Daily Mobility Exercises by Dr. Kelly Starrett › Forums › General › Peroneal Tendon Dislocation advice

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    • 10/05/2013 at 3:52 pm #70510
      AvatarKent Zelle
      Participant

      After enough thought and diagnosis, a strange series of events have led me to believe that I have somehow managed to cause my peroneal tendons to become dislocated on my left ankle. I think I tore the attachment/sheath that holds them behind the bone and now they feel like thye are slipping or silding over the bone and then I have to contort my toes and ankle slightly to relieve the strange feeling and they slide back into place.

      I’ve taped and tried to immobilize but it’s still able to dislocate. I’m on nsaid and a muscle relaxer to help with the peroneal spasms. I’ve stopped all ball and massage work because it seems to make it worse. No painful popping or swelling. Just a small area of pain behind the ankle bone. I’m guessing this is the tear area.

      What now?  Am I doomed to have surgery? Can this heal on it’s own? Anyone else go through this?

    • 10/05/2013 at 10:08 pm #72916
      Avatar[email protected]
      Participant

      Hi Ali, 

      I was diagnosis with this condition after a grade 2 sprain playing soccer in April. I tired conservative treatment for three months. However the tendon would still dislocate. I wasn’t able to do any high impact physical activity with out it dislocating after the initial three months of treatment. I decided to get the surgery on August 20th, the surgeon deepened the fibular groove and repaired the retinaculum. The good thing is my tendon wasn’t torn which would’ve made my recovery a lot longer. As a side note, its important not to push it while you have this condition you run the risk of tearing the tendon thus making the condition worst. As far as the surgery is concerned, it was pretty straight forward. I was in a splint for three days, in a walking boot with crutches for two weeks to let the skin heal. After the two weeks I was walking without crutches. I started lifting and jugging two weeks ago, smashing the calf and voodoo flossing the ankle has been gotten most of my range of motion back, only slight stiffness on the incision. I also started practicing two weeks ago and the ankle feels great. This condition can be quite frustrating, if you can get the surgery, do it, it will save a lot of stress and anxiety over not being able to do what you like to do. I hope this helps if you have any question about my surgery and recovery feel free to ask. 
      Kristian. 
    • 10/06/2013 at 11:28 am #72917
      AvatarKent Zelle
      Participant

      Thanks for the reply Kristian. I’m unsure what to do and yes, dealing with the frustration of not knowing if it’s will heal on its own ofr not. I guess if ‘m not in pain then I can rest and see if I’m one of the few that can heal on my own. I didn’t acutally injure or sprain it so I assume my issue is a chronic breakdown from tight peroneals and something finally gave. My right foot is also really twingy and weird like the left was before it brokedown. Great. I guess I had this coming. I’ve found that once you think you know something or are mastering one areas, then you get hurt or bonk in another. The journey of fitness, huh? I sound like such a fatalist. LOL Now I’m wiser. Just to figure out the way through this now. ( I actually have this strange recollection of this happening to me as a kid- no pain but knobby tendons on this same leg. I think I fell of a horse or got stepped on. Can’t remember exactly.)

      Heat REALLY REALLY helps relieve all the tight knots and spasms. Thank God for heating pads and athletic tape. I haven’t iced. No swelling. No pain with normal, mild, low impact walking and unavoidable stairs. Just some funny spasms and tension. Today, I’m sitting on my ass and eating junk food in front of the TV all day though. For like 2 more days too. (ok, organic veggies and dip. I am TRYING to be lazy…)

      Really not looking forward to being off my feet- my job requires that I’m on my feet all day training dogs and the chores accompanying them. On a monthly rotation cycle, I’d be out of business for an entire cycle! Ouch to my pocketbook… or my ankle. Only time will tell. Maybe I can plan the surgery around a “quiet” time in life. Then go insane since I’d be trying to do- like, yoga or something to keep myself busy- with a boot on. I’m picturing this. Laughing already! How’d you keep yourself from going crazy!?

    • 10/16/2013 at 9:43 am #72998
      AvatarKent Zelle
      Participant

      Update: so it’s been 10 days and I’m happy to say that with ABSOLUTE REST! and no nsaids, taping to inhibit the peroneals and some dorsiflexion (very stiff ankles!), heat pads for two hours a day or more… (LOVE the relaxing heat- it loosened up my lower leg and foot) and some mild gentle yoga stretching of my hip capsules to keep my knees, hips and legs from getting tight from all that ankle stiffness…THEY ARE IMPROVING!

      I’m happy to report that I progressed through to removing the tape, gradually feeling the spasms and the dislocation reduce to a minimum.

       I’m not back to walking as exercise but I can walk about 1 mi to son’s bus stop and only feel my legs warm and not tighten. GOOD!

      I tried to gently roll out some trigger point areas on the lower legs (ouch!) and was successful in releasing alot of knots and gaining more ROM without irritation to the injured area. I marked the points with a Sharpie marker and am keeping an eye on which is getting tight again or not. Very interesting.

      I am working to strengthen my feet and adductors, inverters and internal rotators. This seems to be helping my feet or atleast not aggravating it too much. Yesterday was an increase in foot strengthers and I have a little bit of imflammation near the dislocation are today. Not pain, but I can move my toes around and feel the ropy feeling. Taking it easy. Feet and low legs feel better though.

      We’ll see if this sticks and I can maybe ride the bike or jog like 25 feet in a few weeks.

       

    • 05/13/2014 at 9:03 am #74648
      AvatarDan Thorpe
      Participant

      Any improvement on the injury??

