Peroneal Tendonitis/Tendon Subluxation?

Sprained my ankle last year in May, and have had issues with a pain in my foot/ankle since. I've been to two different podiatrists and they both say it is peroneal tendonitis. I don't think I have any subluxation.

It seems to be a cycle. I feel better so I go out and push it, only to further aggravate the tendons. A couple of weeks ago it flared up pretty bad after a weekend of climbing, and now I am on anti-inflammatory medication and wearing an ankle brace. The doc does not think I have any ruptures in the tendon, only some minor tearing. He thinks after a few weeks of the medication and wearing the brace I can then start strengthening, but will not need surgery.

Anyone had luck treating peroneal tendonitis without surgery?

Thanks a lot Sara!

Glad to hear you fully recovered and Great sharing! Nice pictures too =)

So the whole bill for the surgery is like 14+8+2.5K? which is about 23K in totally?

@Ashort: from what I heard and researched, there is about 50/50 chances the tendons will heal themselves, so surgery is the solution.

I went to my PCP yesterday, I was being told that it was a minor thing after ankle sprain, and the so call subluxation (she mentioned that the term is too serious for my case) may be caused by ankle instability or I didn't use much my left ankle after it sprain for 1.5 years. She mentioned that she doesnt even think I need to do surgery, nor MRI but simply go for PT to strengthen my ankle... she did check a bit my ankle by asking me to push turn left and right, up and down towards her hand... also see if I feel any pain. I havent felt any pain after I "recovered" back in 1.5 years ago.

I was being told that if I got anything torn in my ankle (such as SPR, or retinaculum), or the perondeal tendon subluxation, I would have been really painful and no way I can walk easily. I am really confused now as what the hell is the thing that moves nearby my Fibula if not Peroneal Tendon(s)?! Superior/Inferior Peroneal Retinaculum? any other muscles or scar tissues that I don't know???

Sigh... hope I can get a better answer from a specialist or surgeon... I guess no matter what I should better check MRI or another x-ray and Ultrasound..

Dave N wrote:I went to my PCP yesterday, I was being told that it was a minor thing after ankle sprain, and the so call subluxation (she mentioned that the term is too serious for my case) may be caused by ankle instability or I didn't use much my left ankle after it sprain for 1.5 years. She mentioned that she doesnt even think I need to do surgery, nor MRI but simply go for PT to strengthen my ankle... she did check a bit my ankle by asking me to push turn left and right, up and down towards her hand... also see if I feel any pain. I havent felt any pain after I "recovered" back in 1.5 years ago. I was being told that if I got anything torn in my ankle (such as SPR, or retinaculum), or the perondeal tendon subluxation, I would have been really painful and no way I can walk easily. I am really confused now as what the hell is the thing that moves nearby my Fibula if not Peroneal Tendon(s)?! Superior/Inferior Peroneal Retinaculum? any other muscles or scar tissues that I don't know??? Sigh... hope I can get a better answer from a specialist or surgeon... I guess no matter what I should better check MRI or another x-ray and Ultrasound..

If its still popping the retinaculum is most likely town. Mine stopped hurting after a few days and I didn't even know I had torn anything. The best way to observe is dynamic ultrasound, not MRI. I could walk around fine 4-5 days after but it would still pop in weird positions. It won't likely heal on its own or with PT

redlude97,

Agree. Will wait for the referral letters and hopefully the foot specialist can check everything.

For MRI I think it can see many other things just in case.

Just saw a podiagist few days ago referred by my PCP. He suggested me not to go for surgery if I don't feel any pain. He said it is not 100% fix. Quite stressful as I felt my ankle is so weak. :(

Will make another appoint w an orth dr later on.

I had a follow up with the doc this week. The pain has pretty much gone away. Wearing a brace, taking anti-inflammatory, and not doing any hiking or climbing probably helped. The doc estimates that I should be hiking and climbing in 4-6 weeks. That really depends on me keeping up with stretching and strengthening exercises. I've been through this before, so I know not to jump back in too soon. In the past the pain went away so I just started climbing again. This time I will wait until i get more strength.

Overall I think that my injury is less severe than a lot of others in this thread. I have no subluxation in the tendon, just tendinitis and inflammation. Still, sucks to be injured during prime climbing season.

there's really not much you can do when you get tendonitis in the perineum area.

JSH: Glad that you are pain free =) Wish you Speed Recovery.

climbing friend,

Good news, may you soon be crushing of the climbing rocks.

yes climbing friend,

do not take it out to fast. The climber of female type would not like this.

Awesome photos Jim!

I'm now 3+ years out from the surgery. Still climbing and hiking as hard as ever. The peripheral nerve damage hasn't healed and I'm still numb but it doesn't bother me too much. The peroneal tendon feels a bit "loose"... kinda feels like it would be easy to roll my ankle if I'm not careful. During hard scrambling (boulder-hopping or talus) I can feel the peroneal tendon and muscle strain... kind of disturbing. Not to be confused with perineal. Anyone have suggestions for specific exercises to strengthen and tighten that muscle?

