Peroneal Tendonitis/Tendon Subluxation?

My surgery is scheduled for Friday. Retinaculum repair with fibular groove deepening. I’m trying to figure out how much time to take off work. Fortunately I am able to work remotely, but when I’m working I’m expected to have some time every day in zoom meetings and I’m not really sure what to expect for pain and energy levels post op. I know everyone’s recover is different but does anyone remember how long it took them to be able to work remotely post op? So far I took off Friday and Monday but not sure if I’m being too optimistic 

I had my retinaculum repaired and parts of the peroneal tendon muscle belly removed but did not have the groove deepened. Post op I was in a soft boot and after a week of rest I was back in the office on a knee scooter. The nerve block wears off after the first day and you'll definitely want to take your pain killers for the next couple days. The first 2 days I was mostly either laying in bed or on the couch and keeping my foot elevated to prevent the swelling from getting bad but towards the end of the first week I was feeling pretty normal with minimal pain. I think with the groove deepening your recovery will be a little longer and you might have more pain. I would recommend taking at least a week of rest.

Hey all. Curious if anyone else had trouble wearing their climbing shoes after coming back from the surgery. I had my surgery back in September and in a lot of ways things are mostly better. I’ve been working on running and jumping and stopped wearing my ankle brace while climbing with no issues. Oddly one of the few things that still causes significant pain, is putting on my normal climbing shoes (scarpa instincts). These shoes are normally so comfortable for me but now it is too painful to even keep on and climbing in them is not an option at all. Basically nothing else I’ve been doing hurts my ankle, but this causes a ton of pain and tightness on the outside of my ankle. Fortunately I have no issues in an oversized rental shoe so I’ll continue with this.

did others have the same issue and eventually it went away or do I need to give up on this shoe, which would make me pretty sad. 

I did initially have issues wearing down turned shoes so for the first year post op I pretty much exclusively climbed in TC pros. Over time with PT and stretching it did go away.

Thanks for the response Steven. Wow a year is a lot longer than I was expecting. Good to hear you eventually got better. Were you doing PT for a whole year? Mine seem to want me to be done in about a month.

As for stretching, I’ve been doing a lot of Dorsiflexion stretches both with the knee bent and straight but they don’t have me doing any stretches into supination which seems to be what’s making the shoes uncomfortable. Are there any specific stretches that helped most?

Well I think part of it was that I got really comfortable being in TCs and started climbing everything in them and just never bothered to wear anything else. As for formal physical therapy I did it for 2-3 months until my physical therapist was comfortable releasing me. At that point though you aren't 100% fully healed, it's more like you are just recovered enough to do physical activity. My surgeon told me that it can take up to a full year for full recovery and I did feel like this was the case because I actually couldn't balance on 1 foot until the 1 year mark. After I stopped going to physical therapy I started running, biking, climbing, and staying active so I was still using my ankle and stressing it.

It could be useful to bring your climbing shoes to PT and work with your physical therapist if you have certain mobility goals. There's also a good chance that you'll never gain full mobility back. Unfortunately that's just what happens when tendons gets torn. I can't crack jam with my injured foot that well. Sometimes when I'm balancing on my injured foot my peroneal tendon will snap out of the groove slightly and I lose balance. So maybe overall, my injured foot is 95% as good as my other ankle and I've accepted that it'll likely be like this for the rest of my life. But YMMV, keep using that ankle and work through the pain, it'll get better!

Adding to this since it’s the most comprehensive thread I’ve found on this injury. Mines very simple compared to others, I only tore my peroneal retinaculum in the climbing gym when I locked my left foot between a hold and volume did a drop knee and reached for a hold on my left, overdid it and heard/saw a pop in my ankle. Came off the wall and tried to weight it and collapsed because of pain from subluxation. Googled it and thought straight away I’ve torn my PR. Did an X-ray initially to rule out fracture, then MRI which showed strong suspicion of retinaculum tear, which GP suggested I do a dynamic ultrasound to test for subluxation. During dynamic ultrasound they couldn’t replicate the subluxation but it showed tear right through the middle of PR. Note very painful subluxation has been occurring since injury even in moon boot at least once a day. Was referred to Orthopaedic surgeon who specialises in foot and ankle yesterday who looked at MRI and ultrasound and straight away knew what it was and recommended I do the surgery to deepen bone groove and reattach PR. When I do the surgery this Tuesday it will be 2 weeks since injury. My other issue is I get married in 6 weeks and don’t wanna be in a moon boot. He said if I do surgery now there will be less down time, I’ll be in cast for 2 weeks and moon boot for 3 weeks and will be able to walk down the aisle without moon boot for wedding. Everyone’s timeframe here is so varied. Does this recovery time sound reasonable? Any tips to help me get through this would be great. Hoping to be climbing by the end of this year. 

I’ve recently blown out my SPR. Surgery seems. Eminent. Getting an MRI on tuesday. will report back. 

