Orthopedics Book

Blisters

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Flexor Hallucis Longus Tendinopathy

Aka: Flexor Hallucis Longus Tendinopathy, Flexor Hallucis Longus Tendinitis, Flexor Hallucis Longus Tendonitis
  1. Epidemiology
    1. Most common leg Tendinopathy in ballet dancers (en pointe position)
  2. Causes
    1. Repetitive motion injury in dancers (related to the push off)
  3. Signs
    1. Pain and swelling over the posteromedial ankle
    2. Pain on resisted plantar flexion of great toe
    3. Deeper than achilles tendon
  4. Differential Diagnosis
    1. Achilles Tendonitis
    2. Osteoarthritis
    3. Talus Osteochondritis
    4. Posterior Tibial Tendinopathy
  5. Management
    1. RICE-M
    2. Short leg immobilization (e.g. CAM walker boot) for 2-3 weeks
      1. Indicated in prolonged or refractory course
  6. Prevention
    1. Reduce hip turnout (so dancer stays directly over foot)
    2. Avoid hard floors as much as possible
    3. Core strengthening
    4. Firm supportive shoe

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