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Old 05-30-2012, 07:23 PM   #1
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Back from OS visit, new tendinitis

So I had another post-op visit yesterday with my OS. I had been having pain in my first MTP joint after walking again that was preventing me from following through with the "toe off" phase of gait. My OS examined it yesterday and I have developed tendinitis in it! Ugh! He said it will take about 6 weeks to heal. Not what I wanted to hear. But on a positive note, he said my ankle was progressing well and my strength is good. Need to keep working on my ROM. My calf and soleus are still tight with knots so they are going to continue working on that in PT. He gave me three more weeks of PT and in that time, PT will transition me over to the maintenance program. That is where I can pay a monthly fee and have unlimited use of the facility and equipment to continue rehab as long as I want. I will probably do this up till my 1/2 marathon in December. Then my doctor says well you are through phase 1 and at a plateau (phase 1 being the first 3 months of initial surgical recovery) and now you're in phase 2 which will take on average around 6 months. Oh, what is phase 2 I ask? He says finishing rehab and waiting for all the pain to go away. He said typically patients are completely pain free at around the 9 month mark (on average so plus or minus). Well that answered my next question of how long before my ankle completely quits hurting. I mean I've come a LONG way, but I still have pain and swelling. This all makes sense although I didn't figure it would take that long. My first surgery isn't a great comparison because I went back to work way too early and had complications, no PT and no heads up as to what was normal with pain, etc. This experience has been so much better. I'm also allowed out of my brace except for PT, sports, running, and any activity where I will be on uneven terrain and when I travel (which I do a lot of) because I don't know what I will encounter. Feels good to not have to wear anything, but my ankle is having to adjust and the swelling has increased somewhat. The 6 month period will literally end on the day that I fly out to do the 1/2 marathon so I'm hoping I will be one of those that is out of pain early or sooner! LOL! I don't have to go back to my doctor unless I need him. I figure I will go see him right before the 1/2 marathon to be sure everything is ok with it before I go do 13.1 on it. I went to be sure it wasn't too bad last Nov before I did the 1/2 and that landed me on the OR table! So all in all a great visit! Anyone else still struggling with walking normally, pain, swelling, or other issues from learning to walk again? That part is frustrating!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
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Old 05-30-2012, 09:46 PM   #2
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Re: Back from OS visit, new tendinitis

Hollywood, great news that your ankle is doing good and getting stronger! I'm sorry to hear about the tendinitis though, I hope it heals up quick and doesn't set you back too much. I can't believe that your OS doesn't need to see you any more. You would think he would at least want to see you in 6 weeks to check your MTP joint.
It is awesome that you can pay monthly to keep up with your PT exercises. I am so bad about doing them on my own at home. Seems like there are too many distractions, or I get too busy to do them.
I have been slowly progressing with my PWB and am at full weight with the crutches. I saw the OS today and my osteotomy hasn't healed 100% so he didn't want me to FWB yet, but I should probably be cleared in 2 weeks when I see him again. I can relate to the frustration of the pain and swelling. My foot has been swelling allot since I have been weight bearing and I'm still icing and elevating too. I will be glad when things get back to normal!
Good luck with everything. Glad to hear that you are progressing so well. You will be running in that marathon before you know it.
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Surgery March 6, 2012: Calcanal Osteotomy, PTT repair, FDL tendon transfer on left foot.

 
Old 05-31-2012, 01:50 AM   #3
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Re: Back from OS visit, new tendinitis

Thanks PLANEMARK!! I'm not surprised he isn't going to see me regularly. He was seeing me every 3 weeks anyway which is very close following which I loved, but don't need now. If I need him or if it doesn't get better (the tendinitis), I can go see him then. He did continue my PT for my ankle and they will work on my MTP joint to help it. I just need it healed so I can have normal gait so I can progress on the treadmill and get running. As he said, my ankle will hurt for a while so I'm ready for that. Prefer it wouldn't hurt, but oh we'll huh? LOL!

