The Diary of a Severed Extensor Hallucis Longus EHL Tendon – Injury

The Frankenfoot

Severed Extensor Hallucis Longus EHL Tendon

July 11-I got into a tussle with a tape dispenser and severed my extensor hallucis longus tendon. I can’t fathom the odds of injuring one’s self in this manner. The few cases I found online related more to cooks in the kitchen dropping knives on their feet. Ouch. Anyway, here’s how it happened:

I was taping the ceiling in the sunroom so I could paint the walls. Call it laziness or sheer bad luck…that I left the tape dispenser on the ladder when I climbed down to move it. As I scooted the ladder, the tape dispenser fell off and on to my foot in such a way that it severed my tendon. At first it just hurt like hell and I stepped back, into a pool of blood. I looked down thinking I must’ve stepped in paint, saw the blood and things pretty much go fuzzy after that. I understand I let out a wail of a scream and 911 was just seconds away. The hospital emergency room was full so they put me in the pediatric ER; lots of cute wallpaper.

The ER doc couldn’t fix it, but he clamped the severed end and showed me the tendon, which sort of looked like rice paper. He gave me a tetanus shot, vicodin and sutured it up. I left with a soft-cast, set of crutches, a prescription for pain meds and antibiotics, and instructions to see a foot surgeon asap. I saw Dr. D (DPM)the following day.

July 12-Dr. D has so many podiatry degrees on his walls dating back some 24 years, that I immediately felt at ease. He looked at the injury and asked me to wiggle my toes which, at first, I couldn’t. Finally, the 4 little ones came up. Dorsiflexion of the foot at the ankle was almost nonexistent. Still, he needs an MRI to confirm the injury. He re-wrapped the foot and fitted me with a walking boot in addition to the crutches.

Note on Bearing Weight (post-script): Even though I was fitted for a walking boot or “cam boot,” I was told NOT to bear weight on the injured foot. The reason for this is that tendons are stretched like rubber bands and the severed end can get drawn up into the shin making the severed end difficult for the surgeon to locate and lengthens the surgical scar. Best advice: Do not bear weight on the injury until 4-6 weeks post surgery.

Note on DPM vs Ortho Surgeon (post-script): A DPM is a doctor of podiatry medicine meaning they specialize in just feet. While ortho surgeons treat every tendon injury from shoulders to feet. Surgery requirements for EHL re attachment are among the rarest tendon injuries. Regardless of which type of doctor you chose, one of the things to keep in mind is experience, not just in their general practice but specifically how many EHL tendon repairs the doctor has done and what their success rate is. The biggest difference I’ve noticed between the two based on feedback herein is the post care or follow-up wherein suture failure results from allowing the patient to bear weight too soon after surgery resulting in the need for a 2nd surgery.

July 13-Waiting for the insurance company to approve the MRI is tiresome. Don’t they know I’m in a hurry to get well?

July 15-MRI appt. at 6:00 p.m. This was my first MRI and not an experience I’d care to repeat. It feels like a thousand particles of static electricity coursing through every part of the body. You can feel it in the air. The ominous sound of the machine firing a volley of images redolent of a WWII battle scene. It doesn’t hurt but it sure doesn’t feel good. Whatever the result, I won’t know for 3 days until the pathologist delivers his findings to Dr. D.

July 16-I suck on crutches. It’s like trying to dance with chopsticks. I’ve lost the use of my big toe. Without surgery, I’ll be unable to extend my foot upward 15 degrees toward my shin and vice versa…meaning I won’t be able to drive :-( Without special shoes I might even trip over my toe, just walking!

July 18-Took a pain pill and removed my stitches with a small pair of eyebrow shears. Washed the wound with soapy water and checked for seepage. None…so it must be good. Right? This kind of injury longs for the time when doctors rode over in horse-drawn buggies to make house calls. I suppose I could take a taxi to the clinic, but even that requires me moving about.

July 20-MRI results are in; confirming total separation of the EHL tendon. Met with Dr. D to go over surgical procedure and risks associated with surgery. Surgery scheduled for Friday, July 23, 2010 at local hospital.

July 22-Hospital called to confirm schedule for tomorrow at 12:30 p.m. I’m to arrive 3 hours early for check-in and blood work. How come everyone seems overly concerned with payments, co-pays, deductibles, etc… Do I look destitute? Basic instructions followed: No eating or drinking 12 hours before surgery, wear loose comfortable clothes, have ID, insurance card, co-pay, deductible, no jewelry, valuables, or electronic devices. Recommend leaving my walking boot at home and coming in on crutches. It’s an out-patient procedure so I’ll leave same-day approx. 3-5 hours later in a new soft cast and on same crutches. Any questions?

Fear sets in slowly. What if the anesthesiologist screws up? What if my surgeon isn’t the pillar of his profession? By nightfall, I’d worked myself into a frenzy and checked the state’s website to make sure my doctor’s license is in good standing. I’m suddenly reminded of a death-row inmate and wonder, in hindsight, if a frozen chimichanga burrito was really what I would’ve chosen if I’d known it could be my last meal.

About frankenfoot

I'm a 40 yr old, M-W-F, semi-active lifestyle, artist, writer / stay-at-home mom with no previous medical conditions.
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78 Responses to The Diary of a Severed Extensor Hallucis Longus EHL Tendon – Injury

  1. Pogo says:

    Hi Ann,
    Sorry about my obsessive questions, but I’m grateful for your perspective! I’m about 7.5 weeks post-op and although the swelling in my foot has gone down, it’s made the top of my foot incredibly sensitive to pain. My foot used to be numb. Did you experience that? What did you do for the pain?

    (Unlike your doctor, my podiatrist specifically said that I had to wear a stiff shoe/boot until I see him again at 14 weeks post-op. And a stiff shoe/boot translates into a hiking boot with laces. OUCH!)

    • Yes. I did experience that. It started 8 weeks post surgery. I had feeling on the outer top of my foot toward the little toes and numbness on the interior top. Then, at the site of the original injury I developed a squishy lump. It hurt if anything pressed down on it. It was macrophages (foreign body expulsion) a ganglion cyst due to the permanent stitches. It was injected with cortisone and an ultrasound wand (without image) was rubbed over the top of it. It settled down, but the pain upon pressing down at the location remained. It was a neuroma (nerve damage) that probably occurred at the time of the original injury but that went unnoticed because of the initial numbness to the area. When the numbness wore off and feeling began to come back, the nerve damage presented. I was prescribed lidocaine patches, but I’m allergic to lidocaine. So instead, I used an over the counter aspirin cream marketed for arthritis. I rubbed this on the site for awhile, but without use, the pain was intense; sporadic, but intense. I was afraid it might happen while I was driving. The podiatrist told me there was no cure. I looked into alternative medicine and found a doctor that performed “cold laser therapy” for chronic pain. I tried that (2 sessions) and it went away. Then about one and half years later, I was walking down the stairs (in a fairly new pair of shoes) and the neuroma sparked again. It was an isolated event and hasn’t occurred since. I am, however, leery about new shoes and anything that might put pressure on the top of my foot.

    • Tags says:

      hi pogo – when were you released to walk? i was non-weight bearing for 7 weeks and two days. then podiatrist released me to walk in a knee high walking bootboot. i’ll be in the walking boot for 4 weeks meanwhile doing pt twice a week.

      hi Ann – i’m so afraid of re-rupturing my tendon. does this timeline sound ‘normal’? or was a release from non-weight bearing at 7 weeks 2 days straight into boot walking a risky move? i only had 2 pt sessions before my release to walk. i walked quite a bit the first day out of sheer happiness then woke up the next day to pain in the foot. pain subsided after an hour or so. i’m going to limit my walking to an hour or less for the next 6 days and continue to do my pt exercises on non-pt days.

      • I also walked after 2 pt sessions. The 1st was just massage to help circulation and reduce swelling and I stood on both feet trying to distribute weight evenly, but it was more like 70/30. The 2nd session I walked about 10 feet from the table and came back. They gave me poles to balance. I did all right; pretty shaky. The worst part was a jolt to my heel as I walked. Nerves and muscles that hadn’t been used were now firing into action. I was told to limit walking to 15 minutes at a time and not more than 1 hour total during the first few days (5 days?) after that I was walking everywhere and ready to host a bonfire for my crutches. So, yeah, at 7 weeks the tendon has had time to graft, but the foot is still in a weak state and takes time to restore balance and strength. Range of motion takes the longest to get back so the pt exercises help immensely.

      • Pogo says:

        Hi Tags,

        Technically, my podiatrist (who was recommended by my podiatrist-friend) allowed me to walk immediately after the surgery for things like bathroom visits. I decided to be super-cautious so I used crutches for 3 weeks instead. After that, I walked in my orthopedic boot for three weeks. I didn’t walk much because the boot wasn’t comfortable and I got really tired after walking 20 feet.

        After a total of 6 weeks, my podiatrist instructed me to wear my really stiff hiking boot (the kind that you use for mountaineering). Stiff hiking boots are the only things I’m allowed to wear for the next 8 weeks. No tennis shoes, no slip-ons, no sandals and definitely no flip-flops. However, he OKed me to hike as much as I want. So, I went on a 10.5 mile hike today with some steep elevation gain and loss. It wasn’t easy, but I found that hiking forces me to use my big toe for balance and that is helping me recover.

