Funny Bone

Hello again! It’s been a busy last week before surgery — finishing up work (plus freelance work), enjoying my final few ballet classes of the summer, making a gazillion calls to my insurance company (America’s favorite pastime…), and visiting with my in-laws who were in town from Minnesota.

I can’t believe I’m less than five days away from surgery, but before I get ahead of myself, I need to finish the story of how I got to this point!

By this spring, I was not only frustrated with the issues I was having in ballet, but dealing with pain in my “normal” life too. I decided I was way too young to be turning down walks with my husband and dog because of joint pain, and that this problem wasn’t going to disappear on its own.

I have to hand it to a friend who’s an athletic trainer — he’s the one who first posed the possibility of an os trigonum to me. (If you’re just tuning in now, read my last post for more info on this funny-sounding thinger.) I dismissed the idea at first because I’d had x-rays, and the doctor said they were normal. But when I did some research, I realized that the symptoms sounded just like what I was experiencing. I made an appointment with a different orthopedic surgeon, who took another set of x-rays …and sure enough, when the side view of my ankle popped up on the computer screen in the exam room, there it was: a “fairly large os trigonum,” as the doctor said into his little recorder.

The os trigonum is the little nub sticking out above my heel bone. In case you couldn’t tell from my awesome Paint skillz with the ellipse tool.

I think it looks like a bean on the MRI! The white spots around the bone are inflammation/fluid buildup.

I’m leaving out a lot of details here on purpose, but it became apparent that the surgeon wasn’t too experienced in dealing with this issue (which, to be fair, isn’t very common). So I went back to the Interwebs, did some more research, decided I was willing to travel, and hoped the third time would be a charm.

I had to wait a month and drive several hours for my initial appointment with Dr. David Porter, an orthopedic surgeon who specializes in foot and ankle injuries and practices at Methodist Sports Medicine / The Orthopedic Specialists in Indianapolis. He treats a lot of professional and collegiate athletes (and dancers!), including the Colts. He’s known around the U.S. as a foot and ankle guru — seriously, Google him.

The first thing that happened during my appointment was this sweet X-ray of my foot on demi-pointe:

My heel bone is jammed right up against the os trigonum. No wonder it hurts!

As I pretty much expected because I’d exhausted all the other treatment options by this point, Dr. Porter said I needed surgery if I wanted to continue dancing. He showed me on the MRI that the bone is actually fractured, and he also pointed out some nodules that have formed on my FHL tendon and did a (super painful) test that confirmed I have trigger toe in addition to an os trigonum.

Non-medical-expert briefing time again! The FHL tendon runs from underneath the big toe, through the inside of the ankle, and right past the os trigonum, so FHL problems tend to coincide with the extra bone. Trigger toe basically means that the tendon is irritated and doesn’t slide smoothly through the tendon sheath like it should. Instead, my big toe goes from being straight to snapping into a hooked position and getting stuck there. Sounds pleasant, I know. It feels nice too.

While no one wants to hear that they need surgery, I feel as good about the situation as I possibly can! I’m confident in Dr. Porter and his team — he took plenty of time to answer my questions and obviously has a ton of knowledge and experience, both in treating os trigonum syndrome and in working with dancers. Although I’ll be spending many, many hours in the car and beating a well-worn path to Indianapolis over the next few months, I already know it's worth the drive. 

Next update: the gory details of surgery (or at least the ones they've told me)!