Injuries of the foot: FHL tendinopathy
Exercise is one of the ways to improve your physical well-being and it aids in great measure to get rid of ailments, aches and pains. Follow the exercise programme provided by the biokineticists at Anine van der Westhuizen Biokineticist in George and feel the difference. This week biokineticist Lize Coetzee continues the series on the foot.
Last week we discussed the foot structure and Achilles tendinopathy. Our focus for the next few weeks will be injuries of the foot and lower leg. This week we will focus on flexor halluces longus (FHL) tendinopathy. The FHL is the tendon that attaches muscle to bones.
It is responsible for plantar flexion and inverting the foot. Plantar flexion is when the top of your foot points away from your leg, and invention is when the sole of the foot is turned towards the midline of the body or the opposite ankle. However, FHL is unique in that it also functions to flex (bend) the great toe.
FHL tendinopathy usually occurs in one of three places along the FHL tendon: at the back of the ankle, under the mid-foot and under the base of the big toe.
FHL tendinopathy usually occurs in athletes, or individuals of the general population who participate in activities that require a large amount of forefoot push-off, such as running, jumping, hopping and rising onto the toes. This includes long-distance runners, ballet dancers, ice skaters, soccer players, divers and gymnasts, or individuals who work in predominantly standing roles, such as nursing and the hospitality field. These activities place a high load on the FHL tendon. Load is the force exerted by an object (your body mass or an external object) on the muscle.
Tendons become accustomed to a certain amount of loading to assist with movement. However, if this loading is dramatically increased over a short time, without allowing time for the tendons to adjust, or if an insult occurs to the FHL tendon that lowers its ability to tolerate load without adequate time to heal, the FHL tendon can become overused.
Overuse results in damage to the collagen fibres that make up the tendon. This damage leads to the tendon being unable to perform its role, which in turn leads to further changes in the structure of the tendon, ultimately causing pain and dysfunction.
When following the tendon loading protocol that was discussed last week, the tendon has an opportunity to heal and remodel.