Peroneal Brevis Tendon Surgery - Post-Op

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I’m ten weeks post-op from Peroneal Brevis Tendon surgery, and had been healing fine and progressively getting better. I haven’t re-injured the foot or ankle, and PT has been going smoothly with no problems at all.

The past few nights however, I’ve been waking with incredible aches at my incision, in the middle of the night.  It’s not tender to the touch, but extremely achy. It goes on for several hours, and nothing seems to help... I’ve tried ice, elevation, and massage. I’m surprised because I didn’t expect this, and wonder if others have experienced the same? It’s really disheartening to be two-and-a-half months out, and having an entirely new pain. 

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55 Replies

  • Posted

    Hi! I had tear repaired about 8 weeks ago. I can walk ok with some discomfort but I do get nagging ache around my incision that comes and goes as it wants. It is not too horribly bad where I have to take pain medicine but is very very frustrating this far from surgery. I do PT, massage incision regularly and not sure if it getting better. I recently started applying vitam e. Will see if that helps. Not too much help for you but a little similar. 
  • Posted

    Donna, just realized you suggested vitamin e and epson salt for me! I started 3 days ago, haven’t noticed and difference just yet. But hoping will do in few days. If only my nagging would go away sad
    • Posted

      Hi, I was just about to go back to your original post and ask how you were doing. The vitamin E does take a little while to really make a change. I’m still doing that as well. My physical therapist told me it’s working and not to stop. She thinks the swelling is what’s making it hard to flex upwards at this point. She suggested a CP2 cold wrap. I ordered it on amazon and it’s Really good! If you order one make sure you get the straw attachment to blow it up. It’s ridiculous they sell them separately! I found the swelling is worse now than it has been since the surgery.  My PT has become a little more strenuous now as they add more exercises each new session... She said more swelling is to be expected. And she said it will likely be that way for up to a year.  You use the CP2 wrap for no more than 25-30 minutes with your foot elevated. 

      Have you begun your therapy yet? I recall you stating you were told it’s okay to start to run at seven weeks? I was told I had to wait til six months! I had a three-inch tear requiring tubularization only (no fraying, and no other issues) so not nearly as traumatic as a lot of folks surgeries. But it sure has been a painful ordeal. I’ll be talking to my physical therapist tomorrow regarding the onset of this new pain. Waking at 2:30 in the morning and dealing with aches for several hours (I’m allergic to pain meds) isn’t any fun. 

      And I’m told I can’t drive til my PT assesses me next month at hopefully my last session. They report to my surgeon who will also asses me, and only then will I get the okay to drive... I had my surgery Nov 15th.  Have they told you when you’re allowed to drive? 

    • Posted

      Good to know about vitamin E. I am pretty much doing your routine so hopefully I will see improvement soon. Love smell of cocoa butter!  And salt bath for my ankle at night makes me feel like I am in spa  (well, almost spa smile ).

      I had a small tear, less than half inch. The tendon was worn out and had scar tissue around. Surgeon cleaned that up. Also he chipped a smal part of calcaneus bone to allow tendon glide better. He did say I should be able to start walk/run program at 7 weeks but because of nagging I am still waiting to start. Worst part is nagging reminds me what I had before surgery. 

       I started PT at week 4 and it is going well. I don’t have much pain moving around and range of motion is back about 80%. I also swim. Tried to get on bike but that seems to irritate ankle so I stopped. Luckily I am ok to drive but I had surgery on left leg, not right one. It must be super frustrating not being able to drive!!! Hang in there! 

      Definitely longer recovery than I was hoping for originally. I know soft tissue takes a lot longer to heal so I am trying to be patient. 

    • Posted

      The year I had was exactly three inches and she said I had surgery just in time, before it frayed. Knowing how long the year was, I still wasn’t prepared for the scar I’m now sporting... My doctor said to come up with a really good shark tale! 😁

      My therapist said today that my scar is healing better than any she’s seen. She asked me about the vitamin E. I told her I was also doing the cocoa butter, and she said she’s going to start mentioning it to other patients because they’d only recommended the Vit E. 

