info@footandankleunit.co.za | +27 11 647 3735 | +27 11 485 1974 | +27 11 647 3435
PATHOLOGIES
TENDON AND SOFT TISSUE CONDITIONS
Peroneal Tendon Pathology
What is it?
Peroneal tendon pathology refers to issues affecting the peroneal tendons, which are two tendons (the peroneus longus and peroneus brevis) that run along the outside of the lower leg and foot. These tendons are responsible for stabilizing the foot and ankle, aiding in movements like eversion (turning the foot outward) and plantarflexion (pointing the toes downward). When these tendons become damaged or inflamed, it can lead to pain, instability, and difficulty with movement.
Peroneal tendon pathology can be caused by overuse, injury, or wear and tear. The condition may involve tendon tendonitis, subluxation (slipping of the tendon out of its groove), or tears/ruptures.
Types
- Peroneal Tendonitis:
Inflammation of the peroneal tendons caused by overuse or trauma. Tendonitis may lead to pain, swelling, and stiffness. - Peroneal Tendon Subluxation/Dislocation:
The peroneal tendons may slip out of their natural groove on the outside of the ankle, especially with sudden ankle motions. This condition is often accompanied by a feeling of instability or a “popping” sensation. - Peroneal Tendon Tear:
A complete or partial tear of the peroneal tendons, which can cause significant pain, swelling, and difficulty moving the ankle.
CAUSES
- Overuse: Repetitive motions such as running, especially on uneven surfaces, or sports involving sudden direction changes, can strain the tendons
- Acute injury: Ankle sprains or traumatic events may cause damage to the tendons
- Ankle instability: Weakness or instability in the ankle joint can lead to increased stress on the peroneal tendons
- Tight calf muscles: Limited flexibility in the calf can contribute to excessive strain on the tendons
- Structural abnormalities: A deep peroneal groove or high arches may increase the risk of tendon dislocation or damage
- Age and degeneration: As people age, the tendons may lose elasticity, becoming more susceptible to injury
SYMPTOMS
- Pain: Along the outside of the ankle or lower leg, especially during activity
- Swelling: Around the peroneal tendons or the lateral ankle
- Instability: Feeling of weakness or giving way in the ankle
- Tenderness: Over the peroneal tendons or their groove, particularly when pressed or stretched
- Limited range of motion: Difficulty moving the foot or ankle, especially with activities like running, walking, or pivoting
DIAGNOSIS
- Clinical exam: A physical examination to assess tenderness, swelling, and the ability to move the ankle and foot
- Imaging studies:
- MRI: To visualize tendon damage, tears, inflammation, or subluxation
- Ultrasound: To assess the tendons in motion and evaluate for tears or abnormal movement
- X-rays: Used to rule out bony abnormalities or fractures
- Stress testing: A test to assess ankle stability and check for tendon subluxation or dislocation
TREATMENT OPTIONS
Non-Surgical
- Rest: Reducing activities that place strain on the tendons, such as running or jumping
- Ice therapy: To reduce inflammation and swelling
- NSAIDs: Nonsteroidal anti-inflammatory drugs for pain relief and inflammation control
- Physical therapy: To strengthen the peroneal tendons, improve ankle stability, and enhance flexibility
- Orthotics: Custom insoles to correct foot alignment and reduce strain on the tendons
- Taping or bracing: To stabilize the ankle and prevent excessive movement of the peroneal tendons
Surgical
Surgery is typically reserved for severe cases that do not respond to conservative treatments, or in cases involving tears or dislocation:
- Tendon repair: In the case of a torn tendon, surgical repair may be necessary to restore function
- Tendon realignment: If the peroneal tendons are dislocating or subluxating, surgery may be required to stabilize the tendons in their groove
- Tendon transfer: In rare cases, the peroneal tendons may be transferred to another location to improve function if significant damage occurs
- Ankle stabilization: In cases of severe ankle instability, surgical interventions may be performed to stabilize the joint and prevent further tendon stress
PROGNOSIS
- Non-surgical treatments: Most cases of peroneal tendonitis and mild subluxation respond well to rest, physical therapy, and other conservative measures
- Surgical outcomes: Surgery for peroneal tendon tears or chronic dislocation is typically successful, with most patients returning to normal activities after rehabilitation
- Recovery: Full recovery from peroneal tendon surgery may take several months, and rehabilitation is essential to restore strength and mobility
