I sprained my ankle pretty good in February and it was a rather ugly injury. I had an MRI that did not show a tear in the Longus or Brevis tendons although both were inflamed. Have been to PT for 3 months and still having pain and have not been able to do ANYTHING (no walking very far, no stairs, no biking, etc). The orthopedic surgeon put me in orthotics as little did I know but I have high arches and he felt that could be causing stress on the tendons and not allowing them to heal. (He is worried about my tight achilles with the high arches also.) After 8 weeks of living in my tennis shoes with the orthotics and still not better, the surgeon ordered an ultrasound of the peroneal tendons. I just this past week was finally diagnosed with a Peroneal Longus Tendon Tear. I guess the tendon is split. Only took 4 months to figure it out!
The orthopedic surgeon says surgery is necessary for me to get back to normal. He will be stitching the tendon back together. Has anyone here ever had surgery on this tendon? I just got the call today so I have not talked to the doctor in depth about it yet. He told me I will be in non-weight bearing cast for 3 weeks and then walking cast for 3 weeks and then 6 weeks of PT. He said I will pretty much be back to normal when I am healed. I guess the surgery is outpatient. I have no idea how long I will be out of work.
I am worried because I have an 11 day hiking vacation planned the last few days of September and the first week of October. My spring has been shot, my summer is shot, is my hiking vacation shot too you think? I assume I should not wait until October and just suck it up through the pain? I am guessing I risk further damage if I wait until after vacation and not a good idea? Any idea how long you are off work? I will be calling the doctor next week again, but in the meantime I have tons of questions!
Anyone who has had this injury/surgery or any docs in the know, I would appreciate your thoughts!
In 2002, I tore my brevis (can’t remember trail running). Ironically, I had a stress fracture at the same time that masked pain from the tear. After a summer of running and getting back into 16:00 5K shape, I thought something was wrong. That’s when my MD found the tear. He did surgery later in the year and I was back to running in about 8 weeks. It took a lot of PT, but I wasn’t pushing myself that much. Could still run about 18:00 flat. I had some trouble train running though. About 1 year after my first surgery, I had major ankle instability. Turns out I tore my longus. Had surgery again. While waiting for surgery, the MD gave me the green light to keep running and I did the British national XC championships in Leed with friends for fun. I started running again in about 8 weeks after the surgery. Training was going well, then got knee pain. Thought it was IT band, but turned out to be defect in my articular cartilage. That’s why I took up cycling. Now I’m waiting for the boomers to boost cartilage repair research. Now that I’m biking, I do miss running about all of my friends who ran in college and took up cycling feel the same. I still run once inawhile, but I want to get better at cycling to do duathlons.
Go through with the surgery and just listen to what the doctor tells you. I know running is super addicting. I’ve pushed myself to hypothermia, heat stroke, run through stress fractures and everything else. Listen to your body.
The MD who did my surgery is in Chicago…Dr. Kelikian at Illinois Bone and Joint. The group he’s in sees the Bears, Blackhawks, and Chicago Fire. If they work on the pros, they’re good enough for us…
Good luck and PM me if you want to know anymore about surgery and the recovery.
-Pete
P.S. I don’t know if someone can go back to being a world class marathon runner after peroneal surgery, but you still be fast…
Yes, I have repaired MANY peroneal tendon tears (I’ve got some great before/after photos as well if you want to see). Just did one this week in fact. PM if you want any details. Also, you need to be absolutely sure of the diagnosis before you go to surgery. An ultrasound is NOT a very good imaging modality for this. A good musculoskeletal radiologist with another MRI would be my suggestion. The surgery itself is not very technically difficult at all for the surgeon. I’ve had a few surgeries that I’ve done with a “positive” ultrasound or MRI only to find simple tendinosis, or minor longitudinal tearing that really didn’t warrant surgery at all. Your surgeon is absolutely relying on this information. Recovery is a little on the long side for runners, but nothing to bad and you should be as good as new if you follow directions.
A good musculoskeletal radiologist with another MRI would be my suggestion.
rroof speaks great truth here. Never, ever trust musculoskeletal ultrasound beyond determining cystic vs. solid for masses or fluid collections. Very operator dependent modality, and though there are a few who are proficient at it, it is generally unreliable in this application. And besides all that, you already have a baseline MR for comparison.
