• Broken Hand
  • NSAIDS: To Use or Not to Use
  • Hydrocele, Spermatocele and Strained Groin
  • Hand: Arthritis
  • Open-Heart Surgery
  • Osteopenia and Increasing Bone Density
  • Body: Pain Meds vs Sex
  • Appendectomy and Climbing Training
  • Body: Injury Truths
  • Body: BPA and Waterbottles
  • Body: Bouldering for Bone Density
  • Body: Chronic Injury
  • Body: Bouldering for the Bones
  • Body: Antibiotics and Tendon Damage
  • Back

  • Lumbar Bone Spurs
  • Options for Disc Herniation
  • Back: Spinal Fracture
  • Back: Preventing Hunchback
  • Back: Herniated Disc
  • Abdomen

  • Abdomen: Muscle Tear/Hernia
  • Arm

    No items found.


  • Thoracic Musculature Tightness
  • Chronic Posterior Shoulder Pain
  • Supraspinatus and Labral Tears
  • Chronic Shoulder Pain
  • Shoulder Replacement
  • Shoulder Pain
  • Exploding Shoulder
  • Shoulder: Thoracic Outlet Syndrome
  • Shoulder: SLAP Lesion and Cortisone
  • Shoulder: Frozen Shoulder
  • Shoulder: Torn Labrum, SLAP Lesion
  • Shoulder: Separation
  • Shoulder: Pain and Virus
  • Biceps

  • Bursting Biceps
  • Elbow

  • Golfer's Elbow
  • Elbow: Brachioradialis Pain
  • Tennis Elbow
  • Medial Epicondylosis Tendonitis
  • Dodgy Elbows Revisited
  • Synovial Chips
  • Quack Elbow Treatments to Avoid
  • Elbow Pain and Cortisone Use
  • Do Compression Sleeves Work?
  • Elbow: Tennis Elbow
  • Elbow: Medial Tendonosis
  • Elbow Pain and Dodgy Elbows
  • Elbow: Tendonosis
  • Elbow: Medial Epicondylosis and Taping
  • Elbow: Tingling and Numbness
  • Elbows: Minimizing Fingerboard Injuries
  • Elbow: Medial Epicondyle Tendonosis
  • Elbow: Stress Fracture
  • Elbow: Pain and Hangboarding
  • Wrist

  • TFCC Tear
  • Wrist Pain From Cleaning Routes
  • Wrist: Klienbock's Disease
  • Wrist: Ruptured Tendon
  • Snap, Crackle, Wrist
  • Wrist: Fractured Scaphoid
  • Wrist: Instability
  • Hand

  • Broken Hand
  • Hand: Hook of the Hamate Fracture
  • Fingers: Everything You Need to Know About Finger Stress
  • Hands: Dupuytren's Disease (lump in palm)
  • Hands: Numbness and Carpal Tunnel Syndrome
  • Fingers

  • Swollen Right Index Finger
  • Pinky Numbness
  • Avulsion Fracture
  • Hand: Arthritis
  • Finger Numbness
  • Fourth Metacarpal Break
  • First Pulley Strain
  • Freezing Fingers Today, Benefit Tomorrow?
  • Cysts in Fingers
  • Ruptured Finger Pulley
  • Major Finger Pain
  • Fingers: What To Do with a Ruptured Flexor Digitorum Superficialis
  • Fingers: Everything You Need to Know About Finger Stress
  • Fingers: Hyper-extended
  • Fingers: Cysts and Pain
  • Fingers: Cracked Fingertips
  • Fingers: De Quervain's Tenosynovitis
  • Fingers: NSAID Treatment
  • Fingers: Torn A2 Pulley
  • Fingers: Trigger Thumb Syndrome
  • Fingers: Stiffness, Soreness
  • Fingers: Grip Position and Injury
  • Fingers: Cortisone for Tendon Injuries
  • Fingers: Pinky Finger Pain
  • Fingers: Electrostimulation
  • Hands: Numbness and Carpal Tunnel Syndrome
  • Fingers: Taping Truths
  • Fingers: Flappers
  • Fingers: Trigger-Finger Syndrome
  • Fingers: Torn A3 and A4 Pulleys
  • Fingers: Cysts
  • Fingers: Arthritis
  • Fingers: Numbness
  • Fingers: Blown Tendons
  • Leg