        My podiatrist also said that I could skip PT because hiking will rehabilitate the toe. Right now, I can point my toe and lift it up. It’s still swollen, but I almost don’t have a limp. I’m almost 8 weeks post-op.

        I think the difference in recovery timeline and recovery protocol among all the EHL patients stems from where the tendon was severed. Mine was on knuckle of my big toe and it supposedly was a textbook repair.

        I was pretty nervous because my recovery protocol was so different from Ann’s and almost everyone else’s on this blog. I wondered if I was being too active, too soon because I was allowed to weight-bear immediately. But so far, it’s worked for me and I trust my podiatrist.

        If you trust your doctor, I wouldn’t worry too much even though I was obsessed over it. Good luck. Hope that helps.

  2. Pogo says:

    Hi there. I’m about 5 weeks post-surgery and my big toe still droops. Do you remember how long it was before yours wasn’t droopy? For some reason, I’m worried that I did something to re-rupture my tendon, even though I don’t think I could have.
    And thanks for describing your physical therapy exercises. My insurance won’t cover that so I’ll have to pay out of pocket. I might just do some on my own before I decide to go that route.

    • Post Surgery, the toe was never as droopy as it was pre-surgery. However, there was a gap that existed, between the great toe and the 4 little ones that remained apart until 1 week post physical therapy or week 7 post surgery. To see this, simply set your good foot up (like propping feet up on your desk) and look at how the toes align, almost overlapping they’re all together or close to it. Then set your injured foot up and see how the toes align. Mine looked like the 4 little ones were a team and the big toe was apart or not with them in alignment or direction. The great toe sort of went out instead of coming in. This began to improve greatly in week 7 and by about 7 months was unnoticeable. Then the difference became between the flexibility of the injured foot compared to the good foot.

      There were times when I worried that my stitches were compromised and then a little involuntary twitch at night or early morning would painfully remind me that all was good with the stitches. If you don’t see any sign and the toe is very droopy, ask your doctor; maybe he’ll get a second MRI.

      Best luck and hang in there!

  3. Don Stimson says:

    Good blog. It was very helpful reading about what you experienced before my own EHL tendon surgery. I am the only one on here (so far anyway) who ruptured mine not by dropping a sharp object on it, but simply while I was running. I had had bunion surgery on the same foot in December and had recently been cleared to resuming full activities, including running and cycling. The running was coming back slowly, and not without discomfort, but I thought I was finally getting back to a decent level 5 months after my bunion surgery. However, during one run (my last), the foot started hurting so bad I had to walk back. (There was nothing special or traumatic about the run or the onset of the injury — it was just a nice even asphalt road surface.)

    I thought I had done something to one of the pins left in my foot from the bunion surgery. That night, I must have flexed my ankle while sleeping because I woke up in a lot of pain. The next day, while walking barefoot I noticed my big toe was just hanging down and I had no control over it. Of course, this happened while I was out of town as well.

    Went to the doctor as soon as I got back and found out I’d ruptured the EHL tendon, requiring surgical repair and 6 weeks of non-weight bearing. The repair ended up including about a 3 cm length section of cadaver tendon. I’m now 5 weeks into it and can’t wait until next week! Having just been through the 6 weeks on crutches thing for the bunion surgery, I really dreaded doing it again. Especially during the summer. But at least I was well acquainted with using the crutches. And since it is my left foot, I have been able to drive.

    I am an amateur bicycle racer and had attempted to time my bunion surgery such that I would still be able to race this year. I hadn’t realized how long the recovery from that is, so I had missed a good portion of the season. I had finally just gotten back into racing shape when this injury occurred.

    • Hi Don, How disheartening. Yes, it’s the first sports related injury vs. accident that I’ve heard of in this forum. I think that when stress (like from running) is placed on the tendons they can become inflamed and/or tear. This may be why some runners experience tendonitis. It sounds like you’re hanging in there and have an idea what to expect going forward. The best advice I can give is listen to your body. You’re an athlete, so your mind will steer you in that direction whether your body is ready or not. Remember that Serena Williams had to undergo a second surgery because she tried to do too much too soon. You’ll get there and I promise, you will run again. Hugs, Ann aka Frankenfoot

      • Cyclist says:

        After 6 weeks on crutches, I was disappointed to find out I have to remain in the boot for 4 more weeks. On vacation in Hawaii, I was at least given permission to walk short distances (like from the beach to the water) without the boot. Lightly kicking in the water is supposed to help strengthen the tendon.

        Having been here for a week, it is either getting stronger or I am just getting better at trying to walk more normally on it when the boot is off. Have also done hikes up to 2 miles long in the darn boot (which I would not be doing at this point without the boot, though).

        I have a really good physical therapist, who was actually able to come up with a reasonable hypothesis for how I managed to rupture my tendon running. I think if I had had him for the bunion surgery recovery, I may not have ruptured my EHL tendon.

  4. Pogo says:

    Frankenfoot: Did you mostly sit on the couch, waiting for you foot to heal, for the entire 6 weeks? Or were you somewhat mobile, using crutches to go to the grocery store, bank, shopping…etc. I’m going completely nuts sitting on the couch, and it’s only been one week post-surgery.

    I completely ruptured my EHL tendon when I dropped a kitchen knife on it. I”m pretty lucky that the knife didn’t take my toe!

    • frankenfoot says:

      Hello. I hear you with the boredom. It’s the worst, well one of the worst parts ;-) I hobbled about on the crutches and got the ride-around carts at the store…except not all stores have them. I couldn’t drive, so my hubby chauffeured me about. He’d of been happy to have me leave him to it, but I enjoy shopping. I was definitely the anchor on his speedboat, but we fell into a groove that soon felt comfortable. I got to get out and he was forced to slow down. I think it did us both good.

      In retrospect, I wish I’d learned about the knee-scooters sooner. We rented a wheel chair and got a temporary handicap sticker. But the knee scooter would’ve helped immensely, maybe even freed me up enough to walk the dog. I pulled weeds and kept up with the gardening; crawling about on hands and knees. Some tasks were definitely easier than others.

      Shoulders back. Chin up. Deep breath. Exhale. Smile! :-)

      Do what you can, don’t fret what you can’t. Remember that you’re in a delicate state and too much activity could disrupt the healing process. Your foot is on vacation whether you approved it or not, so take it easy and keep your mind occupied reading, writing, thinking up penny dreadfuls, etc… All of this is temporary. Things will improve.

      Here’s a penny dreadful to get you started:
      ‘That awkward moment when you realize the necklace you just found with your metal detector is attached to a skeleton.’

      And here’s a joke:
      So this blind guy walks into a bar and says to the bartender. “Wanna hear a blonde joke?”
      A woman leans over from the stool next to his and says,
      “I think I should warn you: the bartender’s blonde, the barmaid is blonde and I’m a blonde! Now, do you still think you wanna tell that joke?”
      He thinks about it for a moment then shakes his head.
      “Nah,” he says. “Not if I have to explain it 3 f—ing times!”

  5. Pogo says:

    Oh my…I have joined the ranks of the Frakenfeet! I just had my surgery last week for a completely torn EHL. How long was it before you started driving? And, were you as paranoid as I am? I’m convinced that every time I run into the wall, I’ve ruined my repaired tendon. I’m pretty clumsy with my crutches.

    And sadly, unlike you, I’ve had a great appetite since the surgery, including the first dinner post-op! Yikes. I will never lose any weight, but I’m definitely worried about getting fat in my sedentary state!

    Thanks for the blog. It’s interesting to read everyone’s experiences.

    • Tags says:

      Hi – i’m 11 days post surgery for completely lacerated EHL. I am SO paranoid that I willl retear the tendon. I literally think of it with every turn, twitch, minor movement and especially when i slipped in the bathroom and put full weight on the injured foot. Dr says time will tell – foot too swollen to know if surgery was successful. However – i took pre-surgery photos of my toe which was hanging down. I compare these to how my foot looks now post surgery and the tip of my toe is slightly ‘turned in and up’. This assures me (somewhat) that the tendon is still sutured. The toe still ‘hangs’ below the other four toes but again the tip of the toe very slightly turns in and up – so good news I hope.
      Good luck to you!!

  6. Sylvia says:

    Hello! I had an EHL tendon severed in my right foot in 5/12. There is lots of scar tissue causing cramping and pain in my foot leg. Do you still have issues with your foot?

    • frankenfoot says:

      Most likely this is a neuroma (nerve sensitivity due to nerve damage at time of injury) or it’s a ganglion cyst (undissolvable stitches can cause macrophages or foreign cell build up that your body wants to evict). I did get this from time to time, about 8 mos post-op. Then it subsided and I get it maybe once or twice a year, usually wearing a tight shoe or performing an activity where my foot is in an up/down motion, like climbing stairs or hiking. I used over-the-counter aspirin cream, the kind marketed for joint pain and arthritis. If you see a podiatrist, they’ll most likely give you a steroid injection at the site. If your insurance covers it, try to get a referral from the doctor to have an ultrasound done; it’s non imaging, topical only and does wonders to flatten scar tissue. If you’re like me and look for natural remedies, cold laser therapy is the best.

