A plot twist.

I went to PT for 4 weeks, have been doing the exercises, the therapist noted improvements in various measures of strength and range of motion. But my ankle is not better. I am still very limited in the amount of walking I can do, and some of the exercises I was doing for PT made it hurt. The doctor had said that if it didn't improve I should go for an MRI and come back to see him. So I had the MRI last week and saw the doctor today. He looked at the MRI and said, it looks like a different tendon is damaged. Um what?

In my crude understanding of the anatomy -- there are three tendons close together in a normal foot and ankle -- the posterior tibial tendon, the flexor digitorum longus, and the flexor hallucis longus. Back in the day I had a torn PTT. The surgery I had was a "tendon transfer," in which part of the PTT was removed and the FDL took its place. The location of the pain I've been having since January indicated that the current problem was where the FDL and PTT were attached. But on the MRI, that area looks okay -- and the FHL looks damaged.

As a next step, I will go next week to have a long-acting anesthetic injected into the FHL. If this relieves the pain, it confirms the new diagnosis. Based on what I've read about the function of the FHL, and one particular PT exercise that caused pain, I suspect this will be the case.

One good thing is that I'm still able to ride my bike. I have noticed some minor pain when I ride up steep hills. Based on today's developments, I think I need to be more conscious of my foot position when I pedal, to make sure I don't point my toes at all.