Is it possible to have pf with a torn peroneal tendon and not realize it?Posted by dixie on 7/10/05 at 19:42 (178146)
I am 12 wks. out of open pf surgery with a tarsal tunnel release. All along I've had pain in my heal and swelling. The dr. has treated this injury primarily as pf injury. About a year ago, the pain from pf magnified 10x's after playing soccer in the summer of 2004. During this time I turned my ankle while playing soccer, and ever since then, the pf has hurt badly! The pf/tts surgery has helped the pain in th a.m. and general pain on the bottom of my foot. BUT I still have pain on the lateral side of my foot and ankle with great pain around the bone that is in the center, lateral part of my foot. (cuboid bone, maybe????) Could it be possible to miss a torn tendon and think it was just a bad case of pf?
Thanks for all comments or anyone who has experienced this kind of injury!
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?Dr. Z on 7/10/05 at 20:25 (178147)
You could have all of the above. In addition you could have a calcaneal cuboid syndrome which is due to the orginal plantar fascia release which can cause weight transfer to the the outside of your foot. This is fairly common and needs to be treated. Some of the treatments are orthosis, physical therapy, local steriod injection, taping. What has your surgeon told you about the side effects of pf release it appears you have one
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?dixie on 7/10/05 at 20:41 (178150)
Hey Dr. Z.
My dr. told me of several side effects, including a possibility of a fallen arch.
I felt that the syndrome that you described is what I had, but before the surgery,
I was playing soccer again, somehow went up on my toes, next thing I knew, I was on the ground. Took a very hard fall without anyone tripping me up or bumping me, just out of the blue, I was on the ground! The ankle totally went out. I've had some near falls coming down stairs or bleachers. The ankle wants to roll outward at these times. Even walking across the yard feels very unstable. Would the syndrome you described be a cause to all this?
I asked the dr. if pf made your ankles weak. He said no. I did not persue the question, because I did not want to 'go looking for trouble.' Was hoping that everything would heal quickly.
I've noticed some lateral snapping on the outer part of my ankle. This sort of worries me.
Please tell me that the cuboid syndrome could cause this. I don't want to deal with another problem. :-)
Thanks for your time!
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?Robert J. Sanfilippo, DC, CCSP, ART on 7/10/05 at 21:32 (178151)
Hi Dixie and Dr. Z,
I was wondering if I could chyme in for a moment. Dixie, you said you 'rolled' your ankle so I assuming you had an inversion ankle sprain? If you did roll your ankle, you would more than likely damage the anterior talofibular ligament which is the ligament that gets damaged with an inversion ankle sprain. If you did damage this ligament you could very easily have instability when weightbearing. If you combine that with your surgery you will have multiple instabilities of the foot. So with this surgery, the biomechanics of the foot have changed along with the function of the soft tissues (ligaments, tendons, muscles). I agree with Dr. Z that the calcaneocuboid articulation could be under alot of mechanical stress. I'd throw in with his treatments that the articulation be assessed and mobilized if needed. I'd also assess the soft tissues in the area such as the peroneal tendons and the retinaculum that overlies those tendons. Good luck to you.
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?Dr. Z on 7/10/05 at 23:09 (178154)
Get an MRI
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?dixie on 7/11/05 at 10:34 (178163)
Thanks for all the advice. I go for a follow-up soon, so I will hopefully find out what this is.
Dr. Rob, you said 'mobilize' the foot. What does that mean? I know immobilze means casting or splints, right? (Been there and done that twice). After I noticed the snapping on the side of the ankle, I was certain that casting would take care of it. I was in a cast for 8 wks. and then again 4 weeks after surgery. Still having the pain in the side of my foot just behind and below the ankle bone/also at the cuboid bone with painful snapping on the outer side of ankle.
Thanks for the advice! Maybe the doc. will order an MRI, and then we will be able to see for sure.
The ortho. practice that I go to is very conservative in their ways, which I like, but I guess when you are dealing with issuses, one tends to get a little anxious.
Thank you for your time.
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?april l on 7/11/05 at 10:52 (178164)
Dixie, reading your description of your ankle pain and pain on the outside of your foot, it sounds like what I went through when I had PF. In fact, the pain on the outside edge of my heel is was brought me to a podiatrist, who dx'd me with pf. I had surgery, and that pain on my side and ankle did not go away until I started walking properly. My doctor said the reason for the pain there was because I was walking incorrectly to avoid the heel spur pain on the bottom of my foot. I think I turned my ankle in or out with every step. After surgery, it was still there because I got so used to walking that way. Once I healed (over a year), I began walking normally and the pain eventually went away. This might not relate to your foot situation, but I do remember the pain on my ankle, especially right below the bony part on the outside.
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?dixie on 7/11/05 at 18:36 (178201)
Did you feel the tendon by your ankle snap across the ankle before or after your surgery?
I know I am walking all wrong, still am even after the surgery. My ankle now bows outwardly from walking on the side of my foot for so long.
I was wondering if walking on the side of my foot for maybe over two years, would cause
the peroneal tendon to stretch, so that it does this, or it was from the inversion sprain?
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?april l on 7/11/05 at 20:11 (178209)
I didn't feel any tendon snap across my ankle. I did hear snapping at times though.
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?Liboralis on 7/12/05 at 20:07 (178266)
If it is over or around your lateral ankle bone it can be a peroneal. It can do a number of things like split or snap over your ankle bone like a chain jumping off the sprocket on a buke. Basically what controls it as it travels around your ankle becomes compromised. The middle of your foot could also be pain at the base of your 5th met. That is the bump that sticks out on the outside of your foot, half way between your little toe and heel.
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?dixie on 7/12/05 at 22:11 (178280)
Sounds like you have experienced this kind of injury.
The middle of my foot does hurt, just inside the arch area and where I feel most pain IS at the that little bone half way between the little toe and heel. Also it hurts at the lateral base of my foot, just behind the ankle bone. This bony area is pretty swollen later on in the day/night. Just want to get all this taken care of. Been dealing with a sore foot for so long.
I just think that having both pf and a torn peroneal tendon is so unlikely, but symptoms point to this. I wonder if there is anything like this in the medical books?
Re: Is it possible to have pf with a torn peroneal tendon and not realize it?Liboralis on 7/12/05 at 22:18 (178281)
Yes peroneal splits or other injries are common but many times get missed. Sometimes a higher arch can cause one to bear more wt on the lateral border. Other times an injury or pain can cause you to invert or bear more wt on the outside to make it less painful. Problem is the foot cant take longterm load on the lat border so you can do a number of things to it.
What area are you in?