Sounds like you are progressing too!! Sorry the osteotomy isn't a hundred percent, but maybe in 2 wks it will be! Yay for almost FWB! The swelling is frustrating and yes it increases once you start weight bearing. Hang in there!!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 05-31-2012, 04:14 AM   #4
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Re: Back from OS visit, new tendinitis

Are you on an anti inflammatory? Don't think I could live without meloxicam! (but sure wish I had my vioxx back)

 
Old 06-01-2012, 12:25 AM   #5
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Re: Back from OS visit, new tendinitis

Well I was surprised that he didn't suggest it since he had me on anti-inflammatories before surgery for a couple months. I didn't want to take them after surgery since he broke and drilled the bone. However i did take some recently to try to help with rthe pain and inflammation. It isn't working. I guess the issue is that joint is used with every step I take and so how do you really rest it? You know? I'm icing it and my PT is taping it for therapy to help it. The more I limp to not bend that joint as much, the more stress it puts on my ankle and that isn't good because it makes it hurt more than usual!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-01-2012, 08:17 PM   #6
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Re: Back from OS visit, new tendinitis

Hi Hollywood,

So sorry about the tendinitis, I know it is discouraging and frustrating I too am still dealing with swelling and pain - I was up til midnight last night cause it was throbbing, even with taking the Tramadol. I am struggling with learning how to walk again in rehab - although my range of motion is getting better, thankfully. I've only been seeing my doc every six weeks - so I don't go back to him until 6/19/12 and I'm supposed to start back at Dominos on 6/27/12. So hoping I will be ready by then, the PT isn't sure she can get me up to 100% by then, but said she would try.

My frustration is driving still - it is getting better, as the ankle is getting stronger, but still painful in stop & go traffic. I am not wearing the brace when I am home and in the house but if I leave the house I put it on....just never have any idea what you're gonna wind up walking on, etc. Sadly I walked on a cat toy last night - it really hurt!!! I think that's why I had so much pain last night! Hang in there.....we are getting there!

 
Old 06-01-2012, 09:54 PM   #7
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Re: Back from OS visit, new tendinitis

JOYFUL--Sorry you are still dealing with pain and swelling too. Having just really started therapy, you will still have a lot of that. I'm still in therapy, but the tail end. My doc renewed it for another 3 weeks and said if I needed more I could do more, but I've already had 21/30 visits my insurance will cover per year. So we're stretching those out and then they will put me on the maintenance program. I'm sorry even with the tramadol you were still in so much pain, but I understand. I still have to take pain meds occasionally too and the only thing I have is Percocet. He never gave me anything different so on those days ibuprofen doesn't cut it, I end up taking one of those. Sorry about the driving and the cat toy. I'm glad I don't have the driving issue since its my left foot. I hope you are ready to go back to work by then too, but I'm not so sure since you just got started with PT! My doc kept asking me on Tues if I felt like the ankle was stable or if it felt like it was going to go out or go over. I kept saying I think it's fine, but I haven't (at that point) been out of the brace much to know. Well tonight as I was getting dressed, I got my toes caught in my pj pants and landed on it. The angle I landed would've normally twisted it thus a sprain and a lot of pain, but it snapped back and I was so relieved! Now it hurt doing that but not an injury hurt. Just a post surgical I'm still recovering hurt...if that make sense! Thanks for the encouragement! We will get there, you are right!! I'm getting nervous about my Spain trip in 3 weeks. Mostly the swelling on the long flight and the pain of long days of activity!!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-02-2012, 03:48 AM   #8
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Re: Back from OS visit, new tendinitis

Hollywood I had surgery in November for a tear in my peroneal brevus tendon. I was NWB while in the surgical splint then full weight bearing in the boot. I returned to work in January and due to issues with pain and swelling, was back in the boot during the months of February and March. I finished with pt in May. A new MRI was done which really did not show much. My foot is still not right and I still have pain issues. He prescribed a compounding cream and as long as that controls the pain and swelling I do not need to see him. It does take time for full recovery, especially when there is bone involvement. But, if the pain and swelling continue I would definitely go back and see the doctor. I have a question for you on the subluxation. On my "good foot", the surgeon is going to start addressing my flat foot/joint issues. But I have also had a lot of pain by my peroneal tendons. Even when I am in bed it aches by the bone. I noticed last week that if I flex my foot, I feel a popping right behind the bone - is this subluxation?

 
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Old 06-02-2012, 09:00 PM   #9
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Re: Back from OS visit, new tendinitis

MISSY--Thanks for your post. Very helpful! I'm sorry you are still having pain and swelling! Ugh! What kind of cream is it, do you know? My doctor said I was now in the second phase which is 6 months long. He said most patients are pain free at 9 months from surgery, so that's 6 more for me. That explained a lot because I'm still having pain and swelling. So I figure unless there's just a huge increase in the pain and swelling that I will give it 6 months. At that point, I'm supposed to do my 1/2 marathon again and regardless of whether I'm still having pain I will have him check it before I go do that. I was having increased pain last Nov after another sprain that Sept and went to have it checked before my 1/2 marathon last Dec to be sure it was ok and well, clearly it wasn't okay! Think that's an appropriate way of looking at it? Otherwise, if there isn't an INCREASE in pain and swelling, I'm afraid he would just say you're still in your 6 month window (although he's really attentive and caring and my not). The only reason I might go in sooner is for the tendinitis in my first MTP I was just diagnosed with. He said that will take 6 weeks to heal, but I wonder how when I use it every step I take?

