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peroneus brevis split in left foot

khewitt120khewitt120
in General Training Discussions

I just bought a 20 week plan for ironman texas.  This will be my 4th ironman race.  I have done all sorts of other crazy stuff too, including a 50 mile run.  

While pounding through Achilles Tendonitis while training for the Disney Dopey Challenge in January, I have wound up with a split peroneus brevis tendon in my left foot.  This happened on or about November 1.   Obviously, My Disney races are not going to happen, but  I am hoping that my A race for 2014, Ironman Texas will not be ruined as well. 

Let me tell you I have done everything I can possibly think of to speed the healing.  I have not ran a step in 5 weeks.  I have done Massage, ART, laser, heat, cold, ultrasound, stem.  I am no better than the day I stopped running 5 weeks ago. 

Last week my orthopedic surgeon says that the injury is too old to heal on its own with immobilization.  Surgery is a very likely scenario.  The problem with surgery is that is will be a long road to recovery.  I would be ok with that if I could swim and bike as soon as the foot would tolerate after surgery.  I could have surgery in early January. I am heading in for a second opinion this week. 

 Does anyone have any experience or advice for this. 

THANKS! 

Comments

  • Carrie ChavezCarrie Chavez
    Hi Kristen,

    Welcome to EN. I am sorry to hear of your injury.

    How did your injury happen? Was it just from running on a chronic achilles injury or did you sprain your ankle? Do you have ankle instability also? This peroneus brevis injury you have is often coupled with instability and other things need fixing in the surgery. Just curious. Based on my limited knowledge ( i have not treated a pt with this in my 20 plus year PT carreer) you would be in a cast or immobilized somehow for a period of time. It appears on research the outcomes are good but that is a long term study- many years later. I honestly don't know how long it takes the tissue to heal, mature and then build strength and become painfree.

    I feel for you and hope the second opinion can answer all your questions and concerns.

    As a fellow endurance junkie I can only imagine the angst you must be feeling.
  • khewitt120khewitt120

    I think the tendon split occurred  during a 10 mile run.  About mid way through, I my foot and ankle went weak, and I had a very sick feeling come over me.  I did not sprain my ankle.  I had been running through the achilles pain for 4 months.  Not smart.  I really think it was because of the chronic tendenitis that I was battling at the time.  More than likely my running stride was way off because of the chronic pain.  I think it gave in.  The MRI revealed that the achilles does have chronic tendenosis and the brevis tendon does have a longitudinal split. 

    I am very depressed about this injury.  Running is my outlet for life.  I am doing IMTX for my 40 birtthday!  I really want to be able to make it to the line healthy.  I hope to find a surgeon that will let me swim, bike and find an alternate for running (like pool running) as soon as the foot will allow.  

     Thanks for your thoughts!  Kristen

  • rlh2000rlh2000
    Hi Kristen, I am also a PT (though with a shorter career than Carrie) and also have not treated this, but just wanted to lend my support. I know how awesome it is to have big goals like an IM and how the thought of road blocks are so devastating. Just remember that your #1 priority is to get healthy right now. IM isn't going anywhere, and even if your dream doesn't come true this year, you can rebuild yourself even stronger and the victory will be even sweeter. My personal as well as PT experience has let me know how upsetting this can be, when so much of our identity is wrapped up in what we do athletically, so you are not alone in these feelings. We're all here for you!!
  • Jan SchorpionJan Schorpion

    Kristin, I have treated several females with a longitudinal tear of the peroneal muscles. I can remember 2 non surgical and 2 post op. The ones with a surgical repair, began physical therapy 2 months post op, after spending 2 months in a boot with minimal weight bearing, but this all depends on the doc and his or her protocol they use. Once in PT, a good deal of time is spent on soft tissue work, balance training and leg/ankle strengthening prior to any impact training. Unfortunately it is a long rehab, but a good PT will help you get through it. 

    Although none of the non surgical women were endurance athletes, they were tennis players playing 2-3 times per week at that time. One presented with chronic pain, for the other it was more an acute injury. Both were in a boot, and followed same protocol in PT, as those who had surgery- soft tissue work, strengthening, balance training, correcting foot posture.  They came to PT for about 3 months, but they both were able to return to playing tennis again without surgery. 

    I don't know the extent of your injury, but it is possible to heal via conservative therapy rather than surgery. Tendons do not have good  blood supply and so healing generally takes longer and there is never a guarantee that it works, but if it does the road to recovery will be shorter. 

    Hope your recovery goes well!

    Jan

  • missyschorpionmissyschorpion

    Hey Kristen,

    Sorry to hear about your injury.  I noticed that you're in the South Florida area.  If you're looking for a great foot/ankle surgeon I would recommend Dr. San Giovanni.  He is based out of Doctors Hospital in Coral Gables, he specializes in foot/ankle surgery.  I worked as a PT in Miami for 4 years and saw great results from his patients.  Best of luck to you with the recovery!

    Melissa

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