Understanding Peroneal Tendon Tears: Causes, Symptoms, and Treatment

Peroneal tendon tears refer to the damage or rupture of the tendons that connect the peroneal muscles to the foot bones. This type of injury can occur due to acute or chronic trauma and can be accompanied by pain, swelling, inflammation, and weakness in the affected ankle. 

Understanding peroneal tendon tears is essential because immediate diagnosis and care can lessen the long-term consequences. Peroneal tendon tears can cause prolonged ankle instability, chronic sprains, and even tendon rupture if left untreated, demanding more complex procedures. 

This article will provide an overview of peroneal tendon tears, including their causes, symptoms, diagnosis, and available treatments.

Causes of Peroneal Tendon Tears

Below are some causes of peroneal tendon tears discussed in detail.

  • Ankle Sprains and Trauma

One of the most common causes of peroneal tendon tears is ankle sprains and trauma. The peroneal tendons can be stretched or torn during the ankle’s sudden twisting or rolling motion, such as when landing awkwardly from a jump or slipping on an uneven surface.

  • Overuse Injuries

Overuse injuries can also contribute to peroneal tendon tears. Repetitive stress on the tendons from running, jumping, or dancing activities can cause small tears to develop over time. These tears worsen with continued activity, leading to pain and dysfunction.

  • Degeneration and Aging

Degeneration and aging can also play a role in peroneal tendon tears. As we age, the tendons become weaker and more susceptible to injury, and the blood supply to the tendons decreases, slowing down the healing process.

  • Other Contributing Factors

Other factors for peroneal tendon tears include poor footwear, muscle imbalances, and abnormal foot mechanics. High-impact activities, such as basketball or soccer, can also increase the risk of tendon injury. 

Individuals with certain medical conditions, such as rheumatoid arthritis or diabetes, also be more prone to peroneal tendon tears. Identifying and addressing contributing factors is important to prevent future injury.

Symptoms of Peroneal Tendon Tears

The following are the torn peroneal tendon symptoms

  • Pain and Swelling

Pain and swelling are common symptoms of peroneal tendon tears. Individuals experience pain outside the ankle, especially when walking or bearing weight, and notice swelling or tenderness around the tendons.

  • Weakness and Instability

Weakness and instability can also occur with peroneal tendon tears. The tendons help to support and stabilize the ankle, and damage to these structures can lead to feelings of weakness, instability, or giving way in the affected ankle.

  • Audible Snapping or Popping Sounds

Audible snapping or popping sounds be heard with peroneal tendon tears. These sounds can occur when the tendons move out of place or over bony structures in the ankle, accompanied by pain or discomfort.

  • Difficulty Walking or Standing

Difficulty walking or standing results from peroneal tendon tears, especially if the injury is severe. Individuals have difficulty bearing weight on the affected ankle and experience pain or weakness, making it difficult to stand, walk, or perform other activities.

Diagnosis of Peroneal Tendon Tears

The diagnosis of peroneal tendon tears typically involves a combination of physical examination, imaging tests, and diagnostic injections.

  • Physical Examination

Physical examination includes an assessment of the ankle and foot and reviewing medical history and symptoms. The healthcare provider checks for tenderness or swelling around the peroneal tendons and tests for strength, range of motion, and ankle stability.

  • Imaging Tests

Imaging tests such as X-rays, ultrasound, or MRI scans be ordered to confirm the diagnosis and assess the extent of the injury. These tests can provide detailed images of the tendons, bones, and other structures in the ankle, allowing healthcare providers to identify any tears or damage.

  • Diagnostic Injections

Diagnostic injections can help confirm the diagnosis and identify the specific source of pain or dysfunction. A local anesthetic or corticosteroid be injected around the peroneal tendons, and the individual’s response to the injection can help determine the location and severity of the injury.

Treatments of Peroneal Tendon Tears

Peroneal tendon tear treatment depends on the injury’s severity and includes conservative or surgical approaches.

Conservative Treatment

Rest, Ice Compression, Elevation (RICE): Conservative treatment options include rest, ice, compression, and elevation (RICE) to reduce pain and swelling. 

Physical Therapy and Rehabilitation: Physical therapy and rehabilitation exercises can help improve the affected ankle’s strength, range of motion, and balance. 

Bracing and Orthotics: Bracing or orthotics support and protect the injured tendons during activity. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections also reduce pain and inflammation.

Surgical Treatment

Surgical treatments are recommended for more severe or complex cases of peroneal tendon tears.

Tendon Repair: Tendon repair involves reattaching the torn tendon to its original location.

Tendon Reconstruction: Tendon reconstruction involves using a graft from another part of the body to replace the damaged tendon.

Arthroscopy: Arthroscopy visualize and repair the peroneal tendons using small incisions and a camera.

Recovery and Rehabilitation

  • Postoperative Care

Recovery and rehabilitation after treatment for peroneal tendon tears typically involve a combination of postoperative care, physical therapy, rehabilitation exercises, and a gradual return to activity. After surgery, individuals wear a cast, splint, or brace to protect the ankle and promote healing. 

  • Physical Therapy and Rehabilitation Exercises

Physical therapy and rehabilitation exercises help improve the affected ankle’s strength, flexibility, and balance, reducing pain and inflammation. 

  • Return to Activities

A gradual return to various activities, starting with low-impact exercises and slowly increasing the intensity over time, can help prevent further injury and promote long-term healing. 

Prevention of Peroneal Tendon Tears

  • Stretching and Strengthening Exercises

Regular stretching and strengthening exercises, such as calf raises and ankle rotations, improve the range of motion and promote stability. 

  • Proper Footwear

Wearing proper footwear, such as shoes with good arch support, can also help reduce the risk of injury. 

  • Avoiding Excessive Training

Avoiding excessive training and using the proper technique during physical activity can also help prevent peroneal tendon tears.


Peroneal tendon tears can cause significant pain and functional limitations, but prompt diagnosis and treatment can help individuals recover and return to normal activities. A comprehensive treatment plan should include physical therapy and rehabilitation exercises to restore strength, stability, and range of motion. 

Preventive measures such as stretching and strengthening exercises, proper footwear, and avoiding overuse or excessive training can also help reduce the risk of future injuries. Early intervention and proper treatment for torn peroneal tendons are crucial for optimal recovery and prevention of peroneal tendon tears.

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