Hi,
Has anyone ever had a peroneal tendon injury? Mine is stretched or partially torn and it keeps subluxing. The orthopedist I saw didn’t really know what to do about it. Any guidance you could give would be greatly appreciated. Thanks!
Luckily I haven’t had a problem with the tendon, but my peroneals are always acting up. I really can’t think of anything that you can do directly for the tendon except rest it and avoid further strain. Maybe heat packs for 20min every night to try and increase circulation, which is usually poor. However, I would recommend being consistent with massaging the peroneal muscles, since your tendon injury was probably the result of spasmed peroneals not doing their job, with the result being excessive loading shifted to the tendon.
I’m not an expert and not reccomending anything other than seeing a good therapist - but I would also look at some of the most recent research into eccentric loading for tendon injuries.
Hedge,
What do you mean by your tendon "keeps subluxing"? Subluxations happen to joints, not tendons.
There are three peroneus muscles (longus, brevis and tertius). Which one is the one you’re having problems with?
flash’s suggestions should only be used if the tendon is not inflamed, which it probably will be if the injury occured recently. You can try to massage and heat-treat the muscle belly but keep away from the injured area of the tendon.
Regards,
Robin.
That’s correct. Since the post was posted a while ago I was assuming that the acute inflamation has died down by now. Like I wrote, there’s not a lot you can do directly for the tendon itself but rest it and avoid further aggravation. Very frustrating.
Along with what flash mentioned, find a good ART Provider. From what you’re saying, it sounds like the Superior and Inferior Peroneal Retinaculum need to be treated, along with the posterior talofibular and calcaniofibular ligament.
Local ankle problems normally have corresponding muscular problems further up. I usually treat the Peroneus Longus, Brevis and Tertius along with local ligaments of the ankle. In my experience, I get the best results by not looking just locally at the tendon, but the surrounding structures and muscles.
Remember to look at the whole picture, not just locally where it hurts.
Peroneal tendons do sublux or dislocate. When the retinaculum that holds them in place in the peroneal groove on the posterior aspect of the lateral malleolus tears or stretches, the tendons pop out of the groove onto the lateral aspect of the malleolus. This could be due to congenital or acute injury factors. In cases that do not respond to conservative measures (i.e. physcal therapy, immobilization, ART, etc.) surgery is sometimes needed to deepen the peroneal groove and/or reconstruct the peroneal retinaculum. As allows, exhaust all possible conservative measures before considering surgery. I can empathize with anyone who has had this injury as I dislocated the peroneal tendons on my right ankle over 10 years ago. While I responded to conservative measures, I still have times when I can re-aggravate this old injury.
Paul,
Thanks for the explanation. I've learnt something new today! :)
Chiropractors define the term subluxation slightly different to the medical community, so I wasn’t aware that the medical definition also includes tendinous pathologies.
Thanks again,
Robin.
Yes, that’s what it felt like was happening and boy did it HURT. It was an acute injury that occured while I was rock-climbing (indoors).
The first orthopedist I saw put me in a plaster cast to immobilize my ankle and prevent further injury, but after 5 days it happened again.
I had it removed and got an aircast instead, and that’s been working much better. Plus, I can still workout somewhat with the aircast on.
I’m seeing another orthopedist in two weeks. Hopefully it will be healed enough to start PT.
You worry me though when you say that it still recurs for you. Is there something I should be doing, now, to prevent this? What did you do to heal it? How long did it take?
And a different orthopedist had noted that I have looser-than-normal ligaments. Do you think that’s partly why my major injuries tend to be ligament/tendon ones?
Thank you!
Does this still apply to an acute injury, vs a chronic one?
I have pretty well developed calves and those lateral muscles down there from cutting. Do you think they are too strong in relation to my tendons, or that I just put my ankle in a weak position and stressed it too much, or both?
I’d like to not only recover fully from this injury, but prevent this from happening again, to either ankle.
Thanks!
Hedge, yes there was an audible pop and I could feel the tendons pop over the lateral malleolus. However, they relocated after a hop or two. The reason that I still can aggravate this injury (the tendons do not sublux or dislocate anymore) is if my activity level exceeds a certain level. Too many hills or too many lateral agility type movements and the tendon gets sore. The original injury occurred on the first day of a family vacation, the rest of the week we hiked in Yellowstone Park. I wrapped my ankle and laced my boot really tight to get through the week. Probably not the best way to treat this type of injury but I did not want to be a spoiler for the vacation.
Hedge, I hope this helps you out:
Does this still apply to an acute injury, vs a chronic one?
**With an acute injury you have to modify the protocols, its not a good idea to work directly on the tendon if its inflammed. If acute, I use other soft tissue techniques and do ART protocols on related surrounding structures.
I have pretty well developed calves and those lateral muscles down there from cutting. Do you think they are too strong in relation to my tendons, or that I just put my ankle in a weak position and stressed it too much, or both?
** I am guessing you play football? I really cant say what a possible cause is without getting my hands on the area and feeling whats going on between the tendons, muscles and retinaculum. I normally like to see game footage, or at least some type of on field drill work before I could say for sure its a technical issue. In regards to you muscles being stronger than your tendons, I highly doubt thats the case.
I’d like to not only recover fully from this injury, but prevent this from happening again, to either ankle.
** Your doing the right thing, seeking proper medical help from an orthopedist. That should get you on your way to managing the problem.
Paul,
I just saw my new ortho this morning. He told me that surgery would be the only way to fix it - it wouldn’t heal on its own w/o surgery because there was nothing holding the tendon in place.
Did you have to undergo surgery? If so, could you tell me about the procedure and recovery? THanks!