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Peroneal Tendon Injuries

Asheville treatments for peroneal tendon injuries

Do you have pain on the outside of your ankle that gets worse when you walk, run, or point your toes? You may have injured the peroneal tendons, which run along the outside of your ankle, helping connect your lower leg muscles to your foot.

Peroneal tendon injuries most commonly occur from overuse, and are more prevalent in athletes whose sports require repetitive ankle movement.

What is the peroneal tendon?

Tendons are thick, strong pieces of connective tissue that attach muscles to nearby bones. Each of your feet has two peroneal tendons, which connect the peroneal muscles in the lower leg to the foot. One of these tendons attaches at the middle, outside foot; the other runs underneath the foot and attaches at the arch.

The peroneal tendons help stabilize your ankle when you walk, run, jump or point and flex your foot.

How can you injure the peroneal tendon?

Peroneal tendon injuries tend to occur following a rapid increase in intensity or duration of activities that require repetitive ankle movements, such as running, dancing, or jumping. Patients with high arches are also more prone to peroneal tendon injuries, as this foot shape requires the peroneal tendons to work harder than normal.

The injury can appear gradually as chronic pain, or occur from an acute tear. Peroneal tendon disorders typically fall into one of following categories:

  • Peroneal tendonitis. The tendons become inflamed due to overuse.
  • Peroneal tendinosis. The tendons become swollen, overstretched, or develop tears due to overuse.
  • Subluxation. This is a common secondary injury following an inversion ankle sprain (the ankle has rolled inward), where the peroneal tendons are pulled out of place and stretch or tear.

How do I know if I have a peroneal tendon injury?

Common symptoms of peroneal tendon injuries include:

  • Pain on the outer ankle, which gets worse with activity such as walking, running, or pushing off the ball of the foot
  • Swelling or tenderness behind the ankle bone
  • Pain or weakness when pointing the toe or moving the foot outward

If you suspect a peroneal tendon injury, or you have any pronounced or persistent pain in your foot and ankle, see an experienced orthopedic foot and ankle specialist.

Diagnosing peroneal tendon disorders

At Carolina Hand & Sports Medicine in Asheville, our experienced orthopedic surgeons can evaluate your injury, make a diagnosis, and recommend an appropriate treatment plan at an appointment.

Depending on your symptoms and medical history, your doctor may order X-rays or MRI in addition to performing a physical examination.

Treatment options for peroneal tendon injuries

Most peroneal tendon injuries can be treated successfully through non-surgical methods, including:

  • Activity modification to exercise that rests the ankle, such as swimming or biking
  • Immobilization of the joint with a brace or splint to allow tendons to heal
  • R.I.C.E. (rest, icing, compression, and elevation)
  • Anti-inflammatory medications, such as ibuprofen (Advil) or naproxen (Aleve)
  • Physical therapy to improve strength, flexibility, and range of motion of the ankle and lower leg

Peroneal tendon surgery

If the injury is severe or fails to respond to non-surgical treatment, surgery is usually the next step. Depending on the nature and severity of injury, as well as the patient’s desired activity level, our surgeons may perform one of the following:

  • Tendon release to clear away irritated tissues around the tendon
  • Debridement, which also removes degenerated tissue within the tendon
  • Tendon reconstruction to repair a split peroneal tendon

Recovery from peroneal tendon surgery varies depending on the extent of surgery and the patient, but typically involves up to 6 weeks non-weight bearing, plus a period in a walking boot before normal activity is resumed. Physical therapy is also an important part of the recovery process.

Contact us to make an appointment

If you believe you have injured your peroneal tendon, we can help you get to the bottom of your injury and find an effective treatment to get back on your feet. Call Carolina Hand & Sports Medicine at 828-253-7521 to make an appointment.

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