Peroneal tendon surgery recovery

Foot care
1

Hello, I really need help. I had surgery two weeks ago and it seems like it went well. I'm on a splint and surgeon is encouraging me to start using boot and trying to bear weight little by little. This is so dramatically different from last year where I had same surgery but with a different surgeon who was firm on NWB for 8 weeks and then slowly introduce boot.

New surgeon says that early weight bearing promotes faster healing and prevents the formation of scar tissue. Has anyone done it like this

Appreciate your comments,

 

2

No, I have never heard such a thing. I cannot imagine putting weight on it at this stage. I don't think I could stand to my foot to the floor at this stage. The tendons are still way too weak to support the weight. I am a small guy too and only weigh 140 lbs. I just started walking at 4 months and today is month 5. I still have pain and have to stop and get off of it when it starts to hurt. In fact, I wore the boot a few days last week and still use my cane quite a bit. Keep us posted on this works out for you. I have other foot to do but am going to have to wait awhile. My surgeon had some of my blood work come back with protein M-spikes. I had a bone marrow biopsy last week and am going to be battleing Multiple Myeloma. If its not one thing its another.

3

Sorry to hear; one issue at a time. Sending healing thoughts your way.

4

I'm at the same place as you 5 months and yes use cane and still in boot. Some days painful other days good. Good luck with your other health issues, that is a lot to deal with!!!

Margie

5

Hi, I hope your recovery is going well. I wish I had been able to weight bear as tolerated when I had mine repaired, but due to other things being repaired, no such luck.  Being at about 8 mos post op and having the difficulties I am currently having, scar tissue can cause a lot of problems on top of the regular post op swelling and such. It is my understanding that the ankle in general and peroneal tendon area have less blood flow or something, therefore they heal slower.

While I think it is fine to question this with your surgeon, perhaps his recommendation is due to the particular details of your repair or perhaps some new research suggests patients do better in the long run if they are able to weight bear sooner.

I do believe (someone part of my healthcare team also confirmed this) that earlier weight bearing promotes faster healing.

Fortunately the peroneal tendon fix part of my surgery wasn't as bad as we thought, however it has been the hardest to get strengthened and back to full painless functioning. I tore the tendon a few years ago and tried every conservative therapy before surgery, but I also had a second torn tendon and needed surgical repair for stability/high ankle spraing repair.

6

Thank you for your reply. In my particular case I believe I went "conservative treatment" for way longer than I should have. Everyone around me kept saying surgery should be your last option. Of course so, but delaying surgery for too long can be more damaging.

Sending healing thoughts your way.

7

Don't hesitate to ask your surgeon or nurse about his recommendation. It is your body and really you should let your surgeon know if you are uncomfortable with the instructions (otherwise he/she might assume everything is fine). There could also be some specific reason unique to your case that suggests some weight bearing early on may be beneficial.  

I think they forget, because this is what they see and do every day, that as patients we have an entirely different experience.

I did a ton of research online both before and after my surgery. For some repairs, there did seem to exist vast differences in recommended post op time periods for non weight bearing, or if it was required at all.  I am not sure if that was based on the particular surgeon's experience or if some are just more conservative or 'old school' versus others. I even ran across a more technical site that had brief summaries of cases and it would often conclude with a statement saying that certain periods of nonweightbearing or time in excess of (however many weeks) did not prove to affect the long term outcome.

If you are able to view your surgical report it might provide specific information regarding the repair. Were there some sutures placed to repair it or did part of it have to be removed? Was the tendon okay and surrounding structures keeping it in its groove or place peformed? Seeing the specific details of the procedure may also help shed some light on the recommendation to put some weight on it.

 

8

lisavila, I had  the same surgery 12 weeks ago! I now have scar tissue and this surgery is painful. I had my boot since I came out of surgery. My stitches was removed at 6 weeks and then I went to physical therapy for 6 weeks. I had made followup with Dr. and basically at therapy my tendons was being pulled and stretched. Now I have to wait till next follow up and then go for ultrasound. Back to surgery it is! Why did you have a 2nd surgery?