      Good luck!

  7. Tags says:

    Hi Frankenfoot – It’s been said before but bears repeating – THANK YOU for this blog. I dropped a box of glass bottles in my garage on May 15, 2014. The glass shattered and a piece went through the top of my left shoe. Immediately I felt a dull ache and knew it was bad – not a band-aid, Neosporin type of injury. I took the shoe off to uncover a deep gash, the blood was pooling in the wound. I wrapped the foot with a piece of a t-shirt and drove myself to the urgent care up the street from my house. The urgent care PA (not DR mind you) said it wasn’t as bad as i thought it was and if i stayed off it, it would heal in a few days – to come back and get the stitches out in 7 to 10 days. I kept pointing out to the PA that I COULD NOT MOVE MY BIG TOE. She seemed to blatantly disregard my concern. I even took my other shoe off to show her that my big toe normally points up and the toe on my injured left foot was hanging down. So I went home and went to to bed. I knew this wasn’t over. I went to a proper Hospital Urgent Care the following day (5/16) and the DR said immediately that she was referring me to Podiatry. The DPM fit me in the same day. He said he was pretty sure the EHL was completely lacerated but he wanted an MRI. Had to get the MRI approved by Insurance which took several days. I had the MRI on (5/27) and follow up with DPM today (5/28). He confirmed the worse fear – the EHL was completely lacerated. Surgery is needed. I go in for surgery on Tue 6/3. Hoping for the best. Glad to have this blog and know that I’m not alone. My doctor is relatively young and inexperienced but seems very bright and knowledgable of the injury and the associated anatomy. I trust him to do a good job. The irony of my injury is that I just joined a running training team and had gone to my first practice 3 days before the injury. I desperately want to be able to run again and walk my very large dogs. Has anyone resumed running after a total EHL laceration? How long after surgery were you able to start running again? I’m pretty much on my own but I think this will make me stronger. My survival instinct has kicked in – I’m not going to let this get me down. Frankenfoot – re: the water fast – for a first time faster – what do you recommend? Thanks all!

    • frankenfoot says:

      I’m humbly reminded how fragile our bodies are. That you knew your injury was serious shows that you’re in-step with your body. That intuition is going to help in the post-op recovery. So keep listening and remember that all of this is temporary and things will improve. You’re definitely not alone, but time is the great healer. Unfortunately, pre-surgery, there’s not much you can do other than take it easy and refrain from bearing weight on that left foot. Regarding fasting, post surgery, it’s likely that your digestive system will shut down; as mine did. If this happens and you can rest, drink water (I drank 3 bottled waters daily) to keep hydrated and keep some oyster crackers or saltines nearby in case you get nauseated or feel hungry. Chances are, you won’t initially. I sort of thought I had to eat something, but I really didn’t need to and that’s why I threw-up when I did try to eat something. It was close to 2 or 3 weeks before I actually felt hungry and started eating again. I became so intrigued by this that I did a lot of research on fasting and one book, in particular: Fasting and Eating for Health by Joel Fuhrman, M.D. helped me to understand the body’s amazing healing process. There’s also a quote by Hippocrates that summarizes it in that “Everyone has a physician inside him or her…” Anyway, 10 mos. later I went on a self directed fast, as in not the natural one that my body seemed to take on its own post-surgery but one that I initiated through sheer will power. I found that all of the things in the fasting book were quite true and, in fact, my injured foot ‘re-healed’ giving me greater flexibility; specifically the ability to crinkle the great toe which I had not been able to do before. The sad part was that aside from my husband, I couldn’t share the experience with anyone because most people don’t understand fasting or they think you’ll die if you don’t eat for even just 2 days. Obviously, it can be dangerous especially if the person has pre-existing medical conditions like diabetes for example or is malnourished to begin with, so a doctor’s consent or agreement to monitor the fast is highly recommended. Usually people can fast safely anywhere from 3 to 28 days and I think the longest is 40, after which it’s completely un-safe and not recommended. All I can say is that when it’s a natural fast it’s easy and you’ll know when you feel hungry again. When it’s self directed the first 3-5 days are agony, then the hunger disappears and eventually boredom creeps in, but you know it’s working and eventually the stink gives way to a sweet smell, the tongue turns from white to dark healthy pink and your stomach starts to growl; you feel an unmistakable hunger. I broke all of my fasts with vegetable broth and ate like a baby for several weeks after, 4-6 very small (like 1/4 cup or less) meals that were extremely healthy, planned and well thought out. I went from pre-fast aerobic and running to post-fast lifting weights and focused on building muscles. I do both now…but I still have a weakness for chocolate :-) Whatever you decide, it’s important to listen to your body. Best luck to you and I hope your recovery meets and exceeds my own. Cheers, Ann aka Frankenfoot

      • Tags says:

        Thanks for your reply. I’m sure you want to leave the whole EHL tendon thing behind you but we (the newly injured) keep bugging you : ) I’m now 4 days post surgery. The surgery went really well and I’m in a boot – non weight bearing for 6 weeks. I’ve hit my foot a few times in the last few days and my (very large) dog has stepped directly on the foot twice. I’m very worried that hitting the foot or the dog stepping on it has damaged the repair. I think the worry/anxiety is worse than the pain — lol. The last thing I want is to have to start this whole process over with a second surgery. I go to the Dr. in a few days for my first post op appt. Crossing my fingers that I get a good report. For anyone going through this ordeal (lacerated EHL tendon) – you have my greatest sympathies. Until you go through this, you have no idea what it’s like to not be able to do the most simple and necessary tasks like moving from one room to another, emptying and loading the dishwasher, changing the sheets on the bed, sitting on the toilet, filling dog food bowls and refreshing the water bowl, bending down to pick up a dropped item, carrying a cup of coffee or plate of food from one room to another. It is so hard to accept that I will be this limited for the next 6 weeks meanwhile worrying constantly that I’ve re-lacerated the EHL. I’m really not a drama queen although I sound like it now. I have a profound respect and appreciation for my pre-injury body. And in hindsight, I’m developing an appreciation for my body and mind’s ability to adapt to this situation.

  8. Jan says:

    2 days ago glass bowl hiding in fridge flew out and left me with a gash just below the knuckle of my right big toe. I did not know feet bled profusely like heads. Anyway urgent care said they would clean it and numb it and if there was tendon damage they would send me to hospital. No tendon visible so I was stitched up. I have mostly stayed off it except to shower. Which leaves me bored silly…so I notice I can flex my big toe down but have issues with flexing it up towards my knee cap. I feel pain at the ankle, not at the gash site when I try to flex up in this manner. Thank you for this blog, because I know now the tendon is damaged in some way. I know an excellent foot doctor down the street, whom I shall see next week.

    • Hi Jan, So happy you found the information useful. I hope it’s nothing but if it has to be, then maybe just pulled or strained… but not severed. Good luck to you!!! – Ann

  9. Shagging, high-heel wearing Momma says:

    Terrible stories….A soap dish fell on my foot 5 days ago; big gash below my big toe. My neighbor is an ER nurse who came over an put steri strips to close the wound. Only today did I realize I am unable to move my big toe. Not my driving foot. Just an ignorant question, but why can’t I just live with a big toe that doesn’t move?

    • frankenfoot says:

      Sorry to hear about your mishap. If it is a tendon rupture, specifically the EHL tendon, than it’s not just a droopy toe you’d have to deal with, but also the loss of motion in raising the fore foot using just the ankle, which could impact walking, running and several other tasks (imagine trying to walk with one foot normal and the other by using the knee to raise the foot; you’d develop an unnatural gait). The best thing would be to see a podiatrist or ortho-surgeon soon. I think, only an MRI can determine the severity. Good luck.

      ps/If it does turn out to be severed/separated vs. just torn/able to heal, see section re: “Coping with Changes”, there’s a comment there by a veteran who didn’t have surgery and the affect it had.

