Peroneal Tendon Injuries
April 11, 2018
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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.

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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.

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