I too suffer from the same thing, just not flat-footed. I have done everything possible, next is surgery. It is set for a tendon transfer, however, I am getting a second opinion. It sounds so severe. I am able to walk and all, using orthotics, and some days alot of pain (taking inflammatory) while others not too bad, which in turn lets me rethink about having any surgery at all. It would require using next tendon (that operates toes), break the heel, reposition it, insert 2 screws and off work 3 months. That... I don't like. I am just not sure anymore at all. I've been dealing with the severe swelling at ankle (inside foot) and just want it to get well. I've heard of using a cadavear (sp?) tendon, but this Dr. says they don't do that. I am not sure. Has ANYONE ever had a tendon transfer and what is your outcome?? Is it worth it? Or is it just a short-lived thing? Thanks. b51kitty

I have been having inner ankle pain on and off for about 2 years, then it became constant. I finally went to see an OS who ordered an MRI, which shows a partial tear of the posterior tibial tendon and fluid accumulation in the tendon sheath. I asked him about non-invasive possibilities such as orthotics or braces, and he said that they would be of no use since the tendon is torn. He referred me to a foot and ankle specialist who said the same thing. The foot and ankle Dr., who is the author of the text book on foot and surgery that medical schools use, took x-rays, did some simple testing and looked at my MRI's and recommended tendon transfer, calcaneal osteotomy and synovectmy. I am scheduled for surgery on Dec. 6. He also told me that the longer I put off surgery that the worse it would get and eventually it would not be fixable with the above mentioned procedures, but instead would require fusion. He said I would be on crutches for 5 weeks, then in a walking cast for 5 weeks. I hope this information is helpful to any of you that are wondering what to do.

Hi Surely-

I had the exact same thing show up on my MRI...partial tear and fluid. That was over a year ago, and things haven't changed. I have worn custom orthotics for about a year, and they do help some, but I still do have pain and swelling daily in my arch and area around the tendon. I am currently recovering from my second ankle ligament reconstruction surgery (3 months ago). I asked my OS (foot and ankle guy) if he would fix the tendon problem when he did the last surgery and he said no because a partial tear did have the ability to heal if I wore my orthotics religiously. He said only a complete tear warranted immediate surgery, and I may need surgery in the future to correct it and my fallen arch, but wouldn't mess with it now (I'm only 20). Anyways, just wanted to share my update, as I posted this thread quite a while back. I hope your surgery goes well on the 6th (thats my b-day..lol). Please keep me updated on how it goes!

Take Care!

Megan

Megan
Hope you have a terrific birthday! I will definitely keep you posted on the surgery. I am so looking forward to being able to walk without the constant pain.
Rita

Please let me know how you are after the surgery. I hope it is a fix. I am going for a 2nd opinion late Dec. I am not sure what to do yet. The surgery you are having is exactly what the 1st Dr. was going to do.

I'm in the same boat as you guys. I've been putting off surgery and just dealing with mine for the past 3 years. It isn't getting any better, but also it isn't getting worse. I'm curious to see how the surgey went on dec 6th so keep us posted.

Hi all
Well here are the highlights of my surgery thus far. The surgery lasted about 90 minutes. The doctor came out and told my husband that the surgery went well. I was in recovery for about 90 minutes. After coming to, they gave me 3 or 4 nerve block injections to numb me from knee to toes. I was told that when the block wore off that the pain should be a little less than what I had experienced coming out of surgery, before being given the nerve block. Ouch!They sent me home with scripts for Vicodin and Percocet. I had about a 4 hour ride back home that evening, so being numb was a good thing! Upon getting home, I experienced nausea and lightheadedness whenever I had to get out of bed and hobble to the bathroom, which is all of about 10 steps. This lasted into the next day. Of course my body was somewhat in shock from the surgery, and being drugged up. The nerve block didn't totally wear off until sometime on the 8th, so it lasted almost 2 full days. When it finally did wear off, the pain was not at all what I was expecting. I actually felt more discomfort than I did pain. The pain I did experience a few times a day starting on the 9th has been horrible muscle cramping in the bottom of my foot and up the outside of my leg. Thankfully, it only lasts a minute or so since I am not able to reach these areas to massage them. I occassionally wiggle my toes up and down a few times to stretch the muscle on the bottom of my foot. I think it helps to keep the cramps down. I haven't had any cramps in almost 2 days now. When I feel like one is coming on, I tell it to go away-maybe it's listening:) I have been getting out of bed and attempting to do some chores around the house every day since the 9th. I do have to rest quite often and elevate my leg when I do, as my foot will start to ache.
Two of my 5 kittys spent a lot of time in bed with me the first couple of days watching over me:) and my husband has been so helpful and thoughtful. What a great support team I have! I go for my 1st follow-up visit on the 14th. It will feel good to get this dressing changed and interesting to see how it looks and what the doctor has to say. I am feeling optomistic as of now! I will post again after my appointment and let you know what he says.
Take care and Blessings
Rita

