Peroneal Tendon Issues

The Peroneal tendons are on the outside of the ankle. The belly of the muscles are on the outside of the shin and two of the tendons run behind the lateral ankle bone – Peroneus Longus and Peroneus Brevis. The Brevis attaches to the top of the 5th metatarsal or toe bone, whilst the Longus disappears under the foot and attaches to multiple points. The third tendon, Peroneus Tertius, runs just in front of the outside ankle bone to the top of the 5th metatarsal, but is only present in 80% of us.

They are commonly strained when you laterally roll over on the ankle. It should be these tendons which stop you and strengthening of them is an important part of any ankle rehabilitation process.

Occasionally you can get inflammatory issues where the tendons run behind the ankle bone. These are common is runners or twisting sports as well as dancers. Treatment for all of these is manual therapy, shockwave and exercise as well as looking at the reasons why the tendons have become strained or inflamed to start with. If it is traumatic then control and balance work to help prevent recurrences are important. However, if it is to do with poor bio mechanics, typically a lateral foot strike, then work to stop this is essential and it begins at the upper back, chest and hips!