Posts for: September, 2014
As opposed to the tibialis posterior tendon that runs inside the ankle, there are two peroneal tendons that run side-by-side behind the outer ankle bone. The peroneal brevis tendon attaches to the outer part of the fifth metatarsal at the middle of the foot, and the peroneal longus 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.
Peroneal tendon injuries most commonly occur in individuals who participate in sports that involve repetitive ankle motion, and those with higher arches. Tendonitis and tendonosis (degenerative tears) are usually due to overuse, whereas acute tears can be caused by a traumatic event. Subluxation is when one or both tendons have slipped out of their normal position. It can be due to a variation in the shape of the bone or muscle that a person is born with, or it occurs following a trauma (such as an ankle sprain). Damage or injury to the tissues that stabilize the tendons (retinaculum) can lead to chronic tendon subluxation. As in all peroneal tendon injuries, symptoms of a subluxating tendon include: pain, swelling, warmth, and weakness or instability of the ankle. What sets subluxation apart from other peroneal injuries is a snapping feeling of the tendon around the ankle bone. Early treatment of a subluxation is critical, since a tendon that continues to sublux is more likely to tear or rupture.
Radiographs or an MRI may be needed to fully evaluate the ankle. Treatment options depend on the type of peroneal tendon injury that Dr. Mendoza diagnoses: immobilization, anti-inflammatories, RICE, bracing, and surgery to repair the tendon or tendons are all options.
Click here or call our office at 615-452-8899 to schedule your appointment today!
The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. The tunnel is covered by the flexor retinaculum, a thick ligament that protects and maintains the structures contained within the tunnel (arteries, veins, tendons, and nerves). One of these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome. This syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from a compression of a nerve in a confined space. Tarsal tunnel syndrome is a compression on the posterior tibial nerve that produces symptoms (tingling, burning, numbness, or pain) anywhere along the path of the nerve.
Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve, such as:
- Having flat feet
- An enlarged or abnormal structure within the tarsal tunnel (i.e. varicose vein, ganglion cyst, swollen tendon, or arthritic bone spur)
- An ankle sprain that produces swelling near the tunnel
- Systemic diseases (such as diabetes or arthritis) that can cause swelling, therefore compressing the nerve
There are a variety of treatment options available, often used on combination, to treat tarsal tunnel syndrome: rest, ice, elevate, and compress, anti-inflammatory medications, immobilization, injection therapy, supportive shoes or custom orthotic devices to maintain the arch and limit excessive motion of the foot, and as a last resort surgery.
Call our office at 615-452-8899 or click here to schedule your appointment to have Dr. Mendoza develop the best treatment plan for your tarsal tunnel syndrome!
Cavus foot is a condition in which the foot has a very high arch. Because of this high arch, an excessive amount of weight is placed on the ball and heel of the foot. This condition can lead to a variety of symptoms such as instability of the foot, calluses on the ball and heel of the foot, hammertoes, pain in the ball of the foot, pain in the bottom of the heel, and Achilles pain. Cavus foot can be caused by an inherited abnormality or medical condition such as cerebral palsy, spina bifida, polio, muscular dystrophy, or stroke.
Callous trimming may alleviate the pain, custom orthotic devices may be beneficial by providing stability to the foot, or surgery may be needed if Achilles pain begins to limit your everyday activities.
Call 615-452-8899 or click here to schedule your appointment with Dr. Mendoza to develop the best care plan for your cavus foot!
Haglund’s Deformity is a bony enlargement on the back of the heel that often leads to painful bursitis, which is inflammation of the fluid-filled sac (bursa) between the tendon and bone. In Haglund’s deformity, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. The deformity is most common in young women who wear pumps – it is often called the “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking.
To some extent, heredity can play a role in Haglund’s deformity. In a person with high arches, the heel bone is tilted backward into the Achilles tendon causing the uppermost portion of the back of the heel bone to rub against the tendon. Having a tight Achilles tendon can also be a contributing factor – pain can be caused by compression of the tender and inflamed bursa. Another possible contributor to Haglund’s deformity is a tendency to walk on the outside of the heel resulting in a grinding of the heel bone against the tendon.
Anti-inflammatories, icing, heel lifts, heel pads, and immobilization may be used to alleviate the pain – and surgery as a last resort. After evaluating the structure of your heel bone through x-rays and examination, Dr. Mendoza will develop the best treatment plan for you. Click here or call our office at 615-452-8899 to schedule your appointment today!