Recovering from Posterior Tibial Tendonitis

I would like to be able to give you meaningful advice, but without actually examining you and determining whether or not I agree with what was possibly a shoot-from-the-hip diagnosis, I really have no basis for responding to your questions with specific recommendations or prognosis. It is simply beyond the capability of a forum responder to adequately address your issues, but it is certainly not only within the purview of the attending to supply you with these answers, but is his/her duty. If you are not getting the information and the results you desire from your doctor, you need to consider a second opinion based on examination and re-evaluation.

 

Hello again Doctor,
Thank you for taking the time to read my post. I will see my hip doctor in a few weeks and pose some of these questions to him. When you said "shoot-from-the-hip" (no pun intended?), I would tend to agree. He listened to what I had to say about my foot but did not do a physical examination. Perhaps I can ask him to perform a physical examination rather than Dx me from an oral report (he's a hip man and his primary examination when I see him is to check and see how the labral repair/chielectomy is doing).

In terms of my other questions to you, I understand that you prefer not to answer questions about specific foot problems and would like writers to ask specific questions to their own doctors. However, you will answer general questions. So rather than these being questions about me specifically, could you answer from your general experience the following:

What frequency of patients do you see with posterior tibial tendonitis or for that matter, other forms of foot tendonitis who avoid surgery but have a very long recovery, say a year or two, and fully recover? Is this rare/common?

When is it, in your experience, that a foot tendon is beyond the body's repair and surgery is necessary? I ask this because I have a feeling that people are busy, working and moving around and expect to get better from a foot injury but they continue to prevent it from healing because they operate as if they are not compromised (especially with tendon issues because the tendons are slow to show immediate pain/damage and thus people unknowingly re-injure themselves). The result is impatience and the desire for a quick fix like surgery.

Again, thank you for your time and energy in answering so may questions from your forum.

Take care.
C

 

Does Anyone else have any bright ideas?
Any recovery stories out there on how best to recover from PTT without surgery?
Are there any recommendations for what to do at this point from others on the forum?
Any information would help.
Thank you
C

 

I am wondering what the best orthotic device is for tendonitis of the PTT. It isn't torn based on an MRI. Currently I wear an aircast for PTTD which is not great for fitting in a shoe.

 

Generally speaking, orthotics that provide greater support to the inner arch will help. This eases the tension on the PTT. When you bear weight and/or step off, the PTT tenses. In a relaxed state, it will be under less tension with a high inner arch support than it will without.

i had to have the surgery. i could have prevented it (I believe) if I'd gotten orthotics sooner (i have high arches and need HIGH arch support). Long story - and in another post - but my PTT tear was brought on by a different surgery (plantar fascia release many years ago wherein the doc cut partially across the fascia to prevent heel spur recurrence - which worked, but was the primary cause of the eventual PTT tear over about 15 years).

Anyway, if you have high arches, then yes, I recommend orthotics FROM A DR, and NOT Dr. Scholls.... (nothing against those, but you need a podiatrist to prescribe because he will do so based on your foot and your condition, i.e. PTT issues, not just a fancy footprint on a machine).

If your PTT problems are farther along, then immobilization is probably in order. While it's great to jump on crutches to remove the weight bearing aspect, that may not be entirely necessary (yet) - a walking boot which inhibits flexion and extension of the PTT will really probably help. Again, depending on how advanced your problems are, the Doc may still Rx crutches AND immobilization - for the fastest and most complete healing. Inconvenient, yes, but better than ending up under the knife. Trust me on that one, I didn't heed the symptoms and paid the price - surgery. And it sucks.

So, yes, PTT issues: Orthotics from a Foot Dr or Ortho, then maybe also walking boot, then also crutches on top of that. All to prevent the need for surgery. If you can get it healed up before a tear occurs, then you can prevent recurrence with just Orthotics by themselves.

All based on my personal experience, I'm not doc, so take it with a grain of salt.

 

Hello everybody,

I am a 30 year old about a year and a half in from developing PTT. I was ignoring my body's warning in the form of shin splints and was running 3-5 miles 5 days a week. I suffered a soccer injury in high school which eventually led to shin splints and progressed into PTT. I am naturally a little heavier and rely on cardio to keep the weight off. (Went from 170 to 195 since the injury...) I have tried P Therapy, seen a sports med specialist and now wear superfeet inserts for arch support. The inserts help with my low arch but have not solved the problem. It doesn't seem to matter if I give the foot complete rest for 2 weeks or 6 months, the injury rears it's ugly head each time I try to jog any more than a half mile. I've resorted to the elliptical and stationary bike, but have experienced enough pain even on these to restrict how much time I spend on each workout. I'm afraid the answer may be a complete life change by using swimming or some other cardio method. I'm intrigued by some of these new "stable" rocker shoes that provide a lot of cushion but restrict side to side movement (like the Z-coil or Ryn brands). I haven't tried any yet but would love to hear if someone else has.

-B in GA

 

Have you gone to a foot and ankle specialist lately? Do you have tendonitis or rips in the tendon? Rips will not heal. Two years ago, I had posterior tibial tendonitis. It eventually progressed to a partially ruptured tendon despite wearing good shoes eith orthotics and eventually wearing an arizona style brace. I had flat foot reconstruction surgery about 8 months ago. My surgeon does NOT want me wearing one of the stable walkers as they can put increased strain on the achillese tendon. You may be best served by seeing a doctor to determine the condition of the ptt and find out if he feels that the stable rocker would be safe to use. Good luck

 

Like the rest of you I am really struggling with the time this PTT is taking to heal! I am a dance professional and have pulled back on all non-essential activities for 16 weeks! There is some improvement in that I can walk without pain, but any kind of barefoot activities just sets this off. I am very concerned as I return to my teaching responsibilities tomorrow, and this is simply not supporting my leg and still painful. It seems like people have been talking about a year or more to recover fully. I would be really interested in hearing techniques for speeding recovery and also rationale for why this particular tendonitis is so slow to heal. Thank you.