E Cwrote:

Adding to this since it’s the most comprehensive thread I’ve found on this injury. Mines very simple compared to others, I only tore my peroneal retinaculum in the climbing gym when I locked my left foot between a hold and volume did a drop knee and reached for a hold on my left, overdid it and heard/saw a pop in my ankle. Came off the wall and tried to weight it and collapsed because of pain from subluxation. Googled it and thought straight away I’ve torn my PR. Did an X-ray initially to rule out fracture, then MRI which showed strong suspicion of retinaculum tear, which GP suggested I do a dynamic ultrasound to test for subluxation. During dynamic ultrasound they couldn’t replicate the subluxation but it showed tear right through the middle of PR. Note very painful subluxation has been occurring since injury even in moon boot at least once a day. Was referred to Orthopaedic surgeon who specialises in foot and ankle yesterday who looked at MRI and ultrasound and straight away knew what it was and recommended I do the surgery to deepen bone groove and reattach PR. When I do the surgery this Tuesday it will be 2 weeks since injury. My other issue is I get married in 6 weeks and don’t wanna be in a moon boot. He said if I do surgery now there will be less down time, I’ll be in cast for 2 weeks and moon boot for 3 weeks and will be able to walk down the aisle without moon boot for wedding. Everyone’s timeframe here is so varied. Does this recovery time sound reasonable? Any tips to help me get through this would be great. Hoping to be climbing by the end of this year. 

At least from my experience this past year, that seems quite optimistic to be walking out of the boot by your wedding unless the doctor means on crutches or with a cane. I had the surgery done in September and although I do feel fully recovered, the first 2 months went way slower than I expected. I think I was non weight bearing 6 weeks then weight bearing in a boot for another few weeks after that. And at each transition (from no weight to in boot and then boot to no boot) i wasn’t able to just take the next step day 1. My ankle had to relearn how to walk and it was pretty painful. Around month 3 and 4 is where recovery went from slow and frustrating to exponential improvement. I started climbing again for real around month 4/5 but had been doing a ton of training the whole time leading up to that. Started climbing outside easy stuff around month 5 and month 7 I did a red rocks trip and was able to send a bunch of stuff at a level pretty close to my max.

one other thing I’d note is that if you haven’t had a surgery like this before, you may learn your body reacts to it in unexpected ways. I couldn’t sleep the first 6 weeks and wound up having stomach issues. I went back to work quickly and regretted it because I just didn’t realize how worn down physically and mentally id be for the first few weeks. I’m no doctor so don’t take medically advice from me but there is no way I would have been able to enjoy my wedding at week 6. I’d maybe consider pushing the surgery off until afterwards if you can as the surgery was much worse than the actual injury for me. Despite not being able to walk without sublixation, I limped around right up until my surgery because it’s not like I was going to make it worse

TLDR: first 2 month went way worse than I expected. Things went way better than I expected starting around month 3.5

E Cwrote:

Adding to this since it’s the most comprehensive thread I’ve found on this injury. Mines very simple compared to others, I only tore my peroneal retinaculum in the climbing gym when I locked my left foot between a hold and volume did a drop knee and reached for a hold on my left, overdid it and heard/saw a pop in my ankle. Came off the wall and tried to weight it and collapsed because of pain from subluxation. Googled it and thought straight away I’ve torn my PR. Did an X-ray initially to rule out fracture, then MRI which showed strong suspicion of retinaculum tear, which GP suggested I do a dynamic ultrasound to test for subluxation. During dynamic ultrasound they couldn’t replicate the subluxation but it showed tear right through the middle of PR. Note very painful subluxation has been occurring since injury even in moon boot at least once a day. Was referred to Orthopaedic surgeon who specialises in foot and ankle yesterday who looked at MRI and ultrasound and straight away knew what it was and recommended I do the surgery to deepen bone groove and reattach PR. When I do the surgery this Tuesday it will be 2 weeks since injury. My other issue is I get married in 6 weeks and don’t wanna be in a moon boot. He said if I do surgery now there will be less down time, I’ll be in cast for 2 weeks and moon boot for 3 weeks and will be able to walk down the aisle without moon boot for wedding. Everyone’s timeframe here is so varied. Does this recovery time sound reasonable? Any tips to help me get through this would be great. Hoping to be climbing by the end of this year. 

I was in a splint for 2 weeks and air boot (assume that is the same as moon boot) for 4 weeks. Is he shortening the time in the boot in order to help you to be able to not use it for the wedding? I think that sounds reasonable. You could always use a lace-up brace (that would not be visible to guests) for extra stability. 

But I do also agree with the other recent comment that postop issues are a little unpredictable. My gait being off prior to surgery caused sciatica which then resolved when I was non weight bearing and returned once I was in the boot. I had trouble sleeping due to this and ankle pain and sometimes would use the boot at night to stabilize it after being cleared to not use it regularly. Good luck! 