9

One year after first surgery I was still in pain and saw different doctor. He did a new MRI and it showed that there was more tears further down into the foot, and an ossicle was putting pressure on the foot. There was also a grat deal of scar tissue from previous surgery (possiby because I was NWB for way too long) I had second surgery 4 weeks ago. I'm already walking on my boot mostly mornings. I also have nerve damage on that foot which complicates my ordeal. 

Steph, why do you think you got scar tissue? What will be done this time to prevent that? 

10

Hello,

I saw this on google and want to just drop my opinion. I had the surgery in May of 2015 and was walking in the boot with a cane after 10 days on crutches. About 5 days later I did not use the cane anymore and was in the boot. After another two weeks I was no longer in the boot and was in a brace with a sneaker. I did range of motion exercises moving the foot up and down about 3 days after the surgery was complete and full PT after that.

I think a lot of the surgeries you guys had were using old methods. This is exactly why you have scar tissue buildup and have to have another operation. Let me know if you have any questions, but hey it worked great for me and two years later I am in exxcellent condition. Having it done on my left peroneal in a week!

11

I had my right ankle done about 7 years back with the full cast and super long heal times as described by others above. My tendons fused together and are scarred. Luckily, I'm still able to long distance hike and bike without major issue.

Just had left done two weeks ago, and was immediately put in a boot (different doc). I was doing range of motion next day, put weight on 10 days out, and began walking without crutches 12 days out. Today, (14 days out) I'm carrying my 4.5 mo old daughter around pain free in my boot smile

Granted, my issues weren't as bad as my first go around, but my doc did say that sans cast and getting to range of motion is critical to avoid scar tissue. He claims the procedure has evolved.

My best wishes to everyone's speedy recovery.

12

The Dr. told me I have scar tissue because of the pain I have. My ankle is really hurting when I walk and put weight on it!

13

Hello, I had 4 different surgeries at once on my ankle/foot 2 weeks ago. I go back to my surgeon Wednesday to remove my first cast/splint to be put into a walking boot or cast depending on my healing so far. I know they want me to start weight bearing on it then so the doctor wanting you to start weight bearing this soon is normal. Yes one of my surgeries was for peroneal tendon. Hope your feeling better.  I really can't wait to start walking again!! 

14

Hi Renee,

You had four surgeries on your foot at once, that's pretty major. I hope your healing is going great.

So, I've noticed many of us foot patients seem to opt in for more follow-up or remedial ankle surgeries (ligaments and tendons, etc.) Many of these invasive procedures may be necessary, or not, depending on individual circumstances.

We all seem to be in a hurry to get a quick fix to our problems, and surgery may sometimes seem a quicker and 'easier' solution rather than a lot of hard physiotherapy over a long period of time, or using less popular or less-proven techniques like PRP and prolotherapy, for example.

By all means listen to your doctor if you trust him or her when elective surgery comes up in discussion. But folks it is your body, so listen to your gut and if you are doubtful remember that you can always get a second opinion.

As you know, any surgery extends recovery time, and because it is invasive it may lead to complications. And there is no guarantee your foot will return to normal after the procedure.

You are always free to ask your health care provider if non-surgical interventions available for some cases.

Good luck to all of you struggling with your feet. Remember, the informed and aware patient will always do better in reclaiming health.

15

Hi I've been having a lot of problems with my right foot and ankle for over 3 years. I've tried everything before surgery to fix it but nothing worked. So when they were finally fixing my tendonitis in my ankle they also had an internal ankle brace in along with releasing my chronic plantar fasciitis. So unfortunately after years of pain I gave in and did the surgery.

I've been out of the splint and into a walking cast for 2 days now and I can walk without crutches and very little pain. It's been great

16

Quick reply here...

1 - The earlier you can begin movement, stretching and weight bearing, the better. The consensus among my healthcare providers confirms that my long nwb and splint, cast to boot period is a huge contributing factor to the issues I'm experiencing now thanks to the scar tissue.