As far as your question on subluxation...I also had a peroneal tendon tear that I had repaired (peroneus longus though). He actually asked me in my exam if I felt a popping sensation there and I replied, "no they aren't subluxing". He said good. However after pressing on the tendons (which lit me up! Ouch!), he said "they are subluxing". Fabulous! I couldn't believe it because I didn't have the classic snapping over that is usually reported with it. He had me reach down and put my fingers in the right spot and manipulated my ankle and I felt them pop in and out, in and out. I will say it didn't cause anymore pain (obviously since I wasn't aware of it), but he said that if it keeps going, it can cause the tendons to tear further and even completely. So all that to say...if you are actually feeling them pop or snap, have them checked!!! He fixed that by drilling and breaking the bone. I knew he would drill it to make the groove deeper, but it wasn't till day of surgery that I found out he had to drill AND break the bone. I still have some bone pain here and there. Hope that helps! When are you having surgery on your "good foot"?
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-03-2012, 03:50 AM   #10
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Re: Back from OS visit, new tendinitis

The cream is a compounding cream. Many ortho docs prescribe it. Mine has 2 pain meds, 2 anti-inflammatory drugs and 2 muscle relaxers. The doctor chooses which drugs they want compounded and made into a cream. After you begin using it, it takes about a week before you feel the benefits of it. I was skeptical about it until it stared working. If I am to busy at work to apply it, the pain and swelling return. If your tendon keeps acting up, see if your doctor can prescribe it. Workman's Comp. set up my appt. for 6/11/2012. He told me back in Sept. that my flatfoot needs to be fixed, and I also have a lesion in the joint (causing pain and swelling). My good foot is a mess! Problem is, I really can't have surgery until Nov (FMLA) or I will not have a job to go back to.

 
Old 06-03-2012, 10:23 PM   #11
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Re: Back from OS visit, new tendinitis

Bless your heart! Pain like that and knowing what needs to be done and you can't do it for another 5-6 months!! That's hard! This cream sounds very interesting! I've never heard of anything like it in my career, but I dont have much experience with compounded drugs. Do you know what the names are of the 6 drugs in it? If I ask my doctor, he will probably ask me what they are. Right now he has given me more pain meds and says to expect about 6 more months of pain, but past that, if there's still issues, I'm interested in this cream. Actually, there are some times I can't take pain meds and that would be good. I mean I don't need them a lot. I push through mild pain, but you know what I mean. Those days I'm active and on my feet all day and it balloons up! Ugh!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-04-2012, 04:04 PM   #12
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Re: Back from OS visit, new tendinitis

Hollywood, I too was given a pain control gel by my family Doctor. It consists of Lidocaine, amitriptyline and keptoprofen (sp). I can apply it up to 5 times a day and it is incredible! Relief is immediate and while not long lasting, it takes the edge off and prevents me from having to take pain pills. If I've had a bad day I apply the cream and relax for half an hour or so and watch tv or read a book and I am good to go.
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Shattered calcaneous, non surgical repair. Subluxation of both peroneal tendons, awaiting repair.

 
Old 06-04-2012, 05:25 PM   #13
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Re: Back from OS visit, new tendinitis

I read about that pain relieving cream on here before. There were a few people who had been using it when they were farther along in recovery like you, Hollywood. I think it was Debincalif. She had said that her PT had to apply it and massage it in. Maybe you can ask your PT about it next time.
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Surgery March 6, 2012: Calcanal Osteotomy, PTT repair, FDL tendon transfer on left foot.

 
Old 06-04-2012, 09:36 PM   #14
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Re: Back from OS visit, new tendinitis

I didn't know PTs could give out the creams or gels. Interesting. I will definitely look into all of this! Thanks!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-04-2012, 11:27 PM   #15
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Re: Back from OS visit, new tendinitis

From what I read and learned the Dr had to prescribe the cream, but it was administered by the PT. One of the other patients had this done at the place where I went last year and I asked about it. They would massage the cream and do stim and ice at the end of their therapy session.
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Surgery March 6, 2012: Calcanal Osteotomy, PTT repair, FDL tendon transfer on left foot.

 
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