Identifying and Treating Peroneal Tendon Tear

A peroneal tendon tear is an injury that is often associated with sports, but that certainly doesn’t mean that the average Joe can’t sustain this type of injury. This injury involves the tearing of one or both of the peroneal tendons, which are located just at the side of one’s ankle. They run along the outside of the fibula where they connect the muscles of the lower leg to the bone at the outermost side of each foot. When these tendons are torn, the injury is often misdiagnosed as an ankle sprain, but it can be important to understand the signs and symptoms of the tear in order to properly treat the condition. Failure to treat a torn tendon could result in a longer recovery or more extensive damage to it.


The symptoms of a peroneal tendon tear can be difficult to tell apart from a sprained ankle because these conditions often share symptoms. In most cases, a torn tendon will cause instantaneous pain or discomfort that will cause the individual to stop what he/she is doing to inspect the ankle or foot. Upon a closer look at the area, the skin might appear red or even slightly bruised. Swelling will occur to some degree near the outermost bone in the foot or around the base of the fibula, although it may take time for the swelling to become visible. A minor tear will cause discomfort and limping when the foot is in use and the injury will be painful but manageable. A moderate tear in one of the peroneal tendons will cause more significant ankle pain and stiffness. In a worst-case scenario in which one or both of these tendons are severed, the tendon will be completely incapable of use, swelling and bruising will be significant, and the pain will often be very severe.

Common Causes

The most common cause of the tear is tendon overuse. This occurs when the tendon is subjected to frequent and recurring strains over a long period or when it is stretched or twisted further than it can stretch, leading to actual tearing of the fibers. Blunt trauma can also cause this tendon to become torn, such as dropping a heavy object on the outside of one’s foot or ankle. If this is the case, then it is also likely that one or more surrounding bones will also sustain a fracture due to their close proximity to the peroneal tendons. Individuals who play sports that involve running and/or pivoting, such as soccer, tennis, basketball, and football, are at a higher risk of tearing these and other tendons of the feet.


Self-diagnosis is possible, although it can be difficult to rule out other injuries that share the set of symptoms indicative of a torn tendon. Seeking a professional diagnosis is always the best choice of action whenever one is uncertain about how to proceed with treatment. If the injury is very painful or if one has lost the ability to flex their ankle or foot, then it would be best to see a doctor for a proper diagnosis. The doctor will examine the foot by taking in the visual symptoms as well as feeling the swollen area and asking the patient to perform certain movements with his or her ankle. He/she may wish to take an x-ray of the foot and ankle to determine whether or not a bone has been fractured.

Treatment Options

There are two primary courses of treatment that may be necessary with a torn foot tendon. The most common treatment involves immediately resting one’s ankle and foot. The leg should be elevated and the ankle should be allowed to rest on a supportive but soft pillow. An ice pack (or a zip-top bag filled with ice and wrapped in a towel) can be applied to the outer part of one’s foot and ankle. This will help to reduce the swelling caused by the inflammation. The ice pack will also take the edge off the pain. Alternating between nonsteroidal anti-inflammatory drugs (NSAID) and acetaminophen (Tylenol) will work not only to keep swelling down but also to reduce pain without allowing the body to build up a tolerance to one specific type of medication.

It is usually recommended that the individual take a few days off of work or at least work out an agreement with his/her employer so that work shifts may be carried out in a chair. This kind of injury can be very delicate because any wrong movement or taxing pressure can cause the injured tendon to tear even further and will prevent the injury from healing. One should refrain from applying pressure to one’s ankle and foot for at least three or four days. If, after this time, this tendon seems to accept normal walking pressure (there may be a slight limp while walking) without pain, then it should be safe to continue everyday tasks. Sports and other strenuous activities should be avoided for two or three weeks after the initial injury.

A severed tendon requires immediate medical attention. The longer the tendon remains severed, the greater the odds are that it will never fully recover. Surgery will be necessary to reattach the tendon. The recovery period is usually from four to six weeks and will likely involve the use of a wheelchair or crutches.

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