Painful Tendon after severe ankle fracture

by Jenny
(Hong Kong)

I fell 5 metres whist bouldering (rock climbing without rope) and broke my tib, fib, talus, plus complete dislocation of ankle joint, it was an open wound compound fracture. Long story short, it took many surgeries to get all the bones re-aligned properly and the ankle joint put back in properly. Am now in my 9th month of recovery, still on single crutch, and doing physio everyday.

I'm getting acute pain around the area where the posterior tibialis tendon is, from base of the medial side of my foot and up the inside of my leg, basically that's restricting my ability to achieve dorsiflexion, of course the joint hurts too when walking or doing physio, but I think the pain in and around the tendon is rather abnormal.

It could be that the nails put in the medial malleolous is close to the tendon but its very hard to tell. Is it normal to experience pain around the tendon during the recovery process?

Please help!

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Painful Tendon after severe ankle fracture

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Nov 15, 2009
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ankle pain - comments
by: Anonymous

I just stumbled upon this site - I'm on my 9th month of recovering from a bad ankle break (and two bad surgeries)
There are times I am nearly out of my mind in pain. All I want to do is walk again without being in agony - (I used to climb mountains like a goat!)

Sep 22, 2009
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similar injury
by: Lacey

My husband's foot was nearly severed in a car accident in 1996, with a compound fracture to the talus and other small bones.

We were told that most surgeons would not have even attempted the repair and would have amputated the foot. A bone growth stimulator had excellent results and there was no bone death, and the foot healed. I don't remember the exact numbers, but he went through a series of plaster casts with each one bringing the foot a little closer to neutral.

He never did quite make it to 90 degrees and has a limited range of motion. There were pins, then pin removal, then a couple of years ago he opted for achilles tendon lengthening and bone spur removal in the hopes of gaining motion. It was very painful process and unsuccessful in increasing the range.

Most days, he's fine, but after a long hard day of work he can only walk with a cane and suffers with a lot of pain. He won't take any narcotics because of prior substance abuse issues and can't take any nsaids because of stomach problems, so the pain sometimes becomes a problem.

He's now considering the fusion surgery, which is why I got on here to read everybody's story. [Btw - Don't lose hope. Seek many opinions before any optional surgery. Surround yourself with positive people!] He participates in most of his previous activities, except running. He's active and enjoys life, but sometimes has down periods from the pain.

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Sep 22, 2009
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Submitted by: Lacey

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My husband's foot was nearly severed in a car accident in 1996, with a compound fracture to the talus and other small bones. We were told that most surgeons would not have even attempted the repair and would have amputated the foot. A bone growth stimulator had excellent results and there was no bone death, and the foot healed. I don't remember the exact numbers, but he went through a series of plaster casts with each one bringing the foot a little closer to neutral. He never did quite make it to 90 degrees and has a limited range of motion. There were pins, then pin removal, then a couple of years ago he opted for achilles tendon lengthening and bone spur removal in the hopes of gaining motion. It was very painful process and unsuccessful in increasing the range. Most days, he's fine, but after a long hard day of work he can only walk with a cane and suffers with a lot of pain. He won't take any narcotics because of prior substance abuse issues and can't take any nsaids because of stomach problems, so the pain sometimes becomes a problem. He's now considering the fusion surgery, which is why I got on here to read everybody's story. [Btw - Don't lose hope. Seek many opinions before any optional surgery. Surround yourself with positive people!] He participates in most of his previous activities, except running. He's active and enjoys life, but sometimes has down periods from the pain.

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Sep 14, 2009
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21 months post op fracture tib & fib
by: AES

I have had the pain in my ankle since my fracture in Jan 2008 - the only thing to help were the pain killing injections (administerd in day surgery) it was a guanithedine block (not sure of the spelling) but it worked wonders for the pain, although I still have never regained any range of movement in my ankle - I am due to have it fused in 2 weeks - which they tell me will certainly help with the pain (I now have CRPS & accelerated arthritis in my ankle) - only downside is I wil have virtually no movement in the ankle - but I feel the pain being taken away outways the chances if me ever gaining any motion, or normality since my accident (and I will be able to walk fully weightbearing and unaided) - I have tried everything from physio to hydrothwerapy to regain the movement but it is completely frozen ..
I hope you can get some relief from the pain in your ankle soon, I would certainly speak to your consultant about the pain killing injections (although not everyone responds to the injections I am told) - Good luck Liz

Sep 12, 2009
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3 month post op fracture tibia fibula and ankle
by: Liz

I am inquiring about the pain I am enduring it is so severe I spend my time crying . Will i ever have full rangeof motion to my ankle again I ask my physician if there is an end to all this agony. What can I do to help myself regain strength and full use of my ankle please help.

Sep 03, 2009
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every case is different ... however
by: Anonymous

Sometimes the pain gets so bad that just 'living with it' doesn't seem like an option - I would advise you to speak to someone in a pain management clinic - I am sure there must be something they can do for you - especially after 9 months. My consultant has been really good in the sense he is prepared to try any means of getting movement/relieving pain back into my ankle. Although the fusion will leave me with barely no movement he has said it should alleviate/clear the chronic pain I have in my joint - I think when it is with you constantly you have to consider all options especially to relieve the pain. Fusion isn't the only answer (I was told this was the very last resort for my case)but I think having a better quality of life is crucial to recovering from such a bad fracture - really sorry to hear you have been told you must just live with it :(

Sep 03, 2009
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R.O.M
by: Grant

its been 9 months now after my accident, and i still do not have full range of motion, and i still suffer from pain and stiffness, i know its from scar tissue in the joint, but was advised not to go through another surgery to remove it, bassicly they (the rehab people and the doctors) said that its something that will always be with me, and i should get used to it. they offer no pain relief, other the over the counter advil, or tylenol. i guess i just have to live with it .