Hi Rita, I am scheduled for the same surgery due to a ruptured tendon on the 22nd. My original surgery was to be on the 6th as well...but I came down with a cold and it had to be postponed. I am just wondering how you felt on Day 3...as for me that will be christmas day. I just want to be coherent for my kids. My dr. only perscribed Vicodin...which I am thinking may not be enough. Also, I am doing this with a local and iv sedation. No epidural or general. I don't know if I will be getting a leg block or not. Here's hoping! You said that you were up doing chores? Are you doing that on crutches? You seem to be really moving forward rather quickly. Gives me hope!

Hi Alex
I was also given iv sedation. My doctor also prescribed only Vicodin and the anesthesiologist prescribed Percocet. The anesthesiologist gave me the nerve block after I woke up in the recovery room. I can't imagine them not giving you a nerve block, as it is extremely painful when you wake up - I would certainly inquire about it. There is no way that Vicodin would even touch that kind of pain. Vicodin does nothing for my pain and I can't take Percocet, which is a fairly strong pain reliever. I am taking Darvocet when I need something, which is not very often. If needed, I am ususaly taking Ibuprofen. The chores I have done thus far are laundry and wrapping Christmas gifts. You don't really have a lot of energy to do too much, but I have a hard time doing nothing - tho I do have a lot of reading to be doing. I have been getting around on this great device I found called the one-crutch. It is just that - one crutch that has a platform on it which you put your knee of injured leg on. It leaves you with one free hand and is pretty easy to get around on. When you sit down, you can then use the platform as a leg rest for your injured leg.
I think you should be pretty coherent by Christmas day, unless you for some reason just have a lot of pain and are on strong meds. You may not have a lot of energy, but you should be able to enjoy your children and the day.
I'll be thinking of you. Take care:)

:wave: I am interested in knowing exactly what the Dr. did. Did he do a tendon transfer- and you can still wiggle your toes? Did you have your heel cut or broken and screwed back on? It sounded as though you didn't. Sounds as though you are really doing great, esp if you are moving around already. Where did you find that "one-crutch"? It sounds perfect to use - certainly alot cheaper than what my Dr. wanted me to get - the Roll about cart that costs $650. You mentioned dressings. You don't have a cast? What did the Dr. say today? How long are you going to be out of work? I am going for my second opinion next week. I am going to have to do something as I believe with doing nothing, my foot has fallen in the arch area some. The first Dr. tells me I would be out 3 months and would not be able to even touch the floor for 2 months. What you had sounds alot less severe.. Please let me know. Thanks alot.

Hi Kitty
I had the following procedures done. Flexor digitorim transfer(tendon transfer), calcaneal osteotomy(heel shift) and synovectomy(tissue removal). I believe he put screws in my heel, as he told me that would be part of the procedure. I will have to ask him next time I see him if those are permanent, as I am not sure. Yes I can still wiggle my toes - I thought I might not be able to. Yes I did have some sort of a partial cast on under the surgical dressings.
Yesterday when I went for my appointment, which was 8 days after surgery, the doctor removed the surgical dressing and casting, and also the staples from my 3 incisions (a large, 5 to 6" above arch, 1" lateral heel, 1/2" back of heel). All looked well according to him. To me it looked quite bruised and somewhat swollen, but my husband and I both noticed that my foot and arch also looked much straighter! He then placed small sterile strips across the incisions then put a fiberglass cast (I chose purple)on my foot and leg. My toes are sticking all the way out, and it goes up to about 6" below my knee. I am to remain non-weight bearing in this cast for 3 weeks. I have an appointment again at the end of that time period, which will be Jan. 4th, to be taken out of this cast and put in a walking boot for about 4 weeks. The only time I will be allowed to take the walking boot off is for taking a shower.
I did have quite a bit of pain last night, which I am sure was due to the staples being taken out, the new cast being put on, and all of the walking around that I did. I feel better today though!:)
My doctor also suggested the roll-a-bout. When I came into his office with the one-crutch, he was curious and asked me where I got it. It really is great, especially when you live in a small space like we do.
I hope this helps, and I will continue to keep you updated. I wish everyone a very Merry Christmas!!:)
Blessings
Rita

Hey,
Thanks so much for answering all my questions. I will certainly look up the one-crutch site. Your procedure sounds exactly what he wants to do with me. I am really tired of the pain and it limits my daily activites now. I have surgery set for Jan 16, but cancelled my appt with him because I wanted a
2nd opinion (set for the 20th at Mayo). I am not sure when I should really get it done as winter is so confining, and I'd rather be outside in the sun with my cats. I do know that my foot is beginning to collapse so I prob. need to do it very soon.

