Subluxing Peroneal Tendon (tendon coming up on the ankle bone from behind)

[neufox47]

Was diagnosed with this last week. I was prescribed a walking boot for 6 weeks, and told there is a 50/50 chance of it working and healing the retinaculum that is allowing the tendon to move. I told my doc that I was going to keep skiing and he advised against it but thought that the ski boot would do a pretty good job of immobilizing the ankle. I'm now heating my boot shells to the point that they are floppy then putting it on to avoid having to dorsiflex my ankle at all. Anyone had this injury before? Did the walking boot help? Most really active people I find who have talked about this say that it comes back even after wearing the walking boot.

[adrenalated]

Yes, I have had that injury.

I went through the walking boot thing - but with a 6mo recovery process incl PT, etc. to return to full activity. Reinjured it in less than 2mo. Had surgery the second time and went through another 6mo recovery, now it's stronger than the other ankle. I was told it was a 75% chance of healing without surgery; in retrospect, I wish I had just done the surgery right away. Having a good PT was KEY.

It sucked. Hope yours heals faster!

Skiing seems like a bad idea unless you don't want it to heal, IMO - but I'm not a doctor, I just play one on the internet.

[Orthoski]

If you had an injury and subsequently began dislocating your peroneal tendons (aka, traumatic dislocation), I'd recommend casting for six weeks. The fibrous sheath that holds the peroneal tendons in place tore, so you can imagine that even if the tendons stay located 99% of the time in a boot, that one time they flick forward again it ruins all the healing that may have happened. Agree that there's a good chance this won't work, but I always recommend trying non-operative management first.

Best of luck to you!

[Andrew31]

have this one tried non operative but didn't work. actualy mine is not a big problem in daily life until i start any kind of sports. so im just taping it if im up for any kind for activity.

[axebiker]

have this one tried non operative but didn't work. actualy mine is not a big problem in daily life until i start any kind of sports. so im just taping it if im up for any kind for activity.

Not a long-term solution, however. If it won't rehab, get it fixed. You won't get any younger, and it won't get any cheaper. I was rehab successful once, re-injured, and then unsuccessful. Tried "just living with it", but it has degraded, and especially while skiing. I really don't want to rupture the tendon either.

Surgery in a week for me.

[Bunion 2020]

11 weeks post op now.

Strength in the ankle is good and getting better. ROM also getting better.

As I told a friend who just had ACL work done. PT, that shit really works!

[Andrew31]

Not a long-term solution, however. If it won't rehab, get it fixed. You won't get any younger, and it won't get any cheaper. I was rehab successful once, re-injured, and then unsuccessful. Tried "just living with it", but it has degraded, and especially while skiing. I really don't want to rupture the tendon either.

Surgery in a week for me.

it's nice when you can have surgery but there is no surgeon in my country who can do this specific operation, actually in my town there was 0 operations for subloxation. an we have 1 doc who can perform but there is no guarantees because he haven't done this type of operations yet. so i don't want to be first one so they just could experiment on me. (yeh it can be pain in ass to be living in shit hole called ester europe) but my groove under bone kind deep so for past month i had barely any subloxations and if i have it's mostly without pain.

anyway good luck with your surgery

[powpig]

I popped mine for the first time 10 years ago while skiing. Hurt like hell and I had to cancel a heli trip to AK. I mostly stayed off it for the rest of the season but when I did test it out a couple times in a ski boot, it was sore. I eventually went to a doc who recomended surgery but I never got it. A few times a year it'll pop/move around, usually when in ski boots and my feet are cold, just standing around and wiggling/scrunching my toes to warm 'em up. The first few times this ever happened it hurt like the first time, now when it happens I barely notice. I don't really have any instabilty issues or experience this any other time, for me the problem is not really a problem. No telling what it would be like if I'd had surgery but from where I'm at now, I'm glad I never did.

