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Peroneal Tendon Subluxation??
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Feb 18, 2013
Hi. I was doing a sit in move on my left ankle while bouldering last week and suddenly there was a loud pop in my left ankle and I saw my tendon on the ankle bone and soon after, it went back into the original position. On that day itself, it came out a few times when I tried to stand up. After a week now, the tendon is still moving out of place onto the outside of my ankle bone and relocating again. I was trying to climb with ankle guard for the past week as the pain subsided. Now I have totally stopped climbing and I'm going to see if it heals. I can run now without any pain or dislocation of my peroneal tendon. It only pops out again when I do a sitin move on my left ankle or when my foot is pointed outwards and upwards. When the tendon pops out, there's only a little pain and more of a "shock". I'm very worried about this as I'm afraid i cant climb again. Can someone tell me if my case is minor or severe and if I could recover without any surgeries? Thanks!! I think im going to see a specialist soon... Junxiang
Joined Feb 18, 2013
0 points
Feb 18, 2013
Junxiang wrote:
...I think im going to see a specialist soon...

This is probably your best bet. When stuff starts moving around it's best to have it checked out.
Joined Apr 23, 2009
22 points
Feb 18, 2013
I did the same thing climbing. Unfortunately it won't likely heal on its own, and the only way for it to without surgery is to get a nonweight bearing cast put on it for 6 weeks and hope it heals. This has a 50% or less success rate. I tried this and it wasn't successful and I ended up having the surgery to fix it. I recommend just going straight to surgery because it is actually likely to fix the problem. redlude97
Joined Jun 21, 2010
8 points
Feb 18, 2013
Sounds like you may have ruptured the pulley for the tendon and it won't stay in alignment...especially if you heard an audible pop. The pop indicates something tore and afterwards the tendon won't stay in place, just makes me think its a "pulley" and not the tendon itself. I use the term pulley loosely for the structure that keeps the tendon in place and aligned correctly. These sorts of things generally don't fix themselves easily and surgery may be needed to fix or create a new pulley to keep it in place. If you continue experiencing it moves as it is, over the bone and back, you could do damage to the tendon and chronic inflammation/discomfort is an almost guarantee. See a specialist and hope for the best. Brad Caldwell
From Deep in the Jocassee Gorges
Joined May 22, 2010
1,370 points
Feb 19, 2013
Ohh... Okay thanks for your advices! Can you share about how it feels like after the surgery and how long before you can climb again? Junxiang
Joined Feb 18, 2013
0 points
Feb 19, 2013
Rock Climbing Photo: Top of Castleton
Friend had this happen to him. Happened in the summer but he climbed until winter then got surgery. He had something before the boot but now has the boot on for several weeks. If I talk to him I'll get better details for you. Best of luck to you Zeke6
From Akron, Ohio
Joined Feb 6, 2011
80 points
Feb 19, 2013
Junxiang wrote:
Ohh... Okay thanks for your advices! Can you share about how it feels like after the surgery and how long before you can climb again?

Depending on the exact procedure they perform the level of pain is moderate. I ended up having to have them enlarge the groove the tendons run through which required cutting the bone, shifting it, and then screwing it back on in addition to repairing the retinaculum. I was in a nonweightbearing cast for 6 weeks, then a walking boot for another 4 before then PT began. Started climbing in the walking boot after 3 months but wasn't back to normal strength in the ankle for ~6 months.
Joined Jun 21, 2010
8 points
Feb 20, 2013
Oh no... Seems like I can't climb anytime soon then... Anyway, my tendon hasnt moved for the past two days!! Does this mean any improvement? Junxiang
Joined Feb 18, 2013
0 points
Jul 23, 2013
Hi everyone,
I just wanted to share my experience with my peroneal tendon injury for those of you whom may be wondering if they have the same injury.

Initial Injury
On May 7th, 2013 while climbing in the gym I heard a loud pop/crack followed by a sharp pain that lasted for several minutes and subsided into a dull burning sensation for another 10 minutes or so. Immediately after the injury I sat down until the pain subsided and then tried to walk on it. I could walk fine, however it occasionally would "pop out" (i.e. sublux) again. I stopped climbing and just chilled with my friends for the rest of the night, however by the time I left i could not take more than a few steps with out my tendon subluxing.

