Peroneal Tendon Injuries
The 2 peroneal tendons in each foot and ankle are responsible for turning the foot side to side. One of the tendons attaches to the outer midfoot, the other one attached to the inside of the arch. Another function of the peroneal tendons is to stabilize the ankle and prevent ankle sprains. Injuries to the tendons can be acute (occur suddenly) or chronic (occur over a period of time). Active individuals or sports athletes are more susceptible to peroneal tendon injuries.
Cause & Symptoms:
Tendonitis is inflammation of one or both of the tendons. THis can be caused by overuse injury, with repetitive movements putting strain on the tendons. Recurring ankle sprain can also lead to inflammation of the tendons. Symptoms often include pain, swelling, and warmth at the site of inflammation.
Acute tear of the tendons is caused by repetitive activity or trauma which causes partial or complete tear of the tendons. The symptoms are immediate, including pain, swelling, and weakness or instability. If untreated, acute tears can lead to altered shape of the foot, with the arch gradually becoming higher.
Degenerative tears are due to overuse that occurs over a long period of time. The tendons become stretched over overtime, until it eventually becomes thin and frayed. Having a high arch foot increases the chance of developing degenerative tears. Symptoms can include sporadic pain, weakness or instability, and increase height of the arch.
Subluxation of the tendons involves the tendons slipping out of the normal positions. Subluxation can occur due to abnormal anatomy of the tendons, or from trauma. During trauma, the soft tissue around the tendons that holds it in place is damage, leading to displacement of the tendons during activity. The trauma can be from a broken ankle, or severe ankle sprains.
Diagnosis:
Peroneal tendon injuries are often misdiagnosed as ankle sprains. A complete history, and careful examination of the foot and ankle is important. The site of the pain, instability, swelling, warmth and weakness can pinpoint to the site of injury. In addition, x-rays or other advanced imaging modalities can assist with the diagnosis.
Treatments:
Conservative treatment is reserved for tendons that are inflamed or relatively intact. It includes the following:
If the symptoms do not improve, or instability of the ankle exists, then surgery can be considered. Also, with acute tear of the tendons, surgical reapproximation of the tendon is often recommended. After surgery, physical therapy is an important part of rehabilitation.
The 2 peroneal tendons in each foot and ankle are responsible for turning the foot side to side. One of the tendons attaches to the outer midfoot, the other one attached to the inside of the arch. Another function of the peroneal tendons is to stabilize the ankle and prevent ankle sprains. Injuries to the tendons can be acute (occur suddenly) or chronic (occur over a period of time). Active individuals or sports athletes are more susceptible to peroneal tendon injuries.
Cause & Symptoms:
Tendonitis is inflammation of one or both of the tendons. THis can be caused by overuse injury, with repetitive movements putting strain on the tendons. Recurring ankle sprain can also lead to inflammation of the tendons. Symptoms often include pain, swelling, and warmth at the site of inflammation.
Acute tear of the tendons is caused by repetitive activity or trauma which causes partial or complete tear of the tendons. The symptoms are immediate, including pain, swelling, and weakness or instability. If untreated, acute tears can lead to altered shape of the foot, with the arch gradually becoming higher.
Degenerative tears are due to overuse that occurs over a long period of time. The tendons become stretched over overtime, until it eventually becomes thin and frayed. Having a high arch foot increases the chance of developing degenerative tears. Symptoms can include sporadic pain, weakness or instability, and increase height of the arch.
Subluxation of the tendons involves the tendons slipping out of the normal positions. Subluxation can occur due to abnormal anatomy of the tendons, or from trauma. During trauma, the soft tissue around the tendons that holds it in place is damage, leading to displacement of the tendons during activity. The trauma can be from a broken ankle, or severe ankle sprains.
Diagnosis:
Peroneal tendon injuries are often misdiagnosed as ankle sprains. A complete history, and careful examination of the foot and ankle is important. The site of the pain, instability, swelling, warmth and weakness can pinpoint to the site of injury. In addition, x-rays or other advanced imaging modalities can assist with the diagnosis.
Treatments:
Conservative treatment is reserved for tendons that are inflamed or relatively intact. It includes the following:
- Immobilization. A cast or splint may be used to keep the foot and ankle from moving and allow the injury to heal.
- Medications. Oral or injected anti-inflammatory drugs may help relieve pain and inflammation.
- Physical therapy. Ice, heat or ultrasound therapy may be used to reduce swelling and pain. As symptoms improve, exercises can be added to strengthen the muscles and improve range of motion and balance.
- Bracing. The surgeon may provide a brace to use for a short while or during activities requiring repetitive ankle motion. Bracing may also be an option when a patient is not a candidate for surgery.
If the symptoms do not improve, or instability of the ankle exists, then surgery can be considered. Also, with acute tear of the tendons, surgical reapproximation of the tendon is often recommended. After surgery, physical therapy is an important part of rehabilitation.