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Peroneal Tendon Injuries

A tendon connects a muscle to a bone. The peroneal tendons are actually three different tendons, but two are usually focused on: the peroneus brevis and the peroneus longus. Improper training and significant shifts in training intensity can lead to peroneal tendon injuries. People with high arches are also more likely to injure their peroneals. The peroneals are responsible for stabilizing the ankle and everting the ankle.

There are four kinds of basic peroneal tendon injuries:

  • Type I: Tendonitis or inflammation of the tendons
  • Type II: Acute tears
  • Type III: Tendonosis or degeneration of the tendons
  • Type IV: Subluxation or the slippage and misalignment of the tendons

Symptoms:

Tendonitis:

  • Pain
  • Swelling
  • Redness and warmth of the outside of the ankle

Acute tears:

  • Increased pain with physical activity
  • Swelling
  • Instability of the foot and ankle

Tendonosis:

  • Varying or coming and going pain outside the ankle
  • Weakness of the ankle
  • Increased arch of the foot due to weaker tendons

Subluxation:

  • Ankle instability
  • Snapping and popping of the tendon around the ankle
  • Varying pain outside the ankle

Diagnosis:

Peroneal tendon injuries may be misdiagnosed as other common ankle injuries. To confirm a diagnosis, the clinician will need to observe the patient’s past medical history and perform a physical examination to look for pain, swelling, high arches and ankle instability. Imaging studies may be ordered to evaluate the severity of the injury and to rule out other possible causes.

Treatment:

As with usual foot injuries, RICE with NSAIDs may help to alleviate pain and discomfort. Immobilization, braces, orthotics and physical therapy are likely to be ordered as well in order to stabilize the foot and allow for proper recovery. Surgery may be needed in severe cases of peroneal injuries and tendonosis to allow for proper functioning of the tendons.

Sources:

https://footcaremd.org/conditions-treatments/ankle/peroneal-tendinosis 
https://www.foothealthfacts.org/conditions/peroneal-tendon-injuries 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508858/