Peroneal tendon is a cord like structure that passes behind lateral malleolus and connect the muscle belly with bone of midfoot area on lateral aspect. Chronic accumulation of micro trauma or any acute trauma can affect the tendon. Conditions affecting Peroneal tendon are broadly divided into three categories, tendinopathy with synovitis, tendinopathy with tendon rupture, tendon subluxation.

Accumulation of microtear or following any acute injury can cause peroneal tendon disorders. There are few risk factors associated with it.

• Varus alignment of heel
• High arch foot
• Chronic ankle instability
• Participation of sports and activities like, endurance runner, young dancer, ice skater, basketball player

Aching pain on the outer side of ankle, specially with activity and relieved with rest. Swelling and tenderness behind the outer aspect of ankle. Pain and weakness when actively moving foot in outward direction, while push off and walking on slope.

Any pain at back of lateral aspect of ankle with swelling and impaired function is indication to visit a specialist foot and ankle surgeon

He will do a thorough evaluation of your symptom and activity pattern to exclude any overuse factor and local examination for any deformity predisposing the pathology. He may advise for an x-ray, MRI or USG to find out the severity of the condition.

Treatment of peroneal disorders are conservative in most cases. Surgical treatment is indicated only in severe form of disease and or in tendon subluxation type. Conservative treatments are

• Rest
• Immobilization with brace or pneumatic walker
• Icing
• NSAIDs
• Physical rehabilitation
• Local infiltration with steroid or PRP

Surgical treatment depends on the condition of the tendon and type of pathology involved which can be

• Tendinosocpy & debridement
• Tendon repair with or without tenodesis
• Tendon sheath repair with peroneal groove deepening
• Hindfoot deformity correction along with tendon repair