Possible FHL tendon tear in big toe, please help!

Have you experienced any improvement ?.. I had the same symptoms and I just got surgery. I would like to exchange experiences.

 

I have very similar symptoms and course. Not healing after 5 months. Ortho foot specialist thinks it's an FHL tendon rupture but need a 2nd MRI to confirm. What surgery did you get? Hopefully you have recovered by now but what was the real diagnosis (I see your post was 1 year ago so hopefully you recovered.
-j

 

Today, 3.31.2011, My Hand Doctor said I had tendinitis under neath my thumb. But, I think after working out with a foot / leg / buttock muscle wt. mach. yesterday, I woke up this morning with what I am certain is tendinitis on the bottom of the main jt of my big toe. A tear, ?? Sounds like the same thing as what happened to my hand. The Doc injected steroids under my thumb.(today) so I don't know the outcome.

But the Doc would not look at my Big Toe. Go figure?? Another specialist!
??? Has surgery help anyone? What kind of surgery? Recovery period? Out come?

 

I don't know about you but I think it might be helpful to know what the problem is before anyone can tell you if surgery might help and what kind how long the recovery would be and what the outcome would be.

 

Good Idea, thanks. I wish there were more than just 3 or 4 posts on this site. If you know of any others similar sites (foot ailments) please provide a link - or name. Besides a suspected small tendon tear in underneath my big right toe, I have a sense of deadness (numb) in the middle toes of both feet. It's taken three years - and getting a bit worse, I believe. Internal medical doctor said it was not diabetes, but could be a pinched nerve in my vertebra. Any comment on experiences from anyone would be appreciated.
1. numb toes
2. small tendon tear (I think) underneath/ on the side of the last joint of my big right toe.

 

If you can curl your big toe, the FHL tendon is not ruptured. You could have a tendonitis. My FHL spontaneously ruptured and I am unable to curl my big toe or use it to help to support that side of the foot when walking (70% of the weight you put on a foot is supposed to fall at the base of the big toe and normally you use the big toe to help push off). As a result, my 2nd and 3d toes hare getting all the pressure and are digging in to my shoe and they hurt. I hope you don't have this.

 

Hello,

While I see all the commets here are dated I wanted to add to the discussion. I have a confirmed FHL tendon rupture with a 3 cm distance between the tendon ends. I have pain in the arch of my foot running through the heal of my foot and the possible start of tendonitis. I have seen 4 specialists with regard to repair to date and all state a complete 'as was' repair is not available. The options available are a FHL tendon transfer (option 3 specialist have suggested) or to leave the tendon torn (1 specialist stated if it was his foot he would not have the surgery). From the opinions I have had, all state the possiblity of the big toe eventually sticking up and possible bunion development are concerns. This would eventually require a toe fusion operation later thus taking all of what flex I currently have leaving the toe unbendable.
I have a final appointment at our local Medical College for a final opinion and possible case study as a FHL tendon rupture is very rare. Would anyone who has the same condition care to share their experience with a tendon transfer surgery (has it helped or not) or the decision not to have corrective action.
Thank you in advance for any input you may share.

 

You are right to say that FHL tendon rupture is very rare. How did you get your injury?

Also, the FHL tendon can be irritated by a condition known as "Os Trigonum syndrome". it is caused by an accessory bone at the back of the ankle.
Also, fracture of the posterior talar process can be similar.

Make sure you have these ruled out before you consider surgery

 

Thank you for your response. My rupture likely started as a tear via gardning (excessive squatting etc). Sad that a relaxing thing as gardening could cause such havoc. I began to favor the foot and reduce my activity but to no avail as one day I had the sensation of a rubber band snap within my foot - most notably felt in the arch of my foot. Both incidents nearly took me to my knees with walking almost not possible for 3-4 days following. After the 1st incident I had toe function but very limited; 2nd flexing/curling of toe no longer possible with notable imbalance.
The MRI shows the rupture near the heal and most orthopedic surgeons feel ithe small triangular bone you mentin could have agrivated the possible tear to rupture. PT treatment has not been successful and my ankle continues to swell in addition arch pain. PT specialist also notes arch collapse.
To reduce additional tendon aggrivation I have been given a boot cast to use until surgery. While the boot has reduced ankle swelling it has also contributed to increase ankle soreness, heel pain and arch pain. Discussion of boot design (rubbing on heel) and not arch support are suspected. For non walking periods it is off.
Current surgical thoughts are to inspect FHL for possible transfer. In addition, removal of the small bone and cleaning scare tissue are being performed. My concens now turn to the surgery, recovery & complications.
Your thoughts are appreciared.

