The second patient, a 31-year-old male, came to the orthopedic clinic with left ankle pain following a twisting injury while playing basketball. He had twisted his ankle several times however this time his ankle was really painful. On physical examination, retromalleolar pain was present in addition to ankle instability. Positive anterior drawer test was noted and talar tilt test showed no end point. MRI result showed peroneal sheath filled with fluid collection in addition to peroneal brevis split tear. Over the lateral ligament complex, the anterior talofibular ligament (ATFL) was redundant and heavily fibrotic. Calcaneofibular ligament (CFL) was fibrotic and redundant as well. Intraarticular pathological findings showed the presence of anterior bony impingement over the distal tibia. We concluded that the source of ankle pain was due to concomitant peroneal tear in lateral ankle instability. We planned to address all symptomatic findings surgically.