Dislocated peroneal tendon

 

Are you a sportsperson or someone who has had an ankle injury recently? Ankle sprain is usually a cause of dislocated peroneal tendon. Tendon is something which connects bone to a muscle. The main function of this tendon is to stabilize and protect the ankle from sprains. Injury to these tendons can result in pain or sometimes even swelling. Let’s have a look at some of the main factors associated with this condition and how can you prevent from it.

 

Overview

What are the main causes of this dislocation?

How common is the dislocation of peroneal tendons?

What are the symptoms of tendonitis, dislocation, and subluxation

How is this condition diagnosed?

How can you prevent the dislocation?

What happens if the dislocation goes untreated?

Can the dislocation heal on its own?

What are the treatment options?

· Non-surgical

· Surgical

When should I see a doctor?

 

Overview

Dislocation of the peroneal tendon might follow an ankle sprain or any kind of ankle injury. There are mainly two tendons which sit in your feet; they are fibularis longus tendon and fibularis brevis tendon.

Both tendons lie in the groove just below and outside of the ankle. To keep these tendons in position and support them, bands of tissue which are tough pass over the tendons. If by any cause these bands are injured or damaged, the tendons move out of the groove which result in the dislocation of the tendons.

Dislocation is also known as subluxation. It is commonly seen in athletes or in someone who has unstable ankles.

 

What are the main causes of this dislocation?

For these tendons to dislocate, the band that lies over these tendons must be injured. This usually takes place when the foot or the ankle is twisted forcibly inwards.

Different condition that are associated with this tendon are tendonitis which means inflammation and subluxation or dislocation.

You are certainly at a higher risk if you are a sportsperson or indulge in the exercises or any harsh physical activity. It will involve any type of tear or elongation in the tendons or bands.

 

How common is dislocation of peroneal tendons?

The dislocation or the subluxation of the peroneal tendons is very common in athletes. If you are a sportsperson, you are at a higher risk of getting a sprain or injured ankle which can ultimately lead to conditions like tendonitis, subluxation, or dislocation. These conditions are often misdiagnosed, and they are not significant clinically.

 

What are the symptoms of tendonitis, dislocation, and subluxation?

If the retinaculum is injured, it might result in a sensation of ‘popping’. This maybe because of swelling and tenderness behind the heel present on the outside of the ankle. This in turn can result in dislocation which means the tendons are no longer in their actual position and they tend to move outside of the groove. It remains out throughout the injury. You can easily compare the ankle on both feet to spot the difference between the injured and the normal ankle.

 

· Tendonitis

It is term that is given to a condition when one or both tendons have inflammation. Any physical activity that is repetitive can put force on the tendon and can result in this condition. Other things that can contribute to the inflammation may be overuse of the tendons, or any sprain or injury in the ankle. Trauma can also result in inflammation.

Some specific symptoms that accompany this condition are as follows:

· Swelling

· Warmth to touch

· Unstable ankle

· General weakness in the ankle and the foot

· Pain

These kind of tears as a chronic condition can result in the change shape of the feet and a higher arch.

 

· Dislocation

This injury is usually seen in skiers, football players and other sports persons. With different sprain and injury to the ankle, the tendons are no longer in their specific place, and they tend to dislocate from their space which in turn causes damage to the tendons. Stiff peroneal muscles have also been seen as an associating factor in this condition.

Additional clinical manifestations that accompany this condition include:

· Range of motion is decreased

· Stiffness

· Inflammation

· Problems in walking or gait

 

· Subluxation

This is a condition where one or both the tendons slip from their usual position. The abnormality in the shape of the bone or muscle can often be congenital which means it is present since birth. In some other cases it takes place after a trauma or sprain in the ankle.

Sometimes it becomes a chronic condition. In this case it is recommended to get treated as soon as possible.  Continuous subluxation can result in rupture and tear pf the tendons.

 

How is this condition diagnosed?

Most important factor in the diagnosis of any condition is a detailed physical exam. Your doctor checks all the movements in your feet and check for other conditions like pain swelling or warmth to touch. It is necessary to visit an orthopedic surgeon so that proper diagnosis is made on time. Chronic phase of tendon rupture can lead to severe conditions. Many times, it is misdiagnosed.

Doctors may use other type of imaging studies which are more advanced, like X ray, MRI, or CT scan. If you suspect to have this condition, you should book an appointment with the surgeon and get a checkup.

 

How can you prevent this condition?

You can prevent the peroneal tendonitis by different ways some of them are mentioned below:

  • Always choose the right footwear
  • Always choose the right footwear
  • Do not be harsh when doing exercises
  • Be sure you don’t have an unstable ankle
  • Indulge in more exercises which develops the core and strengthens the stamina
  • Always stretch your feet before starting any workout
  • You can also wear an ankle band before you start exercising

 

What happens if the dislocation goes untreated?

The complications can get worse and result in immobility and sharp pain.

It is therefore always better to get treated as soon as possible. It can avoid ruptures and any further tears. Surgeons can also treat the tears by other ways like surgery and local treatment. The doctors usually prescribe anti-inflammatory and pain killers like NSAIDs. They also recommend stopping moving and start the treatment with immobilization.  You’ll be asked to avoid harsh exercises. Surgical intervention might be necessary if the tendon has undergone secondary changes. 

 

Can the dislocation heal on its own?

If you suspect that your tendons have been dislocated, be sure that you visit some professional physician. They can confirm the diagnosis for you and tell you exactly how serious your condition is. If you have the swelling since some days, you can follow the RICE method which comprises of REST, ICE, COMPRESSION AND ELEVATION. It will reduce the swelling and pain.  You can also use a splint. Never leave it on its own to be healed. Home remedies can always be helpful. Don’t put any weight on your feet and ankles.  If you are lucky and you have a mild tear or injury. The doctor will recommend non-medications.

 

What are the treatment options?

There are mainly two types of treatment options available, they are the surgical and non-surgical options.

 

1)Non-surgical:

There are different type of options that are available for the non-surgical category of treatments. They include:

  • Limiting the movement in your ankle: this is called immobilization. It is where you are put in some splint or plaster in order to avoid the movements in your ankles and feet.
  • Oral or injected medications: anti-inflammatory and pain killers like NSAIDs can help reduce the swelling and painful conditions. It can help alleviate the severe pain.
  • Physical therapy: in this type of treatment your physician might use heat or ice to reduce the pain and swelling. Some other therapies like the ultrasound are also used sometimes. The physiotherapists also recommend some specific exercises to help with the balance and improve the range of motion. It can also help build your muscles more strong.
  • Bracing: if you are not up for surgery and you fear it. You can use an ankle brace in order to keep the ankle intact till it heals on its own.

 

2)Surgical:

This is a more invasive type of option, but it often proves to be the best one. There are different ways of how a doctor does the surgery. He can opt for the one where he will repair the whole peroneal retinaculum (the band that we talked about earlier). Another way is where the whole groove is reconstructed. In some cases, the tendon is repaired and is replaced by some bony blocks in order to support the ankles and feet. All of this depends on your choice, severity of the condition, and lifestyle.

You will be most likely referred to a physiotherapist following your surgery.

 

When should I see a doctor?

If you see any type of changes in your symptoms you should consult a doctor. Following the RICE method and other home remedies is acceptable but as mentioned above it is recommended to visit a specialist as soon as possible. The specialist can assess the injury accurately and treat you the best of ways.

 

 

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