Peroneal Tendon Injuries
Foot & Ankle Care of Colorado
To understand peroneal tendon injuries, it’s essential to grasp the role of the peroneal tendons. Tendons are bands of tissue that connect muscles to bones. In the foot, the two peroneal tendons run alongside each other behind the outer ankle bone. One peroneal tendon attaches to the outer part of the midfoot, while the other travels under the foot and attaches near the inside of the arch. The primary function of these tendons is to stabilize the foot and ankle, providing protection against sprains.
Peroneal Tendon Injury Causes & Symptoms
Peroneal tendon injuries can manifest as either acute (sudden onset) or chronic (developing gradually) conditions. They frequently affect individuals engaged in sports requiring repetitive ankle motion. Those with higher arches are particularly susceptible to peroneal tendon injuries. The main types of these injuries include tendonitis, tears, and subluxation.
Types of Peroneal Tendon Injuries
Tendonitis
is an inflammation of one or both tendons. The inflammation is caused by activities involving repetitive use of the tendon, overuse of the tendon or trauma (such as an ankle sprain). 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
Degenerative Tears
are usually due to overuse and occur over long periods of time, often years. In degenerative tears, the tendon is like taffy that has been overstretched until it becomes thin and eventually frays. Having high arches also puts you at risk for developing a degenerative tear. 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. In some cases, subluxation is due to a condition in which a person is born with a variation in the shape of the bone or muscle.
- A snapping feeling of the tendon around the ankle bone
- Sporadic pain behind the outside ankle bone
- Ankle instability or weakness
Peroneal Tendon Injury Diagnoses
Because peroneal tendon injuries are sometimes misdiagnosed and may worsen without proper treatment, prompt evaluation by a foot and ankle surgeon is advised. To diagnose a peroneal tendon injury, the surgeon 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. The foot and ankle surgeon will 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.
Nonsurgical Treatments
Treatment depends on the type of peroneal tendon injury. 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.
When Is Surgery Needed?
In some cases, surgery may be needed to repair the tendon or tendons and perhaps the supporting structures of the foot. The foot and ankle surgeon will determine the most appropriate procedure for the patient’s condition and lifestyle. After surgery, physical therapy is an important part of rehabilitation.
