What happens to the peroneal tendon when the core is destabilized?

Updated: Mar 07, 2018
  • Author: Steven J Karageanes, DO, FAOASM; Chief Editor: Craig C Young, MD  more...
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When the core is destabilized, the following problems may develop, not all of which are conscious to the patient:

Gluteus medius muscle firing is slower and weaker, allowing more femoral adduction and internal rotation with gait. The tensor fascia latae tends to avoid such inhibition and instead tightens up. This is a common cause of lateral snapping hip syndrome.

Functional short leg may develop. This is related to rotation of the ilium, sacral torsion or shear, hypertonic psoas major, quadratus lumborum, or iliacus muscle, lumbar rotational dysfunction, or all of the above. This shifts load onto one side more than the other and rotates the talus within the mortise, thus increasing pronation.

Low back tightness or soreness with prolonged sitting or standing can develop, which restricts hip extension, leading to more stress on the ankle.

An astute physical therapist evaluates the kinetic chain for these problems. A rushed examination that targets only the location of pain misses all this and leads to prolonged pain and disability. Once the core muscles develop a maladaptive compensation pattern, the road to recovery becomes much longer.

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