Sunday, May 17, 2015

peroneal tendonosis or something worse or just impatient???

Family is running the Bodies of motion 5k today and I am in starbucks keeping my mind off the fact I am injured.   According to the MRI, I got a diagnosis of peroneal tendonosis and it has to be one of the toughest injuries I have had, hands down. 

Here is the timeline from hell:

3/30:  rolled ankle at the Manassas National Battlefield and thought it was a sprain (little did I know, I had peroneal tendonosis going on).  Skipped my trail 1/2 marathon in PA, was sick too.
4/1 and 4/2: 
4/5:   Biked all week and ran 3.16 miles to test it out and didn't feel that bad.
4/6 - 4/11:  Biked this week
4/12:  Ran 4.2 miles in 38:30.  Ankle ached a little bit seemed to warm up after running
4/23 Got MRI on left ankle and received results (Negative for tears in peroneal tendons, have tendonosis)


There is mild scarring of the deep fibers of the deltoid ligament without tear.

Tendon Findings:

The extensor tendons are intact.  There is mild juxta insertional tendinosis of the posterior tibial tendon without tear.  Remaining long medial flexors are unremarkable there is a small amount of tenosynovitis about the flexor hallucis longus at the know of henry.  The peroneus longus tendon demonstrate mild to moderate degeneration distal to the fibular tip.  Peroneus brevis tendon is intact, Achilles tendon and plantar fascia are unremarkable.

Overall Impression of MRI:

There is mild to moderate degeneration of the peroneus longus tendon distal to the fibular tip without tear.  There is mild tenosynovitis about the flexor hallucis longus tendon distally.

Got a description of the difference between peroneal tendonitis and peroneal tendonosis:

The distinction between tendonitis and tendosis is important since tendonitis is more of an acute injury, and rest, ice, anti-inflammatories, etc. tend to resolve it quickly (within 6 weeks or so). Tendinosis is when the tendon itself changes (hence your MRI findings) from chronic stress and takes much longer to resolve (hence modalities like PRP injections, Graston therapy, etc.).

However, I am a big opponent to anti-inflammatories and have not used any during this time period.

4/24:  Started PT regimen
4/24 - present:  Biking as prescribed by PT
5/12:  Saw a Dr. Neufeld (he spent a whole 3 minutes with me and referred me to someone else, isn't he the specialist???  Thinks peroneal nerve entrapment)
5/13:  put ankle brace back on for immobilization, keeping it on for two weeks, no bike, just PT exercises and see how that works.
5/29:  Have appt with Dr. Lutta with OrthoVA to go over MRI results again and get a plan.

Days since ankle roll:  48
Days haven't run:  35
Days since PT:  23

So, yea, I am pretty bummed out however, I am looking for any sliver of improvement.  To tell you the truth, biking would be a godsend at this point!

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