So as I mentioned in my weigh in post, on Tuesday I was playing volleyball at the local community center....
It was a 3 on 3 game and we were receiving. My teammate passed the ball to the setter and I was backing up to position for the approach for the spike (licking my chops too I might add as the pass was perfect)… When I changed directions to start my approach (not even a very athletic move) there was loud pop and I thought who just throw a rock at the ground at my foot (the pop was so loud I assumed it originated behind me as I approached the net.) In addition to the sound, there was a minor tingle on the outside of my ankle heading towards the front of the foot and a split second later I immediately knew something was very wrong... Nothing like any athletic injury I had ever had before. (Believe me, I have had more than my fair share of sprained ankles and the like.) (This is ~1:30pm pst.)
In that split second when I realized it was not a normal problem I chose to simply catch the volleyball instead of jumping and spiking it... The bizarre part is that I was not experiencing acute pain... I immediately started RICE (rest, ice, compression, and elevation), a routine I know well from past injuries...
I called 3 orthopedic doctors to attempt to get in to see one asap... I also called a trusted physical therapist that had been used by family in the past... Trudi at Functional Rehabilitation and Sport Therapy (FRST) agreed to see me at 6pm. While waiting to see Trudi, I was contemplating going to the ER (6 hour wait when I called to check), one the doctor's called back and had an opening for 2 weeks from then (I told them were to fly their kite)... Then at 5:oopm just prior to leaving to go to FRST, I got a call from SOAR - Sport Orthopedic and Rehabilitation - which happens to also be the medical provider for the San Francisco 49ers. They had an opening at 8:10am the next day...
I saw Trudi, she immediately knew the same thing I did, which is that this was not a minor injury such as a sprain. She also, concluded that it was not the Achilles tendon (a good thing I guess.) Most doctor's might disagree, but in my book athletic trainers see more injuries immediately after they happen than doctors. I would trust the initial unassisted first opinion of a sports therapist as much as a doctors initial unassisted opinion. After documentation (XRay, MRI, etc.) quality of the opinion is obviously not the same comparison, but initially they are usually spot on. Trudy and her staff were awesome... They went above and beyond... In addition to an informed opinion of my injury I also got a whirlpool session, ice, electro stimulation, ultra sound, and a massage. AND SHE WOULD NOT TAKE PAYMENT for the visit... (She probably knew what was coming... but what an incredible gesture.)
As it turns out, my doctor at SOAR, Lawrence M. Oloff, DPM, is the absolute best foot and ankle orthopedic in the Bay area and he is used to large individuals (49ers)... I arrived for my 8:10am; was seen quickly; and immediately given an xray. The X-Ray was negative and an MRI on the ankle was scheduled. I was also fitted for a walking boot (putting weight on my ankle caused my only real pain at this point.) The MRI on the ankle saw a tendon that was thinning (Peroneus Longus) but the end of the tendon was not in the picture so another MRI of the mid foot was scheduled for the following day.
48 hours after the initial injury my foot was still not swollen and I still had most of my strength and mobility, but the pain was significantly higher. I asked for pain medication after the second MRI and was prescribed generic Darvocet-N 100 with 650 mg of APAP. Ahh... relief.
Dr. Oloff called at 6pm Thursday with the news... Complete rupture of the peroneus longus tendon... Rupturing the peroneous longus is highly unusual, but even more than that... Rupturing the peroneus longous in the location I did (where the tendon attaches to the foot) is virtually unheard of. The doctor (THE specialist in the Bay area) had only ever seen one other case and it was in a 49er. Here is a rendering of the peroneus longus to give an idea of the location of the tendon.
Basically, the peroneus longus is a muscle that starts at the top of the fibula and turns into a tendon near the ankle. If curls around the outside of the ankle and occupies the same fiber channel as the peroneus brevis. It is responsible for helping to move your foot out and up.
So what next? Dr Oloff is going to surgically repair the tendon... It is an intricate procedure with a long recovery... After surgery I am in a cast and completely non weight bearing for 2 months. After that in a walking boot and partial weight bearing. After that he expects a minimum 6 month rehab to return to normal... If, after the surgery the tendon becomes detached or scar tissue develops a 2nd surgery will be required to tie the peroneus longus to the peroneus brevis and a crazy long rehab will be required. Yowzars...
