Ace Physiotherapy and Sports in Singapore
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+65 81535374 -
ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
#08-03 Singapore 428766 -
Opening Hours
Mon to Fri: 08:00am - 8:00pm -
Opening Hours
Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Peroneal Tendon Surgery 'Snapping Ankle'
Peroneal tendon surgery is a procedure that repairs or replaces part or all of the peroneal tendons. A tendon is a soft tissue that connects muscle to bone. There are two peroneal tendons located on the outside of the foot and ankle: the peroneus brevis and peroneus longus. The peroneal muscles attached to these tendons dorsiflex the ankle (pull the toes upward) and evert the ankle (move the ankle outward). These tendons are important for maintaining balance in the foot and ankle and preventing the foot from inverting (rolling inward). There are several ways that these tendons can become injured, including:
- Acute ankle sprains or twists that overstretch the tendons
- Chronic ankle instability causing repeated strain on the tendons
- Overuse injuries from running, jumping, or high-impact sports
- Direct trauma to the outside of the ankle or foot
- Anatomical variations such as a high-riding peroneal tubercle or shallow tendon groove
- Degeneration or tearing due to age or previous injuries
There is a ligament (soft tissue that connects bone to bone) which holds the peroneal tendons firmly against the fibula (the smaller bone of the lower leg). If this ligament is damaged during a sprain-type injury, the tendons may move out of position and become stretched, causing the ankle to become unstable. This condition is known as tendon subluxation. If you have experienced any of these injuries, you may notice various symptoms that require appropriate treatment. These may include:
- Pain and swelling along the outside of the ankle
- Clicking or snapping sensation when moving the ankle
- Weakness or instability of the ankle during walking or running
- Difficulty bearing weight on the affected foot
- Recurring ankle sprains due to tendon instability
- Tenderness along the peroneal tendons when touched
There are various treatment options for peroneal tendon injuries, depending on the severity of the symptoms. Initially, treatment is usually conservative (non-surgical) and may include: Rest to allow the tendon to recover Cryotherapy (ice therapy) to reduce pain and swelling Gentle joint mobilisations to maintain ankle and foot movement Calf muscle stretches to relieve tension on the tendons Ace Physio Sports can also assess your need for orthotics (specialist footwear) and provide strengthening exercises for the peroneal muscles, alongside electrotherapy modalities such as ultrasound to aid recovery.
If conservative treatment is not effective or the injury is too severe, surgery on the peroneal tendons may be necessary. There are various surgical options, and Ace Physio Sports can provide a comprehensive physiotherapy programme both before and after surgery to optimise your recovery. The following surgical procedures may be considered, depending on the extent of your injury:
- Peroneal tendon repair – stitching the torn tendon back together
- Peroneal tendon debridement – removing damaged or degenerated tissue
- Tendon grafting – replacing part of the tendon with a section of another tendon if it is too damaged to repair
- Tendon transfer – rerouting a nearby tendon to support the damaged peroneal tendon
- Retinaculum repair – repairing the ligament that holds the tendons in place to prevent subluxation
- Bone procedures – correcting any bony abnormalities contributing to tendon instability
Physiotherapy prior to peroneal tendon surgery
The specialist physiotherapists at Ace Physio Sports can design a personalised programme to optimise the success of your peroneal tendon surgery. This programme may include:
- Pre-surgery conditioning to maintain strength and flexibility in the ankle and surrounding muscles
- Pain management techniques such as ice therapy, electrotherapy, or manual therapy
- Range of motion exercises to restore mobility in the ankle and foot
- Strengthening exercises for the peroneal muscles and other supporting lower leg muscles
- Balance and proprioception training to improve joint stability
- Gradual functional exercises to prepare for return to work, sport, or daily activities
Symptoms after peroneal tendon surgery
After peroneal tendon surgery, you may experience various temporary symptoms, and the physiotherapists at Ace Physio Sports can advise you on how to manage them effectively. These could include:
- Swelling around the ankle and foot
- Pain or discomfort at the surgical site
- Bruising in the surrounding area
- Stiffness in the ankle or foot joints
- Reduced range of motion during the early stages of recovery
- Muscle weakness due to immobilisation or reduced activity
Physiotherapy after peroneal tendon surgery
For minor peroneal tendon surgery, including repair, debridement, and synovectomy, you will typically need to wear an aircast boot for 4–6 weeks but may be able to weight-bear after 48 hours, depending on your pain levels. If a tendon graft is required, the recovery period is longer. You will initially be placed in a cast for up to 6 weeks before being transferred to an aircast boot, and it may take up to 12 weeks before you are fully weight-bearing.
Weeks 1-2
The first few weeks of your rehabilitation programme at Ace Physio Sports will focus on reducing post-surgical symptoms and helping you regain comfort and mobility. Treatment may include:
- Pain management techniques, such as ice therapy or gentle manual therapy
- Elevation and compression to reduce swelling
- Gentle range of motion exercises to prevent stiffness
- Soft tissue mobilisation around the ankle and lower leg
- Education on safe weight-bearing and movement to protect the surgical site
- Advice on activity modification to support healing
Weeks 4-6
You may now be able to put more weight through your leg, and the post-surgical symptoms should be decreasing. Rehabilitation with Ace Physio Sports will now include:
- Progressive weight-bearing exercises to improve strength and stability
- Targeted ankle and calf strengthening exercises
- Balance and proprioception training to restore joint awareness
- Gait retraining to ensure proper walking mechanics
- Stretching and flexibility exercises to regain full range of motion
- Manual therapy as needed to address stiffness or tightness
Week 6 and onwards
Unless you have had a tendon replacement, you should now be fully weight-bearing and experiencing less post-operative pain, allowing you to begin a more intense rehabilitation programme at Ace Physio Sports. Your treatment will now focus on:
- Advanced strengthening exercises for the ankle, calf, and surrounding muscles
- Functional training tailored to your daily activities, work, or sport
- Dynamic balance and proprioception exercises to prevent reinjury
- Endurance and conditioning work to restore overall leg function
- Sport-specific or job-specific drills to safely return to previous activity levels
- Manual therapy and mobilisation as required to optimise movement and flexibility
Summary
Peroneal tendon surgery is a procedure to repair damaged peroneal tendons, either by minimally invasive surgery or using a graft from the Achilles tendon. After surgery, your foot and ankle should feel more stable, and with adherence to a specialised programme designed by Ace Physio Sports, you should soon regain your normal strength and range of movement. For the best chance of returning to full fitness, call +65 81535374 to book an appointment today!
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