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Ankle pain long after injury
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Ankle pain long after injury

Hello there. Thanks in advance for reviewing the question. It's kind of a lengthy story, but I'll keep it as short as possible. In August of 2007, I was standing at a table. When I turned to walk away I felt an extremely sharp pain (probably the worst pain I've ever felt) in the back of my ankle where my Achilles tendon is. I could barely walk. I did not have health insurance at the time so I was unable to see a doctor for this. While I was at home, I would keep the leg elevated and stay off of it, but I had to go to school everyday so I did have to use the ankle probably far too often (I just had to limp on it). It took 2 to 3 months for the pain to subside. After that period, I was left with a lot of ankle popping. My ankle never popped before and now it pops excessively. Sometimes as many as 5 pops with one movement of the ankle - loud audible pops. The popping itself isn't painful. I did eventually go to the doctor for the popping. He took some X-rays, and said all my bones look very healthy, so the popping isn't due to anything bone related. He did say I have mild peroneal tendon subluxation so that was probably where the popping was coming from. He said the groove for the tendon is shallow. He really didn't have a straight answer for me about the injury and felt it unnecessary to have an MRI done. He just recommended I get some orthodics and be careful when doing certain activities. I'm not very happy with this response though. I have no confidence in my ankle. Some days, my ankle just feels sore for no reason at all. I often get what I call "mini" ankle sprains. For example, I'll be running around the house with my dog, and I'll get a sudden sharp pain that feels like an ankle sprain, so I sit down and the pain goes away about a minute later and the ankle is fine after that. The ankle feels very unstable, mostly when I make sudden movements, not so much just walking forward but if I turn or something is when it happens most often.

So here are my questions: If I have peroneal tendon subluxation because of a shallow groove - why did it just start after 26 years? Also, can that tendon cause all of that popping? It doesn't feel like it's the culprit for the popping if I place my finger on it. I feel the popping in other places mostly. I feel most of the popping coming from the top part of the ankle, where the foot and ankle meet, towards the inside of the ankle. It feels like something is popping sort of deep inside that area - that's a tough one to describe without showing the area. Secondly, when this injury happened, I was working out heavily that summer. I was doing a lot of heavy weight lifting. Based on the symptoms I had, it seems like I ruptured the tendon from having too tight of calf muscles (I didn't stretch often enough). If this is the case, is there anything that can be done about the ankle problems I'm currently having, or am I stuck with this because I didn't go to the doctor fast enough?

Thanks again for reviewing the question, I really appreciate it! This is something I really worry about because I love a lot of physical activities, such as hiking. I would hate to not be able to do those again. I haven't been very active since this injury happened, but I'm ready to become more active again so I wanted to see what I could find out about the ankle. Perhaps my ankle is messed up because I have been so inactive since the injury? Maybe it just needs some strengthening?
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Avatar_dr_m_tn
hello TGOST,
if it's a peroneal tendon problem, then you should be having pain over the lateral side (outer) of ankle. Am i right?? And  if its on the inner side(medial side), then the diagnosis is fully wrong. i know you have mentioned near the attachment of achillis tendon, but i still want to clarify medial or lateral side.
I will answer your queries n ow thinking that the diagnosis is right. Ok?

1) If I have peroneal tendon subluxation because of a shallow groove - why did it just start after 26 years?
Answer) Due to shallow grove (from beginning), repeated wear and tear over 26 years made it more shallower , resulting in the tendon popout.

2) If this is the case, is there anything that can be done about the ankle problems I'm currently having, or am I stuck with this because I didn't go to the doctor fast enough?
Answer) I think yu are stuck basically as you have lost more than a year.

And , MRI is the best investigation for now, if you can afford it.
Regards
abhijeet

Do keep us informed.
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Avatar_n_tn
Hello there, thank you for taking the time to respond. I do have pain on the lateral side occasionally when I make sudden movements, but it doesn't seem to be the only part of my ankle that is having difficulties ever since that 'injury' or whatever it was that happened. Is it possible that on that day, the shealth for the peroneal tendons broke and caused that amount of pain to radiate over more of the ankle, making it feel like the pain came from the achilles tendon instead of the lateral part of the ankle? I know that I had extremely tight calves that day because I had did a heavy leg workout the day before (and had been doing heavy workouts all summer long without doing enough stretching). Having the tight calf muscles and the extreme pain I felt at the back of the ankle makes me think I ruptured the achilles tendon. It was extremely difficult to walk on that ankle for more than a month - would  pernoeal subluxation cause that amount of pain only that one time and take a couple of months to heal? Thanks again for your help!
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Avatar_dr_m_tn
hello TGOST123,
sometimes when i get patients having tendinitis, etc,, i put them on a walking Cast(plaster of paris) for 2-3 weeks. The idea is to stop thejoint movement. You can try that.
regards
abhijeet
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Avatar_n_tn
I was kind of thinking about that. I was thinking that either A) Like you said, maybe I have some sort of tendinitis that isn't going away because I keep using the ankle like normal, or B) I was also thinking that maybe because there was some sort of injury to my ankle, maybe it just needs restrengthened to get it back on track. Maybe some stretching/yoga to stretch out my leg muscles to alleviate some of the popping and some light training to strengthen the ankle. Thanks again for all your help, I appreciate it!
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Avatar_dr_m_tn
hi,
all the best and keep posting
abhijeet
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