peroneal tendinopathy “my painful ankle!”. peroneal tendons: connect muscles to bones common...

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PERONEAL TENDINOPATHY “My Painful Ankle!”

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Page 1: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

PERONEAL TENDINOPATHY

“My Painful Ankle!”

Page 2: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

PERONEAL TENDONS: CONNECT MUSCLES TO BONES

Common cause of “outside” ankle pain

Usually result of overuse

Slow to heal!

Page 3: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

ANATOMY2 Tendons:

Peroneus longusPeroneus brevis

Location: outside part

of ankleFunction: turn

ankle up and out

Page 4: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

SYMPTOMS

“Burning”pain

Swelling “Catching”“Popping”

Page 5: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

SYMPTOMS

StiffnessWorse with…

Prolonged standingWalking on uneven surfaces

Page 6: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

AT RISK POPULATION

AthletesHikers/skiers

SedentaryOverweight

Diabetics

Page 7: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

COMMON CAUSES

OveruseRunning on uneven surfaces

( sides of road)Tight calf musclesExcessively flat feet

Page 8: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

TRADITIONAL NONOPERATIVE TREATMENTRestIce Heel insertDeep tissue

massageOrthoticsPhysical therapy

modalities

Page 9: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

IMMOBILIZATION

Walking bootUsually 2-4

weeksOften helpful“Burns no

bridges”

Page 10: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

NEWER TREATMENT : SHOCK WAVE THERAPYSafeNoninvasiveIn-office procedureEnhances tendon

healing“Brings blood to tissue with poor blood supply”

Page 11: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

SURGICAL OPTIONS

Debridement of diseased tendon

Removal of swollen “scar tissue” (“synovectomy”)

Repair of tearsPossible tendon transfersRequires some

immobilization

Page 12: PERONEAL TENDINOPATHY “My Painful Ankle!”. PERONEAL TENDONS: CONNECT MUSCLES TO BONES Common cause of “outside” ankle pain Usually result of overuse Slow

OTHER SURGICAL OPTIONS

Tendon transfers

Bone realignment procedures