Initial Treatment
The next morning my father (who is an orthopedic surgeon) diagnosed me with a subluxing peroneal tendon. I wore a brace for the next week until I was able to see an orthopedist at my university. She beleived that I had torn my retinaculum tendon and decided to have me wear a walking air cast which I wore for 6 weeks. During that time, the tendon would only sublux on occasion and always when I wasn't wearing a boot. After six weeks, I began to walk around without a brace or cast and, perhaps foolishly decided to try to climb on it. After only about a half hour of bouldering my peroneal tendon was subluxing again. On top of that I must have re-aggravated it because during the following two weeks it began to sublux with more frequency while doing simple tasks (i.e. walking).

Further Treatment and Surgery
After the first attempt back at bouldering and subsequent problems I went and saw an ankle specialist at Kerlan-Jobe (a great group of orthopedists in LA). They ordered an MRI and diagnosed me with a tear in one of the ligaments in my ankle. Today (July 22) I finally had surgery to repair the tear as well as to deepen the groove in which the peroneal tendon sits.

The estimated recovery is as follows: 1 week in a large cast (non-weight bearing); 2-3 weeks in a smaller "normal cast" (still non-weight bearing); 1 month in a walking cast; 1 month of PT. After this time I can begin "physical activities" such as walking without the cast, running and hiking. However, I have been advised to wait a further 1-2 months (4-5 months post-operation) before I climb again.

I would like to strongly advise that if you believe you have a peroneal tendon injury that you see an orthopedist immediately and ask for either a dynamic ultrasound or an MRI. Additionally, as others above have stated, the chances it will heal on its own are low and you may wish to consider getting the surgery immediately. I know I wish I had.

Oh, and for fun, here is the cast I have to wear for the first week after my surgery.

Good luck everyone! I hope to see you out there soon and if you want to know about my surgery and recovery fell free to PM me.
From Los Angeles
Joined Jul 22, 2013
0 points
Jul 21, 2014
Hi Everyone,

I think I have the same problem: peroneal tendon subluxation

I wish you all are fully recovered, and speed recovery for those who are not.

I had a fall, popped and swollen couple years ago, I didn't see a doctor at that time, just rest and ice, and ankle seemed to be fine; did x ray back then and no problem as no pain too. then I went to see a Orth. Dr and he diagnosed me may have peroneal tendon subluxation with ultrasound device. Told me eventually I had to do surgery in order to fix this.

Every now and then the dislocation or subluxation happened when i walk or stand too long, or if high pressure on my foot or ankle. or when I squat. It doesn't hurt in a way.. I can also easily move the "tendon" back and forth.

I haven't gone to check MRI and still looking for good ankle and foot specialists or surgeons in New York.

I am extremely worried about the pain, cost, complication and mental depression after the surgery. Wish you can help me out,

How much does it cost to do the surgery? also the PT?
The pain, is it really unbearable? or how you manage it? how long did you think you are pain free?
any complication? still pain? popping? any other side effects after 2 years?
as the depression, i am really worried or depressed now :(
Also when did you start taking bath? 2 weeks after surgery?
Anything I need to prepare in advance for the recovery? as simple as knee walker? or bath chair??

Thanks in advance
Dave N
Joined Jul 17, 2014
0 points
Jun 23, 2015
I'm not a climber, but I found this thread valuable when I was considering surgery. A little background. In 2007, I fell off a ladder and inverted my right ankle. Tore the retinaculum holding the peroneal tendons in place. After many years of chronic pain, I finally saw a orthopedic surgeon and got the surgery done.

Am I satisfied with the result?
YES! It was totally worth it. I am almost pain free 6 months later.

How did I find a good surgeon?
I'm a healthcare consultant. Look for someone who has done lots of these types of surgeries. Consult the database at American Academy of Orthopaedic Surgeons and find a center where several docs practice. IMHO the good ones will practice together.

What did I experience during surgery and recovery?
Okay, so it ain't easy. Especially for athletes. The mental game is hardest part. Plenty of emotional swings. Just follow the doctor's instructions. And STAY OFF YOUR ANKLE!! There's plenty of time when the surgery has healed to do the physical recovery. I made the mistake of walking on it. Could have screwed something up. Fortunately, I didn't. STAY OFF YOUR ANKLE until it's complete safe to put weight on it. And keep telling yourself that you'll be fine. Because you will. The mental game is the hardest part.
Joined Jun 23, 2015
0 points
Jun 24, 2015
Rock Climbing Photo: JSH @ home  photo courtesy of Gabe Ostriker
For posterity, here's another thread about ye olde peroneals:
Joined Apr 3, 2007
1,076 points

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