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  • Am I looking at another foot surgery?

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    Old 10-24-2016, 06:24 PM   #1
    NewRunner13
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    Question Am I looking at another foot surgery?

    I just had an MRI and have a follow up with a podiatrist and also a foot and ankle orthopedic in a couple of weeks but for those that have some experience with this type of injury....any guesses/thoughts on how this will be treated or what it means. My main symptom is pain behind my outside ankle. Definitely worse in the morning and after physical activity/walking. The pain is not constant or severe, but does limit my overall activity level. At times my ankle can feel weak (i.e. I've noticed I'm holding onto the handrail when going down the stairs "just in case") but other than that it doesn't roll easily.

    Impressions from the MRI:
    (1) Calcaneofibular ligament is attenuated likely a result of prior partial tear
    (2) Attenuation and indistinctness of the anterior talofibular ligament, likely chronic tear.
    (3) Longitudinal split tear of the peroneus brevis tendon at the level of lateral malleolus and mild peroneal tenosynovitis

     
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    Old 11-09-2016, 02:30 PM   #2
    NewRunner13
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    Re: Am I looking at another foot surgery?

    I had a follow up last week and it sounds like surgery may be in my future but at this point it is up to me. For those that have had tendon tears...did you regret waiting or not waiting to have surgery? How long where you able to wait? Dr. said she did not think the tear would get worse if I waited but seems I've read opposite opinions elsewhere. Right now it appears this would be a fairly simple surgery to fix. My biggest fear is that by waiting I would risk more damage and would need more extensive surgery.

     
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    Old 11-12-2016, 04:30 PM   #3
    pwk787
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    Re: Am I looking at another foot surgery?

    I had a peroneal tendon repair in February 2015 and in spite of extensive PT my ankle never really felt stable after. I went to a new physician and had additional surgery in August 2016. I had a Brostrom, scope of the joint that discovered a huge plug of scar tissue in the joint, the tendon was cleaned up again and a piece of bone was shaved down on the side of my calcaneus. I am 9 weeks out from this surgery and my ankle, although still sore, seems much more stable than before surgery.
    Although this surgery is not ever an emergency, I would encourage you to plan to schedule it as soon as it works for you. The tendon is not going to heal on it's own. I believe the funky ways that you start to move to compensate for the tendon pain is going to cause problems in the ankle or somewhere else in the your body.
    I would strongly encourage you to talk to you doctor about examining the joint arthroscopically during the tendon repair. Since my first surgery I learned that there is a huge number of issues, scare tissue, cartilage problems, and other loose junk in people with a peroneal tendon tear. These often don't show up on MRI. Mine didn't.
    The surgery itself is pretty straight forward. I regret not pursuing and MRI and surgery faster after the initially injury and after the first surgery did not seem to have fixed the problem. For me, it was like have about a week old grade 2 sprain for about 2 years. It was tolerable but I certainly wasn't doing what I wanted to a lot of the time. I hope this gives you some perspective. I know that a lot of the information on this board and on the internet are horror stories.
    I hope this helps. If I can answer any questions please let me know.

     
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    Old 11-12-2016, 06:50 PM   #4
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    Re: Am I looking at another foot surgery?

    i had lots of damage during an accident for surgery in my signature. i had no option but to get surgery.

    i also led a very physical life and work. so in my opinion if i am not right and cannot function as normal i honestly don't want to limit working out and live hobbling around so i would get surgery no matter what.

    my experience with sitting still and limiting your body is depressing. and you will find yourself holding back and your body will try to compensate and if you are older i get the feeling that you will hurt yourself more if you try and keep moving.

    i also was very surprised to see just how much the limited strength and range of motion were hurt during my initial stages of booting after my accident. on one hand i was hurt and couldn't move around the same even with static non weight bearing exercise. i wanted to but it was too much.

    i think bad things happen though if you just sit still and let scar tissue develop. for me after surgery and rehab i actually felt at my best and still do to this day after i am warmed up and loose and i keep active almost every day of the week.

    as soon as i take a few days off from everything i feel my foot sore in the morning, etc.
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    Old 11-12-2016, 07:54 PM   #5
    NewRunner13
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    Re: Am I looking at another foot surgery?

    Thank you both for sharing you stories! It is greatly appreciated. Up until this point I have been seeing a podiatrist but after reading so many of the helpful posts on here, I scheduled an appointment with a foot and ankle orthopedic specialist. After a 6 week wait, I see him this week so I am anxious to get his thoughts and ask some of these questions...thank you pwk for sharing your experience! I am told the tear is about 2 cm long and has been there at least two years (it was there on my last MRI)...although the pain has just gotten worse in the last 4 months or so. So although its not a tiny tear, its not huge either!! I have a feeling that surgery is likely I just need to work up my courage!!! I will post again after my appointment.

