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What Are the Peroneal Tendons?

The peroneal tendons run along the outside of your ankle and help stabilize your foot when walking, running, or changing direction. When these tendons become irritated or torn, they cause sharp or aching pain on the outer ankle — often mistaken for a simple sprain.

Peroneal tendon injuries are common in athletes and active adults.

Common Symptoms

• Pain along the outside of the ankle

• Swelling or tenderness

• Pain that worsens with activity

• Feeling of ankle weakness

• Instability when walking on uneven ground

• A popping sensation (possible tear)

• Chronic “ankle sprains” that never fully heal

Why Peroneal Tendonitis Happens

These injuries often develop due to:

• Repetitive ankle sprains

• High‑impact sports

• Running on uneven surfaces

• Flat feet or high arches

• Sudden increases in activity

• Tight calf muscles

• Ankle instability

Over time, untreated tendonitis can progress to partial or full‑thickness tendon tears.

Peroneal Tendon Tears

A tear may be present if you experience:

• Sharp pain on the outer ankle

• A popping sensation

• Persistent swelling

• Difficulty bearing weight

• Ankle giving out during activity

Tears often occur in patients with chronic Ankle Instability or previous sprains.

When Peroneal Tendon Problems Become a Problem

You should be seen if you experience:

• Daily outer ankle pain

• Recurrent ankle sprains

• Pain that worsens with walking or running

• Difficulty balancing

• Swelling that doesn’t improve

• Pain that interferes with work or exercise

If your pain is accompanied by arch collapse, it may be related to PTTD or Adult Flatfoot.

Treatment Options

At Orthopedic Foot & Ankle Institute, we offer:

• Custom Orthotics

• Bracing for ankle stability

• Anti‑inflammatory treatments

• Shockwave therapy

• Physical therapy

• PRP injections for chronic tendon damage

For advanced cases or tendon tears, learn more about surgical options on our Reconstructive Surgery page.

Do Peroneal Tendon Tears Require Surgery?

Not always. Many patients improve with early conservative care. However, surgery may be recommended if:

• Pain persists despite treatment

• The tendon is torn

• Instability continues

• Daily activities are limited

Dr. Sibel offers modern tendon repair and stabilization techniques designed for long‑term relief.

Author

Roman Sibel, MD Dr. Roman Sibel, MD is an orthopedic surgeon practicing at Orthopedic Foot & Ankle Institute in Henderson, Nevada. Dr. Sibel specializes in a variety of cutting-edge foot and ankle treatments, including reconstructive surgery, sports medicine, trauma surgery, diabetic care, and laser treatments for removing nail fungus. Dr. Sibel retains active affiliations with numerous Las Vegas hospitals, including Southern Hills Hospital and Medical Center, and St. Rose Dominican Hospital’s multiple campuses throughout Nevada. He also works with several local surgical centers, such as Parkway Surgery Center, Sunset Ridge Surgery Center, and Coronado Surgery Center. Graduating from Pennsylvania State University in University Park, Pennsylvania, Dr. Sibel went on to earn his medical degree from MCP-Hahnemann School of Medicine in Philadelphia. He completed both his internship and residency in orthopedic surgery at Ohio State University in Columbus, Ohio, and finished his foot and ankle fellowship training at the Hospital