Back to the Good Old Bad Days

Posted by on September 6, 2012 at 7:06 pm :: 2 Comments

Ever since I rolled my bad ankle while playing laser tag at my own birthday party two months ago (Boohoo!) the wellbeing of my peroneal tendons has been uncertain. A couple of doctor visits and an MRI later I now have a few things figured out but the fate of my foot is still a looming question mark. Here are all the gory details.

My First Doctor’s Visit:

Six weeks after my little misstep my ankle was still having issues. A normal sprain usually heals in 2-4 weeks so 6 weeks of persistent troubles didn’t seem regular. My slow recovery and the many eerie similarities between my current situation and my previous tendon tear experience convinced me that it was time to get a doctor’s opinion. My sports medicine specialist, unfortunately, didn’t have any concrete answers for me. He said that the prior damage to my ankle would definitely lengthen my recuperation from a sprain; 3 months of mending wouldn’t be unusual. But he also told me that once a tendon has been torn retears are common. When a tendon has been weakened it’s an easy target for more problems. So? The doc concluded that I may or may not have torn my tendon again. Hmm…not exactly the non-answer I was looking for. He said I could wait it out for another month to see what happens or I could get an MRI and find out exactly what is going on. I chose the MRI and the path of information.

My MRI Results:

The machine used for this MRI, though not as friendly to those fidgety in tight places, produced a much clearer image than the open design one that magnetically photographed my ankle last time. The radiologist reported that my peroneus brevis suffered from advanced tendinosis and my peroneus longus was healed in intervals. Additionally, he noted that there was quite a bit of fluid surrounding my peroneus brevis. I had no idea what all of this meant.

My brace is a longtime frienemy. I hate that it’s become a necessary part of my life again.

My Second Doctor’s Visit:

I made another visit to my doctor after my MRI to decode the results and figure out my next course of action. My doc was great; he spent over half an hour looking at MRI pictures with me and explained everything I was seeing. Thanks to his helpful conversion of medical talk into layman’s terms I think I understand my MRI details. Allow me to interpret for you.

Doc Speak: The peroneus longus is healed in intervals.

English Translation: Your peroneus longus looks better than it did before you had surgery. Your last MRI showed fluid buildup around it and that is no longer there. Go longus!

Doc Speak: The peroneus brevis tendon shows signs of advanced tendinosis.

English Translation: Unlike tendinitis, which is an acute short-term tendon flare-up, tendinosis is a lasting problem involving the tendon’s structure and it takes considerably longer to heal. This particular case of tendinosis is a result of your recent ankle injury and, by the way, you have an associated partial tear in your tendon but it’s not completely ruptured.

Doc Speak: There is fluid retention around the peroneus brevis.

English Translation: Fluid isn’t good. Fluid means your body is hurt and can’t figure out how to heal itself.

Ugh! As my comprehensive translation indicates, my peroneus brevis, the tendon that I had surgery on 4 years ago due to it being torn almost to the point of rupturing, is once again torn. Of all the ridiculous things! Tendon, did I offend you in a previous life or what?

My Course of Action:

According to my newest MRI, the tear in my peroneus brevis this time is worse than its previous one and this tendon is in poorer condition now then it was before my surgery. I find this assessment hard to believe because my tendon was so messed up last time that it was almost beyond repair. However, since the MRI machine I used the first time didn’t give a very sharp image that is hopefully the main reason for this grim report. I’m crossing my fingers.

Another ankle surgery is now a real possibility for me. The recovery from my last one took forever and almost drove me into the funny farm so I’d like to avoid a repeat of that near-insanity if possible. Is there any hope?

My ankle might heal on its own. It will probably take a couple more months for it to get its act together, given its current state, but it could repair itself. The fact that it has slowly been improving over time, instead of plateauing, is a positive indication. If its progress ever levels off that could mean that my body has done all that it can on its own. So far I’m still making headway, thankfully. The fluid surrounding my tendon is a bit of a downer though; it’s a bad sign. It means my body is having a hard time coping. But, even with the fluid, my doctor was optimistic that avoiding surgery may be possible. It all depends on how my foot is doing in about two months.

Until then I have been instructed to massage my ankle meanly to increase blood flow to the area and do strengthening exercises with the elastic band my physical therapist gave me the last time I rode this pony.

I’m wishing for a tendon miracle. (My tendon doesn’t have a very good track record in the miracle department.) I have an appointment scheduled with my surgeon at the end of November but I’m hoping that I’ll get to cancel it. The last thing my questionable stability needs is another trip onto the operating table. Physical activity is one of the few things that stands between me and iffy sanity. Take that away and I’ve got some real cuckoo potential. Tendon, please don’t make me go down the lazy road to crazy again.


  • Su says:

    Hi Rachel–

    I had very similar surgery to yours approx a year and half ago. I found your blog when I was researching my surgery and expected recovery.

    For those of us with peroneal tendon issues, my doc feels it is all about prevention and babying the thing if we want to avoid further surgery. I am also very active person, but I don’t hike without really sturdy boots and hiking poles, only wear good shoes with arch support, no running shoes without bracing, etc. I also always look down and very conscious of foot placement. It was a tough realization, but the surgery and recovery sucked so bad, I would do anything to avoid it again. Also, my doc explained that it could get to a point where repair may be incredibly difficult. He also implied to me that he expected to see me back at some point as these injuries do tend reoccur, especially in active people.

    Hang it here! Hopefully, with some babying of your ank, you can get the fluid and swelling down, and strengthen some surrounding soft tissue so that you can live with the partial rupture.

    Good luck!

  • Rachel says:

    Thanks Su for your kind response. I’ve been shelling out encouragement to my fellow tendon sufferers for years now and wasn’t expecting to be the one in need of consolation. But here I am again on the verge of starting over with the whole mess.

    I too have babied my ankle. That’s what makes my current predicament even more depressing. I used my brace for a full year after surgery as ordered by my doctor and I have been wearing my custom orthotics since then as I was instructed. But alas, even with all that carefulness it just took a single bad step and now I am back to square one.

    May you have better luck in the retear department and thanks again for taking the time to send some reassurance my way.

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