     
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    Old 11-12-2016, 09:14 PM   #6
    dama
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    Re: Am I looking at another foot surgery?

    this was my first major injury and surgery. i couldn't handle being what i would call crippled, having been an active person all my life.

    so i was actually calm and excited while waiting to be rolled into the operating room

    i had a nerve block before having surgery in the am, and within a few hours of being done i was able to be carted by wheelchair to the car. you NEED a helper and to be very carefull getting around to start. i recall wanting to get up and get around but i ended up not having my faculties like my brain said. scary stuff.

    my nerve block started to wear off that night and i started pain pills. took them only 2 weeks and since then advil maybe a handfull of times.

    the pain and swelling was worse than the initial injury and sitting around. i had an issue with pain pills and being jumpy in and out of sleep. i would get these shockwaves where i would jolt my foot and pain would shoot up my nerve. the harshness went down after the first month but i couldn't even put my bare foot down during this time, it would flush and pulsate. so when getting around, using bathroom i had to raise my foot right away.

    i used a boot to keep my foot safe and was actually allowed to walk around the house after a few weeks! i started rehab soon which was simple stuff to start. massage, machines and certain movements.

    had pt for almost 3 months and this was slow progress for me, but did each week.

    i was back into my shoe with a brace at just under 2 months. that wasn't fun the first few days but i hobbled around. i was so tired after the first five minutes and achy i had to quit. BUT walking progressed a ton. i was doing all rehab and by month 3 post op i was walking atleast an hour/day. at that point i was still working on range of motion, strength and all of that. but if i was carefull and just needed to get around i could do it. stairs and all the wierd terrain came later with time as well as advanced stuff.

    my goal was to get hiking and back to old physical job and i was doing that before month 6. at that point i carried a brace around just in case i needed it and had to look down like a hawk to make sure i planted straight ahead with all activities so i didn't roll my foot. proprioception was the latest thing to come back, even progressing at the year post op mark.

    to this day i am not normal and get aches and pains. but i haven't had an ankle roll, i don't look down and seem to adapt on the fly which is good. so i find myself lucky considering the shape i was in.
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    Old 11-13-2016, 04:13 AM   #7
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    Re: Am I looking at another foot surgery?

    I had a tendon tear that was not picked up by mri, it said tendon was flat in appearance but not torn. I had ankle instability and and failed two bromstrom procedures so my surgeon decided to do a tendon transfer to reconstruct the lateral ligaments. I also started to have problems with tendon subluxation which my surgeon told me would be taken care of with this surgery. When my surgeon went he found a significant tear in the tendon. He was splitting the tendon anyway so it did not need to be repaired, it was incorporated into split. I was told that if I did not have the tendon transfer I would have had to had surgery to fix tendon eventually since they usually do not heal on their own.

     
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    Old 11-17-2016, 08:56 PM   #8
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    Re: Am I looking at another foot surgery?

    I chose a different path than most people. I'm not sure I'd recommend what I did but it can work.

    I had a long history of mild sprains of my ankle and then in 2009 I fell and tore my peroneal tendons, AFTL, CFTL, achilles, probably my deltoid ligament slightly and tore up the joint lining thoroughly. At the time I had a job that would have meant taking a significant amount of time off (months) and so I just kept working. After PT failed I started seeing a podiatrist who made some mistakes but at least realized how unstable my ankle was and got me into a heavy duty brace that prevented me from injuring another person if my ankle gave out while I was lifting. I wore it and didn't have another sprain for about 5 years. Then one day I went out to the driveway without it and my ankle turned completely under; my mom said it made her ill to see how far it turned. And that was it. There was no way I was avoiding surgery at that point as no brace was enough to prevent my ankle giving out. That was March 17. I saw a dr who suggested PT thinking I could somehow make the ankle better that way (she was a very weird dr) and my AFTL ruptured during a PT session. That was in April and I was very limited in getting around from then until surgery in June.

    My surgeon is very conservative and so I had a slow recovery. 6 weeks on bedrest while elevating at all times. 10 weeks in a cast (4 in a walking cast). 6 weeks in a boot. 3 months in a brace. 4.5 months of PT (which was longer because I had been braced so long that I had to re-learn how to walk). Most doctors move through the process more quickly than mine. I'm happy to have done it his way as it worked. My ankle is definitely not biologically normal and I will always need to be careful of it but it works now and I only wear a brace if I'm doing something with a risk of my ankle giving out.

    Leaving it so long was convenient for me and the brace worked fine. Had I worn it the day I hurt myself again I might still have not had surgery. I was told as long as I did it before developing arthritis I could postpone a long time. But since I do have some arthritis in there already I would not want to have let it go a lot longer. They cleaned a great deal of debris from the joint and I'm sure time would have made that worse.

    I don't have 100% strength in my ankle and that is less than it would have been if I had surgery sooner. It's completely functional and not a problem but if someone tests the strength in there it is less because the muscles did not work as much while I was in the brace.

    I think you have to do what works for you, knowing that it does take time to recover and sometimes in life are better for that than others.
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    Old 11-19-2016, 07:26 AM   #9
    NewRunner13
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    Re: Am I looking at another foot surgery?

    Well so much has happened this week!! I appreciate so much the support of those on the board. After talking with the ortho specialist I decided to go ahead with the surgery. They had a last minute opening so I was able to have it done yesterday! MRI had shown a brevis tear of around 1 1/2 cm. The surgeon said it was actually around 4 cm when he got in there. The tendons were also subluxing so he tightened the ligament that holds them down and removed an extra muscle in that area. After the surgery dr said it was great we went ahead with this because it would not have healed on its own. Foot stayed numb yesterday but in a lot of pain right now. Just trying to ice and elevate and stay on top of the pain pills. I think it may be time now for a Christmas movie!

     
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    ligament, mri report interpretation, peroneal brevis



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