As the winter season rolls in and the weather gets cooler, sports begin to move indoors. Beach volleyball games become gym games, and outdoor pickup games of basketball become indoor court games. Even joggers and runners find indoor tracks or gym equipment to avoid the harsh winds and slippery sidewalks. Just because the athletes are moving away from the icy, cold conditions however, does not mean that they are moving away from the risk of injury. A common foot injuries for athletes, whether indoors or outdoors, is a peroneal tendon injury.
Each foot contains two peroneal tendons, located behind the outer ankle bone. They stabilize your foot and ankle, and help reduce the likelihood of sprains. Athletes are at the most risk of injury to these tendons as repeated ankle motion is what is the most common cause of damage. However, people with high arches in their feet naturally are also at risk for injury. The most common types of peroneal tendon injury are tendonitis, tears, or subluxation.
Tendonitis is classified as an inflammation of the tendon. In the case of the peroneal tendon, it may be one or both tendons. This may be caused by overuse, repetitive use, or trauma, such as a sprain. Symptoms of tendonitis include pain, swelling, and warmth around the injury.
With tears, there are two different kinds
An acute tear is caused by trauma, or repetitive use. Symptoms of this kind of tear include instability of the ankle and foot, and immediate pain and swelling. Over time, this kind of tendon injury in the foot may lead to a change to the shape of your foot, heightening your arch.
A degenerative tear happens over a longer period of time, and is often due to overuse. It usually takes years for this kind of tear to develop. Essentially, the tendon has gotten stretched out to the point of becoming thin and weak and begins to unravel like a thread. As previously mentioned, high arches pose a risk for injury, but particularly a degenerative tear. Symptoms include periodic pain where the peroneal tendon is located, instability and weakness in your ankle, and an increased arch height.
A subluxation is a partial dislocation. In the case of the peroneal tendons, a subluxation refers to when the tendons move out of their normal positions behind your ankle bone and move in front of the bone due to trauma. Normally there is a piece of tissue called a retinaculum that holds the tendons in place, but in the case of a sprain, the retinaculum can tear or lift off the bones it’s attached to and allow the peroneal tendons to move out of place. Damage to the retinaculum could lead to chronic subluxation. Some people are also prone to subluxation due to the shape of the bones or muscles in their foot. Symptoms of subluxation include feeling a snap around your ankle and the tendons, pain behind the ankle bone, and instability or weakness in your ankle. Seek treatment for subluxation as soon as possible, as the tendon is more likely to tear, snap, or rupture when it is out of place or when it continues to move out of place.
There are five treatment options for injuries to your peroneal tendon.
- Immobilization – A cast or a splint, to prevent movement and allow healing
- Medication – Anti-inflammatories to reduce pain and swelling
- Physical therapy – Exercises, ultrasound, hot, and cold therapy
- Brace – To be worn in short amounts when your ankle needs to be used
- Surgery – To repair damage, as determined by a surgeon if needed
If you’ve sustained injury to your peroneal tendon, you’re a new patient looking for a podiatrist in Toronto, or you have any other foot care concerns, don’t hesitate to contact our foot clinic today!