At Family Foot & Leg Center, we often see young patients who experience unusual ankle symptoms. One such case involved an active 11-year-old girl who came in with a very specific complaint:
> “It feels like a bone is popping behind my ankle.”
This is a classic description of *popping peroneal tendon syndrome* (also called peroneal tendon subluxation). Let’s break down what this means, why it happens, and how it can be treated.
What Are the Peroneal Tendons?
The peroneal tendons are two important tendons located on the outside of the ankle:
* Peroneus brevis tendon – attaches to the base of the 5th metatarsal (outer edge of the foot).
* Peroneus longus tendon – runs under the foot and attaches near the arch.
Normally, these tendons glide smoothly behind the fibula (the small bone on the outside of the ankle) inside a protective groove. A strong ligament called the peroneal retinaculum helps hold them in place.
What Causes the “Popping” Sensation?
When a patient describes a “popping” or “snapping” behind the ankle, it usually means the tendon is slipping out of its groove. Instead of gliding smoothly, the tendon jumps forward over the bone.
This can happen for a few reasons:
1. Shallow fibular groove – Some children are born with a groove that is too shallow to hold the tendon securely.
2. Weak or loose retinaculum – If the ligament that stabilizes the tendon is weak, the tendon can dislocate.
3. Tendon tear (less common in kids) – A split or tear in the tendon may also contribute to instability.
How Do We Diagnose It?
A careful physical exam is often the first step. During movement tests, such as flexing and turning the foot outward (a peroneal stress test), the tendon may visibly or audibly “pop” out of place.
An MRI scan may be ordered to confirm the diagnosis and check for:
* The depth of the fibular groove
* The strength of the peroneal retinaculum
* Any tendon tears or damage
Treatment Options
The best treatment depends on the underlying cause:
* Shallow groove → A surgical procedure may be performed to deepen the groove and prevent the tendon from slipping forward.
* Weak retinaculum → The ligament can be repaired or reinforced to hold the tendon in place.
* Tendon tear → If a tear is present, surgical repair may be needed.
When to See a Podiatrist
If your child complains of a popping or snapping sensation around the ankle, especially if it happens on both sides, it’s important to have it evaluated. While not always painful at first, untreated tendon instability can lead to:
* Chronic ankle pain
* Swelling
* Tendon tears over time
At Family Foot & Leg Center, our team uses advanced imaging and specialized surgical techniques when needed to restore tendon stability and get kids back to their activities safely.
Take the Next Step Toward Healthy Ankles
If your child is experiencing ankle popping or pain, schedule a consultation today.
📞 Call 239-430-3668 (FOOT) or visit https://www.naplespodiatrist.com to request an appointment with our expert team.
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