    • 01/07/2015 at 8:01 pm #75631
      AvatarJOHN NICHOLS
      Participant

      Kristian, 

      Have you regained full ankle dorsiflexion since the time of your surgery?
    • 01/11/2015 at 9:23 pm #75645
      AvatarPeter Bagwell
      Participant

      I’m curious about this injury. If you had torn the attachment or sheath then is this an injury that would heal itself at all? And if it does…then would the active movement during the healing process mean that the tendon might be set in a less than ideal location?

      It sounds like things are on the mend. I hope it makes a full recovery for you!

    • 01/12/2015 at 11:38 am #75648
      AvatarKent Zelle
      Participant

      So it’s been over a year since I’ve suffered from this overuse injury to my peroneal tendons on both sides. What a crazy journey I wish to never repeat! If I have one word of advice for you… it’s to be patient, because it’s taken a long time but I’m getting back to not having my ankles interfere with my ability to exercise.

      What I’ve learned so far…
      This injury was not JUST an overuse injury, but an injury due to compensation. It seems that my peroneals were taking over because I did not have a strong inner thigh or properly functioning obliques. All the lateral stability that my core and inner thigh was supposed to offer was not there and so my peroneals were taking over to prevent my leg from rolling past midline by everting the foot. I has a bad issue of walking on the outside of my foot through my gait and I’m working to consciously step through the center line of my foot, using my breath and inner thigh to re-pattern. I also make sure I’m walking with my feet straight (look at the out edge of your foot, not the inner) and externally rotate the femur (i suffered from internal femur rotation, ugh!). 
      They still get sore from time to time but I am no longer running or cycling. Cycling I think was the link to causing the lateral stabilizers to weaken, then when I started running all hell broke loose since I was no longer strong and able to keep from rotating and use my core correctly. 
      I really NEEDED to exercise for my sanity to I went back to riding horses (yes, folks- its a sport! It aint easy.) Jumping, riding bareback, and doing strength work to ride in better form really got my core working and my inner thigh muscles turned back on!!! My psoas released and my lower back lengthened. My calves started to relax from the heels down position in the stirrup. My lats began to turn back on from the rein use and jump position. I was able to walk farther and jog farther (not for exercise but, literally, just across the barnyard without fearing that I would roll my ankle.)
      I also did Yoga dvds- jill miller Core integration, hips, shoulders. Pretty much all of her videos. foam rolling, all the mobility wod stuff for warming up and getting my joints to move in full range. I did this to unwind from riding and now to unwind for crossfit. And especially after road trips. I hate driving in that car! Katy Bowman’s boot and tips on making sure the femur is straight was helpful. I gave up sitting in chairs for like 4 months, unless I couldn’t help it.
      I also recently started Crossfit. (yay!) and that has been the real fix. Getting stronger, especially my core and being more aware of mobility and breathing has allowed me to fix what the peroneals were compensating for. I can now run for the warm ups, walk 3 miles without too much of a reminder (I can feel them burn and tighten, especially if I haven’t been aware of tying in my obliques or inner thigh when moving) I can squat ATG with no issues in my calves and keep my feet straight. I could NOT do this EVER before in my life. I can fold into a sitting position from a stand and get back up with no stability issues (sit from a stand and get back up without using your hands and stay stable and smooth- it’s not as easy as it sounds- atleast it wasnt for me!)
      I found that NO amount of rolling the lower leg helped, no amount of massage, trigger release, strengthening, etc, helped my peroneals. Taping helped them to have a break was helpful, but turning on and using properly, the muscles that werent carrying their load was the ultimate cure. Opening up the front of the hip, releasing the psoas, strengthening the lower abs, lengthening the lower back helped me to get a better pelvis alignment so my core, inner thigh could work correctly. I also stopped sleeping with a pillow to get my tspine to stop being forced into flexion. This helped my low back to lessen the curve from APT. 
      Also, no amount of liniments helped or meds. Anti-inflammatories did nothing. Methocarbomal (muscle relaxers) hardly did anything. Essential oil mixes like pan away or deep blue did help some. Serious rest, with NO ZERO NONE… no use is what healed them, but until I fixed what they were compensating for, they kept getting sore again. I took b vitamins, fish oil, d3, bcaa, k2-mk7, magnesium to help boost healing. I guess it helped.
      I can still dislocate the left one by moving my toes. I can feel it slip out of it’s groove and go back in. It stays in otherwise. I also have to pop that ankle sometimes or it feels strange. My right it much better. But that’s also my “gimpy leg” that does less work. Maybe a leg length issue or a hip alignment issue. No other issues that prove which. I think it’s a neuro or patterning issue that I’ll be addressing in CF, for sure.

      Going barefoot for the majority of my work or day time and then wearing/walking in minimalist zero drop shoes but WITH cushioning helped alot too. The difference in the cushioning made a huge difference in the pain I had to tolerate while healing. Altra, Innov8, Merrell have good cushioning choices that are still zero drop. VFF were too harsh for my ankles and feet while I healed. Now I can wear them easily.  
      BRAYDON: I partially tore the sheath on the left. It healed itself. I never had a doctor look at me- no insurance when this happened. I just did alot of research. I avoided surgery but if it’s fully torn, you may need surgery. Tape it and stabilize it laterally Taping the achilles also helped me. Keep those peroneals from getting tight and pushing on the sheath. 
      Hope this helps. Send e any q’s as I know there is not alot of info about this stuff out there. 🙂
    • 05/02/2015 at 2:20 am #75991
      AvatarBryn Waibel
      Participant

      Thank you for sharing your story. Your early symptoms are very similar to those what I am currently experiencing.

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