Sep 03, 2009
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Pain after ankle fracture
by: Anonymous

Wow great picture ...
I have had pain in my ankle since my accident - I have however had a few guinathidine blocks injected into my ankle (which worked really well, they say not everyone responds to it) - although the pain can be really sore when these wear off. I did have an achilles tendon lengthening op to try and allow me more dorsiflexion but this hasn't worked - but I do have a bit less 'tighteness' around the back of my ankle now.
I do know how frustrating being on crutches can be - I have now been on elbow crutches for 21 months - I am due to have my ankle fused in 3 weeks (as even with the removal of scar tissue) I still have dorsi flexion at all in my ankle - I am really quite unstable walking around without my crutches as my foot is stuck in a way that it drags along the floor and I trip up very easily - it has been a very frustrating time for me. I just hope that the fusion will allow me to be more active and get some normality back again. And I am assured I will eventually be off the crutches ... fantastic thought!

PS - I did also have all the metal work removed from my ankle (they thought this might have been causing some of the pain - but it hasn't helped with the pain at all)

Good luck with your recovery - a pain management clinic might work wonders for you in your recovery.

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Sep 03, 2009
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Submitted by: Anonymous

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Wow great picture ... I have had pain in my ankle since my accident - I have however had a few guinathidine blocks injected into my ankle (which worked really well, they say not everyone responds to it) - although the pain can be really sore when these wear off. I did have an achilles tendon lengthening op to try and allow me more dorsiflexion but this hasn't worked - but I do have a bit less 'tighteness' around the back of my ankle now. I do know how frustrating being on crutches can be - I have now been on elbow crutches for 21 months - I am due to have my ankle fused in 3 weeks (as even with the removal of scar tissue) I still have dorsi flexion at all in my ankle - I am really quite unstable walking around without my crutches as my foot is stuck in a way that it drags along the floor and I trip up very easily - it has been a very frustrating time for me. I just hope that the fusion will allow me to be more active and get some normality back again. And I am assured I will eventually be off the crutches ... fantastic thought! PS - I did also have all the metal work removed from my ankle (they thought this might have been causing some of the pain - but it hasn't helped with the pain at all) Good luck with your recovery - a pain management clinic might work wonders for you in your recovery.

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Sep 03, 2009
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dorsiflexion
by: Jenny

I just had my 7th surgery since my ankle accident, the surgeon dug out a lot of scar tissue as well as extra bone growth (due to lack of cartilage) and lengthened my Achillis tendon. Prior to this surgery I couldn't even get my ankle to neutral, now I'm 7 centimetres past neutral and I think it will improve. I think surgically freeing up the joint by digging out all the impingement will help,

May 22, 2009
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Frozen ankle
by: Anonymous

I too am suffering from 'frozen ankle' after breaking both tib and fib in left ankle - does anyone know if removing scar tissue from ankle will help with dorsiflexion of ankle - it has now been 16 months since my accident - don't think I can cope with being on these crutches much longer. I am currently at physio & hydrotheapy every week as well as swimming every day ... any advise would be greatly appreciated - my ankle joint just won't move which is really frustrating!

May 04, 2009
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Scar Tissue
by: Jenny

Am getting the scar tissue removed this August. Its been almost 15 months since my initial injury, am still limping, in pain, and my ankle is virtually frozen. The range of movement has gotten from bad to worse. Am hoping that removing the scar tissue might free up the joint a little bit, I now have serious problems in both knees and hips as well, am so fed up!

Mar 30, 2009
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me too
by: grant Jordan

after an ORIF on my right ankle, i have been in therapy now for 2 weeks,(its been 4 months since my motorcycle accident) and i too see no improvment in range of motion. in fact it seems to be getting worse, i know i have severe scar tissue that is hendering me, but is this normal? i go to therapy 3 times a weeks also and everytime they bend the ankle and twist it as far as they can(very painfull) but no improvment. can my ortho go in orthascopiclly and remove scar tissue?

Nov 25, 2008
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Any suggestions?
by: Jenny

Hi Bart

I am still preserving with physiotherapy 3 times a week, and doing my own exercises at home. I have problems with swelling, I take anti-inflamatories and when I can, put my foot in a bucket of cold water to cool it.
What is really frustrating is that my range of movement has not improved at all in the last 7 weeks - my physiotherapist measures the distance between my knee and toe and there is not even a 1 centimetre gain. I know I should be doing more exercises, controlling the swelling more, but I'm becoming very concerned that I might be stuck limping. Granted that time starts again from my reconstruction surgery in August, its been 3 and a half months since that. But you can imagine how fed up I am, having been on crutches/crutch for almost 10 months now. Remaining optimistic is easier said than done, can you give me any other advice?

Oct 23, 2008
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posterior tibialis pain
by: Bart - SII

You most likely have a significant amount of scar tissue built up all around the ankle - I know that they removed a lot with the last surgery, but adhesions and such could be restricting normal gliding of the tendon.

Also, since you don't have normal motion yet, the posterior tib is working harder to help stabilize the ankle, and is likely having some overuse issues.

Soft tissue massage around the areas that are painful and the course of the posterior tibialis may help to reduce any adhesions or healing by-products - and time and strengthening should also help.

Bart

p.s. Great Picture!