So where does that leave me... Needing to find a way to exercise without putting weight on one of my legs. The crutches themselves will be good exercise and Trudi has an arm bicycle and I can lift upper body weights... But outside of that I am not sure I have very many options... Any ideas?
Regardless I am sticking to my diet and trying to lose more weight... The less I weigh the easier getting around on the crutches will be. This is yet another reason why I should have lost weight months if not years ago.
I will continue my regularly scheduled programming and I will also continue to inject progress reports... These progress reports are sure to be a little more exciting that simply the fact that I lost 7 pounds in a week (or 0.6 as the case may be.)
To end on a positive note, with this injury being so rare... my care and recovery will almost certainly be turned into a medical case study. I will at least get the pleasure of knowing that future orthopedics will study my case and may even be tested on it...
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Categories:
Peroneus Longus, about, injury, tendon
Tags:
6pm, acute pain, ankles, asap, elevation, fair share, fly, functional rehabilitation, game, kite, local community, loud pop, medical provider, orthopedic doctors, physical therapist, playing volleyball, san francisco 49ers, spike, teammate, trudi
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17 comments ↓
My buddy just ruptured a different tendon on his foot when we were playing ultimate frisbee recently. He’s hobbling around and will be sidelined for a couple weeks. It doesn’t seem as bad as your injury though… Hope you heal well - even if it does take awhile.
Thanks… Surgery was the only option presented to me… With each passing day I can tell it is getting worse although I can still hobble around in my walking boot if I had to.
I just accepted that surgery was the answer, but it would be worth asking him if I have a choice.
only YOU would have that great attitude you pulled out at the end of the post.
HANG IN THERE
Oh, man! I’m sorry! It must be very frustrating for you contemplating the long recovery… but a the same time, that recovery period will only help your foot heal better.
Do you have a rowing machine? That might be an option for getting your exercise. You would need to find a way to rest your injured foot slightly off to the side while pushing with just the good foot/leg.
You could also focus on strength training your upper body. Could you still work your quads without involving your injured foot?
Swimming is always mentioned as a way to exercise during an injury, but I think in your case it might not be the best since you might be too tempted to kick and move your feet.
Maybe you could ask Trudi her recommendations. She sounds like a really skilled (and very cool) person!
Good luck in your recovery!
I think swimming is great option once the scar from surgery and tendon have healed enough to get out of the pool.
The rowing machine is a good idea, I hadn’t thought of that.
I don’t know if I can work quads without tensing my ankle, but if I can I will… Major muscle use so much more energy.
Trudi and I have talked and I think exercise (as opposed to rehab) is going to involve upper body only and maybe some core training as well.
I am 10 weeks out from an ankle reconstruction from a torn peroneal tendon of my right ankle. Surgery really is the only way you will be able to repair this. My first couple weeks were rough, and it sounds like your injury was more severe than mine (complete rupture! wow!), but I’ve had great results. I was non-weight bearing for 5-6 weeks and i’ve been just in a brace without crutches this week. The body is so resilient! Upper body will be the way to go. I am just able to start getting on the exercise bike to get some cardio in.
Good luck. Check out my blog…I have pictures and the story of my surgery if you are interested!
Ouch! Good luck with the surgery. I hope it all goes well.
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Please let me know exactly what type of surgery was done. I have related issue, with peronus longus ruptue & broken OS perenoum (calcification in tendon) that looks to require (scary part) cutting the tendon. None of the surgeons in my town will go for “spare parts” splices and I will be making critical decision soon.
@Scott
I got lucky… It turns out that I probably don’t need surgury… Instead I tore it in 3 places and need to just rest.
http://www.weightladder.com/2008/06/21/torn-peroneus-longus-tendon/
[...] you are just getting into exercising or you are an old pro, injuries can happen at any time. It doesn’t take much to injure our joints or muscles and exercising improperly only contributes [...]
i am 2 weeks out from surgery on my perneol tendon. 2 inch split. crutches stink but everything is looking good
good luck to you.
I had an MRI yesterday and have a complete rupture of my achilles tendon, a tear of my peroneus longus muscle, and a sprain in another ligament (calcaneal?). I am dreading how long I am going to be out of action….. any pick me ups out there?
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