  10. Shay says:

    Like other people had mentioned… there really isn’t that much information out there about this particular injury so I highly enjoyed reading a lot of the comments on this page. It was nice to see I’m not the only one for an affinity for freak accidents! I was cooking a pork tenderloin wrapped in tinfoil and placed in a glass casserole dish. I had used it plenty of times before and yet this time around when I pulled it out of the oven it just simply exploded. Of course, people thought I was crazy when I told them the story but I promise it happens more than you realize due to temperature shock of the glass. Well, long story short it gashed the top of my foot open and severed all the tendons to my big toe. Ohhh the shock on my face when the ER doctor asked me to wiggle my toes, which I totally thought I was doing, only to look down and realize my big toe wasn’t going anywhere. He could not visualize the tendons at the time due to the fact that they had retracted so he did an xray to check for any glass, cleaned the wound out and sewed me up with directions to go see the surgeon in the morning. I am now 3 weeks post-op with a huge surgical air boot and crutches with instructions of no weight bear with the exception of slight weight through the heel. I am to go back for an appointment in 4 weeks. I am currently in my last semester of nursing school for my BSN degree and in case anyone was wondering that is terrible timing for this to have happened! Not being able to drive myself anywhere is driving me insane, not to mention I am scheduled to start 12 hour clinical shifts in the hospital 1.5 hrs away for my preceptorship. Not sure yet how that is going to play out but I am hoping that this process of recovery goes by quickly and smoothly! Totally appreciate all of the interesting stories :)

    • Shay says:

      P.S. If you think you have a frankenfoot you should definitely see mine! I was immediately drawn to this blog solely because of the name…I have been referring to mine as frankenfoot ever since the first set of hideous stitches ;)

  11. Deanna says:

    First a great big thank you for this blog! I’ve only read through your first entry and all the comments so far. My accident occurred on 8/11/2013 again in the kitchen while I was bare footed. My plan was to make Au gratin potatoes. I pulled out the food processor box (since I barely use it I keep it in the box) well from about waist level the one blade fell and completely severed my EHL on my right foot. Oh the blood… My husband had ran to the gym about 5 minutes from our house and I was home with our two sons. Long story short I wouldn’t call an ambulance. He came home. I hobbled into the car… Every bump we went over on the way to the hospital I could feel my big toe moving with the bump and I couldn’t move it myself. Two X-rays were taken and the wound was cleaned, then I was stitched and sent home with a soft boot and crutches. Told to as soon as the orthopedic surgeons office opened in the morning to call and that they wanted me in within a few days. I got an appointment that next day and surgery followed the day after on 08/13/2013. The doctor had to make my cut (that goes across my foot not up and down) a bit longer. I went home with a walking boot and my crutches. It is crazy how such a stupid accident effects EVERYTHING! Not being able to drive is making me go batty! I can’t take my oldest son to football practice, I can’t drive to work, the stairs have gotten easier but aren’t fun, I can’t pick up my 13 month old because I can’t balance with his weight on one foot… I have to ask my 7yo to bring my youngest to me to change his diaper or clothes. Preparing anything in the kitchen is such a task with one foot and crutches. I keep sitting on a chair to cook, clean, do dishes, load or unload the dishwasher. I’m 27yo and feel like an invalid! It is terrible! It has encouraged and discouraged me reading all the stories on this blog. I am not alone! (Sang like Michael Jackson)

    My discharge papers say full weight bearing on foot is allowed. I thought that I was a big sissy because I couldn’t put any pressure on my foot at all. I’m just now 9 days PO and I can set my foot on the ground (not putting weight on it but I can atleast set it down instead of holding it up in the air). I keep seeing that most of the people on here didnt put an weight on their injured foot for a good 4-6 weeks. I thought my doctor was crazy with that comment on the discharge papers. I have heard he’s a very good surgeon and has had many good outcomes. I did not ask him if he had every repaired an EHL before though. I have my follow up appointment on 8/26/2013. My foot has been swelling so bad.. Also I haven’t seen anyone mention this… I have been getting charley horses in my calf of my injured foot. I drink plenty I water, eat bananas, and have tried massaging it. The pain has been there for the past two days and nights nonstop. It hurts continuous but then the pain will worsen without warning. Anyone ever have this?

    So I’m 9 days PO and see I have a long way to go… But I truly appreciate this blog!!

    • frankenfoot says:

      Hi Deanna, Thank you for your comment. How terrible and shocking. I sliced a finger on one of those once, they’re really sharp. Can’t imagine it falling on my foot. Your situation is a lot more challenging than mine was. My youngest was 9 and my oldest could drive so I had a lot of support around the house. I think you’re going to have to tell your husband how incredibly wonderful he is every single day because he’s going to be giving 110% for the next few months. I’m sure you’ve already thought about your options but don’t feel shy about reaching out to neighbors, coaches or other moms. You’d be surprised how kind some people are. One of my neighbors cleaned for me. I didn’t experience the cramping at night that you describe, do tell your doctor about it. Sometimes in addition to the tendon injury there is nerve damage which may or not present immediately due to trauma at the injury site. If it’s just muscle cramping separate from this, bananas should help. I wish you the best luck and hope your recovery meets and exceeds my own. Check back anytime and know that despite the rarity of this injury you’re not alone so hang in there. Cheers, Ann

  12. Pg says:

    Foraging for food in the fridge at home a plate dropped out, bounced on the floor breaking in half and chopping down on the bridge of my foot.
    A tiny but deep cut bled a little so I stuck a plaster on and carried on regardless.
    I played golf a few times with some discomfort over the next few days but just thought I had some sort of bruising.
    Eight days later while going to a meeting in London (as it happens and ironically at the HQ of the Royal College of Surgeons!) I felt an almighty ‘snap’ in my foot which ran up my shin.
    I managed to hobble home but my ankle swelled and my foot felt hot. So off to accident and emergency.
    After x-rays and an ultra-sound scan it turns out the plate had partially severed the EHL until it was hanging by a thread, which was the snap!!
    Surgery to attach the tendon ends, which had separated by about 2.5 inches. I have a Z shaped scar across the bridge of the foot and had a plaster cast fitted.
    3 days after surgery had the plaster cast removed and had a metatarsal slipper, incorporating the big toe just up to the nail (so the interphalangeal joint is immobilised as much as possible) fitted. I was given a heel wedge orthopaedic shoe to fit over the top of the slipper when ambulating. I have been allowed partial weight bearing with this (advised 40% and to use a hopping motion in conjunction with crutches) for 6 weeks.
    After that pending assessment it will be full weight bearing weeks 6 to 9 in a flat soled shoe.

    • frankenfoot says:

      Hi Pg, Thank you for your sharing your experience with this rare injury. Aside from the “Stingray Incident” contributed to this blog, most of these injuries occur from falling objects ranging from glass, knives, plates and tape dispensers. ;-) The prognosis you describe is similar to the course ortho-surgeons in the US recommend, with the exception of bearing weight. I feel obliged to pass on to you the instances, others have shared, regarding suture failure. Until the tendon, tissue and sutures have had time to graft (usually 4-6 weeks) there is a high risk of suture failure; hence no bearing weight during the initial healing process. I always say, “Listen to your doctor,” but you should also listen to your body and at times, seek second opinions. Also, there’s a “knee-scooter” device others have mentioned that I wish I’d of known about. ;-) In any case, do exercise much caution when moving about. Best wishes for a speedy recovery, Frankenfoot

  13. Liz says:

    Hi Frankenfoot,

    Would you believe, it’s been 5 years since my original botched hallux valgus operartion, and 4 since they did another botched “repair” operation on the big toe of my right foot. I’ve been left ever since with 2 screws, a plate, and either a severed or a stretched EHL tendon… I’ve had physio, ultrasound, and two sets of orthotics worth 600 euros… It seems that I can’t have an MRI scan because of the screws, and so the ultrasound was all that was left to me… I haven’t been able to walk properly since and have put on weight because of it. My asthma has also disimproved. To be honest, my life has been ruined… I can’t afford to go private, and so am just left there. My big toe and all down the inside of my foot is numb and cold. I can raise my big toe on it’s own but can’t pull it down. Also, I have morton’s toe on my next digit, and when the surgeon was doing the bunion op. he shortened the big toe too much, leaving the toe next to it much longer. As a result, when I walk, the next toe to the big toe seems to get in the way. When I saw another surgeon last year for a second opinion, he offered to amputate the top part of the digit so it wouldn’ t be in the way when I walk… He also said that if he had done the original op. I would have had a 100% success rate, but if he was to try now to correct it (after 2 previous ops) He would only give me a 25% success rate. So I left it. My whole body weight now when I walk, goes down through the toe next to the big toe and it’s causing me terrible problems with pain in my opposite side, hip, knee, shoulder etc. I can’t walk fast either as I get a severe cramp in the calf muscle of the right leg. I don’t know what to do about it… I’m afraid (after 4 years *since the 2nd corrective bunion op.) that if I get corrective surgery on the tendon now, that it might also go wrong, and that I have permanent damage done now. Anyway, I can’t afford to take 6 weeks off work. There seems to be no comeack when these surgeons do damage to you, and ruin your life. Thanks again for this blog, as I haven’t been able to find out anything about long tendon damage from anybody, not even my GP…

    • frankenfoot says:

      Hi Liz,

      I’m so sorry to hear that you’re still in pain and unable to walk properly. The numbness/cold sensation on the interior is nerve damage, not uncommon in these types of injuries. I had feeling on the interior initially, but it was blotchy. It’s fine now, but the area over my long scar near the toe remains completely numb.

      Obviously, I’m not a doctor, but I think you have to look at the Morton’s toe separate from the tendon and tackle these issues with clear medical plans. 25% recovery odds is better than none, right? I would focus first on the 2nd toe, getting it out of the way so the foot lays correctly. Then assess whether any of the advances in medical science since the time of your injury allows for repairing the tendon. I’m thinking of a new synthetic grafting process or even cadaver tissue and there’s a relatively new powder potion that stimulates re-growth naturally within our body.

      Plan it all out first. If you have trouble with insurance coverage, health plans or finance, offer yourself up to the best medical schools, because these procedures would be supervised, if not conducted by actual surgeons and schools have donors to help with getting them the newest science has to offer… at least here anyway.

      It never ceases to amaze me how an injury, seemingly so small in nature, can have such a major impact on one’s quality of life. Good luck to you.


