Peroneal Tendon Injuries

Foot Facts

  • Each foot has 26 bones
  • There are more than 100 ligaments in each foot
  • Diabetes is the #1 cause for lower extremety amputation
  • A toenail takes 4-9 months to completely grow out
  • Pain in the feet is NOT normal

Surgery: YES OR NO????

  • Deciding whether or not to have surgery is a big decision. 
  • Our foot and ankle surgeons are skilled in both surgical and conservative options. 
  • We will present the options most suitable for you and help you with your decision.

How much pain should I be in before I make an appointment?

  • Foot pain is not normal.
  • Foot pain is a signal that something is not right.
  • Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
  • Most foot pain left untreated will get worse and become more difficult to cure.
  • If you have foot or ankle  pain, make an appointment, do not wait.

Will soaking cure my ingrown toenail?

  • Soaking an ingrown toenail will often make it feel better, but it will not cure it. 
  • The symptoms of an ingrown toenail include pain, redness, and swelling.
  • An ingrown toenail is easily cured with a simple in office surgical procedure. 
  • The toe is anesthetized so that pain is not felt during the procedure.
  • The ingrown nail, or portion of the nail, is removed.
  • Most people feel no pain afterwards and return to normal activities the next day. 

What are orthotics?

  • Custom made foot arch supports designed to hold the foot in its optimum position
  • Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet. 

Happy Feet...Happy Bride

happyComfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!

Thoughts on Celebrating 30+ Years

anniversarySome thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.

My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.

Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives.  My staff has been and continues to be essential.  To all my staff, both past and present, I say a most sincere Thank You.

I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!

What Are the Peroneal Tendons?
PeronealA tendon is a band of tissue that connects a muscle to a bone. The two peroneal tendons in the foot run side-by-side behind the outer ankle bone. One peroneal tendon attaches to the outer part of the midfoot, while the other tendon runs under the foot and attaches near the inside of the arch. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains.

 

Causes and Symptoms of Peroneal Tendon Injuries
Peroneal tendon injuries may be acute (occurring suddenly) or chronic (developing over a period of time). They most commonly occur in individuals who participate in sports that involve repetitive ankle motion. In addition, people with higher arches are at risk for developing peroneal tendon injuries. Basic types of peroneal tendon injuries are tendonitis, tears, and subluxation.

Tendonitis is an inflammation of one or both tendons. The inflammation is caused by activities involving repetitive use of the tendon, overuse of the tendon, or trauma (such as an ankle sprain). Symptoms of tendonitis include:

  • Pain
  • Swelling
  • Warmth to the touch

Acute tears are caused by repetitive activity or trauma. Immediate symptoms of acute tears include:

  • Pain
  • Swelling
  • Weakness or instability of the foot and ankle

As time goes on, these tears may lead to a change in the shape of the foot, in which the arch may become higher.

Degenerative tears (tendonosis) are usually due to overuse and occur over long periods of time – often years. In degenerative tears, the tendon is like taffy that has been overstretched until it becomes thin and eventually frays. Having high arches also puts you at risk for developing a degenerative tear. The symptoms of degenerative tears may include:

  • Sporadic pain (occurring from time to time) on the outside of the ankle
  • Weakness or instability in the ankle
  • An increase in the height of the arch

Subluxation – one or both tendons have slipped out of their normal position. In some cases, subluxation is due to a condition in which a person is born with a variation in the shape of the bone or muscle. In other cases, subluxation occurs following trauma, such as an ankle sprain. Damage or injury to the tissues that stabilize the tendons (retinaculum) can lead to chronic tendon subluxation. The symptoms of subluxation may include:

  • A snapping feeling of the tendon around the ankle bone
  • Sporadic pain behind the outside ankle bone
  • Ankle instability or weakness

Early treatment of a subluxation is critical, since a tendon that continues to sublux (move out of position) is more likely to tear or rupture. Therefore, if you feel the characteristic snapping, see a foot and ankle surgeon immediately.

Diagnosis
Because peroneal tendon injuries are sometimes misdiagnosed and may worsen without proper treatment, prompt evaluation by a foot and ankle surgeon is advised. To diagnose a peroneal tendon injury, the surgeon will examine the foot and look for pain, instability, swelling, warmth, and weakness on the outer side of the ankle. In addition, an x-ray or other advanced imaging studies may be needed to fully evaluate the injury. The foot and ankle surgeon will also look for signs of an ankle sprain and other related injuries that sometimes accompany a peroneal tendon injury. Proper diagnosis is important because prolonged discomfort after a simple sprain may be a sign of additional problems.

Non-Surgical Treatment
Treatment depends on the type of peroneal tendon injury. Options include:

  • Immobilization. A cast or splint may be used to keep the foot and ankle from moving and allow the injury to heal.
  • Medications. Oral or injected anti-inflammatory drugs may help relieve the pain and inflammation.
  • Physical therapy. Ice, heat, or ultrasound therapy may be used to reduce swelling and pain. As symptoms improve, exercises can be added to strengthen the muscles and improve range of motion and balance.
  • Bracing. The surgeon may provide a brace to use for a short while or during activities requiring repetitive ankle motion. Bracing may also be an option when a patient is not a candidate for surgery.

When is Surgery Needed?
In some cases, surgery may be needed to repair the tendon or tendons and perhaps the supporting structures of the foot. The foot and ankle surgeon will determine the most appropriate procedure for the patient’s condition and lifestyle. After surgery, physical therapy is an important part of rehabilitation.