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what should I expect, possible tendon rupture

Posted by matts on 8/23/03 at 15:35 (127763)

I found a local pod experienced in ankle and foot who ordered an mri that may show rupture of a pereoneal tendon, on outside of foot and ankle. He is going to consult a colleage to make sure because of all the swelling and mri signal in the area. I am to go back to discuss treatment plan on Thursday, there was mention of surgery but it sounded like there might be other options. Any idea what options might be for this problem?

This is my 3rd mri in the last couple of years as I have had a lot of foot pain from posterial tibial tendon, arch pain, pf and although one dr recommended surgery earlier for the ptt I was able to avoid it by wearing a leg brace for many months. I hope this earlier decision did not cause my latest problems. The outside foot and ankle pain has been the worse for me because I can not get rid of it and can find no relief with medicine, supports or injections.

Re: what should I expect, possible tendon rupture

BGCPed on 8/23/03 at 18:06 (127769)

I would go to another person for a 2nd opinion. I would not get a peroneal injected with cortisone. It can be os peroneum, split, torn etc. I am not picking on your Dr but if my foot spec had to consult another to have an mri read for that diagnosis I would prob want to see another person.

If you have been messing around with it for this long something is not right. What set it off? did you get a different shoe and or orthotic before it happened? many times if it was not from a trauma like rolling your ankle it is from other source. Most people with peroneal issue have a higher arch foot and or a plantarflexed 1st met shaft that make the foot bear wt on the outside border.

That motion also puts tension on the peroneal. If you roll the foot in and flaten the arch you take tension off of it. I often see orthotics made that actually tip the foot out and lift the arch and it makes it worse. Also a pronation control running shoe can be a problem as well.

Having your arch supported is ok but it can make peroneal worse. What city are you in?

p.s. not a dr just giving you some advice. Maybe Dr Ed or Dr Z will help

Re: what should I expect, possible tendon rupture

matts on 8/24/03 at 10:52 (127810)

The pod has not seen the pictures yet, just read the radiologist report, so i am glad he is taking the time to look and to let someone else look. Two orthos had suggested it might be split, but one said surgery and the other said injected it and said most people do better if they do not have surgery. I was wondering what options might be presented when i go back to podiatrist on Thursday. Do you know of orthotics that can help pereoneal, you are right about arch support even the slightest can make my ankle hurt.

Re: what should I expect, possible tendon rupture

BGCPed on 8/24/03 at 16:06 (127840)

Yes the right shoe and orthotic can help. If you are not an athlete you may do ok with just that. If it is the wrong device which I see often it can inflame it and make it worse, even a few degree too much can flare it up. I also dont agree that the surgical ones dont do well. That is like saying re-roofing a house isnt a good idea. If it is a problem and a good surgeon does the work there is a good chance it will work well.

If you dont address the common issues in peroneal problems and just fix the tendon you wont always get positive results. If you try the right shoe and orthotic for a while and it gets better they may not want to do surg.

Re: what should I expect, possible tendon rupture

BGCPed on 8/25/03 at 06:56 (127885)

p.s. if you can post a few pics of your bare feet on a hard floor one from the front, one from the back then post a pic of your orthotics and standing in your shoe with the orthotics in them also front and back may be able to tell if it is a high degree of over correction.

Another easy was is to wear a neutral running shoe like new balance 879 or 880 without the orthotics for a few days and if the peroneal pain reduces then that may be part of the problem. The tendon wont heal on its own but if it doesnt hurt than repair is a question you have ask a good foot surgeon that has done many of those procedures. Some do 5 per month some do 1 a year. Good luck

Re: what should I expect, possible tendon rupture

matts on 8/26/03 at 22:13 (128117)

BGCPed, I do not know how they compare but NB 801 cause the foot and ankle on outside to hurt more. Does this tell you anything? Thank you for your comments and suggestions.

Re: what should I expect, possible tendon rupture

matts on 8/26/03 at 22:21 (128118)

Other than surgery are there any other treatments for pereoneal tendon if it is ruptured? I have tried and continue to try to find shoes and/or othotics that help, but no success yet. I go to pod Thursday to discuss treatment plan, I am hoping for options other than surgery. More info on this foot and ankle pain is in the message above in this thread. Thanks for any experience and suggestions.

Re: Dr. Appt, Surgery Recommended Re: what should I expect, possible tendon rupture

matts on 9/02/03 at 19:04 (128610)

Mri shows lot of inflammation and dr is almost certain perieneal tendon is ruptured and have scheduled surgery, for now, on Sept 24th. I am concerned that I still have some pf and arch pain on some days, but the surgery is to fix the outside pain. Pain is mostly near ankle bone and at bone on side of foot, dr thinks mostly tendon cleaning and repair but may include anchor to bone if necessary.
The only thing I have not tried is 'casting', but I do not know what he meant by that, he said it would not work if tendon ruptured anyway. I called the office to ask about this.

He said I would be on crutches 4 weeks and then walking cast for a month or so and then should be able to walk. Interesting he said we are shooting for 75 to 80% improvement with this surgery.

I would appreciate any comments on experience with this type of surgery and suggestions on the recovery period or other treatments. Also, should I be worried about the remaining pf and arch pain because we do not really seem to be addressing that, unless it is related to all the other problems with the tendon. Thanks for any comments or assistance.