Lateral Ankle Pain from Tendon Irritation or Instability

What Are Peroneal Tendon Injuries?

Peroneal tendon injuries affect the two tendons (peroneus longus and peroneus brevis) that run along the outer side of the ankle and foot. These tendons play a key role in stabilizing the ankle and preventing sprains. Injuries can range from acute tears to chronic tendonitis or tendon subluxation (tendon slipping out of place).

These injuries often develop in athletes involved in cutting, pivoting, or uneven terrain sports — like soccer, basketball, trail running, or snowboarding — but they can also affect anyone with ankle instability or abnormal foot mechanics.

Causes and Risk Factors

• Repetitive ankle stress or overuse
• Ankle sprains or chronic instability
• High-arched (cavus) foot structure
• Inadequate rehabilitation from previous ankle injuries
• Improper or unsupportive footwear
• Direct trauma or fall onto the outside of the ankle

Symptoms

• Pain and tenderness along the outer (lateral) side of the ankle
• Swelling behind or below the fibula
• Feeling of ankle weakness or instability
• A snapping or popping sensation during movement (indicative of tendon subluxation)
• Increased pain with activity, especially on uneven ground or during side-to-side motion
• In some cases, ankle sprain symptoms that don’t resolve with typical care

Diagnosis

• Physical exam including resistance testing and palpation
• Observation for subluxing tendons during ankle movement
• MRI or ultrasound to confirm tears, inflammation, or tendon instability
• X-rays to rule out bone abnormalities or fractures

Treatment

Non-Surgical Treatment

• Rest, activity modification, and bracing
• Ice and anti-inflammatory medications
• Physical therapy to strengthen ankle stabilizers and improve mechanics
• Immobilization in a walking boot for moderate tears or severe inflammation
• Ankle taping or orthotics for foot alignment issues

Surgical Treatment

• Considered for patients with tendon tears, chronic subluxation, or failed conservative management
• Procedures may include tendon repair, debridement, or groove deepening to stabilize the tendons
• Reconstruction techniques used in severe or degenerative cases

Recovery Timeline

• Mild to moderate injuries typically recover within 6–8 weeks with conservative care
• Surgical recovery may take 3–6 months, depending on the procedure and rehab compliance
• Return to sports is gradual and guided by strength, flexibility, and functional testing

Expert Treatment at Kerlan Jobe Institute

Our orthopedic foot and ankle specialists at Kerlan Jobe Institute are experienced in diagnosing and managing complex peroneal tendon injuries. We use advanced imaging, precise clinical evaluation, and tailored rehabilitation programs to restore tendon function and prevent recurrent ankle problems.