Tarsal tunnel versus medial plantar and lateral plantar injury
Hi, I just found this group and hoping to learn from others experiences. July 2020 I had a plantar flexion injury to my foot (my big toe and foot folded under me). I was diagnosed with avulsion fracture of big toe and placed in post-op shoe for 4 wks. I had some bruising along inside of foot, swelling and pain on top of foot, but the podiatrist was dismissive, never examined the foot and said it would be fine. I had worsening pain in midfoot, along medial aspect of foot and swelling for several months. I finally went to sports med doc this spring. I've had x-rays and MRI of foot, ankle, EMG, and nerve US. The MRI showed atrophy of muscles innervated by medial plantar and lateral plantar nerves. The EMG also showed that the motor function of those nerves weren't working, but the sensory aspect was fine. The nerve US didn't show any identifiable entrapment. I've had to advocate for myself to get this far, and still not getting a lot of answers in terms of how this could have happened or what, if anything, can be done. I'm having a difficult time finding a specialist who can help as it seems like an unusual injury. Time is running out for a chance of nerve and muscle recovery, and I'm used to being active so this is hitting me hard.
Has anyone else had injury to motor function of medial plantar and/or lateral plantar nerves and subsequent weakness of foot intrinsic muscles? What type of doc did you see? What treatments helped or didn't help? They were initially thinking tarsal tunnel, but the MRI and US don't show any entrapment. Thanks.
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Oh man this sounds incredibly painful. Good for you for advocating for yourself to get this far. If the podiatrist is dismissive, I would not waste any more time there. Is there a good orthopedic group or a good sports medicine group nearby?
Hello @sunflower1, I would like to add my welcome to Connect along with Chris @auntieoakley and other members. I saw this YouTube video and thought it might be helpful.
The Lateral Plantar Nerve – Everything You Need To Know – Dr. Nabil Ebraheim
Hi Chris, Thanks for the encouragement. Yes, I've already been to a sports medicine doc – I called in April for the appointment, was able to see him a month later. Long story short, it's like pushing string – doc ordered MRI of foot and ankle but insurance denied the ankle, so just did the foot – wait a couple weeks to get that done, and then can prove that MRI of ankle is also needed so wait another week, and then need EMG and wait 6 wks to get that (and that's after begging to get in sooner in attempt to address the nerve damage before it's too late). Then the doc gets the EMG results which shows motor aspect of medial plantar and lateral plantar nerves aren't working properly. So, doc says it's not reversible and suggests PT. I know enough to know that PT is palliative and without all the tiny muscles in foot working I'm going to be in trouble. So, I started doing my own research and sent my records to other places. I paid out-of-pocket and met with a specialist in a major city/health system a couple hours away, and I'm sure he is top of his field, but I'm not sure he even reviewed my records, the visit was very short and he wasn't really open to discussion. He did recommend an ultrasound of nerves, and when I told my doc at home, he said that he has a colleague he is in contact with who does this – UGH!!! So why didn't he offer this 5 months ago?! He just gave up. So, sorry for the rant – I'm so frustrated, confused, overwhelmed. I'm relatively young and like to be active, and have pain with just walking. What happened to the days when you could go to the doctor and rest assured that if they couldn't help you, they would help get you to someone who could? Thanks again for your encouragement.
Thank you @johnbishop for the kind welcome and video! That was kind of you to take the time to post it! I've been doing a lot of research, but this video did a nice job of showing the anatomy, thank you! I'm glad I found this group, as I'm hoping to learn from others experiences. Unfortunately, the docs I've seen this far are stumped, and I've had to keep pushing to try to get help – it seems if they don't know the answer, they just give up. I thought they would at least refer me to someone else, but I've had to instigate that myself, which is a slow process also as I can't really make phone calls/appointments during the work day. Anyway, thanks again!