Peroneal Tendon Tear

Peroneal tendonitis is often associated with burning pain along the outside of the foot, ankle, and lower leg that increases with activity and decreases with rest. Peroneal tendon tears have similar symptoms to tendonitis but athletes may also experience a sharp, tearing kind of pain. Common symptoms may include:

• Pain along the outer side of the ankle
• Pain that is more pronounced when stretching the foot inwards or turning the foot outwards
• Swelling
• Warmth and tenderness to the touch on the outer side of the ankle
• Weakness and/or instability of the foot

Peroneal tendonitis is often seen in athletes who play sports requiring them to run and jump. The injury can result from a sudden twisting motion or lateral ankle sprain that stretches the ankle’s outer ligaments too far. This can result in tearing of the tendons. Overuse of the tendons is another common cause, usually occurring due to running on uneven surfaces, wearing poor running shoes, or chronic ankle instability from an ankle sprain or other injury.

Your doctor can diagnose peroneal tendon injuries. During a clinic visit, your doctor will perform a physical exam and take a full medical history. In some cases, your doctor will order imaging tests such as:

• X-ray
• MRI
• Ultrasound

If your pain is affecting your ability to perform your daily activities, your doctor may recommend a nonsurgical treatment such as:

• Staying off the affected foot and pausing strenuous exercise is imperative during rehabilitation.
• Heat and ice. Alternating ice and heat can help relieve pain and make movement easier.
• A cast or splint to immobilize the foot and ankle
• Physical therapy. Physical therapy is key, first to reduce pain and swelling and then to increase strength and improve range of motion
• Keep your ankle and foot elevated with a pillow when you’re sitting or lying.
• OTC medications. Over-the-counter pain relievers such as ibuprofen or naproxen can relieve pain caused by peroneal tendon injuries
• Injected pain relievers. Your doctor may inject an anti-inflammatory medication such as cortisone into the affected area.

There are several things that people can do to try and avoid getting peroneal tendonitis:

• Wearing appropriate footwear that properly supports the foot and ankle.
• Stretching the calf and peroneal muscles. If this is during recovery, the patient should wait until inflammation and pain have gone.
• Increasing training workload gradually.
• Maintaining a level of activity throughout recovery. This is particularly important for sportspeople during the off-season.