As previously posted, the initial diagnosis of my ankle/foot injury made with MRI imaging was a Ruptured Peroneus Longus Tendon and surgery was scheduled for this Monday... However, there have been further developments...
At a preop (pre surgery) appointment 10 days ago the doctor felt that my strength and range of motion was not indicative of the complete rupture that was diagnosed via MRI. He ordered an ultra sound study to confirm the initial diagnosis. 3 days later that study was changed to a ct scan with the assistance of contrasting dye.
The cat scan study was performed by injecting contrasting dye via a needle into the sleeve around the peroneus longus tendon. Other than a small pin prick it was painless and the entire study took less than 1 hour.
On Thursday at a followup / preop I was given the good news. I have 3 near complete partial tears at 3 different points along the peroneus longus but not a complete rupture. The surgery was cancelled (for now) to give the conservative rest treatment a chance to heal the tendon.
Since the tendon is in approximation (ie it is attached or very nearly attached) the body is capable of filling in the gaps with scar tissue. My new marching orders are fairly similar to my previous marching orders -- RICE. Rest, ice, compression, and elevation. Any walking I do is to be done in a walking boot.
On the personal side, every day the ankle/foot has been feeling a little better... It is still a achy and if I overdue it one day I can tell immediately. Luckily I work with computers and sitting in front of my computer with my foot extended does not inflame the injury. This morning I am off to try swimming. I won't be kicking and my biggest concern is actually getting into and out of the pool carefully. If this goes well I will be exercising extensively via swimming, knee pushups, and upper body weight lifting.
I would like to thank Lawrence M. Oloff, DPM of SOAR - Sport Orthopedic and Rehabilitation for his diligent and careful evaluation of my injury. I am glad to not be having surgery and even more glad to be in a weight bearing recovery. I was not looking forward to the prospect of 2 months on crutches.
The picture shows normal peroneal tendons on an unknown person. This is not am image of my foot.
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Peroneus Longus, about, tendon
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appointment, approximation, cat scan, ct scan, dpm, elevation, gaps, initial diagnosis, mri imaging, oloff, orthopedic, partial tears, peroneus longus tendon, personal side, pin prick, pushups, range of motion, scan study, scar tissue, small pin
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10 comments ↓
I’ve been reading your blog with great interest since I sprained my ankle a year ago (playing tennnis) and resprained it two more times. Most recently, I sprained it very badly 3 weeks ago. Since then, I can barely walk and I’m thinking about surgery. The doctor said I have tears in my peroneal tendons but that he wants to try conservative treatment (the famous “walking boot”) instead of rushing into surgery. My question: Can you walk without pain in the walking boot? I was on crutches the first 10 days, and now I’m using a cane but leaning extremely heavily on it… I’m thinking of going back onto crutches. This walking boot seems like a misnomer. So that’s my question–what does the boot do for you?? P.S. Swimming has been a lifesaver for me this month. You can definitely do it while holding your legs kind of inert. I recommend wearing one of those sock-like strappy braces in the water, just to remind yourself that you have an injured ankle. Otherwise, you might start kicking by mistake! Best wishes in your recovery and please write back if you have time.
So glad to hear that the tendon is not injured as previously thought and is able to heal without surgery. That must be very good news to you indeed!
how was the swimming? difficult getting in and out?
I know this must all be FRUSTRATING even with the joy of no surgery…
@Clara
I am not a doctor so please do not take this as medical advice.
I don’t think that my injury is a sprain. It is certainly not like the 10-15 severe sprained ankles I have had in my life of play basketball up and through division I in college.
Since I do have a bit of knowledge about sever sprains (even ones with partially torn tendons) I will give you my 2 cents.
In terms of preventing future sprains… Considering you sprained your ankle without stepping on something (??) you should consider getting custom made orthotics and different shoes. If you want to be extra cautious get a lace up ankle brace. I always liked Mueller High Performance ATF Ankle Brace
personally but there are other brands.
You ankle sprain sounds like it has a lot of trauma. It is inflamed and your range of motion is limited. RICE RICE RICE. (Rest Ice Elevation Compression). Do as little walking around as your can. Take an antiinflammatory medication (Ibuprofen for example.)
To answer the actual questions you asked
I can walk short distances without pain. If I overdue it I get very achy. I walk with a bit of a limp, but it is because the boot restricts movement more than anything.
The boot made a huge difference when I got it the day after my injury.
Initially you may want to consider using your cane and the boot in combination.
Good luck.
@ MizFit
Swimming was great. Getting into the pool was the hardest thing.
I ended up using a noddle to keep my feet floating behind me. I will be writing about it in the near future.
Thanks for responding! Yes, it’s unlike my previous sprains…. The tendons were actually already torn before this most recent sprain — but somehow they were asymptomatic until I fell and disturbed their peace. (An MRI a month before my fall showed that they had already torn.)
Well, I’m glad you’re OK in the walking boot. It definitely helps me, too, but it doesn’t completely get rid of the pain. Better than a non-removable cast, of course. Please keep writing so others with this tricky problem can see how you’re doing!
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