Definition
The peroneal tendon is the muscle attachment tendon of two muscles, the fibula muscle (Musculus fibularis) or long fibula muscle (M. peroneus longus) and the short fibula muscle (M. peroneus brevis), which are located in close proximity to each other on the fibula and are involved in the movements of pronation (inward rotation of the forearm) and plantar flexion (flexion of the foot towards the ground).
Introduction
Parts of the peroneal tendon are also involved in the construction of the transverse arch of the foot. The peroneal tendon runs, wrapped in tendon sheaths, from the muscles behind the outer ankle of the fibula, malleolus lateralis, and then runs along the sole of the foot to the sphenoid bone (Os cuneiforme) and the first and fifth metatarsal bones. Connective tissue plates, the so-called retinacula musculorum fibularium superius and inferius, give the peroneal tendon additional support in its position. A common clinical picture of the peroneal tendon is inflammation of the tendon itself and also of the associated tendon sheaths.
Causes of Peroneal Tendon Inflammation
The cause of inflammation of the peroneal tendon and tendon sheaths is in most cases overloading or incorrect loading. Since the peroneal muscles are responsible for pronation (inward rotation of the foot) and plantar flexion (bending of the foot in the direction of the sole of the foot), sports, hobbies and professions in which this muscle group is particularly stressed are particularly responsible for inflammation. Typical sports include ballet, cycling and running.
The repeated movements of the peroneal tendon when muscles are tensed behind the outer ankle cause the tendon to rub against the bone and the tendon sheath. This leads to irritation of the peroneal tendon and its tendon sheath, which in turn leads to inflammation of the tendon sheath. Even a minor injury, such as a tear in the peroneal tendon, can promote the development of inflammation.
A similar cause is the so-called peroneal tendon snapping, in which the peroneal tendon slides from its position behind the external ankle over the latter to the front. This dislocation of the peroneal tendon rubs against the outer ankle with its tendon sheath and can cause irritation or even damage, which can lead to inflammation. Peroneal tendon snapping is caused by eversion (inward rotation and upward pulling) of the foot and simultaneous contraction of the peroneal muscle and is favored by a flattened outer ankle.
Another cause of inflammation of the peroneal tendon is immunological in nature and occurs after infection with certain pathogens. During infection, pathogen-specific antibodies are produced which are later directed against the patient’s own tissues, such as the peroneal tendon with its tendon sheath, and cause inflammation. Furthermore, direct contact of the peroneal tendon with the environment, such as an injury, can lead to contamination with bacteria, which then cause bacterial inflammation.
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