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Saturday, August 30, 2014

Calcaneal Fracture: Email Advice

Hi Dr. Blake,

Eight years ago I had two calcaneal fractures and plates and screws on the outside of both heels.  About two years ago, my left foot became very supinated, and I had to quit bicycling because of the overloading on the outside of my foot. I recently had the painful left heel plate removed, and it was discovered one or both of the peroneal tendons was diseased and torn (rubbing on the plate).
Dr Blake's comment: When the peroneal tendons, which pronate the foot at the heel, are injured it creates an imbalance with the tendons that supinate the foot, and the foot goes into supination/inversion. This is a pathological situation and must be corrected. 
The strange thing is that two weeks ago, my right foot was not supinated, until I started doing calf raises in order to rehab the left foot.  Almost overnight, the right foot became very supinated.  Could this extreme supination be caused by damaged or irritated peroneal tendon(s) becoming tight or shortening?  Thanks.
Dr Blake's comment: Definitely, the calf raises were probably the straw that broke the camel's back. The peroneal tendons are accessories to the calf muscles to lift the heel off the ground. If you get into a situation were the calf muscles are fatigued, the peroneals try to help, and if already injured, they are vulnerable to tearing. 

Regards,
Bill (name changed)

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.