 

Hello,

I torm my FHL February 25th, 2012 rebounding basketballs for my son. One went over to the wall, I pushed off with my right foot, heel off the floor and most all pressure on the big toe, not much, just going into a light jog and felt the snap. I turned around and told him I think I just broke my foot then retrieved the ball. We continued for about another 20 minutes then went hoime. Upon removing my sock the side of my big toe and about half way down the inside to the middle of my foot was purple. Knowing something was injured but not even knowing what an FHL was, I waited for about 4 weeks to see if it would improve. It did not. I went to the doctor, and got an MRI that showed a clean tear. I had surgery April 12 and was non-weight bearing for 6 weeks. I have regained movement in my big toe, I can move it up and down, whereas I was not able to pre-surgery, but I still cannot curl it. I can curl it with my left hand so it is not fused, but not on its own. It has no resistance if I curl it and then push back trying to hold the position. Just like nothing is there. I can feel and see the FHL move under the arch of my foot when I move it up and down.

I have since been told that it can take 18 months to two years to regain full mobilty. I did about 6 weeks of physical therapy but now just do all the exercises at home. There is just not enough data out there on this injury. I am not sure if I will be able to curl it again. When I walk, all my weight goes onto my 2nd toe and it is all calloused up on the end due to it being the toe that is pushing off on every step. There is no pain however. There was some concern by my doctor that the scar tissue had adheared to the tendon and was restricting movement. I took some direct cortisone steroid shots to the scar area to help break up the scar tissue. Still no improvement. Has anyone else regained full curling movement of the big toe and how long did it take?

Than

 

I tore my FHL February 8th, 2013 bowling. Two days after the injury I had no downward movement in the big toe but normal movement up. I waited a week to see if the condition would improve, it did not. Once seen, I was referred to an Orthopedics to confirm a FHL tear via an MRI and then referred to the only Orthopedic Surgeon in my area who had the experience to do the surgery. I was non-weight bearing for six weeks and then transitioned to a walking boot. Two weeks later, I was off crutches and out of the boot and started physical therapy. I am 11 weeks post surgery and have restricted up and down movement of the big toe with no ability to curl it, except by hand. I have quite a bit of pain on the side of the foot during physical therapy where the FHL tendon path is, with the concern its scar tissue buildup. Nothing so far has worked to relieve the pain or breakup the scar tissue. I can feel the FHL tendon trying to work when I am doing flexing exercises and have been told not to push too hard too soon, to give the foot time to heal.

Patty

 

Hello,
I ruptured FHL last year and I have received same response from podiatrist that surgery is not recommended. To go in and fix it could cause worse problems due to the location and proximity to other vital tissues. It sucks not being able to do the exercises I use to do and could possibly need surgery anyway in the future because without the use of the FHL, the toe can begin to extend upward so part of the tendon that does that would have to be cut. I would think the FHL could be repaired in this day and age of advanced surgery techniques but apparently we aren't there yet.

 

did you have the surgery? I also ruptured my FHL and opted not to operate. 3 mos later having pain in ball of foot.

 

I am 4 weeks from a spontaneous complete rupture with retraction of the FHL tendon during a tennis match, confirmed by MRI. I got 3 professional opinions and did all Internet research. At this time, I've decided NOT to have repair. Brevias is intact so I can move toes up but cannot curl. Pain in arch- right about where the retracted end is hanging out. Second toe is already sore from doing the push-off for the big toe.
My question to any of the above responders: what is your status right now? Post-surgery or no-surgery: what is your recovery?

 

I just had full thickness tear of FHL confirmed yesterday (most likely from aerobics and running). I see the Dr. tomorrow. I imagine surgery is the answer. I have a very physical job and can't go limping around forever. And if it is completely torn, how does PT help?
i also would like to hear of other surgery recoveries.

 

Hi, did you repair your foot? If so, how did it go?

 

UPDATE: I am now 18 months out from complete spontaneous rupture of the FHL tendon. My big toe is starting to "curl" up, my second toe is doing all the push -off work and is callused. No pain in my toe and walk without a limp. Pain in my arch and was staring to get pain in my knee and hip due to compensation. No surgical intervention. Instead I am learning what works and what doesn't: I need arch support for my shoes, flip-flops (or any sandal that requires my toes to grip) aren't comfortable for any length of time, high heels are ok. If I don't have arch support I use an orthotic arch and this has mitigated pain in my knee and hip. I am still consistently active, playing tennis several times a week, 2-3 hours at a time.

Tendon has not retracted any further than right to the Knot of Henry.