Tendon Conditions: Peroneal Tendon Tear and Dysfunction

In this video we discuss peroneal tendon injuries and their treatment options.


The team of foot and ankle surgeons are trained trauma experts and have decades of extensive experience in the treatment of ankle tendon injuries. 

Our physicians have authored many papers about the treatment of peroneal tendon injuries and often teach other surgeons how to repair peroneal tendon tears. 

We pride ourselves in offering the very best, state of the art care all within a relaxed, professional environment.

Peroneal Tendon Injuries

Peroneal Tendon Tear

Peroneal Tendon tears can occur from a previous ankle sprain or from chronic looseness of the ankle following a sprain. In rare cases, there may be poor mechanics of the ankle and foot, leading to overuse and injury to the tendons. One or both of the tendons can be torn.  Read more about Ankle Sprains here.


Peroneal Tendon Dysfunction

When they pop out of the supporting ligaments that hold them in place it is called a dysfunction (dislocation). Unless treatment is given for acute dysfunctions they inevitably reoccur. For that reason, they need to be repaired to prevent future injury.



What Does a Peroneal Tendon Injury Feel Like?

Symptoms of Peroneal Tendon injury include:

  • Swelling
  • Pain
  • Sense of instability behind the outside of the ankle



Diagnosing Peroneal Tendon Conditions

If there is pain noted along the course of the peroneal tendons, an x-ray may be taken to check the foot alignment and any fracture or looseness (laxity). An ultrasound may be used to examine the gliding of the tendons and look for any small tears or scar tissue within the tendons.


If there is a suspected tear, an MRI may be necessary to check the region to see how large or extensive the tear may be. Furthermore, an MRI is used to check for ankle damage such as ligament tears, arthritis and cartilage damage.



Conservative Care Options for a Peroneal Injury

Conservative treatment options include:

  • A cast or splint immobilizes the foot until healing occurs
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain
  • Rest, ice, compression and elevation (RICE)
  • Physical therapy to increase strength and mobility


Patients may experience continued symptoms that worsen with conservative measures. This can lead to instability, and lead to falls or further injury to the ankle.


If after six weeks the tear or dysfunction is not responding to treatment, surgery may be indicated.



Peroneal Tendon Surgery

Peroneal Tendon Tear, Peroneal Tendon Injury

If surgery is indicated to repair the tendon or tendons, your doctor will determine the most-appropriate procedure for your condition and lifestyle.


The operation is performed at one of University Foot and Ankle Institute’s out-patient surgery centers, under general anesthesia. It typically takes your surgeon 1-1/2 hours to perform this procedure. It is important to repair the tendon in such a way to create adequate strength. If one of the peroneal tendons is very badly torn, it may be cut out and the two peroneal tendons sewn together to work as one strong tendon.


If the peroneal tendon is found to be dislocated from the posterior of the fibula, it is relocated. The groove is deepened and the retinaculum tendon cover is tightened and repaired.


Often, peroneal tendon tears are due to ankle sprains or ankle instability. When the ankle ligaments are loose, the peroneal tendons are overused causing strain and eventual tear of either tendon. If there is cartilage damage or loose or torn ligaments, these will be repaired at the same time.



What to Expect After Peroneal Tendon Repair Surgery

After surgical repair of your peroneal tendon, the best medicine is rest and foot elevation. It is essential to keep weight of the foot. Your doctor may provide you with an ankle splint for added support.


You will return to our office in about two weeks to have your sutures removed. At that time, your ankle splint will be replaced by either a short cast or a splint known as a cam walker.  You may begin bearing weight using the cam walker in about a month. Normal footwear can resume three to four months after surgery.



Physical Therapy and Your Recovery  

Working with one of our physical therapists to strengthen your ankle will play a key role in your recovery, and be prescribed eight to 12 weeks after surgery. Physical therapy usually involves learning an ankle stretching routine and performing ankle and lower leg strengthening exercises.


By following a physical therapist’s routine, we find that many patients can return to sports and activities within six months.



UFAI, We’re Near and Here When You Need Us!

Our team of physicians pride themselves in offering the best foot and ankle care all within a professional and comfortable environment. We are pleased to provide the convenience of nine offices throughout Greater Los Angeles and Southern California.

Our West Los Angeles, Beverly Hills, Sherman Oaks, Manhattan Beach, Valencia, West Hills, Torrance, Santa Barbara and Santa Monica Podiatry Locations offer full radiology service including, Physical Therapy, MRI, neurosensory nerve testing, ultrasound. This means you rarely need to visit multiple locations when tests or therapy are ordered. Our state of the art surgical centers and physical therapy services are conveniently located within our Valencia and Santa Monica Podiatry locations and close to our other locations.


We are committed to offering our patients the very best foot and ankle care.

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