How long do you have to be off from work? I have gotten a shower chair -then I can prop my leg outside the tub plus bag it up to keep it dry. Well, sounds like your getting along great and I wish you a speedy recovery. I will watch for your updates.
Merry Christmas to you.
Betty

Surelynine, how are you feeling now? I went for my 2nd opinion and it was exactly like the first dr. He said to do it and get on with life. Guess I will. Unsure as to if I want him or the first one. The 2nd dr. didn't think it was a huge deal as the first one made it out to be. 1st one is closeby and the 2nd one is far away. Just wondering how you are doing. I looked up the one-crutch site and it was unique. Can you do stuff around the house still? Are you in any pain? Have you put it down yet? when do you get your boot? Were you off work 8 wks or more?

Have a Merry Christmas.
Kitty

Hi Kitty
Thanks for asking, I'm feeling fine. I do as much as I can -laundry, a little bit of cooking and cleaning, sewing. I even drove my car a little bit the other day. Actually, I've had more discomfort than pain. When I do have pain, I usually take ibuprofen, as it works better for me than vicodin, which is what the dr. gave me. I get my cast off and the walking boot put on the 4th of Jan. I am self-employed and work from home, so I have been working part-time. From the day I had my surgery until the day I get the walking boot it will have been 4 weeks. The dr. said absolutely no weight is to be put on my foot until I get the walking boot. Good luck with your surgery.
Take care
Rita

Hi, I am now wondering how your foot is going to "feel" when you get to put it down. You mention some discomfort. I am still unsure about my surgery. My foot feels good.. just some days it swells if I go too much, and have big time burning and pain - but just when I over do it. Otherwise, its pretty good. I just hate to go through it to hopefully get a better outcome "for the long term use". I know if I don't it will collapse- so I have to. I go see my dr. here in early Jan. Seems like just the other day you had surgery and now your fixing to go into the boot. Time goes fast. I am interested in knowing how your foot feels walking - if there is any pain - and how it feels - if it's the same or different feeling. The Dr. here tells me it will never be the same, you will have no pain, but it will feel different. That really bothers me. I don't kow what "different" will be. Well, back to work. Have a great day! Kitty

Well, I had my cast removed yesterday:) X-rays were taken and all looked well. The cast was replaced by an ace bandage and a removable walking boot, which I am only allowed to remove for the purpose of bathing. I was told to put a pillowcase over it when sleeping so I don't get my bed dirty. I am experiencing heel pain when I put my foot down, although it it nice to be able to put it back down again. I am now walking with the assistance of regular crutches. I am not putting total weight on my foot until the pain eases up which should happen within a few days. I was told that I would be in the boot for 5 weeks. I am scheduled to go back in 3 weeks and be shown some exercises to do on my own at home. I'll keep you updated on my progress with the pain and crutches.
Rita

Hi
Just thought I would post a progress update. I have been hobbling around the house for the last week using just one crutch instead of two. Yesterday I drove to town and did some errands using just one crutch to go in and out of buildings. Today I have been hobbling around the house without the use of any crutches occassionally. My incisions are healing up nicely, but I do still have some pain along the inner incision and the latteral incision. The latteral pain and tingling seems to be coming more from nerve damage or iritation, which I know in time will go away. Also the walking boot seems to put some pressure on my foot where the incisions are, causing pain. I remove the boot for a few minutes twice a day to let my foot get some air, apply some lotion and shower. I am hoping that I will not need the use of crutches at all by the time I go back to see the dr. on the 29th to be shown my pt exercises.
Rita

Hi, sounds like your progressing at least. Further examination on my foot has shown that I do not need surgery at this time. It is healing somewhat apparently, I have had little pain, no swelling and go all day long on it. It feels tight and bothers me just a bit now and then - must be where the tear is, as its the same spot, but as I see it why have it done when I don't have to yet. I was wondering how you have been. I hope your nerve problem will get better in time. Sure sounds like a lot to go through.. I am going to try to avoid it at all cost. IF it were to hurt all the time, then I would surely get it done. I am glad you are over the hump now and soon you will be out of that boot and won't have to use the crutch. I am glad that we have talked as at least I have some idea of what I will have to go through if it returns. I pray it don't. Keep in touch!! Betty

Glad to hear you guys are doing well in your surgery! I wish I had found this thread before. I searched all over the internet looking for someone who was going through the same thing as me, but didnt find any. I am four months out of my second flat foot reconstructive surgery. I had SEVERLY flat feet. I had the tendon transfer done, two tendon repairs, two fusions, my achilles tendon lengthened, my heel moved over and screwed back on, and, I think thats about it! I have six screws and two metal clips in each foot, but they dont bother me at all. I had cadaver bone crafted in too. I am doing great, can even jog some now! I was nervous to do the surgery, but I am 23 and didnt want to get arthritis from waiting to long. So glad to hear you guys are doing well!

