Peroneals

This blog discusses a brief overview of the structure function and action of the peroneal tendons.

The peroneals refer to a muscle group located on the lateral (outside) compartment of the leg.  The muscle group originates from the fibula and inserts into metatarsals and is comprised of peroneus longus, tertius and brevis. The main function of the tendons are to support and stabiles the foot and ankle preventing any sprains.

Peroneus Longus is a major tendon within the leg and foot and runs along the outside of the ankle which then wraps underneath the arch and inserts in to the first metatarsal and medial cuneiform. The role of this tendon is to evert (roll in) and plantarflex (pull down) the ankle.

Peroneus Brevis is a shorter and smaller tendon in comparison to the longus tendon. It inserts in to the outside of the foot and its action is similar but weaker to the longus tendon.

Perneus Tertius action is to pull up and roll in the foot.

Peroneal tendon injuries can either be acute or chronic and is commonly seen in patients, who participate in sports that involve repetitive ankle motion (tennis/squash) or patients that suffer from high arch profile.

Tendinopathy occurs when one or more of the tendons become inflamed. Inflammation is caused by activities involving repetitive use of the tendon, overuse of the tendon, or trauma (such as an ankle sprain).

Symptoms include:

  • Pain around the outside lower third of the leg, outside of ankle or outside of the foot
  • Swelling
  • Warmth to the touch

As time goes on, these tears may lead to a change in the shape of the foot, in which the arch may become higher.

Symptoms 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

Diagnosis

At The Footcare a member of the podiatry team will carry out a diagnosis of the condition. The podiatrist will examine the foot and look for pain, instability, swelling, warmth, and weakness on the outer side of the ankle.

Treatment

We offer a wide range of non-surgical advice and treatment:

Low level laser therapy can be very helpful in both the acute and chronic phase of peroneal injury.

Strapping to try and temporarily alter foot mechanics and offload the tendon again can be used in acute and chronic phase.

Orthoses are mainly issued for chronic tendinopathies or if you have a regular tendency to sprain you ankle and they work by:

  • Supporting and stabilising the foot preventing further collapse. This will reduce the abnormal pull on the tendon, and allow it to function without pain.
  • Providing shock absorption for the arch and tendon.
  • Richie Brace is also considered for a more controlling device

If these more conservative methods fail for chronic tendinopathy then Extracorporeal Shockwave Therapy (ESWT) can be a very successful course of treatment.

Also by combining these treatments with physiotherapy as an adjunct will be discussed.

 

Please do not hesitate to contact The Footcare Centre either online or phoning 01932 849373 to book a consultation with one of the podiatrists if you are (or think you are) suffering with this condition.

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