Peroneal Tendon Injuries

There are two peroneal tendons, the peroneal longus and peroneus brevis. Both peroneal tendons help to stabilize the ankle and are used in activities like running, walking and jumping. They both start from different muscles of the outer lower leg (calf) and run behind the bone in the ankle (fibula). The peroneal longus (the shorter of the two tendons) attaches to the based of the 5th metatarsal. The peroneus brevis tendon runs along the bottom of the foot and attaches to the first metatarsal.

What Causes A Peroneal Tendon Injury?

One or both of these tendons can be injured during an ankle sprain, commonly as a secondary complication. In a scenario where the foot turns inward on an ankle, the tendons can be damaged as they contract to counteract the force. They can also be injured as the result of chronic overuse injuries and chronic ankle instability. The severity and structure of an injury to one or both of these tendons vary greatly. Tendons can be slightly stretched, torn or ruptured. They can also split. A tear can occur directly across the tendon, where the ends of the tendon become separated. A tear can also occur within the tendon, splitting the tendon or a portion of it. Even a small tear can enlarge over time.

A person who has injured one or both of these tendons may experience swelling, weakness during activity, pain that worsens over time, frequent ankle sprains, and a popping sensation while the move their foot.


A foot and ankle specialist will review your medical history and ask about the symptoms you are experiencing. X-rays are typically taken to see if the patient has injured a bone and to check foot alignment. Additional imaging test like a CT scan or an ultrasound may also be used to evaluate the area. It is likely that your doctor will order an MRI to evaluate the extent of injury to the tendons, ligaments, and cartilage.

Peroneal Tendon Injury Treatment

The type of treatment your doctor recommends will depend on the severity of your condition and other factors (strength lost, duration of injury, etc.). Initial treatments can include:

  • RICE (Rest, Ice, Compression, Elevation)
  • Immobilization (Cast or Splint)
  • NonSteroidal Anti-inflammatory Medication

Patients who are not responding to initial, conservative treatment methods may require surgery to restore stability and functionality to the injured area.

If surgery is indicated, your foot and ankle surgeon determine the most appropriate procedure. Surgery is typically done under general anesthesia. In most cases, patients are placed on their side during a procedure. Tendons may be sutured, relocated, or tightened. A tendon graft may be done if neither tendon is salvageable. Ligaments and cartilage will also be repaired during the same procedure if needed.

After surgery, a patient should expect to be immobilized for a period of time, especially if complex repair were made.

Physical therapy is commonly recommended to help patients regain their strength, stability and mobility.

Podiatry At The CMD

The podiatrist at The Center For Musculoskeletal are highly experiencing treating patients with foot and ankle disorders and injuries. Schedule an appointment to consult with one of our foot and ankle specialist. After diagnosing and evaluating your condition, our specialist will discuss individualized treatment options so that you can return to your normal activities.