Peroneal Tendon Tears

A peroneal tendon tear often occurs because of overuse or injury. This condition is common among athletes who run and jump at high intensity for prolonged periods of time.

What You Need to Know About Peroneal Tendon Tears

What Are Peroneal Tendon Tears?

Peroneal tendons (peroneus brevis and peroneus longus) run behind the bone on the outside of the ankle. Peroneus brevis connects to the fifth metatarsal, and peroneus longus extends beneath the foot and connects to the first metatarsal.

These two tendons connect the lower calf muscle to the ankle and foot bones and stabilize the ankle during direction change and when pushing off the toes. The tendons' primary function is to turn the foot outward and support the ankle as it moves.

You may experience a peroneal tendon injury because of overuse or injury of the tendon. Doctors may categorize peroneal tendon tears as one of the following subtypes:

Acute tears: Acute tears occur because of high-impact trauma or intense, repetitive movements.

Degenerative tears: Degenerative tears—also called tendinosis—develop from overuse over a period of months or years.

The foot and ankle specialists at Resurgens Orthopaedics provide exceptional treatments for all types of peroneal tendon injury. Schedule an appointment to discover how we can get you moving again!

What Causes Peroneal Tendon Tears?

A peroneal tendon injury occurs when the tendons become inflamed from overuse. If left untreated, the inflamed tendons can tear. Peroneal tendon tears result from repetitive movements — such as running and jumping.

Athletes who run on uneven surfaces or wear improper footwear are especially likely to experience this injury. Elite athletes who exercise at high intensity and frequency may also be at increased risk.

Peroneal Tendon Tear Symptoms

Patients with peroneal tendon tears often report common symptoms, including:

  • Pain in the outer ankle

  • Pain that worsens when turning or stretching the foot

  • Swelling in the ankle

  • Warmth to the touch at the injury site

  • Foot weakness or instability

Degenerative tears develop over time and can cause sporadic pain in the ankle that worsens at the foot's arch.

How is a Peroneal Tendon Tear Diagnosed?

Your Resurgens physician will diagnose the severity of your peroneus longus tear by examining the foot and ankle. During the exam, the physician will ask about recent activities, feel for warmth at the injury site, assess the ankle's strength and stability, and gauge the patient's pain while turning the foot in different directions.

Doctors also use an X-ray or MRI to confirm the severity of your peroneal tendon injury. They will use this information to plan the best path forward for your treatment.

Peroneal tendon tears are often misdiagnosed and can worsen without the appropriate treatment. It is recommended to receive an evaluation for a peroneal tendon injury as soon as possible.

How is a Peroneal Tendon Tear Diagnosed?

The treatment depends on the severity of the injury. Some cases can heal with conservative treatments, while others will require surgery to repair the tendons.

Non-Surgical Treatment

Non-surgical treatment options for peroneal tendon tears include:

  • Wearing a boot or brace to immobilize the ankle

  • Resting the tendons to allow them to heal

  • Icing the tendons on and off for 20 minutes

  • Taking anti-inflammatories, including ibuprofen and naproxen

  • Physical therapy

Surgical Treatment

Doctors will recommend peroneal tendon tear surgery for cases that do not improve with non-surgical treatments.

Surgical procedures for a peroneal tendon injury include:

Tendon debridement: In this procedure, the surgeon operates on the sheath surrounding the tendon to clear away damaged or inflamed tissue. The surgeon does not repair the sheath as it will naturally fill with scar tissue.

Tendon repair: In this procedure, the surgeon operates on the sheath surrounding the tendon and either removes the torn tendon segment or sutures the tear. The surgeon does repair the sheath in this procedure.


Getting relief from your peroneal tendon tear starts with a visit to Resurgens Orthopaedics. Schedule your appointment at one of our Metro Atlanta locations now!

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