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Peroneal Tendon Injuries

A tendon is a band of tissue that connects a muscle to a bone. The two peroneal tendons in the foot run side by side behind the outer ankle bone. One peroneal tendon attaches to the outer part of the midfoot, while the other tendon runs under the foot and attaches near the inside of the arch. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains.

 

Causes & Symptoms

Peroneal tendon injuries may be acute (occurring suddenly) or chronic (developing over a period of time). They most commonly occur in individuals who participate in sports that involve repetitive ankle motion. In addition, people with higher arches are at risk of developing peroneal tendon injuries. Basic types of peroneal tendon injuries are tendonitis, tears, and subluxation.

-Tendonitis is an inflammation of one or both tendons. This inflammation is caused by activities involving repetitive use of the tendon, overuse of the tendon, or trauma to the tendon.
Symptoms of tendonitis include:

  • Pain
  • Swelling
  • Warm to the touch

-Acute tears are caused by repetitive activity or trauma.
Immediate symptoms of acute tears include:

  • Pain
  • Swelling
  • Weakness or instability of the foot and ankle

-Tendinosis are degenerative tears that occur from overuse over long periods of time, often years.
The symptoms of degenerative tears may include:

  • Sporadic pain (occurring from time to time) on the outside of the ankle
  • Weakness or instability in the ankle
  • An increase in the height of the arch

-Subluxation means one or both tendons have slipped out of their normal position.
The symptoms of subluxation may include:

  • A snapping feeling of the tendon around the ankle bone
  • Sporadic pain behind the outside ankle bone
  • Ankle instability or weakness

 

Our Approach

Because peroneal tendon injuries are sometimes misdiagnosed and may worsen without proper treatment, our prompt evaluation is crucial. To diagnose a peroneal tendon injury, we will examine the foot and look for pain, instability, swelling, warmth, and weakness on the outer side of the ankle. In addition, an x-ray or other advanced imaging studies may be needed to fully evaluate the injury. We may also look for signs of an ankle sprain and other related injuries that sometimes accompany a peroneal tendon injury. Proper diagnosis is important because prolonged discomfort after a simple sprain may be a sign of additional problems.

Based on our evaluation, options include:

  • 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

 

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