Likely Torn Peroneal Retinaculum

Thanks, Chris.

Yeah, I expect an easier recovery for a retinaculum repair compared to what you went through for a longus repair.

I was contemplating a destination IM next fall, but now those plans are on hold until I have clarity on this.

Well, apparently, it's worse than the doctor thought.  I had an MRI this week, and it showed that not only is the retinaculum gone, both the brevis and longus are torn partway through, and there is edema on the cuboid and some other surrounding tissues that they feel is associated.

The sports med specialist referred me to an orthopedic foot and ankle surgeon.  I see her in about a week and a half.

It looks like this may be a fairly long road to full recovery.  The only amusing upside is that my pain threshold must be greater than I thought, and my 18 y.o. son says I'm BA for racing a HIM and 2 Olys on this ankle to finish the season.  

Anybody have personal experience with surgical repairs to the brevis, longus, and retinaculum all at the same time?

Have not had the surgery but I have done it.  Get it fixed.  Its the winter.   Probably 12 week recovery.  Feel free to PM me if you have questions

Thanks, Susan, I appreciate that.

It came on gradually, starting around the time I did Musselman in mid July.  It didn't hurt when I ran, but I'd notice it occasionally other times of the day walking around.  It got worse over the last 4 months, even though I haven't been training.  Now it's bad enough that it hurts pretty much 24/7 and I limp a little bit all the time.

I'm not certain of the original cause, but the doctor thinks I snapped my retinaculum some time when I rolled my ankle, and then once that was gone, the brevis and longus were free to move around and rub bone, which led to them both tearing.  More than 10 years ago, I turned my ankle really bad on steps, and there was a loud pop sound and a lot of pain.  The pain went away in about a week, and I never gave it another thought.  The doctor said it's possible that was when it all started, and that my active lifestyle made it just a matter of time until the tendons were damaged from rubbing on the bone.

My suggestion is if your issue isn't going away with rest, go see a sports medicine specialist.

Here's an update that may be helpful to anyone who finds this thread because they're experiencing a similar injury...

After about 7 or 8 doctor visits, 3 x-rays, the MRI, an ultrasound, calf stretching exercises, and wearing an air cast while training clients for a few weeks, it's been confirmed that surgery is the remaining option.  It's scheduled for this Friday, January 10th.  In addition to the brevis and longus repairs and retinaculum repair that were expected, they may also deepen the groove in the bone where the peroneal tendons ride, because the docs believe that it's naturally more shallow than average, which contributed to the injury.  They won't know until they're in whether the bone work is needed.

WARNING!  This video isn't for those with weak stomachs, but this is basically what they plan on doing:

http://www.youtube.com/watch?v=XEEaXvl5N3c

The plan is a splint and wrap for about a week after the surgery, at which point they will put on a hard cast.  The hard cast will be on for 4-6 weeks, then it will be replaced with a walking boot.  The boot will be on another 4-6 weeks.  Somewhere along the way, there will probably be physical therapy.  All told, it sounds like 3-4 months until I can resume some semblance of normal training.

I've been going crazy from not biking or running the last few months, and doing a limited amount of pool time with a pull buoy.  My wife and friends don't believe me when I say that I'm looking forward to getting this done so I can move back towards normal activity levels.  I'm approaching the whole thing the same as training for a big race - I plan to do what I can each day to improve based on my current condition.  No more, no less.  It's going to be a long process with no huge improvements overnight, and will probably include some days when it feels like things are getting worse instead of better.

In the end, this should be an interesting experience that I hope will make me a better trainer and coach, because I will come out of it with first hand knowledge of the challenges my clients face sometimes.

I'll try to provide more updates in the coming weeks.

That sounds right.  Some people are predisposed to this problem if they have that shallow groove and its just genetic unluck of the draw. There are a bunch of different procedures for correcting that.  The longitundinal tears and the subluxing tendons usually go hand in hand.  Sounds like you are in good hands, Good luck on Friday. 

Thanks, Susan.

Yeah, I feel like I've gotten good advice from my sports medicine specialist, Dr. Michael Cordas (http://www.arlingtonortho.net/arlington-orthopedics/michael-cordas-d-o/  who referred me to Dr. Suzette Song ( http://www.ossortho.com/provider-directory/people/show/suzette-song  for the surgery.