Peroneal Tendon Dislocation/Dysfunction

What Is Peroneal Tendon Dislocation?

Peroneal Tendon Dislocation, occurs when the peroneal tendons, which run along the outside of your ankle and foot, slip out of their normal position. The peroneal tendons are important for keeping your foot stable. They support the Peroneus Brevis and Peroneus Longus muscles, which are located on the outer calves and help your foot roll outward when you stand. Sometimes called stirrup tendons, they also help maintain your foot's arch. These tendons are held in place by a tissue band called the peroneal retinaculum. When this tissue stretches or tears, it allows the tendons to dislocate, leading to pain and instability. Several factors can contribute to peroneal tendon dislocation:

• Injury – Sudden twisting or spraining of the ankle can force the tendons out of their groove.
• Sports – High-impact sports like skiing, football, basketball, and soccer increase the risk due to frequent falls and repetitive ankle movements.
• Repetitive Motion – Activities that require repetitive ankle movements can gradually weaken the retinaculum and lead to dislocation.
• Congenital Factors – Some individuals are born with shallow grooves for their peroneal tendons, making them more susceptible to dislocation.
• Neuromuscular Disorders – Conditions affecting muscle control increase the risk of tendon dislocation.

Who Does Peroneal Tendon Dislocation Affect?

This condition is most commonly seen in athletes and people who engage in physical activities that put stress on the ankles. However, anyone can suffer from peroneal tendon dislocation, especially those with high arches or neuromuscular disorders. Recognizing the symptoms early can lead to quicker diagnosis and treatment. Common symptoms include:

• Sharp pain behind the outer ankle bone
• A popping or snapping sound during ankle movement
• Tenderness and swelling around the ankle
• Instability or weakness in the ankle
• Difficulty walking or standing on the affected foot

• Rest and Immobilization – Initial treatment may involve rest, ice, compression, and elevation (RICE). Anti-inflammatory medications and physical therapy can also help.

• Anti-Inflammatory Medications – Consult your physician before taking any medications.

• Bracing and Casting – In some cases, wearing a brace or cast can immobilize the tendons, allowing them to heal properly.

• Physical Therapy – Exercises to improve balance and range of motion.

• Suture Repair – Repairing tears in tendons or retinacula with sutures.

• Groove Deepening – Deepening the groove where the peroneal tendons rest to prevent future dislocations.

• Calcaneal Osteotomies – Correcting the position of the patient’s heel could also help prevent dislocations.

• Stretching and Strengthening Exercises – Incorporate regular stretching and strengthening exercises for the ankle and lower leg. Focus on the peroneal muscles to enhance their stability and support.
• Proper Footwear – Wear proper shoes that provide adequate support and cushioning for your foot type. Avoid high heels or shoes with inadequate ankle support, especially during sports or physical activities.
• Warm-Up Before Activities – Always warm up before engaging in sports or intense physical activities. A proper warm-up prepares the muscles and tendons for movement, reducing the risk of injury.
• Use Ankle Supports – If you're involved in high-impact sports or activities, consider using ankle braces or supports to provide additional stability during movement.
• Listen to Your Body – Pay attention to any signs of discomfort or pain in your ankle. If you experience persistent pain or notice swelling, consult a healthcare professional to address any potential issues before they escalate.