I'm having SPR reconstruction this Tuesday. Doc said no exercise (like floor mobility, or push ups) for 2 weeks post surgery. Will report back. 

Thanks for everyone's response. I had the surgery exactly 2 weeks ago and the first 3 days were extremely painful, Chummer, I suggest you take all the strong pain killers they give you, I was stupid and tried to ration them thinking the pain would last longer and I wouldn't have enough - Goodluck with surgery and recovery! Also, I don't think I could've put off surgery, even stretching my legs/ankle laying down I would subluxate the tendon and it was extremely painful for me. I actaully did it again just before changing into my hospital gown before surgery and collapsed on the floor with the nurse next to me - which kinda cemented my decision even more. The pain from subluxation was so bad it would last for 30 mins + after. All of these incidents happened while I was in a moonboot/cam boot. So for me I think surgery was the right decision even though I was nervous and never had surgery before. The pain after the first 3 days was way more tolerable for me. Tomorrow I will get the backslab cast removed and be put in a moon boot for 3 weeks - Kaeli C he may have shortened the time because he knows my wedding is coming up but I never asked him what the usual timeframe is. He also mentioned because I was active and not overweight etc, recovery would not be as complicated as overweight, diabetic etc. patients. The surgeon just told me its better to do surgery now and be on the mend instead of waiting for 6 weeks in a moon boot until my wedding, and hoping for conservative therapy to improve it (which he highly doubted because it kept subluxating), then just for me to do surgery later and go through recovery time again, essentially increasing the overall time for recovery. 

1 week post op. First week is kinda grim. Constipation. Extreme pain at the surgery site. Difficult to sleep. The nerve block was extremely “unnerving”. ha. Seriously tho I had a panic attack cuz I still couldn’t feel my foot in the middle of the night. I had an overwhelming urge to rip off the splint and massage my toes. Never had anxiety like that before. Fun. Calmed down and the block finally wore off about 30hrs after surgery. Then the pain kicks in  

Basically been couch bound the entire time with foot elevated. Day 6 and Pain has improved but very slowly. Still hurts a ton when i stand and blood goes to the site. Opioids do nothing for my pain. Just make me sleepy and constipated. Gave up on them after 2 days. Can't even enjoy drugs anymore. Sigh. Aging is fun. 

Seems like it will be another week of all day elevation for the foot. Managed to do some basic floor exercises so I don’t completely unravel. Band stuff. knee push ups. Iso core, etc. 

Seeing the doc today. Hopefully all is ok under the bandages. edit: it is. nice. 

BTW DONT get this injury. It sux.  

4 Weeks Post op.

I was put in a cast after 2 weeks in a splint. It was extremely uncomfortable for the first night but I settled into it ok. I recommend getting a cast scratcher. I also switched to a peg leg/IWALK instead of using the crutches. Sleeping was one of the main challenges. I spent those 2 weeks with my foot elevated most of the day. By the 3rd week most of the major swelling finally subsided. Fortunately for me I've been able to avoid working during this recovery time but if I had to work it would have been a major problem. 

The cast comes off tomorrow and I'm guessing I will still be NWB for a while as ROM returns to the ankle. 

If I had to do over I would have purchased a really beefy and comfortable wheeled walker to get out and cart around the neighborhood. 

6 Weeks Post op

Weeks 4-6 were spent in a boot slowly adding weight bearing to the recovery. I started with a 1/2 mile or so at 25% or so BW. By the end of the 2nd week I was more like 75-85% BW with 2 miles at most. Not all at once. Only a 1/2 mile or so at a time. Sleeping was a pain in the ass with the boot. And my wound site was aggravated and slow to fully heal. Now starting week 7and still in a boot but I'm off crutches and using a cane with FWB. The ankle is super tight and has very little ROM. PT starts soon but I'm also having a surgery for a neuroma soon so it will likely slow down the SPR PT. 

8 weeks post op  

Slowly progressed to near full weight with a cane and running shoes by the end of week 8. Ankle still very stiff and swollen in the AM. Light ROM and mobility exercises. Seems like a pretty typical recovery timeline. Not ahead or behind schedule. Scar tight and a bit sore. 

10 weeks post op

I had surgery on my opposite (right) foot for morton's neuroma last week. My left Ankle was at around 9 weeks post op and it was just barely strong enough to deal with taking more of a load after the other surgery. Now at 10 weeks the ankle is doing quite a bit better. ROM is slowly improving and the ankle has gained a bit more strength and endurance. It is nowhere near healed of course but its come a long way. It would likely be doing even better minus the MN surgery but it is what it is. I'm hoping to begin strengthening exercises in a few more weeks when the right foot has come back online and I can walk without pain. 

14 weeks post op

Walking fine. Strength 3x a week and riding the bike. Soft pedal. Ankle still tight and quite weak. Hopefully climbing by December.