Best of luck to everyone recovering from tendonitis and tendon surgery. It's great to hear that so many of you are still climbing after all of your experiences. I wanted to share some resources that I personally found helpful when dealing with my elbow issues:

Peroneal Tendonitis Recovery

General Tendonitis Info

Stretching

Hello all.
I found this post just before my surgery and it helped a lot with my decision making. I tore my retinaculum doing a high step, but I think it was weakened by a previous ankle injury already. I had the surgery 7 weeks ago where they deepened the groove, reattached the retinaculum and removed a small bone chip from the previous fracture. Tendons were in great shape and didn't need any repair, but the surgeon wrapped them in some kind of stem cell membrane (subject to approval by the insurance company ) that reduced the swelling dramatically. The ankle was no bigger after the surgery than before. I was 4 weeks in the cast, then transitioned into full weight bearing in a boot for another 2 weeks. Now I am walking in street shoes, but with considerable amount of pain. The foot and the entire lower leg are constantly sore and there is a lot of pain at the retinaculum area. I'm trying to stay positive, but I have no idea how much pain is normal at this stage. My surgeon still insists that this is part of the process and that I'll be at 95% 12 weeks after surgery and able to get back to climbing, hiking, skiing... I really want to believe that, but it feels so far now.
What were your guys' experiences in rehab? How much did it suck and for how long? I'm at the point where I wake up at least once a night and can't go back to sleep because of the discomfort. I thought this would be the time when it starts to feel better every day, but we're not there yet...

Yes, i have been in PT since the cast came off. I do have an ankle brace that is impossible to wear for longer than 2h because of pressure points and pain it creates itself. I plan to simply stay off uneven ground where it might be necessary until the foot improves to the point where it can tolerate the brace for longer period. My surgeon is fine with that approach.
Also, by "street shoes" I do mean comfortable tennis shoes.

I recall that right around week 7 was a turning point where the pain started to decrease and I made big improvements with walking. I definitely still had pain at 7 weeks though, so I wouldn't let that worry you too much. Physical therapy was also really painful still and I had lots of swelling. It's a long process. I think it was almost a year before I considered myself back to normal. You are through the worst of it though.

I have heard that the more bone-work is done (like deepening the groove), the more painful it is. Not sure if that'd be a factor at 7 weeks out though.

Oh, and my doctor had me go from the boot to walking without an ankle brace. It's pretty easy to be careful walking around at that stage because you're walking really slowly. I did use an ankle brace when I started climbing again.

Good luck!

Hey guys, I feel obligated to post my story/progress since this thread has been a good resource for me.

I dislocated my peroneal rock climbing about 2.5-3 months ago. I was bounced around between specialists for a bit, so by the time I found the right doctor it had been about 6 weeks of walking around with this. In that time I probably re-dislocated the tendon about 10 times. All were pretty painful and had that associated 'snap' sound.

Being a very active person and understanding the low success rate of the non-surgical route, I pushed him to go with surgery, but he was very pushy about saving this as a last resort. Instead I did a hard cast for 3 weeks with my foot angled slightly down and inward to relax the tendon in the groove. After the 3 weeks I was put into a walking cast (aircast). I'm in this for 6 weeks and have a little over a week left.

The plan after the aircast is to switch to a sports brace and begin some light PT. I'm honestly not very confident in this working. I've heard the non-surgical route is about 50% success, but I don't think I've heard any success stories yet. I'm also a pretty aggressive skier, so I feel like I'm going to blow this thing out eventually, even if it seems to work for a bit.

I'll keep you guys updated. In the meantime, have any of you heard of people having success with the non-surgical route?

I have spent countless hours researching this issue before my surgery, and I have found no optimism regarding this getting better without surgery. Did you have an MRI? I had one done on my foot, and apparently it was very clear that the retinaculum was detached and needed to be repaired.
My decision to go with the surgery was easy. I had already been fighting this foot all summer long, so I didn't want to waste any more time rolling the dice.

joe henderson wrote:Hey guys, I feel obligated to post my story/progress since this thread has been a good resource for me. I dislocated my peroneal rock climbing about 2.5-3 months ago. I was bounced around between specialists for a bit, so by the time I found the right doctor it had been about 6 weeks of walking around with this. In that time I probably re-dislocated the tendon about 10 times. All were pretty painful and had that associated 'snap' sound. Being a very active person and understanding the low success rate of the non-surgical route, I pushed him to go with surgery, but he was very pushy about saving this as a last resort. Instead I did a hard cast for 3 weeks with my foot angled slightly down and inward to relax the tendon in the groove. After the 3 weeks I was put into a walking cast (aircast). I'm in this for 6 weeks and have a little over a week left. The plan after the aircast is to switch to a sports brace and begin some light PT. I'm honestly not very confident in this working. I've heard the non-surgical route is about 50% success, but I don't think I've heard any success stories yet. I'm also a pretty aggressive skier, so I feel like I'm going to blow this thing out eventually, even if it seems to work for a bit. I'll keep you guys updated. In the meantime, have any of you heard of people having success with the non-surgical route?

Get a second opinion and get surgery. If the retinaculum is torn there is no way to heal on its own. Skiing will only make it worse

I popped my retinaculum (shown on MRI) that hold the tendon behind that ankle bone. Went with air cast for 4 weeks before I was able to get appropriate diagnoses. Then my first doc thought I was young active and healthy enough that we had a shot with non surgical so I went 8 weeks in a boot. The problem was that the torn retinaculum had already done too much healing without being reconnected. I basically lost 8 weeks where I could have been doing the surgery and rehab. I know any surgery isn't great, but with this, I have to agree with everyone. Get the surgery, do the rehab, and get back to kicking ass!