The peroneal tendons run along the outside of the ankle, just behind the “ankle bone” (fibula) and into the foot, through a specialised tunnel (retinaculum). They act as dynamic stabilisers of the ankle, and malfunction of these tendons can cause functional ankle instability.

During a severe ankle sprain, the retinaculum can be torn, allowing the tendons to dislocate around the fibula. This can lead to chronic peroneal tendon instability, with snapping / clicking, pain and swelling during certain activities. The peroneal tendons can also tear or rupture during a severe ankle sprain, or after prolonged and repeated episodes of tendon dislocation. Peroneal tendon problems can co-exist with other ankle pathology, such as chronic ligament instability.

Acute flare-ups of symptoms often respond very well to a period of rest and then rehabilitation, supervised by a physiotherapist or sports therapist. If initial treatment fails, recurrent tendon dislocation is usually cured with a peroneal tendon reconstruction operation. If a tendon tear or rupture is diagnosed prior to or during the operation, then a repair or tenodesis is performed at the same time.