One morning last November, while doing some aerobics to a DVD, my inner left ankle started to ache like a sonofagun. Over the next few days, while I idiotically "worked through the pain," the area felt like I had stuck a patch of fire to it. I haven't done any cardio since. It swells and gets sore if I walk around a lot. It's like this burning, scratching feeling just under the skin.
I've spent a lot of time icing it, stretching it, taking anti-inflammatories, going to doctors, having diagnostic tests, going to physical therapy, going to acupuncture, going to a chiropractor, rubbing different linements on it, praying, researching online. My third orthopedic doctor diagnosed it as flexor hallicus longus (FHL) tendonitis.
Wednesday I went back to the foot and ankle doctor. Since six weeks of PT hasn't worked, he said the next step is surgery, with a four- to six-month recovery period. If I want to put off surgery and try one more thing, I can wear a hard walking cast for six weeks. There's a chance that if it really is FHL tendonitis, a cast will allow it to rest and heal. However, if the FHL tendon has tears in it -- which he believes it does but, since tears are not always detected by an MRI, it's anyone's guess -- then surgery is the only thing that will fix it. During surgery, the doctor will also release the tendon sheathe (the tendon is tight, despite stretching) and clean out the fluid that's on the tendon.
Surgery entails:
- Cutting into my ankle. This is not arthroscopic surgery, folks.
- No weight on the ankle for one month, perhaps less if there are no tears.
- Two to three months to return to normal activity, i.e., standing, walking.
- Four to six months to return to unrestricted activity, i.e., running across the beach to save Ava from a flock of seagulls.
It's funny the way my mind has been working the last few days. I've talked to the owner at my physical therapy place, a chiropractor, my mom and husband, and a few other friends and family members. One minute I'm like "Put the cast on!" The next, "Get this surgery over with!" And then, "PT can work! Give it more time!" Wednesday I scheduled a pre-op appointment for Friday. Friday morning I cancelled it and rescheduled for a week from Monday.
The thing is, I have been hyper-diligent in taking care of this ankle. The doctor said that's an indicator that it will require surgery to fix. Part of me feels like I should try the cast, but I did wear an air cast for 10 days and that made it worse. Things rubbing on the tendon really irritate it, like sneakers or, in the cast's case, fiberglass. I've been doing ice, stretching, applying special ointments and massaging trigger points to help it heal. If I have a cast, I won't be able to do any of that.
So, that's where I am: in Ankle Land. Trying to keep the household running and myself from gaining 50 pounds. Trying to make the right decision. Today I'm going to buy myself some new shoes and some cushion inserts. And some new fat, er, larger-sized pants.
One thing I've noticed is that when I mention to someone that I may have ankle surgery, they react with, um, some negativity. My other ankle started hurting this week, something I don't even want to make more real by saying out loud, so I went for a 1/2 hour massage of my calves and feet last night. The therapist went on about the problems that scar tissue from surgery cause. And really, that's not what I need to hear.
Surgery is a good thing, a blessing. It fixes problems in our bodies. I'm fortunate that it's an option for me. And I believe that God is working to heal my ankle right this very moment, and that it will heal completely. I'm not sure when, or what the road between here and there will look like. But it will happen.
8 comments:
Kris-
I stumbled across your blog and was startled to see that we are in the same predictament. I have fluid collected in the FHL tendon sheath and have done the PT, immobilization, rest, etc. deal for the last 16 months. My doctor suggested the cast idea today and it doesn't sound appealing. I'm debating the surgery and am strongly considering it as I don't see any benefit from the other remedies. Best of luck!!!
Let us know how you feel with the shoes with cushion support. I was wondering if that air cast made my condition worse also. Seems like we are in the same predicament. Thanks
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I was reading your blog and noticed that you seem to have a lot of the same symptoms I've been having. I went to my foot and ankle doc last Wednesday, and what I ended up getting was steroid meds for 6 days (I'm allergic to all NSAIDS), and wearing a lace-up ankle stabilizer with my walking shoes. I don't know that it has helped all that much yet, as it's only been a week. However, I will go back to see the doc again in 6 weeks, where they will look at what happens next. I did have surgery in my right ankle last year in February for a tarsal tunnel release. While that is healing, I have had much less pain and it did not take long to notice how much better it felt! Good luck with your foot! Do what you need to do to get better and back to enjoying life again, without pain!
Kris,
I have been dealing with the same thing - going on three years now. I have been to two orthopedics and a podiatrist and have done all the following, anti-inflammatories, hot/cold treatments, walking cast, custom orthotics, injections, PT. I think my only option left is surgery. I’m just want to find someone in Chicago who has ‘been there done that’ with repairing FHL. Did you have the surgery and how is your foot now. Hoping you’re feeling better…Doug
Hi Doug,
I ended up being diagnosed with small nerve damage/peripheral neuropathy. It healed very slowly over time, but I still avoid shoes that rub tightly on my inner ankle, and if I'm too active I feel it in my ankles also. It's not pain, more like "sensations." I go many days now without feeling anything there. Good luck to you!
When the problem escalates and PT doesn't seem to work, surgical procedures becomes necessary. It's really not a bad thing, especially with a lot of procedures having high chances of recovery.
Hi Doug. I have had FHL tendonitis going on 3 years now. After misdiagnosis, I went to a guy in Chicago who treats and operates on Joffrey Ballet dancers, his name is dr. Anand Vora. PT was not very helpful as the exercise just irritated the tendon. Cortisone helped somewhat. It seems avoiding biking, going up on my toes and wearing boots does help. I'm doing everything to avoid surgery and heal this up.
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