Flexor hallucis longus tendon

Abstract

Athletic disorders of the flexor hallucis longus (FHL) tendon primarily afflict dancers andtend to be overuse injuries. The commonest symptom is posteromedial ankle pain, arisingfrom FHL disease in the unyielding fibro-osseous tunnel at the posterior talus. Less commonsites are the knot of Henry in the midfoot and intersesamoid area in the forefoot. Ahigh degree of suspicion is necessary to distinguish FHL pathology from co-existing clinicalentities, since the FHL is intimately related with various other structures in its course.Conservative treatment focuses on FHL stretching exercises. Surgery is reserved for athleteswith debilitating symptoms refractory to nonoperative measures. Open and arthroscopicapproaches each have advantages and disadvantages, however no consensus exists regardingthe superiority of one over the other. Rehabilitation cornerstones are neuromuscularre-education, rectifying faulty sport technique, and physical conditioning to minimizerecurrence.