Peroneal Tendinopathy
The tendons on the outside of the ankle and around the back that run down to the foot can be injured for a variety of reasons including ankle instability, cavovarus alignment or acute injury.
This can lead to pain around behind the ankle, down the foot and up the leg. This if often addressed at the time when surgery is performed for other reasons (e.g. ankle instability ligament repair) or as a standalone procedure.
In rare cases the peroneal tendons can dislocate out of their groove causing painful clicking behind and on the outside of the ankle.
Figure 1: possible locations of pain in peroneal tendinopathy
Figure 2: clinical photograph demonstrating the peroneal tendons dislocating out of their groove
Treatment options:
Non operative treatment
Footwear: changing to a comfortable trainer with a slight heel provides support., Avoid flat/hard or unsupportive shoes.
Modification of activity – pacing and spacing out difficult physical tasks
Physiotherapy to help strengthen the peroneal muscles
Helpful advice about peroneal tendinopathy and some simple exercises can be found at the following web link: https://www.nhslanarkshire.scot.nhs.uk/services/physiotherapy-msk/peroneal-tendinopathy/
Operative treatment is typically offered to patients who have ongoing pain after a minimum of three months of conservative management of ongoing symptoms. Or peroneal tendon pathology can be addressed at the time of other procedures such as ankle ligament reconstruction.
Procedures for this condition include:
Peroneal tendon repair