The peroneal tendons, the combined peroneus longus and brevis, travel together through a fibro-osseous groove behind the lateral malleolus held in place by the superior peroneal retinaculum. They are the primary dynamic stabilisers of the lateral ankle against inversion forces and are susceptible to both tendinopathy and retinacular disruption allowing the tendons to sublux anteriorly over the lateral malleolus during plantarflexion and eversion.
Foot eversion; lateral ankle stability; push-off assistance
Peroneal tendon subluxation produces a painful snap or click at the lateral ankle as the tendons escape anteriorly over the lateral malleolus during foot movement. It is often misdiagnosed as an ankle sprain because it frequently accompanies lateral ligament injuries. The mechanism of injury is forced dorsiflexion and eversion rather than the typical inversion of an ankle sprain. Superior peroneal retinaculum repair is required for recurrent symptomatic subluxation.
Anterior displacement of the peroneal tendons over the lateral malleolus from superior peroneal retinaculum disruption, producing a lateral ankle snap with eversion that requires surgical retinaculum repair for recurrent cases.
Overuse degeneration behind the lateral malleolus producing posterior lateral ankle pain worsened by running and eversion activities, managed with load modification, orthotics, and eccentric strengthening.
