Peroneal Tendon

Tear or Split

The peroneal tendons are the two tendons on the outside of the ankle that attach the muscles to the bones. Peroneal tendon problems commonly occur from an ankle sprain. A tear or split in one or both of them can occur after repetitive trauma or overuse.

Pain, swelling, and weakness (or instability) of the foot or ankle are all signs of a tear. At times, it can cause the arch of the foot to increase in height.


Peroneal tendon tears are often due to persistent chronic injury, but may also occur from an acute injury. Repeated, stressful movements may wear the tendons down over time, causing them to tear or split. The tendon may also rupture if an injury puts greater force on the tendons than they can handle. Common causes of peroneal tendon tears include jumping, hurdling, or beginning a sprint.

There are usually several symptoms of a peroneal tendon tear. Some of these signs may include:

  • A “pop” or rip behind the outer part of the ankle.
  • Pain and weakness when moving the foot (especially when pushing down with the front of the foot or turning it inward).
  • Inability to stand on the toes or ball of the foot.
  • Tenderness, swelling, and redness on the outside of the ankle.
  • Bruising after 48 hours of the injury.

Surgery is usually not considered for peroneal tendon problems until it has become impossible to control the symptoms without it. In this instance, the tendon tissue can usually be sewn back together with sutures. If more than half of the tendon is torn, the surgeon will perform a tenodesis, cutting the damaged portion of the tendon away and suturing the remaining portion to the other peroneal tendon next to it.

As an alternative, the injured tendon may be repaired through the use of stem cell therapy, using the patient’s own stem cells to heal the injury with a minimally invasive, same-day procedure.


After the procedure, the patient experiences virtually no down-time and is able to go about their usual routine.