[Orthoski]

I popped mine for the first time 10 years ago while skiing. Hurt like hell and I had to cancel a heli trip to AK. I mostly stayed off it for the rest of the season but when I did test it out a couple times in a ski boot, it was sore. I eventually went to a doc who recomended surgery but I never got it. A few times a year it'll pop/move around, usually when in ski boots and my feet are cold, just standing around and wiggling/scrunching my toes to warm 'em up. The first few times this ever happened it hurt like the first time, now when it happens I barely notice. I don't really have any instabilty issues or experience this any other time, for me the problem is not really a problem. No telling what it would be like if I'd had surgery but from where I'm at now, I'm glad I never did.

It's one thing to attempt nonoperative management IF the peroneal tendon relocates reliably and you cast someone for six weeks - still has a 50% failure rate. I worry about people living with a tendon that constant dislocates because that will likely lead to long term tearing, etc. Glad you had such a good result and it goes to show that there are few absolutes in medicine, but most surgeons would consider that a failure of nonoperative management and worry about leaving someone that way. Underscores that any surgery requires a real conversation with your surgeon about goals, expectations, risks, etc. Best of luck to all you of you!

[axebiker]

2 days post-op. Had a tough night last night, but I'll dose up before I go to sleep this time. Surprisingly though, I'm not as sore as I would have expected. I'm actually a little concerned about the shortage of discomfort to a small degree.

Anyway, I was out for about 3 hours. I really had no idea the procedure would take that long. I ended up having a block on the sciatic nerve, right in my upper calf. That finally wore off last night, which is probably why I wasn't into my pain mgmt yet - I hadn't felt anything due to the block.

So, I'm in a splint for two weeks, no weight, then a boot for 2 weeks, no weight, and finally the boot for 4 more weeks, light weight. Then PT. it'll be a long road, but hopefully worth the pain, expense, and inconvenience.

[Bunion 2020]

As I have written elsewhere, that PT shit really does work. As long as you work at it too.

Every week my ankle feels better and gets stronger. 13 weeks post op now. The only freaky thing is the remaining swelling. I am told that is normal and some day both feet will again be the same size.

Good luck Axe.

[dcpnz]

Had surgery to fix this ~25 years ago. Lasted about 6 months before reinjuring. Been living with it since. Have some instability and discomfort but not bad. When it pops out I can generally pop it back easy enough (tricky in a ski boot). Presumably on the road to a full tear but don't plan on re-re-fixing it any time soon.

Biggest issue is how ankle injury affects entire body, ie.it changed how I flex that ankle, ankle is less stable, changed how i walk, that calf is much smaller than other, that knee hurts more and is less stable etc

Be surprised if PT could ever truly fix this issue, sure it can help but if/when it pops once you've just ruined months of PT.

Recommend getting it surgically repaired and hope for better long term outcome than I got.

[axebiker]

UPDATE cut & paste:

Well, I'm coming up on 3 months post-op now. Started PT last week after finally ditching the boot. First thing I did - bike ride! Next - stand up paddling. I'm feeling very good. I can feel the weakness, but...my therapist is hot, so I'll be going! Stability feels good, and the only thing I notice right now is somewhat limited range of motion, along with some general fear of not "over-doing it".

If things progress as well as they have so far, I should be back on Tele next season! That's a life-saver in MN...

Add: The pain was initially a bit rough, and the incision site was SUPER touchy. It felt like the blister you get when wearing new shoes that need breaking in...except over about 6 inches. All things considered, I was more confident of this than when I rehab'd the injury 5 years ago. As far as additional stuff -- biking will be a good part of my recovery. I'm grateful for that. I can't really do any serious off-road, but just getting back in the saddle may just save my marriage. It's hard not doing SHIT for 3 months. Gained 10 pounds too. Sitting on your ass and drinking doesn't help I guess.

I'm figuring on about 2 months of PT if all goes well. Things are good and getting better. Pain is virtually non-existent, and little to no swelling at this point. I can feel scar tissue that will need to be broken up under the incision, but I'll hire a hooker for that.

[Harry]

Heel up axe, in 6 months you will be out here skiing in Big Sky. FKNA !