  • Leg: Achilles Tendonitis
  • Leg and Knee: Broken Femur and Shattered Kneecap
  • Leg: Pulled Hamstring
  • Leg: Fracture
  • Knee

  • Outside Knee Pain: Tibiofibular Joint
  • MCL Injury
  • Blown Knees
  • Knee Tendonitis after Ankle Fusion
  • Meniscal Tear on a Drop Knee
  • Knee: Rockfall Causes Lump
  • Knee: Chondral Injury of the Lateral Tibial Plateau
  • Leg and Knee: Broken Femur and Shattered Kneecap
  • Knee: Ruptured ACL
  • Knee: Ruptured Ligament and Meniscus
  • Knee: Synovial Cartilage Damage
  • Ankle

  • Osteochondral Talus Fracture
  • Knee Tendonitis after Ankle Fusion
  • Snapped ankle tendon
  • Possible Death of the Talus Bone
  • Broken Talus Bone
  • Ankle: Loud Pop Ankle Roll
  • Feet

  • Bunions
  • Dr. J Attacks Fungal Toenails
  • Feet: Broken Foot
  • Feet: Gout and Pseudogout
  • Feet: Toe Fracture
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    Snapped ankle tendon


    High rock-overs onto a foot can snap your precious ankle tendon. Ilustration by Steve Graepel.I snapped my peroneal retinaculum on my right ankle while high stepping four months ago and had surgery to repair it a month later. I have been going to a physical therapist and she has told me I can do light running and easy climbing. I have concerns about climbing, especially since I don’t think my PT understands the strains placed on the ankles.I’ve been climbing in my post-surgery boot because I’m worried about snapping the ligament again. Have you ever seen a climber who has gone through this injury? Has the person snapped it again?

    —Jason Lumsden / Via e-mail

    The majority of ankle injuries in climbers are either sprains that occur walking to the crag, or talus fractures that happen on impact. Peroneal retinaculum ruptures caused by climbing are next in line, but they are a distant third place.

    When a climber rocks onto a high foothold, or sits down onto one foot, the ankle is pushed into extreme dorsiflexion (the opposite direction is called plantaflexion, which happens when you point your toe).

    The tendons of peroneus longus and peroneus brevis pass behind the outside knuckle (lateral malleolus) of the ankle. When you maximally dorsiflex the foot, these tendons, under enormous load, are physically and architecturally anchored behind the malleolus.

    The peroneal retinaculum performs much like the pulleys in your fingers, holding the tendons in place and close to the bone to enable motion of the foot.In 82 percent of the population, the peroneal tendons are located in a sulcus behind the lateral malleolus (which is actually the end of the fibula bone), making their position more structurally robust. Eleven percent of you don’t have a sulcus, and the remainder have a convex surface. Respective translation—shitty, and shittier!

    When you combine shit anatomy with a big load, the retinaculum is subject to the cutting force of the tendons; it’s a bit like pulling a string through a folded piece of paper.

    I would follow theadvice of yourPT. Surgery followed by rest, then progressive loading is the only option to achieve full capacity (and some). The surgery involves

    reattaching the retinaculum and/or supplementing it with some harvested tendon tissue, along with deepening the posterior groove so that the tendons are essentially hooked behind the malleolus.

    Gentle climbing on a toprope is fine for now. Avoid extreme rock-over positions with the same focus that you avoid poking yourself in the eye with a branding iron. This loading, more than anything else, needs to be progressive over the ensuing months such that the retinaculum, +/- a tendon graft, has time to heal and strengthen.

    Eschew the sharp end of the rope for now since many factors beyond your control dictate how you impact the wall. Absorbing any force with that foot early in the rehab process is beyond bad.

    The reality is that surgery will likely afford you an even stronger peroneal tendon restraint. If anything, I would be worried about the other ankle!


    This article was published in Rock and Ice no. 220 (August 2014).





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