Peroneustendinosis
What is peroneustendinosis?
On the outside of the foot, the tendons from the peroneus longus and brevis muscles run down behind the outer ball of the foot and attach to the outside and underside of the foot, respectively. Its main functions are to assist in toe-raising and pushing off with the foot, stabilize the ankle joint and prevent ankle sprains. The pressure that the tendons are exposed to against the back of the outer ball of the foot when the foot is loaded can lead to irritation and injury – peroneus tendinosis. This most commonly affects people who are active in sports that involve repetitive strain on the foot, such as running, athletics, football, floorball. High arches can also make it easier to get these problems.
Injuries to the peroneal bones are divided into three types:
Peroneal tendonitis: Occurs over a longer period of overload and often comes on gradually. The location of the problem for peroneal tendonitis is behind and below the outer ball of the foot. Symptoms are tenderness and often some swelling in the same area. Pain occurs to varying degrees when you push off with your foot, depending on how extensive the injury is. At the beginning of an injury, it can hurt especially in the morning, when you get up after sitting for a while and at the beginning of your workout. The pain then subsides when your foot warms up and returns after completing the activity. Later in the injury, the pain does not go away when your foot warms up, but it hurts more or less all the time when you put weight on your foot.
Peroneal luxation (luxation = to come out of position): The retinaculum (ligament) that holds the tendons in place behind the outer ball of the foot breaks and the tendons slide out of place onto the ball when the foot is stressed. One symptom is that it snaps at the ball of the foot when this happens, sometimes in combination with pain. This often occurs in connection with an acute injury to the foot, such as an ankle sprain. If this is left untreated, the abrasion it causes to the tendon can lead to partial rupture or rupture.
Peroneal tendon ruptures: These can occur in connection with an ankle sprain and in connection with jumping. If you have long-standing tendinosis in one or both peroneal tendons, the risk of partial rupture or rupture increases with sudden strain on the tendon. Symptoms of rupture and partial rupture are pain behind and under the outer ball of the foot, swelling in the area. You can often feel weak and unstable in the foot when straining.
Treatment of peroneal tendonitis:
As always, our physiotherapists carry out a thorough examination where we look at the appearance of the area, examine mobility and stability of the ankle, and note what hurts and what doesn't. If we suspect an impact on the peroneal tendons, we recommend that an ultrasound scan be performed to ensure that there is no partial or total rupture of the tendons.
Treatment may consist of unloading the foot. If the patient walks with a limp due to pain in the foot, we recommend 1 crutch to normalize the gait and reduce the load on the foot a little. We set up an individual training program to gradually increase the load tolerance in the peroneal tendons. Shockwave therapy can be a good help to speed up the healing of the tendon/tendons.
Treatment of partial rupture, total rupture or dislocation of the peroneal tendons: If we can confirm that any of these diagnoses are present with ultrasound, we will refer the patient to an orthopedist for a decision on surgery.
Forecast
The prognosis for cases that do not require surgery is good and most people can return to full activity. However, it is expected that it will take a few months of gradual improvement as the tendon structures are rehabilitated.
Peroneus tendinosis can also be called peroneal tendinosis, peroneus tendinitis, peroneal tendinitis.
