Muscle Slippage: Effective Treatments and Recovery Tips

Q: Muscle Slippage: Effective Treatments and Recovery Tips

Hello, sir： Thank you for your inquiry. <br>Here are my responses and suggestions： <br>1. <br>Based on your description, the sliding tendon may be the flexor hallucis longus or tibialis posterior, which could be causing ankle instability due to injury (including the tendon and th

Muscle relaxation or muscle detachment?

Hello Dr.
Chen, I have a question I would like to ask you: When I was in the second year of high school (16 years old), I was playing basketball.
It wasn't a very intense game, but during a jump shot, I injured the tendon inside my left ankle.
Initially, I thought it was a sprain, but sometimes when I walk, it feels like the tendon is slipping out.
It seems to slide over the bony prominence on the left side of my ankle, and I can see a tendon bulging over that bone.
When I move my foot slightly, the tendon goes back into place.
I went to a traditional Chinese medicine practitioner for massage, but it was ineffective (the practitioner said it was a "muscle").
Later, I visited a clinic and received some anti-inflammatory and pain relief medication, and I continued to see various traditional Chinese medicine practitioners for massage, but there was still no improvement.
I also consulted a rehabilitation department and a large hospital, where I underwent electrical therapy, but I have not healed to this day.
I can run and jump now, but occasionally I feel weakness in my left foot, and the tendon still slips out occasionally (though much less frequently).
Should I seek treatment? What kind of treatment would be most effective? Will this affect my military service? Thank you for your help.

xuesheng, 10~19 year old female. Ask Date: 2008/08/27

Dr. Chen Xianchang reply Rehabilitation

Hello, sir: Thank you for your inquiry.
Here are my responses and suggestions:
1.
Based on your description, the sliding tendon may be the flexor hallucis longus or tibialis posterior, which could be causing ankle instability due to injury (including the tendon and the medial ankle's deltoid ligament).

2.
You are quite young, and in addition to deep tissue treatments (such as shortwave, ultrasound, and laser therapy) and electrical stimulation, it is important to strengthen the muscle strength in various angles of ankle "dorsiflexion," "plantarflexion," "inversion," and "eversion."
3.
Fast running and intense exercise may have an impact, but walking will not.

Finally, I wish you safety and happiness!

Reply Date: 2008/08/27

More Info

Muscle slippage, particularly in the context of your experience with the ankle, can be a complex issue that often requires a multifaceted approach to treatment and recovery. It sounds like you have been dealing with a persistent problem since your injury during basketball, and it’s understandable to seek clarity on effective treatments and recovery strategies.

First, it’s important to understand what you’re describing. The sensation of a muscle or tendon "slipping" or "popping" can often be associated with tendon instability or a condition known as tendon subluxation. This occurs when a tendon moves out of its normal position, which can happen due to various factors, including injury, anatomical variations, or weakness in the surrounding musculature. In your case, it seems that the injury may have led to some instability in the ankle region, particularly involving the tendons that run along the inside of the ankle.

Given that you have already sought various treatments, including traditional Chinese medicine, physical therapy, and pain management, it may be beneficial to consider a few additional steps:
1. Comprehensive Evaluation: If you haven't already, consider getting a thorough evaluation from an orthopedic specialist. They may recommend imaging studies, such as an MRI or ultrasound, to assess the integrity of the tendons and surrounding structures. This can help identify any underlying issues that may not have been addressed in previous evaluations.

2. Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can design a rehabilitation program tailored to your specific needs, focusing on strengthening the muscles around the ankle, improving stability, and enhancing flexibility. This may include exercises that target the peroneal muscles, tibialis posterior, and other stabilizing muscles of the ankle.

3. Taping and Bracing: Using ankle taping or a brace during activities can provide additional support and help prevent the tendon from slipping out of place. This can be particularly useful during sports or activities that put stress on the ankle.

4. Strengthening Exercises: Incorporating specific strengthening exercises into your routine can help stabilize the ankle joint. Exercises such as resistance band training, calf raises, and proprioceptive training (balancing exercises) can enhance muscle strength and coordination.

5. Gradual Return to Activity: Since you mentioned that you can run and jump, it's crucial to ensure that you are gradually increasing the intensity of your activities. Pay attention to any signs of discomfort or instability, and modify your activities accordingly.

6. Surgical Consultation: If conservative treatments do not yield satisfactory results and the sensation of slippage continues to affect your quality of life or athletic performance, a surgical consultation may be warranted. Surgical options can include tendon repair, reconstruction, or stabilization procedures, depending on the specific diagnosis.

Regarding your concern about military service, it’s essential to address any ongoing issues before enlisting. Military physical requirements can be demanding, and ensuring that your ankle is stable and functional will be crucial for your performance and safety.

In summary, while muscle slippage can be frustrating, a comprehensive approach involving proper evaluation, targeted rehabilitation, and possibly surgical intervention can lead to significant improvements. It’s essential to remain proactive in your treatment and communicate openly with your healthcare providers about your symptoms and concerns. With the right strategies, you can work towards regaining full function and confidence in your ankle.

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