PRESENTASI KASUS

PERONEAL STRAIN

MUHAMMAD JIHAD AL DIKA

1810301160

PROGRAM STUDI S1 FISIOTERAPI

FAKULTAS ILMU KESEHATAN
UNIVERSITAS ’AISYIYAH YOGYAKARTA
2021/2022
 Introduction
• The peroneal muscle and tendons run down the
outside of the lower leg and into the foot. The
peroneus longus and brevis muscles are located
within the lateral compartment of the leg. The
vascular supply is primarily from the posterior
peroneal artery. Innervation of the peroneals is from
the superficial peroneal nerve.
• Peroneal muscle berfungsi untuk membantu
menstabilkan kaki dan pergelangan kaki
 Patofisiologi
• Peroneal tendon injuries may be acute (occurring suddenly) or chronic (developing over a period of time). They
most commonly occur in individuals who participate in sports that involve repetitive ankle motion. In addition,
people with higher arches are at risk for developing peroneal tendon injuries. Basic types of peroneal tendon
injuries are tendonitis, tears and subluxation.
Tendonitis is an inflammation of one or both tendons. The inflammation is caused by activities involving repetitive
use of the tendon, overuse of the tendon or trauma (such as an ankle sprain). Symptoms of tendonitis include:
• Pain
• Swelling
• Warm to the touch
 
Acute tears are caused by repetitive activity or trauma. Immediate symptoms of acute tears include:
• Pain
• Swelling
• Weakness or instability of the foot and ankle
Status Klinis
1. KETERANGAN UMUM PENDERITA
Nama : Diki Mahendra
Umur : 23 Tahun
J.K. : Laki-laki
Agama : Islam
Pekerjaan : Atlet sepak bola
Alamat : Magelang Kota

2. DATA MEDIS RUMAH SAKIT/KLINIK

Diagnosis Medis : -
Catatan Klinis : -

Pem. Penunjang : -
Medika Metosa : -

.
 Status Klinis

ANAMNESIS
Keluhan Utama :
• Px mengalami Benturan saat latihan tactical pada hari senin 10 Oktober
2021
• Px mengeluhkan adanya nyeri dan bengkak pada ankle
• Rasa sakit semakin berat saat malam hari dan pagi hari ketika menggerakan
secara mendadak saat bangun tidur

RIWAYAT KELUARGA DAN STATUS SOSIAL

(Lingkungan kerja, lingkurang tempat tinggal, aktivitas rekreasi dan diwaktu
senggang, aktivitas sosial)
• Px berstatus sebagai pemain aktif PSTN

RIWAYAT PENYAKIT DAHULU DAN PENYERTA

• Disangkal
 Pemeriksaan Subyektif
A. Inspeksi
• Statis :
1) Ekspresi tampak menahan rasa nyeri
• Dinamis :
1) Px berjalan dengan pincang/tidak normal

B. Palpasi
1) Adanya nyeri tekan dan gerak
 Pemeriksaan Khusus
Join Test PASIF
AKTIF
Grup ROM NYERI Grup Otot ROM NYERI Endfeel
Otot Dex Sin Dex Sin
Dex Sin Dex Sin
Dorso fleksi V V V - Soft
Dorso V V V -
fleksi Plantar V V - - Hard
fleksi
Plantar V V - -
fleksi Inversi V V - - Soft
Inversi V V - - Eversi V V V - Soft
Eversi V V V -
 Pemeriksaan Khusus

MUSCLE TEST PEMERIKSAAN SPESIFIK

(kekuatan otot, kontrol otot, panjang otot, isometric melawan
tahanan/provokasi nyeri, lingkar otot) ISOM Grup Otot ISOM

MMT
Ankle Dex Sin
Grup Otot ROM Nilai
S=29-0-45 S=15-0-47
Dex Sin Dex Sin
R=9-0-15 R=10-0-19
Dorso fleksi V V 4 5
Plantar fleksi V V 4 5 VAS
Inversi V V 4 5 Grup Otot Nyeri

Eversi V V 4 5 Diam Tekan Gerak

Ankle 2,5 3 2,5
Provokasi Nyeri Gerakan ( strech) Nyeri
Dorso fleksi V Hasil
Anterior Drawel Test -
Plantar fleksi -
Posterior Drawel Test -
Inversi -
Eversi V
 Underlying Proccess

Keterbatasan •Active exercise

Range of Motion •Passive exercise

TRAUMA Inflamation

Penururnan Strenghtening
kekuatan otot
 Diagnosa Fisioterapi
• S75010 Bones of lower leg
• S7700 : Bones
• S7701 : Joints
Body Structure • S75012 : Muscles of lower leg
Body Function • B280 : Sensation of pain
• B710 :Mobility of joint functions
• B7100 : Mobility of a single joint
• B730 : Muscle power functions

Functional Limitation • Keterbatasan saat berjalan

• Bermain bersama teman

Perticipation Restriction • Bersekolah
• Bermain voli
 Program Fisioterapi

Jangka pendek Jangka panjang

Meningkatkan
Menurunkan nyeri
aktivitas fungsional

Meningkatkan LGS

Meningkatkan
kekuatan otot
 Intervensi Fisioterapi
Protection Phase Control Inflamation and swelling RICE, HARM & POLICE, POLICE, PEACE &
LOVE
1 weak Modalities as indicated US
ROM: AROM Strengthening TENS
Exercise Examples:
•DF/PF/Inv/Ev theraband exercises in pain
free range
• Ankle Isometrics
• Calf Raises
• Toe Raises
• Mulligan : MWM: DF/PF/Inv/Ev
2 weak Strengthening and Ballance • Single leg stance
• Balance board
3 weak Return to Sport • Agility ladder exercises
• Single leg bounding
• Unstable surface landing strategies
• Sprinting, shuffling, backwards running
• Sport specific agility/plyometric training
 Reference
https://orthoinfo.org/globalassets/pdfs/2017-rehab_foot-and-ankle.pdf
https://www.sanfordhealth.org/-/
media/org/files/medical-professionals/resources-and-education/014000-01095-flyer-ankle-sprain-rehabilitation-pt-guideline.pdf
https://www.sportsmedtoday.com/peroneal-tendon-injury-va-136.htm
https://www.researchgate.net/publication/319643518_Peroneal_Tendon_Complex_Injury_and_Rehabilitation?enrichId=rgreq-
4b90482d9a3aca9a838600c7f5b0186a-
XXX&enrichSource=Y292ZXJQYWdlOzMxOTY0MzUxODtBUzo1Mzc2MjA4MzAzMzA4ODBAMTUwNTE5MDIwMjI5OA%3D
%3D&el=1_x_2&_esc=publicationCoverPdf
https://www.foothealthfacts.org/conditions/peroneal-tendon-injuries
 SEKIAN DAN
TERIMAKASIH