Peroneal Tendon Subluxation

Treatment for Peroneal Tendon Subluxation

Simon Moyes and the Capital Orthopaedics team provides expert treatment for peroneal subluxation and other foot and ankle conditions.

The peroneal tendons run in a groove on the outside of your ankle joint. They can get displaced as a result of an injury such as a sudden forceful twisting of your foot upwards and inwards, or as a result of repeated ankle sprains.

The symptoms can include sharp pain around the outside of your ankle, along with a snapping sensation and a feeling of the tendon moving over the bone.

Early treatment is critical, as a tendon that continues to move out of position is more likely to tear or rupture. If you have any ankle pain or ankle injuries, including peroneal subluxation of the ankle, contact us.


What is peroneal subluxation of the ankle?

Peroneal subluxation is also known peroneal tendon dislocation.

The peroneal tendons connect the peroneal muscles on the outside of your calf to the metatarsal bones in your foot.

The two tendons (peroneus brevis and peroneus longus) normally sit in a groove behind the bony lump at the base of your calf bone (fibula). They are held in place by a strong fibrous structure called the superior peroneal retinaculum (SPR).

The peroneal tendons can slip out of position if the SPR becomes torn or stretched. This is usually the result of a forceful twisting injury, or repeated ankle sprains.

What are the symptoms of peroneal subluxation?

Peroneal subluxation is also known as snapping ankle, due to the clicking sensation as the tendons slip in and out of place. Symptoms include:

  • Sensation of the peroneal tendons moving behind your ankle
  • Sharp pain around the outside of your ankle when your foot is pointed inwards or when you stand on it and rotate inwards
  • Tenderness behind the bone on the outside of your ankle
  • Popping or snapping sound
  • Instability and reduced range of motion
  • Swelling around the outside of your ankle
  • Tendon visibly moving across the bone on the outside of your ankle

How Capital Orthopaedics can treat peroneal subluxation

Our highly experienced consultant surgeons will carry out a physical examination to review any tenderness and pain, lack of stability or visible signs of peroneal displacement. They will assess any history of ankle injury such as sprains or fractures.

Diagnostic scans, including x-ray and MRI, will be reviewed by our in-house radiologists and surgeons. These imaging studies show the severity of the SPR damage, ensuring that you get the right treatment for your injury.

Non-surgical treatment

Immobilisation: wearing a non-weight-bearing cast or taping the ankle for 4-6 weeks, while a torn SPR re-adheres to the bone.
Rehabilitation: strengthening and mobilisation exercises after non-weight-bearing period.
Injections: occasionally, injection therapy is used to reduce symptoms.

Operative treatment

Our consultant orthopaedic surgeons use minimally invasive surgery, with reduced impact on the structures of your ankle, and quicker recovery times. Surgical procedures include:

  • Deepening the groove for the peroneal tendon
  • Reinforcing the SPR with graft tissue
  • Reattaching the SPR into the fibula
  • Rerouting the tendons behind a ligament to hold them in place

After surgery, you will spend four weeks in non-weight-bearing cast, followed by two weeks in a weight-bearing cast.

Our team of physiotherapists offer specialised rehabilitation programmes that include strengthening and mobilisation exercises, along with massage and electrotherapy to increase blood flow and improve healing.

Other ankle conditions that we treat:

Torn Ankle Ligament Injury

Getting a correct diagnosis after an ankle sprain is key to the most effective treatment and prevention of long-term ankle conditions. Many sprains can be treated with physiotherapy to build up stability and improve range of motion. Our expert surgeons treat more severe ligament tears and chronic ankle instability using minimally invasive surgical techniques to repair ligaments, smooth damaged bone and stabilise your ankle.

Footballer’s Ankle

Soft tissues can get trapped between the bones as you flex your foot upwards, leading to pain and swelling in the front of your ankle (anterior ankle impingement). This condition is often the result of repetitive kicking or flexing actions. Pinching can occur if soft tissues get thicker or swollen as a result of scarring or inflammation. If the ankle bones jar together, a bony outgrowth (bone spur) can form – which can also lead to soft tissues being pinched as the joint moves.

Posterior Impingement

Posterior impingement is caused by soft tissue being pinched between the bones at the back of your ankle. It can be the result of repetitive actions with a pointed toe (eg ballet dancing, football, gymnastics or fast bowling), or due to a sprain or chronic ankle instability. We treat this condition with physiotherapy and injections to improve range of motion and reduce inflammation. Keyhole surgery may be necessary to remove bone spurs or repair damaged tissues.

Ankle Osteoarthritis

Bone degeneration in your ankle leads to soft tissue damage, pain, swelling and instability. The slick cartilage coating on the bones in your ankle joint can wear away or get torn, and exposed bone surfaces then begin to degenerate. As your bones try to heal, they can also form lumps called bone spurs. It can be caused by repetitive impact, injury or ageing.


Frequently Asked Questions

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The Capital Orthopaedics team is made up of highly experienced medical professionals – from Mr Simon Moyes, the renowned orthopaedic consultant surgeon, to physicians, nurses, anaesthetists and physiotherapists.
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