneal Tendon Injuries

Besides sudden trauma and birth defects, there are several other causes of peroneal tendon injuries. These include:

  • Sudden increase in physical activity
  • Incorrect training techniques or overly strenuous workouts
  • Failure to follow through with physical therapy or rehabilitation post-ankle surgery
  • Recurrent ankle injuries
  • High foot arches
  • Overly tight calf muscles
  • Unsupportive or ill-fitting footwear

There are a few different treatment options if you find yourself with a peroneal tendon injury, and your podiatrist can guide you toward a plan that will work well for you and your particular situation. Some treatment methods include:

Rest and Modified Activity

Your doctor may ask you to refrain from physical activity outside of what is necessary to complete day-to-day tasks so you are able to heal your ankle. Other conservative treatments include wearing a walking boot or ankle brace.

Anti-Inflammatory Drugs and Physical Therapy

There are various medications that can be prescribed to reduce inflammation and bring some relief. These include over-the-counter options like ibuprofin, acetaminophen, or naproxin. Physical therapy can also heal the injury by stretching the peroneal tendons and calf muscles in order to reduce built up pressure.


When necessary, peroneal tendon injuries may require surgery. Peroneal tendonitis usually responds well to more conservative treatment options, but tears are trickier to heal. Surgical intervention is often necessary. The doctor will repair any tearing that has taken place and clean up the area to prevent any infection.

Our Podiatry Team Can Help

If you suspect you’ve suffered a peroneal tendon injury of any type, do not hesitate to reach out to a podiatrist. At InStride Carolina Podiatry, we have experience working with a wide variety of injuries related to this unique portion of the foot. With proper care you will be back on your feet in no time. Give us a call at 803-285-1411 or visit our website.

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