      One odd thing was that they noticed a piece of the stitching (looks like very fine metal) was protruding through the incision. They determined it to be a suture from the tendon working it’s way out. I was a little freaked out, they were calm and said  “It happens... Rarely. But it happens.”  I’m to continue trimming it as it exits until it’s completely out. If it’s totally weird and freaky, it’s going to happen to me... Without Fail! 🙄

    • Posted

      Sorry... I have no idea why I typed “year” obviously meant Tear. 
  • Posted

    Love shark story idea!!! I can only imagine how your scar looks. It ll look ok once it all healed up, I am sure.  Suture coming out sounds pretty freaky, not going to lie. Maybe that is why you have been having aches at night. It is making its way out damaging still healing soft tissue. 

    I went to gym today and got on elliptical for 30min. Nagging was present the entire time but didn’t get any worse by the end of 30min which is good. Scar got super red but ankle itself didn’t swell up too much. Will see how it feels tmrw. 

    Monday will be week 9 for me. Your PT making comment about vitamin E combo is very promising! How long did it take for you starting noticing difference? Week? Two? 

    • Posted

      Sorry I’m so late in my reply... The stomach flu hit our house hard the past two weeks.  I managed to dodge it, but my kids weren’t so lucky. We’re finally rid of it! 

      I’m going on week twelve (on Wednesday) and the swelling is still ongoing. How are you doing with the healing and swelling? The vitamin e is slow going because the healing in general is slow going, but keep at it, it’ll make that scar a lot less noticeable in the end. My doctor keeps telling me it’s a long-long road to recovery.... A solid year.

      I still have to sleep with my foot slightly elevated at night or it really aches. I’m told that’s normal until at least the six month mark. My PT started me on the exercise bike last week and it didn’t hurt at all. In fact she told me the exercise bike (or biking) would be great to start now. How is your PT going? Sounds like you were making some strides in that area! When did they tell you it’s okay to light jog? They told me six months at the earliest. But I wasn’t an athlete when this began... Daily walker, occasional jogger, so I expected my recovery to take longer than someone who’s an athlete. 

  • Posted

    I'm having this surgery on March 7 . did your doctor have you in a cast for 6 weeks?

    • Posted

      I was in a non-weight bearing hospital cast for the first week. Then they cut that one off at one week and put me in a regular non-weight bearing cast (the hospital cast was rough around the edges, longer,  and a bit uncomfortable) which was more comfortable but still as heavy, for about two weeks. Then a walking cast for a week to get me used to putting weight on it again. After that I went to a walking cam boot which I could take off at night to sleep but had to wear during the day. After that I just wore compression socks to help with the swelling, which were a huge help. I still use the socks during the day now because it takes a really long time for the swelling to go away. 

      Good luck with your surgery, and start preparing now to have a few items to make life easier after you’ve had it done! I bought a shower chair, and a shower cover for my cast which made bathing A Lot easier! Definitely get a knee scooter... It was much easier to get around with it! You’ll spend most of your days with your foot elevated above your heart... I bought a wedge and that helped but I still had to stack a pillow or two to get the elevation above my heart. Once you go to the walking cast and then cam boot, make sure you have risers for your other shoe! That saved my back alignment because the cast and boot are thicker, making you limp down onto your good foot. The shoe risers make your other foot level with your cast’ foot, so you can walk evenly. 

      I hope that helps! But I can tell you that every doctor seems to have a different method for type of cast, and time in them, so you might want to ask your doctor beforehand. Mine went the more typical/traditional route, but some doctors will have you weight bearing sooner, and some later... Only your doctor can tell you for sure. 

  • Posted

    Hi Donna. I'm curious if your ankle is stiff? I am 8 weeks post off and I have tons of stiffness. Lots of aches too! I can walk without boot but range of motion isnt totally back. Im curious if all of the aching and stiffness is normal?

    • Posted

      Hi, yes I was still aching and stiff at 8 weeks. For me it was a gradual process and I think about the four month mark I started to wake without much pain. Around the six month mark it was considerably better and although I would wake with some stiffness, the pain was gone. I’m now eight months post-op and when it’s really cold I still wake with a little stiffness. I suspect that will eventually susbside as well... I don’t really think about it anymore, because I wake and stretch out of habit now.  But everything you’re experiencing is normal, at least it was for me as well. 