      • Liz says:

        Hi Ann,

        Thanks for your detailed reply.. The way things are now, is that so much time has passed since the 2 operations, and I’m managing away – that I’m loath to have anymore operations on my foot in case they also go wrong.. What I can’t understand is why the surgeon never even noticed the Mortons, nor even mentioned the impact of shortening the big toe and leaving the other 4 longer than it…. I really don’t want to amputate the longer 2nd toe even though it causes me problems when I’m walking.. It’s good to know about the grafting and new powder for stimulating growth, if I did choose to have surgery… I live on my own, work, and have animals, so I couldn’t really have surgery at the moment as it would be too difficult to manage….

        Thanks again for all the information, and it’s nice to know I’m not the only one in this postiion!

        Best wishes, Liz

  14. Michelle says:

    Thank goodness I found you all on the night before my surgery! I was getting very frustrated over the lack of information regarding EHL ruptures on the internet. I dropped a photo mat cutter from the top of a bookcase on 9/23. It weighs about 6 ounces, but its tiny little razor blade left a 1/2″ cut on top of my left foot, just under the big toe. I drove over to urgent care and they put three stitches in it, after a quick exam that said “no other damage.” Famous last words.

    Yesterday, I made an appointment with a podiatrist because once the pain from the cut (which got slightly infected) wore down, I realized I was still limping and couldn’t move my big toe any more. Dr L is a friend and I got right in. He immediately said I have a severed EHL and it is retracted several inches up my foot. Because it has been so long, there is no way that he can do a simple reattachment. He will need to use other nearby tendons to graft it all back together. If this isn’t viable, he will also have cadaver and a bio tendon on hand.

    I should expect a 4-6″ vertical scar, no weight bearing activities for 6 weeks, then on to physical therapy. I am an active sports photographer and had to cancel a few sessions, but luckily this is the start of my scheduled downtime. I am taking the advice of several people here and will ask for a prescription for a knee scooter, as well as a handicap parking pass. I have 10 hours before I report to the hospital, and I am just dreading the lengthy recovery.

    • frankenfoot says:

      Hi Michelle, Thanks for your comment. I actually went back in and added a post script about not bearing weight until 4-6 weeks after surgery. Obviously, it wouldn’t have helped you since no one diagnosed your tendon damage, but there have been comments herein where that information would’ve been useful to encourage a second opinion when someone’s told they can bear weight on the injury immediately after the injury. Good luck with your surgery and feel free to check back anytime. You’re not alone! Cheers, Frankenfoot

      • Michelle says:

        Thank goodness my DPM Was able to repair without using any of my other tendons. He augmented the graft with Graftjacket, which is basically cadaver skin. It is supposed to make the graft stronger while allowing for collagen growth. Staying positive and am looking forward to healing!

  15. Anonymous says:

    I want to thank Ann for this blog, on behalf of both my husband and me. About three weeks ago, a glass pitcher exploded, leaving me with burns over my legs and a severed tendon. I am 28 years old. I was lucky – I had my MRI on the day after the injury and my surgery the day after that. At one week after the surgery, I stopped taking pain killers. At three weeks, I’ve just had my cast removed, and I’m wearing a boot. The doctor has told me that I can put a little weight on my foot while still using both crutches.

    What I love about this blog is that I do not feel alone. This is an incredibly isolating injury – you do not realize how fundamental walking and the use hands are until you have to use crutches to get everywhere. To be fair, much of the information from the blog was initially disseminated to me via my husband. He’s been awesome – a wonderful caregiver and patient advocate! At times, I pushed myself too far. From the experiences described on the blog, my husband knew when to rein me in.

    I am a professor, and I was eager to get back to work. Students relied on me being there and there was really no one able to take me places. I had surgery on Friday and ended up teaching the following Tuesday. Hopefully this is encouraging to anyone worried about missing work. Honestly, you’ll have some difficulty, but, if you get creative and elevate your foot while you work, perhaps you can come up with a solution.

    My main advice is to know when to push yourself and when to rest (and sometimes you may not know that you are pushing yourself too hard). As my doctor said: listen to your body.

  16. Cathryn says:

    Hi there, so glad I came across this blog, I have been looking for information on this type of injury and not much around. Last Friday 31/8/12 I dropped a knife on my foot, my daughter took me to the hospital where they discovered the severed tendon on my left foot, very painful!!. I had an operation to repair the following day and am now at home resting. The staff and doctors were amazing but I didn’t really ask any questions regarding recovery and rehabilitation so it is good to read this blog and get some idea what I am up against, and also the advice about no weight bearing on the foot was great. They told me I would be in a cast for six weeks but that is all so far. I don’t know how long I will need off work. I am a teaching assistant with 5 year olds and therefore on my feet all day with very low small chairs too! How one small mistake can change things!! What is the next step once weight bearing is allowed? and how long have people been off work with type of injury?

    • frankenfoot says:

      Hi Cathryn, Thanks so much for your comment. I’m so sorry to hear about your injury. No more trying out for the Olympic knife throwing contest, eh ;-) You’re definitely in the “take it easy and rest a lot” phase of the healing process. As to how much time you might need off from work, I would ask your doctor or gauge it by medication… obviously you shouldn’t be working in any capacity while you’re prescribed pain medication, antibiotics and complete rest. (so at least one week). When you’re able to work, consider whether you’ll be able to ice and elevate your foot at work because swelling can lead to a host of other ailments. Also, mobility is a huge consideration. I highly recommend renting a wheel-chair and/or knee walker in addition to your crutches. Decide which mode of transportation will work best for your situation. It’s very important that you don’t bear weight on the injured foot until the sutures, incision and tendon have had time to graft; usually 4-6 weeks, after which physical therapy is highly recommended because a trained PT will monitor and prescribe the amount and type of weight bearing exercises you can or should be doing in tandem with what your doctor recommends. On a positive note… it wasn’t your driving foot so here’s hoping you drive an automatic :-) Hang in there and check back anytime. Cheers, Ann aka Frankenfoot

      • Cathryn says:

        Hi thanks for the reply, I have borrowed a wheelchair so that makes things easier, and I am due back at hospital for a check up and plaster change next week so will have a list of questions now that I can ask thank you. Sadly my car is not automatic :( Living in the uk not many cars are automatics, so driving will have to wait!

  17. Jean says:

    Great blog Ann. Another story. Friday night July 20, 2012 washing a very large vase in my sink, touched the counter and broke in my hands, glass fell on my foot and severed my EHL. ER put it back together with a referral to an orthopedist. Said it was severed. I would push the big toe down but not pull it up. It was drooping. I Called surgeon Monday and was told Wed was the soonest. Wed: Surgeon 1 said he could do surgery Friday and I could be golfing the next day. He stated I would wear a weight bearing boot or shoe insert that would not allow the big toe to flex down. He was only concerned about the toe being pushed under. My surgery was 1 week post accident. Surgeon 1 told me he had done many hand tendon repairs and was EXTREMELY confident. Non weight bearing is crucial to foot and he didn’t know

    Surgery day: Friday. He accessed the tendon through the laceration wound on the top of my foot and made a second incision in the ankle area. Said the tendon snapped up in the leg and had to go a ways to get it. Said the tendon over the big toe was close and he could easily get it from the wound site. I went home in boot and was sick from pain meds, constipation, you name it, throwing up, et. Excruciating pain walking to and from bathroom. I had no crutches nor was I told I should need them.

    3 days PO Monday my husband got crutches and I was able to reduce pain but still horrible. 5 days PO I emailed doctor a picture of my very swollen foot detailing pain and he said it was normal.

    9 days post op I have extreme heat in the arch of my foot, notice the big toe is drooping again. Contact family member in orthopedics, am told it sounds bad, should be non weight bearing, toe should be out straight or slightly upward, and to demand MRI and foot/ankle specialist. Next day,

    10 PO, I see surgeon 1, show him drooping big toe, explain I saw noticeable change, want MRI. He is concerned but he can palpate tendon, though I cannot pull toe up. I ask for definitive test and he agrees to MRI for my peace of mind. Next day get MRI and try to schedule follow up. Get delayed til following Monday because of overloaded schedule on Wed. I agree to delay appt with caveat that if anything negative shows on MRI, they get me in immediately. No word. Assume all is well. My toe moved a tiny bit. Monday 16 days PO appt. suture removal, toe looking same, low pain. Doc says he isn’t thrilled with big toe but thinks the tendon is attached. I ask what MRI showed, he said “You had the MRI?” ” Yes, 6 days ago”. My heart sank. We looked at it together, he can’t tell at first, then “this does not look good. This looks bad.” I am in tears. The pain I have endured with this surgery was horrific. I know the excruciating pain that first week was my tendon ripping and tearing. My confidence is nil. He says immediately I need another surgery and another doctor foot/ankle orthopedist will be doing the surgery with him. The foot will be cast, big toe pinned, blah blah. I knew from the advice of a family member that this was doomed. I wish I had spoken to him 2 weeks prior.

