Peroneal Tendon Injuries

Definition
There are two tendons that make up the peroneal tendons, brevis and longus.  By definition a tendon is a band of tissue that connects muscle to bone. The peroneal brevis tendon attaches to the base of the 5th metatarsal and the peroneal longus travels under the foot and attaches to the 1st metatarsal.  The peroneal tendons function to evert (outward movement) the foot.

Peroneal Tendon Injuries
Peroneal tendon injuries vary from minimally debilitating to severe pain. Three common injuries include:

  1. Tendonitis: Defined as an inflammation of one or both tendons caused by repetitive use of the tendons.  This would also include ankle sprains. Symptoms often include pain and swelling.
  2. Tears:  A tear within the tendon can occur as a result of direct trauma or chronic, repetitive motion causing injury. Symptoms are usually more pronounced than tendonitis and can lead to ankle instability.
  3. Tendonosis (degeneration):  Degeneration of the tendon follows a long period of overuse.  This is a change in the physical make-up of the tendon which leads to an overall structural weakening of the tendon.
  4. Subluxation:  Both peroneal tendons begin above the ankle and course down toward the lateral (outside) ankle joint bone (fibula).  Subluxation occurs when one or both of the tendons move out of the natural groove in the fibula.  Often symptoms include feeling a ‘popping’ or noticing the tendon move over the ankle joint bone.

Diagnosis
Your Podiatric Foot and Ankle Surgeon will evaluate for any weakness, pain or instability around the ankle joint.  Based on the severity of the injury a treatment plan will be recommended.  This may or may not include an MRI to further access the pathology.

Treatment
Low grade injuries such as tendonitis typically respond well to R.I.C.E. (Rice, Ice, Compression, Elevation).  However, long standing injuries or traumatic injuries may require physical therapy or surgical repair.