      The exercises will help with the ROM, and I still do them now. I’ll never have 100% back, but I’m at about 95% and I can live with that. It took me some time to find shoes that fit without any pain, but I found good quality ASICS worked best for me. I loosened  the laces a lot, and as the swelling has gone down, I’ve been able to tie them tighter. I still have a swollen place, but it’s getting smaller every month. The doctor said a full year to full recovery and she has been completely accurate in everything she told me would happen. Just keep up with your exercises, and ROM will continue to improve. Riding a bike is really helpful when you get the okay from your doc... It works the muscles you need to strengthen the tendons. Even a stationary bike works for that. 

      I hope all this info helps... You’re definitely not alone! 

    • Posted

      Thank you Donna. Definitely stuff in the mornings and some aching. It makes me wonder if the surgery was successful.  I guess this is all normal. I appreciate your response!
  • Posted

    Hi I had  the perineal brevis tendon surgery 12 weeks ago Along with ankle stabilization surgery.  It’s been a long tough road.  I was in splint for 10 days and a hard cast for about 10 days with strict non weight bearing.   Then I started with the walking boot and crutches but ditched the crutches within a few days.  I’ve been in the boot for 9 weeks and I am 

    able to alternate my sneakers and boot depending on how my foot feels.  I stand for long periods of time for work and I’m still not working my full schedule yet.   But recently my foot is hurting again on the outside of my foot again under my ankle and I’m worried I may have another injury somehow. I’ve gotten back some range of motion but it’s a slow process..  still stiff and I have difficulty descending stairs, still walk with a limp,   My back has been out of whack from that.   I find my foot ankle and lower calf extremely achy.  Sometimes more painful than the actual surgery.  Did your discomfort and pain get better with therapy and time?   

    • Posted

      Hi, I’m sorry you’re experiencing so much pain and difficulty. It’s a long and slow process. Your doctors process was different than mine. You weren’t in cast as long as I was. And going from the different casts to the walking cast and to the camboot, was about a three month process total for me. I was going to PT almost the entire time. Once I was weight bearing I got a lift for my non-cast tennis shoe. My doctor insisted on it to prevent any back troubles. If you didn’t have one, that could have been the start of your back problems. I made sure my PT checked to make sure my feet were level with the lift. Also, I bought some really good gel inserts which helped considerably. 

      The aches and pains are normal. And my doctor strongly suggested I use a bike or stationary bike to work the tendons. I started slowly and the aches were definitely there! That, along with the regular PT helped a lot. You don’t want to overdo it, your therapist should be able to guide you and help you build strength and stamina. And yes, one day, you simply won’t notice the pain anymore because it just didn’t show up anymore. I don’t remember the exact date I didn’t have the pain anymore, but it was around the six month mark. 

      I like to hike and I still get aches if I go on long hikes in rough terrain.  A thirty to forty minute soak in a warm Epsom salt bath helps.  And yes my calf would hurt as well... My doctor showed me where that tendon runs along the ankle and up the calf, so it makes sense when you see how it’s all connected. 

      One thing I do experience post-op that I didn’t before, is sciatic pain on the side where my surgery was. The doctor said that was a possibility with this type of surgery. But my therapist showed me some great stretches to help with that and it’s been so much better. So if you start to feel that, don’t hesitate to ask your therapist to show you some exercises... And the sooner you start them after it begins (if it begins) the better! The doc told me people who experience the calf aches (like you and I) are slightly more susceptible to sciatic pain. And it’s only when I lay on that side at night that it hits me sometimes. But expect the aches and pains to get better with time. This surgery takes a full year to full recovery.  And the stiffness is to be expected for a while. I got in the habit of waking and stretching, so I still do that now. Climbing stairs was a shaky for me up until the six month mark... Not that I couldn’t, but I think it was the fact the my foot doesn’t bend as much as it did before (just slightly less ROM but enough that I know it) so I have to walk a little more carefully on stairs now. I’m sure that will get better with time.  

      If your back continues to ache, you may want to inform your doctor to see if they can help with an adjustment and to watch your gait because if it’s off and you continue to walk that way, could be creating a problem. My PT said getting the gait correct is pivotal to your recovery and warding off back problems. I had to make small adjustments and my husband helped me when he saw I was off... Even if I didn’t notice and thought I was walking fine. Hope this helps you and that the pain gets less and less each day! 

    • Posted

      Thank you for your response.  You make me think there’s hope.  I feel frustrated not being able to do everything I want to do.  My range of motion is getting better but the pain on the outside and just underneath it are still sometimes very painful as is getting up in the morning.   I’m seeing surgeon next week.  Hopefully I just need a little more time to heal.  

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