    Second sugary was last Wed, the 15th of August with two surgeons, foot/ankle and surgeon 1. My foot is cast, big toe pinned. After surgery, I speak to surgeon 2, whom I have a great deal of confidence in, ask what the condition of my tendon was when he found it and what my prognosis is. He said one end had all the sutures and the other end had none. Which means the sutures held but my tendon ripped. He said he was able to clean both ends with minimal loss of tendon tissue and resuture them. He felt the prognosis was very good. He said the foot will never function as it did before but I should be able to resume to normal activities in 3 months.

    My family member explained a re-rupture as this: Picture two pieces of linguini being sewn together with numerous holes being punched into the ends, lots of threads. The threads hold, the tendons tear and what is left is shredded ends. Lots of holes is a much more challenging surgery and outcome. I am hoping and praying that the second surgeon was able to get enough good tendon and that the quality of the tendon was not too far deteriorated because of time to make a good bond.

    First week post op: I am on oxycodone once every 2 hours and eventually every 4 hours. Pain is what I expect. Foot is elevated all the time.

    9 days PO, feeling better, down to hydorcodone as needed, visit a neighbor keeping my leg elevated the whole time. I have knee scooter, wheelchair, crutches and beloved husband doting over me with loving care.

    I lost 3 full weeks on this because 1: the surgeon did not understand PO care of a repaired foot tendon. 2: The surgeon minimized the findings when I reported them to him over the phone.
    3: Surgeon did not read the MRI for 6 days. I do not know whether my outcome will be affected by the second surgery or the 3 week delay. I am trying to stay positive since I did get a second surgery and do have a competent surgeon at this point overseeing my care. I get sutures out next Wednesday and a new cast. I will get the pin and cast removed in 3 weeks. I did not have time to research doctors and this guy was known in a very large respectable ortho group. My husband is in the medical field, we have plenty of friends in the field, but this is such a rare injury and specialists in this area are few and far between. And time was against me from day one. I will update as I go. I am day 9 post op and hopeful. I want my old foot back and that win’ gonna happen. The best I can hope for is one that works and allows me to walk, golf, work out and get back to living life. I definitely appreciate my good health.

    • frankenfoot says:

      Hi Jean, Thanks so much for your comment and for sharing your experience. It’s truly a rare injury, the kind that makes you wonder how could such a simple cut cause such catastrophic changes? There have been many people who’ve shared their experience here, yet I must say, your post-op care is the worst I’ve heard!!! Forgive me, but I want to tar and feather your 1st surgeon (sounds like he needs to spend less time on the golf course and more time studying his medical books!) I’m glad to hear that your second surgery appears to be on track. I can’t imagine the level of anger and frustration you must be feeling. Surgery is bad enough the first time, let alone a second time for sheer medical incompetence! A couple things, you really should have been told not to bear weight on the injured tendon prior to and after surgery. The reason for this is that the tendons are stretched like rubber bands and the upper section can get drawn up into the leg; thus making them difficult to locate and increasing the length of the incision. In some cases, the tendon cannot be found. Post-surgery, there is a high-risk of suture failure. The tendon/sutures/incision need 4-6 weeks to graft. Any weight bearing prior to 4 weeks post-op can cause the sutures to snap/fail. I’m glad to hear you have a knee walker and a wheelchair in addition to your crutches, sounds like your hubby is everything that’s holding you together right now. Try to keep a positive outlook, it’s so important and your situation will improve with time. You’re in the “take it easy and rest a lot” phase of the healing process. –Cheers, Ann

      PS: A few people have asked me whether I recommend an Ortho-Surgeon or a Doctor of Podiatry Medicine/Surgery. I’m now 110% certain that I recommend a DPM. Ortho-surgeon’s may do 100 knee, shoulder, back or hand surgeries to every 1 foot surgery; simply because the injuries are rare and given all the post-op care comments I’ve received; I’ve noticed a vast difference in post-op care prescribed by Ortho-Surgeons vs. DPMs.

      For People Considering EHL Tendon Surgery:
      Best advice: Find a DPM-surgeon with at least 15 yrs. experience 

  18. Kay says:

    Hi Everyone,

    Thanks so much for this blog. It’s so helpful to read others progress and wish u all a speedy recovery. I am 7 weeks post op (UK) based. My accident occurred when I stood on a wine glass in bare feet and the glass went through my foot. I had operation the next day as I had severed the tendon from by big toe long the bottom of my foot. I ended up being stitched from my inner ankle bone all the way to my big toe. Was in cast for 2 weeks, now just a dressing on which needs changed. I’m supposed to start walking without crutches this week (scared) anyone else got to this point yet? I was told by my surgeon I wouldnt get physio.


  19. texas says:

    Hooray Google! Thank you for writing this. Apparently, this is not a common injury and a good chunk of information on it is in scientific articles that you have to have a scientific background (which I do, but I don’t feel like reading or paying for them).
    I had the same injury, about the same spot you did. Dropped a plate, and I think it hit the floor first, and one of the halves bounced and hit my foot just right to chop up my foot. When I rinsed it out, I noticed it was deep and there was some white showing. I hoped it was not a tendon. Of course, my fiancee had just gone out of town for an emergency at work and I was home alone. Luckily my brother lives close and he picked me up to go to Care Now (it was my right foot and it hurt to walk on, I did not want to drive). As I waited for him, I noticed I couldn’t move my big toe.
    When I saw the doctor, I still couldn’t move my toe and he recommended I see an ortho and gave me a few numbers to call. I called around the next day, and I’m so glad one was able to fit me in. The ortho confirmed that I had severed it, and fit me in for surgery the next day. I didn’t want surgery, but the ortho was good at explaining why it’s a good idea, and what would happen if I did not get it fixed. After the surgery, he said I had cut it clean in two. I’m surprised they made you get an MRI first, and then keep waiting! If you can’t move your toe, that should be a pretty easy thing to recognize what’s up.
    I’m two weeks post surgery, and in a full cast just sitting and waiting for it to heal. Luckily it doesn’t really hurt anymore (I have been told I have a high pain threshold by massage therapists and a chiropractor). Three more weeks before I go back to my ortho and to get a walking boot. Not sure how long I will be in that. Then I get physical therapy. I’m excited to walk again, but I’m not excited about the potential pain associated with it.
    I’m totally loving my knee scooter. Definitely would recommend one to other people with any foot or ankle surgery. Also, please everyone wear shoes in the kitchen. I’ve noticed a lot of these injuries are from there.

    • frankenfoot says:

      Hey Texas, Thanks so much for your comment. I’m glad you found us. So wish I’d known about the knee scooters. I had so much pain from my crutches that had they been made of wood… I’d of had a bonfire ;-) Sounds like you have a really positive outlook and I think that’s so important. I wish you the best of luck with your recovery! Cheers, Frankenfoot

  20. Nicole says:

    Just finished working a hockey camp as the camp MEDIC, and oh how irony has a sense of humor! Long story short, hockey skates and flip-flops don’t mix. The NP at the ER said that my EHL (left toe, between the cuticle and 1st joint) is hangin’ on by “shards of tendon tissue.” My question is how much has the (avg) recovery time been for you all that have undergone surgery? What other treatments are there if surgery isn’t an option?? I have to wait until Monday AM to see my orthoped surgeon :( So, I get to show-off my grace and skill on crutches for the time being… yikes!


    • frankenfoot says:

      Hi Nicole,

      Sorry to hear about your injury. No good deed, eh? On the brighter side, a torn tendon heals much faster than a severed tendon; and doesn’t require surgery. Some people, including doctors, might protest but in all honesty, knowing everything I know now, if it were me, I’d fast. I’d go on a complete water-only fast and rest 24/7 for at least 14 days. When you fast your body goes into heal thy self mode. Whatever you decide, I wish you the best luck.


    • frankenfoot says:

      With surgery, average healing time (for repair to graft) is about 6 weeks. Then physical therapy (anywhere from 1-3 mos, depending on insurance) so 6 mos is when you start to see a huge improvement and after that it depends on your recovered range of motion and continued exercise. It took me 10 months to fully “heal”.

  21. Dropped my prized and scrupulously maintained Wusthof chef’s knife on the top of my left foot on January 22, 2012. And–wait for it….severed my Extensor Hallucis Longus.
    5 Weeks post surgery now.

    Thank you so much for this chronicle. Even though I suspect it’s going to be a long road, I have real hope to regain most function after reading your blog.

    It’s amazing how fragile we humans are. We’re just not designed to drop sharp steel on the complex muscles, tendons and bones on the top of our feet.

    I live in Manhattan and take the subway to work every day. Was out for about two Weeks until I got a weight bearing cast. On a night splint and supposed to be wearing the Frankenstein boot during the day, but wore some comfortable Merrils to work today without complaints.

    Your recovery from surgery seems to match mine in many respects, and this makes me optimistic.

    Thanks again!

    • frankenfoot says:

      Hi John,

      Thanks so much for your comment. I’m glad to see you still have your sense of humor :-) I think it’s important to maintain a positive attitude thoughout the healing process. I wish you all the best and hope your recovery will meet and exceed my own.

      When this is done, I’d like to read about you in the newspaper having invented some nifty titanium device that shields the tops of chef’s shoes from falling knives thus preventing this type of injury for years to come!

