Peroneal Tendinopathy Treatment in Fairfax, VA
Pain and swelling in the tendons along the outside of the ankle, treated with rest, bracing, rehab, and tendon repair for tears.
Overview
The two peroneal tendons run behind the bony bump on the outside of the ankle and help stabilize the foot. Overuse or ankle sprains can irritate them, cause small tears, or let them slip out of their groove. These injuries are often missed, especially when they happen alongside a sprain.
Symptoms
- Pain and swelling behind and below the outer ankle bone
- Pain that worsens with activity, especially turning the foot outward
- Ankle weakness or instability
- A snapping or popping sensation behind the ankle (tendon subluxation)
Causes and risk factors
- Repetitive running, especially on banked or uneven surfaces
- Ankle sprains and chronic ankle instability
- High arches or a heel that tilts inward
- Sudden increases in training
Diagnosis
We test tendon strength and stability and look for swelling and tenderness along the tendons. Ultrasound or MRI identifies tears, tendon thickening, or subluxation.
Treatment
- Conservative: relative rest, a walking boot or lace-up brace, and anti-inflammatory measures
- Rehab: strengthening and balance work through physical therapy
- Orthotics: custom orthotics with lateral support for high arches
- Advanced: regenerative injections for chronic tendinopathy
- Surgery: tendon repair, debridement, or groove deepening for tears and subluxation (Reconstructive Surgery & Trauma)
When to see us
If pain on the outside of your ankle lingers after a sprain, or you feel snapping behind the ankle bone, get it evaluated at our Fairfax office.
Our approach
Peroneal tendon injuries are often missed when they happen alongside a sprain. Dr. Andrew Falco's sports-injury focus and Dr. Shyaun Rafii's reconstructive fellowship training mean we look for these injuries specifically and repair them when needed.
Frequently asked questions
How is this different from an ankle sprain?
A sprain injures the ligaments. Peroneal tendinopathy involves the tendons behind the ankle bone. Both can happen together, and the tendon injury is often overlooked.
Do peroneal tendon tears always need surgery?
No. Many small tears respond to bracing and rehab. Surgery is considered when pain or instability persists.
How long until I can run again?
Mild cases often improve in four to eight weeks. After surgery, return to running is typically three to four months.