Thanks so much for sharing your injury story. It makes me feel much better hearing that you are back to normal activities after the surgery and recovery. I did ask the doctor about that when he called me and he said I would return to normal, but it is nice to hear an actual story displaying that. I wil indeed be good about following the doctor’s orders as I do not want to mess anything up further for sure!
Thank you for your post, I sent you a PM. I forgot to mention in the PM you can send me pics if you want. I do not get too grossed out and they would be interesting to see!
Thank you for your post. I sent rroof a long winded PM. I am going to call the surgeon tommorrow and ask tomorrow about a second MRI. I would never had done that without your post and the post from rroof so thank you for the information. I have already rung up about $2000 in insurance co-pays so what is another $50 co-pay for the second MRI! I want to be safe before I spend even more money and rehab time!
I was diagnosed with a partial tear of the peroneal brevis tendon way back in November/December 2006 right after injuring my ankle in a HIM. I went to see three specialists (and PM’d rroof too - quite helpful!), and the consensus was that my partial tear would heal with inactivity and rest. After 6+ months of total inactivity (other than normal everyday life at a desk job), I’ve gained 10 pounds, am in crappy shape, and my ankle is still screwed. I just got back from vacation and did 2 moderate hikes and my ankle was swollen again in the same spot. I was never really given the option to have surgery, but I may be back looking into that now. I know this doesn’t help you any, but I would certainly consider the surgery if that’s what your doctor is advocating. Your injury sounds worse than mine, and I hate to think that you’ll do what I did only to opt for surgery in 6 months.
PM me if you have any questions. Hope you can still make your hiking trip. Where are you going?
The saga continues! I have my surgery scheduled for late October. I followed thru on the advice offered here and got my questions answered that I indeed did need tendon surgery so I am cool with that. I had to delay surgery as with the doc’s schedule I would have been in a cast on the vacation I am going on in a few weeks, which is not good, so decided to just wait.
Anyway, Just the other day got the release form in the mail to sign. I am freaking out a bit becuase it says he is not just repairing my peroneal longus tendon, but he is doing a Strayer Gastocnemius Recession. I saw that and was like what is he doing to my calf? So I went Googling to find out what the heck this is. I discovered it is an Achilles Tendon lengthening technique that sounds disgusting. (I do not get grossed out easily but this is indeed doing just that.) I have torn this calf before so I am not looking forward to surgery on it as the surgery has to be as bad or worse than the tear. I know the doc when I first went in with my ankle injury was rather concerned that I had high arches and tight achilles/calf. Frankly, I never knew I did! My pre-op appointment with the doc is not until Sept. 28th. I am making a LONG list of questions! I think I am going to be stressing until the 28th!
Does anyone have any insight to this, ever had it done, ever done one (rroof?). I am worried that once I am healed the doc will be saying time to do the left now! My left leg is the same as the right basically, so I cannot imagine it would do my gait any favors to have one “normal” achilles/calf and a super tight one… I think my right calf has some spasticity in it that the left does not, so maybe he won’t go after the left leg. That is on my list of questions to ask.
Any insight would be appreciated. Most of my Google search results led me to Journal/Scholarly websites where a subscription is required. So I do not have a lot of info. I just hope I can run, bike, ski, hike etc. when this is all over with!
Thanks.
To perform a gastroc recession (Strayer, Vulpes, endoscopic, etc.) is certainly optional and I can’t comment without seeing you, although if he is thinking about this in addition to the primary tendon repair, I like his train of thought. I can tell you that it is NOT that big of a deal (as far as the actual surgery/healing is concerned), but may have some long term issues.
I will say that I do NOT typically do a gastroc recession with a peroneal tendon tear repair.
I recently had a piece of metal roofing slice into my ankle causing a laceration to my left ankle severing my Achilles by 80% and completely severing both the longus and brevus tendons. My question is, it’s been 5 weeks (six by time of surgery)… Is it too late to reattach the peroneal tendons with success or is the tissue nacrotic and unable to reattach? Also, the surgeon said that my Achilles would heal (no pun intended) on its own and didn’t require surgery. What worries me about that is that there is a 7mm gap there and I’m a firefighter who is very active. Will I be having a lot of problems from not getting it surgically repaired or will it eventually be just as strong again? Assuming I listen to my doctor and rest and rehab appropriately. Thank you!
