It’s been a long week. I saw Dr. Slauterbeck last week to try and begin piecing together what is going on with my leg. First, we ruled some things out. Despite some pain around my tibia, I don’t likely have a stress fracture. Dr. Slauterbeck feels confident that the release was successful and that he opened the compartments up so extensively that a recurrence of CS is almost impossible. What we did decide on was that something happens when I’m running that causes an interference with a nerve, likely the peroneal nerve. To get more information on this, I was scheduled for a dynamic EMG, which I had today with Dr. Zweber.
For those who haven’t ever had an EMG, think serious poke from an electric fence, at various places along your leg. It’s not painful, per say, but it’s not pleasant either. We started by establishing a baseline and tested me at rest, both with the electricity and with some strength exercises. Then I headed to the treadmill to get tested. The drawback to this, of course, is that I’ve never had symptoms on a treadmill. I ran for 40 minutes until my foot felt like it was flopping around and starting to go numb. Dr. Zweber and I hurried back to the exam room and he repeated the EMG. So what did we find?
The good news is that there is not a trap at the fibular head, as we had suspected. I have some tenderness in this area, but the EMG seemed to suggest that the nerve was happy and free here. As we move lower, however, a trap seems to exist just below the lateral incision. This explains the eventual numbness and inability to control my foot while running. Basically, the sensory feedback that should be coming from my foot as it strikes the ground is getting garbled and my anterior tibialis muscle, ankle stabilizers and toe muscles don’t know what to do to coordinate movement.
So what to do? Dr. Slauterbeck and Dr. Zweber need to put their heads together and figure out what the test results and my symptoms mean, what the solutions might be and what the chances of success are with those solutions. As Dr. Slauterbeck and I discussed last week, a nerve trapped up by the knee would be a far easier (as easy as nerve surgery is) than a nerve near the ankle. For me, the location is also complicated by the vast amount of scar tissue found in the area and the incision.