2 - For lingering pain issues and scar tissue issues, look into physical therapists certified in the Graston technique (specially deals with scar tissue). My initial experience with it several years was unbelievable. Scar tissue around knee from a surgery 15 years prior was treated and knee issue resolved.

I decided to seek this treatment out again due to continuing problems 10 months post op (had to do this myself, don't rely on the surgeon or doctors office and don't go to one of the big or franchise therapy places. Look for small or private practice therapists where you will spend your entire session with the therapist).

After one visit, my first visit a couple days ago, the results have been remarkable. The Achilles tendon had a lot of scar tissue built up around it, a pocket of fluid in the peroneal tendon area was addressed, possible issues with that nerve being compressed were addressed, scar tissue on front of ankle and in foot addressed, etc. I am walking better and ankle and foot are starting to feel more normal again. A lot of natural movement of parts that should move was restored.

Can't wait to go back again next week. I FINALLY HAVE HOPE that I will be able to resume jogging and other activities (and wont be stuck wearing sneakers or unattractive orthopedic looking shoes forever). I might just get my life back!

3- if you are opting to pursue conservative treatment, by all means go ahead, but decide ahead of time what your time or money cap will be on it vs expected outcome. I spent about 7 years in conservative treatment mode and it sickens me to think of the thousands I put into it.

Furthermore, prolonging the ankle surgery only caused issues and damage to foot that could require another surgery. So stress fractures, dropped metatarsal, broken foot bones, neuromas, and increased ankle instability occurred. I hate to think about how so many of those things could have been prevented.

17

Agreed. Conservative measures can fix a lot but when you have totally torn tendons and ligaments etc it's not going to work.

I had my repair for my left foot three weeks ago after having my right done too. Had a brostrum done this time too. Started partial weight bearing at around 9-10 days with two crutches, then down to one crutch around 12-14 days, and have been using boot alone or boot + cane for long walking since. No issues at all. Early weight bearing is always the key.

I saw many different surgeons too and it seemed the three podiatrists I saw were using 4-6 week of casting and no weight bearing and the orthopedic foot and ankle surgeons I saw were early weight bearing early ROM etc. Not in the medical field or anything but that's just my observation from both feet and 5 different foot and ankle specialists (2 orthopedic foot and ankle fellowship MDs 3 podiatrists)

18

I had peroneal tendon repair and ATFL repair on June 5th. Had large area of scar tissue removed and multiple bone chips that were floating around in the joint. I was in a cast for two weeks NWB. at two weeks they removed my cast and took stitches out. In a boot now for two weeks. Allowed to put very little weight on it. I have a lot of nerve pain and a lot of spasms and cramps. Nights are the worse. I think every doctor is different in their recommendations. This surgery has a long recovery time. Far more than I was prepared to hear. I was told 16 weeks before I am back in a regular shoe and 6 months to a year before fully active

19

I had groove deepening and tubularization surgery on my right ankle on June 26 for sublexation of the peroneal tendons. The surgeon also did ankle arthroscopy and removed some inflamed tissue and removed a cyst from my toe. Prior to surgery he said 6-8wks NWB but I would begin pt after staples were removed at 2 wks. After surgery I was put in a splint for 2 wks. At 2 wks the staples were removed and I was put in a cam boot and started pt doing ROM exercises. I went back to surgeon at 5 wks and he said I can begin partial weight bearing at 25% for now and progress as tolerated with my Physical Therapist. In the surgeons offuce he had me step on a scale to get my weight for determining the 25% and it shocked me how painful it was and how week the ankle felt. Once he told me the weight I was actually allowed to put on it with crutches that was fine. Now I wonder if it would have been less painful if I had done it earlier. How much of the pain and weakness is due to the length of time being NWB. What kind of pains etc have others felt when first walking after surgery? How long before it stopped being painful and you could progress to more weight bearing?

20

You need to just push through it. After about 10-14 days nothing is going to go wrong with the repair with weight bearing. Just push through it and it'll slowly get better. Surgeons taking way too long with allowing weight bearing. Ridiculous and hurts your recovery. Been through two of thrse on each foot.