Brief Outline of Peroneal Tendon Subluxation
Peroneal tendon subluxation (dislocation) is most commonly a chronic condition that develops after a sprain or fracture. The tendon moves out of the groove in which it is supposed to sit due to damage to the structures designed to hold it in place. Pain on the lateral side (outside) of the ankle and a popping sensation may be signs of this condition. Running and jumping can cause repetitive stress to the tendon, especially when it is dislocating repetitively.
Anatomy and Physiology of Peroneal Tendon Subluxation
The tendons of peroneus longus and peroneus brevis run from the peroneal muscles to the foot. They pass around the lateral malleolus through a groove in the bone. They are held in this groove sheath that is reinforced by a band of ligament. When this ligament or sheath is damaged, it reduces the stability of the tendons, allowing movement out of the groove. Some people are predisposed to this injury due to a shallow, or non-existent groove where the tendons lie. Peroneal tendon subluxation may occur also if the tip of the lateral malleolus is fractured with forces dorsiflexion, or a direct blow.
Cause of Peroneal Tendon Subluxation
Tearing or stretching of the ligaments that support the tendons, usually due to an ankle sprain or fracture. Repetitive stress to the tendons, causing inflammation and swelling, allowing the tendons to slide out of the groove.
Signs and Symptoms of Peroneal Tendon Subluxation
Pain and tenderness along the tendons. Popping or snapping sensation on the lateral side of the ankle. Swelling may be noted along the bottom of the fibula.
Complications If Left Peroneal Tendon Subluxation Unattended
The peroneal tendons become irritated when they dislocate, which causes inflammation. This inflammation an lead to tearing or complete rupture of the tendons if left untreated.
Immediate Treatment for Peroneal Tendon Subluxation
R.I.C.E. Anti-inflammatory medication. Possible immobilisation, especially with acute dislocation. Seek medical attention.
Rehabilitation and Prevention of Peroneal Tendon Subluxation
Strengthening of the muscles in the lower leg after pain subsides and normal function returns will help support the tendons. Treating ankle sprains properly will help prevent subluxation. Strong calf and shin muscles will help support the whole foot and ankle structure, preventing this condition as well.
Long-term Prognosis for Peroneal Tendon Subluxation
When treated promptly, subluxation of the peroneal tendons usually responds well to non-surgical techniques. In some cases, surgery may be required to repair the sheath and ligaments that cover the tendon to restore stability.