More of a WWYD - ruptured tendon

[ColdAndSuch]

Posting for traffic more than anything I think.

About three months ago, I woke up with a very sore and tender ankle. There’s been no obvious injury at all, it’s been almost overnight. I can walk on it, albeit sometimes I need to use a stick and can’t walk uphill very well. It’s strapped up every day with a support bandage.
After about a week of no improvement (but nothing getting worse) I filled in e consult, and eventually was able to make a F2F appointment with the GP (who called me first)….
so, It took weeks and weeks to get a GP appointment and by the time I did, the GP advised it was too late for physio or surgery (has to be done in three weeks of the injury, apparently).

They advise to rest it, ice it, keep it elevated. I have done but it’s still the same.

Not swollen at all, it looks totally normal. It’s not painful all the time, only if I walk on it/bear weight. Sometimes if I flex the ankle, it feels like it’s “clicking”.

So what do I do? Is this just it now? Or do I go to a&e (inappropriate I think?) given the GP advised there was nothing else they could do? Seems mad.

all help and advice gratefully received.

Bumping for shameless attention

Omg I have exactly this. Mine is my peroneal tendon on the outside kf my ankle, just behind the boney bit. I can also feel it’s clicking which according to my extensive googling means the tendon is “dislocating/subluxating “ at times from behind the lateral malleolus where it should be to in front of it.

I’ve had an mri and a ct scan. Now my first mri was bizarre. The initial report said the tendon was torn. The hospital got a second opinion and said it wasn’t. I fell out with the orthopedic team as they seemed useless and switched to a different hospital with one of the top ankle surgeons. He also said my tendon wasn’t torn. I kept telling him I can feel it clicking out of place, but when I flex my foot for him it doesn’t do it so he refuses to believe me!

anyway he was more interested in a weird cyst I had in my fibula so operated to remove that which was quite big surgery as it was in the bone. When I came ro7nd he admitted my tendon was also torn so they’d repaired that as well. Sadly it’s made no difference.

so another Ct scan and mri and the tendon is torn again, also two torn ligaments. I still feel it’s clicking out of place, they still don’t believe me. They keep fobbing me off with steroid injection after steroid injection, I’ve had 5 now. Plus six months of weekly private physio,

nothing makes an6 difference.

i am convinced I need the torn tendon and ligaments repairing. A groove cutting in the bone to make the tendon stay in place. Also some bone spurs removed as I now have anterior ankle pain/impingement and they’ve seen bone spurs.

hate to say but it’s been 5 years now and wrecked my life. I’m so immobile.

You need an orthopedic referral

But also it’s not too late for physio at all and the gp should refer you. But if you can afford private go private. But you need imaging/mri scan to see if the tendon is torn.

And I think the advice would be to unstrap it, your ankle needs to build up/get stronger not rely on straps even though it may be more painful initially

Right, MRI. Thank you all. Not to generalise but I’ve found if I say to my GP “I need x y z and this referral” then I get the help I need rather than “help me, I’m sore”.

I am so sorry to hear this though! Fucking hell!

And it’s never too late for surgery if needed. Mine was 3 years after it all started before I got mine. Problem with ankle tendons and liagaments is that they don’t tend to heal very well on their own as limited blood supply. But it depends on the extent of the tear which is why imaging is important. Physio can help. Your gp sounds awful.

Yes I’d ask for mri and physio. I’m not sure if you’d need an mri before or after an orthopedic referral. I had an odd pathway as I went private physio first and he did an ultrasound (which doesn’t really show tendon damage well) and that saw the cyst and they thought I had bone cancer so I had a 2 week cancer referral to everyone for mri and orthopedic.

be warned an orthopedic referral might take a year currently!

go9d luck.

My GP is not great and this one in particular loves to fob me off. “You’re too young for physio” or “you can pay for it privately?”

Well no I can’t.

others in my area have reported similar (Hants/Wilts border)

Don't go to a and e with this!
Steroid injections if it is tendonitis might help,. Your GP could try you with some Naproxen first; even if you cannnot see any swelling, it doesn't mean there isn't inflammation at the site of pain.
Try and work out, by looking at diagrams online, which tendon is affected, then youtube diagnosis and treatment for xxxtendonitis videos. You might find some exercises you can do that will help.
GP needs to refer you for an ultrasound scan really. There are a few private clinics around that will scan your ankle for around 100.00. If s/he won't. You can have the report sent to your GP for treatment consideration.
Good luck!

Your GP is an idiot.

Acute achilles rupture can only be operated on easily in the first 2-3 weeks, although I've pushed the boat out and done so succesfully at 5 weeks.

If youve had a ruptured achilles tendon for months, but no treatment, this is a neglected rupture and it needs urgently assessing by a competent foot and ankle surgeon who can discuss options, but if the diagnosis of rupture is correct, and if there are no major risks to surgery, the sooner it is reconstructed, the better.

@FixTheBone can I pick your brains? My husband has a suspected ruptured Achilles after a football injury 8 weeks ago, whole foot swelled up and turned black with bruising at the time but since the swelling has gone he is suffering with pain in his heel and back of calf and limps, very flat footed. He’s going to an orthopaedic surgeon this weekend but everything I’ve seen suggests that a neglected rupture always requires surgery? Is this correct and if so how long is the recovery?

Wondering whether our holiday in the summer will still be possible! Thanks!

In an active person with no l reason to avoid surgery, a complete rupture that's not been immobilised for the first 8 weeks, that's been walked (limped) on will almost certainly need surgery.

Your surgeon will hopefully assess the length of the tendon, size of the gap, strength and may request an uktrasound or mri.

Bruising and swelling in the whole foot is odd though, is he normally flat footed? Could be a tibialis poster tendon or lisfranc injury...

Sorry, forgot to say... Most Rehab protocols are around 8-12 weeks in a boot, 3-6 months until full daily activities, including driving, and 9-12 months until active participation in sports.