      Yours truly,

    • Amy Martin says:

      Hey John,

      I, too, live in Manhattan & just had the unfortunate experience of having a similar accident as you this past Thursday. My chef’s knife fell while making dinner and sliced open my left foot, under my big toe. I got stitches, had an MRI and it looks like I severed two tendons. I made an appt. with an orthopedic surgeon who has done this surgery before for tomorrow (Tues.). I had to wait because of the holiday weekend. I guess I’m writing because I’ve been walking on my foot… it really hasn’t been hurting. I’ve been resting, but I’ve walked a little around my neighborhood. I just started reading this blog and am now panicking because I’m nervous this surgery is going to be super complicated. I can’t imagine trying to get around on the subways with crutches?! I really hope I haven’t made it worse by walking a little bit. It’s creepy to imagine the tendon somewhere in my ankle. Eww! I guess I’m wondering how long were you having to keep your foot up post-op? I’m a teacher and I’m nervous to take time off from work. Did you feel a lot of pain before the operation? I’m worried that the operation is going to bring on some major pain afterward. Hopefully, you are well healed (no pun intended)…any encouraging words are much appreciated. I’ve never had surgery before!

  22. Thank you for your post.Much thanks again. Want more.

  23. Jen says:

    I know they definately recommend fixing it asap. I went to the ER Tues night and they were talking about doing it that night or the next morning. I ended up seeing the DR Wed morning and he said we needed to do it soon! So he took me to OR on Thurs. He did say that as long as the initial sutures were in within 6 hrs that was good (Just the outer ones to keep the skin together), but the surgery couldn’t wait long. I would think the same thing–that maybe you will not regain as much back in it as you would having it fixed right away.

  24. rocio says:

    well, I am frsutrated because the company I work for changed insurances and I have no coverage right now so now they are telling me my coverage starts until Oct 1st, i tore my extensor tendon on August 20th!!!!!! OMG im freaking out do u guys think I might still be able to get surgery on October, because there is no way I can fford to see an orthopedic surgeon without insurance, please advice.

    • frankenfoot says:

      Hi Rocio, I can’t imagine how frustrating this must be for you. I know you’ve been waiting and to have a polonged delay is not good. Obviously, I’m not a doctor, but from what I gather the sooner surgery is done post injury, the better the chances of recovery. This may mean that by delaying the surgery you might regain 50-75% of use post surgery as opposed to 75-98%, but I am just guessing. I wouldn’t want to rule out the possibility that after a prolonged wait, the surgery might not be successful at all. I think the best thing to do would be to ask an othropedic surgery of doctor of podiatry medicine. Good luck to you and I’ll keep my fingers crossed that things work out for you. Sincerely, Frankenfoot

  25. Jen says:

    NO, he did say mine was severed, and I actually cut them both as well and he made a Y connection in mine too and sutured them all together–I thought it would need more time to heal as well, but after the 5 days, he took the dressing off, put a cast on and said I was good to walk on it now. I hope to God, I don’t run into anymore problems, cause I do not want to go through this again and at an ever longer rate because recovering from this after a second surgery would guarentee that. And I know–this is what everyone is saying, to trust the DR, he has to know–but it just seems odd that I am up and at it, and everyone else is still non weight bearing! IDK, I guess we will see when I go to my next appointment how things go. And yes, I am only 27 so maybe he figures my body should heal quicker, but who knows for sure. I will keep you posted on how my recovery goes. Thanks for all the feedback!

  26. Jen says:

    How long did all of you have to be off work? I had surgery on Sept 1st after dropping a knife on my foot and severing the tendon and I am supposed to return to work 9-27-11. It doesn’t seem like enough time from what I have been reading and don’t want to push it and go back to early since I have a job where I am on my feet all day. I currently have a cast over the incision to protect it until my appointment on Sept 21. It is supposed to come off then–I still am not able to lift my big toe, but was told that could take up to a year.

    • Frankenfoot says:

      Recovery after podiatry tendon re-attachment surgery involves a slow process of rehabilitation. Swelling remains an issue for most patients. While each person will recover at a different rate, doctors expect patients to ice and elevate the injury while keeping the foot completely immobile for the first 4-6 weeks; hence no bearing weight on the injured foot until the tendon and sutures have had time to graft. The risk here is suture failure which would cause a need for a second surgery, something I’m sure you want to avoid.

      Returning to work depends on various factors, i.e. Are you able to drive (was it your right/driving foot)? Will you need a wheelchair or can you spend 8-9 hours a day on crutches? Are you able to elevate your foot at work? Are you still on medication that may impair your ability to work? Even something as simple as prescription strength water pills and your proximity to the restroom is something to take into consideration.

      Most doctors feel that the tendon has had time to heal within 6-8 weeks post surgery and will recommend returning office workers to work but physically demanding jobs and/or positions that require the patient to stand for long periods should resume later; 3-6 months post surgery. Returning to work should also be phased; three half-days in the first week, two full-days in the second week, five half-days in the third week, and full-time by week four.

      • Jen says:

        I am wondering if your recovery is longer because you had reconstruction vs just a repair. I only had one incision, where I see it looks like you had 3. The DR told me that if my tendon floated up and he had to find it and do grafts and wires and more extensive surgery I would have to be off 6 wks. He was able to make the one incision and the tendon was right there so he just sutured them back together–he said the only reason he kept me off my foot after surgery was because he put so many sutures in. He has already allowed me to walk on my foot 5 days post-op and says I should be able to put a tennis shoe on in 2wks and return to work ( I am an RN, so I am on my feet for 12 hr shifts). The ER doctor said something about having PT, but my surgeon has not mentioned that-just that it could take a year to regain all mobility in my toe–that is the only thing I was not able to move, my big toe. It was my left foot, so driving is not a problem. And I have just been taking motrin for pain–more to help with inflammation because my pain has been pretty non existent. It started hurting a little more when I started walking on it again, but nothing that I can’t tolerate. I am hoping this is why my recovery is not as long as yours, because I was getting nervous for a bit!!!

      • frankenfoot says:

        Hi Jen, You’re actually walking after 5 days? That’s amazing. Obviously, your doctor should know best and I don’t want to second guess him, but it doesn’t seem possible that your tendon or anyone’s for that matter could heal in 5 days. The sutures are there just to hold the connection while the body produces the collagen necessary to fix the tendon. Simply by bearing weight on the injury, the healing process is disrupted. Remember that Serena Williams bore weight within 2 weeks; her sutures failed and she had to undergo a second surgery. Of all the comments I’ve received regarding recovery, yours is the soonest I’ve heard of anyone walking again.

        Is it possible that your ehl tendon was torn rather than severed?

        Granted, everyone heals at a different rate, it’s possible that you simply heal fast. Age has a great influence, i.e. someone under the age of 30 in great physical condition vs me (over the age of 30 in good physical condition ;-)

        In answer to your question re: my surgical cuts: I had one injury: My ehl tendon was completely severed 3 1/2″ from the hallucis. A day passed between the initial ER visit and my meeting with the surgeon; during which I wore a rocker-boot and bore weight on the injury; feeling movement in my foot as though something was wiggling about 5 1/2″ from the hallucis. My surgeon explained to me that tendons are stretched like rubberbands and in cases of total ehl separation the broken piece can get drawn up into the shin. During surgery my doctor had to “search” for the broken piece. The tip was easy to find, but the upper section lay across the foot and he made several cuts up the foot to locate it. Also, he elected to anchor the sutures of the ehl tendon to the brevis tendon resulting in a “Y” shape formation to add support and reduce the risk of suture failure. Thus, my body had to graft and heal both the ehl and brevis tendons during recovery. My internal sutures were Size O, non stainless steel. My external stitches were removed about 7-12 days post surgery. I didn’t bear weight on the injury post surgery until 6 weeks at physical therapy. From there it took about a week to walk again and 2-3 weeks before I could walk “normally” without limping and at a normal pace.

        I wish you the very best of luck with your recovery and return to work. My best advice is listen to your body; it will let you know if you’re overdoing it.


  27. Becky says:

    So glad to have found your blog (thanks to google!) Last Friday a chef’s knife fell on my foot and severed the same tendon. I didn’t hit an artery, so I didn’t have much blood, but after hearing my story, the orthopedic surgeon said I must have hit the bone because it hurt to put any weight on the foot that night and the following day. Backing up, I didn’t go into the ER that night, and was busy the next day so I taped it up and didn’t bother going to urgent care. I called my father who is a doctor for a quick consultation after sending off a few pictures of the results of my latest accomplishment. He described to me how I should be able to trace the tendon up from my toe, and after comparison with my other foot, it was very clear that the tendon was no longer visible, and it was not being obscured by swelling! Dad recommended that I find a “Foot Orthopedic Specialist,” and didn’t recommend bothering with urgent care or my personal general practitioner.

    The Orthopedic Surgeon didn’t need an MRI to see what was wrong, but did mention the surgery was optional since two other tendons going to the base of my big toe appear to be intact. By taping or using a splint to prop up my toe, I have been able to drive, and walking has gotten less painful over the past few days, but I don’t want to live like this for the rest of my life. Anyway, the surgery has been scheduled, but I don’t know much about it till get some info in the mail, and I have been having trouble sorting through the internet to find relevant information. So far I have only read this single entry, but I can’t wait to continue browsing through the comments and follow-ups!

