Peroneal Tendon Repair

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

NWB in splint/cast wks 0-2; partial progressive WB in boot wks 2-4; FWB boot (no SPR repair) wks 4-6 or (SPR repaired) wk 6+; wean boot wk 6 (no SPR) or wk 8 (SPR repaired)

Key Restrictions

If SPR repaired: no inversion/eversion until wk 6; if SPR repaired: no isometric eversion until wk 6; SPR repair status is the critical variable driving all phase progression timelines; no running until 3-6 months

Timeline & Phases

6 phases: Phase I (0-2 wks, NWB splint, hip/quad strengthening, elevation toes above nose), Phase II (2-4 wks, partial WB boot — PROM/AROM DF/PF/inversion/eversion if no SPR repair; DF/PF only if SPR repaired until wk 6), Phase III (4-8 wks, FWB boot — eversion resistance begins; wean boot per SPR status), Phase IV (9-12 wks, shoe — bilateral heel raises, squats, SL balance, Alter-G), Phase VI (3-6 months, SL heel raises, eccentric calf, lunges, return-to-run program, beginner plyometrics), Phase VII (6+ months, agility program, sport-specific; LE functional tests ≥90%)

Notes

Revised 10/2021; SPR repair status is key clinical variable — dictates inversion/eversion and eversion strengthening timeline; tendoscopic vs open approach may also affect progression; elevation toes above nose Phase I; PRRS for RTS; LE functional tests ≥90% contralateral required; Phase V missing from original document (jumps to Phase VI). [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-02-16.]

Surgeon / Author

MGH Sports Medicine

Published

October 2021