    • Anonymous says:

      Hi Becky, Sorry to hear about your injury. I think you’re right in pursuing surgery. Without it, the range of motion and flexibility will be extremely limited. Good luck to you and best wishes for a speedy recovery. – Frankenfoot

  28. rocio says:

    ok so this seems to be more common than what i thought< yesterday i was trying to reach a jar of honey from the pantry and the jar hds honey that had leaked to the outside bottom of the bottle, when i pulled the jar off the the pantry sitting on the shelf as i lifted the honey the shelf was like glued to the bottom of the jar and the shelf came up with it, in the corner was a bottle of the black vinegar the kind that comes in a glass container fell off the shelf bounced in the countertop and broke in pieces sending the bigest pece to of course my foot, went to the ER got stitches and have to follow up with a foot surgeon, well this is the thing, I dont have insurance until sept 1st ( which is very close) do u think I can wait to get to the the dr until then when my insurance kicks in? I know u r no doc but ur opinion does matter because there is no way i can afford to have this done before, what do u think?

    • Becky says:

      Hi Rocio,

      I realize that it is now September 1st, so I guess your insurance is active now. You need to see someone ASAP. I injured my foot two days after you. I wanted to delay my surgery by a week, and the Doctor said that was fine, as long as we got it done within 4 weeks of the injury. Best of luck to you.

      – Becky

  29. Lorraine furia says:

    After surgical repair on Aril 22,2011, first soft cast, then hard cast, then boot. I used a scooter to get around the house while resting my right knee upon it. Then brace in June. By end of June rehab and short walks July no problem walking only foot swells below ankle and must be elevated and rested. As of today, august 11 have played golf four times and get a little tired but with more exercise my strength seems to be getting better. I am 78 and active and very grateful for trauma podiatrist younger than my grandson. Life is fun again so keep your spirits high and hopeful,

  30. Ashley says:

    24 yr old female.
    I am so happy I found this site. Im not sure if this paticular tendon is the one I will be having surgery on but I know there’s many and for sure the anterior tibial tendon. I was at work and had a piece of glass fall and basically fillet my leg open right above my ankle. 30 stiches and xrays later they let me out of the er. I have been seeing workman comp doctors to keep an eye on the lacerations healing process, take the stiches out ect but nobody seemed too concerned that I could not lift my foot… even though it has been an entire month since the accident. Well today I saw the ortho and many tendons have been severed. If you think you might have this get the surgery done asap. Apparently time is of the essence. After 2-3 months it is completely unoperable. Im glad they caught it but not looking forward to using the crutches again… hell I just got off of them a week ago. So here’s to another 6 weeks on them and rehabilitation … anybody actually had this surgery and already recovered? Trying to get timing on how long im going to be hanging out on my couch.

    • frankenfoot says:

      Hi Ashley, Thanks for your comment. I am so sorry to hear about your injury, in fact these ER horror stories are the worst. There should be a mandatory insurance covered MRI done with any laceration near a tendon. To find out after all you’ve been through that the tendon damage is even more severe is quite disheartening. Try to keep your spirits up. You’re young, and age and health does factor into the speed at which you’ll recover. The best advice I can give is to rest, fast when you’re body doesn’t want food, and take vitamin supplements to encourage collagen production (that’s what tendons are made of). Best of luck to you and feel free to write anytime. Cheers, Frankenfoot

  31. Cori says:

    Hi Rob,

    I am sorry to hear of your accident and am happy to correspond. :) I did write you directly, but got an out of office reply. Please advise, and we can continue. (Probably best not to clog up Ann’s Blog, eh?! ) Wow, such little cuts, lead to such complication!


  32. daclutz says:

    is it possible to rupture EHL by bending your toes under while playing sand volley ball? I can still move great toe a little bit.

    • Frankenfoot says:

      Yes, it is possible to injure the EHL tendon by over-extending the great toe.

      Injuries to the Extensor Hallucis Longus tendon include strain, tear, and total separation. In the latter, the most serious, no movement of the hallucis (big toe) would be possible and dorsiflexion (raising the foot toward the shin) would be severely limited. The only way to be certain is to have an MRI done and reviewed by a pathologist; any doctor of podiatry medicine can order an MRI. If you suspect that your EHL is damaged in any way, it’s best to visit a podiatrist as soon as possible.

  33. Cathy Jones says:

    Interesting to read your ELH saga. It has been a long haul for you with such an innoculous accident leading to such distruption! So, I am here obviously because I have divided mine too! The accident was bad enough. It happened on on 19th June, we were on holiday in Ireland and I tripped in a rock pool (at my age…43) and got sututred up by a Dr and was told that there was no damaged tendon or bone. That night, I was not convinced by his intervention and I went to see another Dr who said he suspected a ruptured EHL and sent me to A&E. I was admitted and put onto intravenous antibiotics for a raging infection. The infection didn’t leave and I had surgery, not to repair the EHL but to wash out the infection. I was IV antibiotics for a further 4 days before I was discharged with a referral back to a plastic surgeon at home in the UK. I have an appointment on Tuesday, which will be 2.5 weeks since the injury and 1.5 weeks since the washout. It was suggested by the Drs in the hospital in Ireland that one can ‘manage’ without having a repair and that I will be able to continue with activities such as walking, badminton and all the ‘outdoorsy’ things I enjoy doing. Would you have any advise regarding repair? Is there a cut off time, after injury that surgery would not be able to be performed? How long does it take for the tendon to retract making repair impossible? At present, I am hugly frustrated having my partner doing all of the chores including dog walking and I am able to do very little, the wound is still very sore and needs ellevating most of the time. I do not at all relish the thought of being in a cast for 6 weeks with furher rehab after that as I am quite an active independant person. This is why I was hoping that I would not need a repair.
    Any advice would be grately recieved.

    • Anonymous says:

      Hi Cathy, I’m so sorry to hear about your injury and the fiasco that followed. When the tendon is separated there’s really no way for your foot or great toe to function the way it did; playing sports, walking barefoot, and even driving an automobile can become difficult to do. The EHL tendon is responsible for the up/down motion of the foot at the ankle as well as the evenness of the great toe (a severed EHL will just hang/droop down). You really should have been prescribed antibiotics from the start. I hope the infection has healed. There really isn’t a cutoff date for surgical re-attachment, however the sooner the better. One of the greatest drawbacks to having it done at this late date is that the broken piece may have retracted up the shin (this is because tendons are stretched like rubber bands and just bearing weight on the injured foot can cause movement in the upper tendon) making it difficult for the surgeon to locate and increasing the length of the scar. Best advice is to get the surgery done as soon as possible, don’t bear weight on the injury before surgery or 4-6 weeks after surgery and incorporate a vitamin regiment that includes amino acids (tendons are made of collagen). Feel free to email me here or at Hope you feel better soon. – Frankenfoot

  34. Cori says:

    Dear Frankenfoot,

    I am so glad to have found your Blog and story! My situation is so similar, and it would be great to reach out to you for support. Here’s my short version (I am on day 3 post-op, btw)

    Two weeks back I was programming my coffee pot and had the carafe in my hand when I bent to pick up something. The pot hit the wall and shattered, sending one single piece of glass straight down into my foot! Ugh… the cut seemed minor, but my partner said “You’re going to emergency for stitches”. As soon as they looked at my deep cut there they confirmed I needed stitches and a tetanus shot.

    Unfortunately, I left with three stitches and unclear direction to follow up with a Podiatrist IF there was a ‘problem’, and to get the stitches removed in a week by a regular doctor or nurse. So, I went for 8 days with no feeling or flex- ability in my big toe, thinking that this was part of the healing process. I actually thought the nerve might have been damaged and it was just ‘coming to’ again! I even drove, went to work, and hobbled around babying my foot the whole time!

    Anyway, after a series of appointments for stitch removal, two podiatrists, a surgeon, etc… and the ‘brand new to me’ insurance company, it became clear that I had lacerated my EHL tendon (just above the big toe, about an inch lower on my foot than you did) and it would require surgery for me to HOPE to get back almost full motion of my foot. (I am 52 years old, and power-walk and run about 5 times a going without this ability was absolutely frightening to me).

    So, this past Wednesday night, June 22nd, I was admitted for the surgery, and the doc did the repair. He was able to find both ends of the tendon, which had retracted quite a bit and were now ‘toughened up’ from non-use, and he mended them together. I was discharged with a hard half cast (huge btw!) and a pair of crutches! Ugh!

    It’s now Sat morning, Day 3 Post Op, and I am hoping to negotiate my first attempt at washing my hair, on a stool, in a bath tub, with a plastic wrap glove over my cast. Gee, let the games begin!

    Please let me know if you can communicate directly and I will send pictures and such to you. Thank you for your great Blog. I am sure it will be a lifesaver!


    • Rob Ecob says:

      Hello Cory
      I did a similar thing by dropping a glass jar in my workshop and severing the tendon with a piece of glass that hit my upper foot. Sitting here with a cast and dopy on pain mess. I hope you mend well, maybe we can commiserate?
      Rob Ecob
      Cambridge Ontario CANADA

  35. Lorraine furia says:

    Just came back from hospital severed tendon in shin wondering about recovery etc.

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