Betty
Glad to hear you don't have to undergo surgery. I am still in my walking boot and getting around without the aid of any crutches. I see the dr. tomorrow to be shown some exercises to do at home on my own. I'll be very glad when this boot comes off in a couple of weeks as it is messing up my hips. Will likely have to go to the chiropractor for some major adjustments.
Rita

I have been following Rita's progress particularly because I knew I was having a posterior tibial tendon transfer.

I finally had the transfer done this past Wednesday. I ordered the Roll-About but rented it for 30 bucks a week. I tried it in the hospital and it is a so easy to use. Yes, it is bulky but these crutches are seriously a pain to use. My pain now is manageable even thouh I am just out of the hospital on Saturday. I had a nerve block and IV sedation but woke up during the surgery. I was surpirsed but just said to the anesthesiologist, "....I don't think I should be up now. Give me more valium/ demoral" and he said ok. I felt nothing so I was not overly concerned. Besides, he warned me that I won't be totally out of it and will be in and out of it. Post-surgery while in the hospital, I was on morphine for a couple of days but I was so itchy from it. Combined with the Benadryl, they had to give me to combat the itchies, I was out of it until they put me on oral pain medications.

I have not much else to report because I am just beginning the recovery process. If anyone has questions or would like me tell me what else to expect, feel free to post!

Hi Betty,
I am wondering who you saw at the Mayo. I would be very grateful to know. I have a foot that has been getting worse for the past (almost) two years. I am 26 years old. It flattens out when standing, and it's gotten wider, and really hypermobile. I can't stand comfortably. It feels like my foot is shifted out from my leg. I just found a great doc in Boston. Am thinking of going to the Mayo for another opinion. Would appreciate any info you have.

Hey,
Thanks so much for answering all my questions. I will certainly look up the one-crutch site. Your procedure sounds exactly what he wants to do with me. I am really tired of the pain and it limits my daily activites now. I have surgery set for Jan 16, but cancelled my appt with him because I wanted a
2nd opinion (set for the 20th at Mayo). I am not sure when I should really get it done as winter is so confining, and I'd rather be outside in the sun with my cats. I do know that my foot is beginning to collapse so I prob. need to do it very soon.

How long do you have to be off from work? I have gotten a shower chair -then I can prop my leg outside the tub plus bag it up to keep it dry. Well, sounds like your getting along great and I wish you a speedy recovery. I will watch for your updates.
Merry Christmas to you.
Betty

Hi Girls,
I found this site quite by accident and have been following the progress of you all. I've had severe flat feet since birth and a year and a half ago, was diagnosed with a posterior tibial tendon tear in my left ankle. As of today, the tendon has not healed and now tendons on the outer side of my ankle are now thickened and inflamed. I've done the recommended treatments, anti-inflamatories, orthotics, walking boot and the last non-surgical attempt is wearing a brace which I can only wear when I'm working as the molded plastic, even though it's padded, irritates my foot worse than if I didn't wear the thing at all. So, I will return to the dr. on March 5th and we'll be talking about surgery more seriously this time. The old saying "a little bit of knowlegdge is worse than no knowledge at all" is certainly true! I've been researching the surgery and can seriously say that if there was any way to get around this, I would do it. I will let you all know what the plan is and hope you are all healing and doing well. Take care, Amy

Amy:

What surgery are you considering? I am 2 weeks post op posterior tibial tendon transfer, as of today. I am in fiberglass cast that was changed from a plaster cast on Monday. I didn't have flat feet. Rather, I had a complete left foot drop.

I would love to hear from you. By the way, where are you located in NJ? I am in Manhattan and have an excellent surgeon!

Hi Lynn,

The surgeon never said exactly what the procedure was called, that there are two ways he could do it. The first would be to go in and clean out the inflamation and repair the tendons. The second would be to clean out the inflamation, repair the tendons and then reinforce the tendons with other tendons. We haven't discussed the details of what is involved with the surgery yet because we were hoping that maybe wearing the brace would take care of the problem. His hesitation is that because he would have to repair the posterior tibial tendon on the inside of the ankle and the two tendons (can't remember the name of them) that run side by side on the ouside of the ankle, he would have to cut both sides of my ankle. I live in southern New Jersey, about 10 minutes over the bridge to Philadelphia.

This is a different surgery from what I had. I had tendons transferred from one area to another area of my foot/ankle. I would recommend my surggeon for another opinion as he specializes in ankle instability, ankle reconstruction and posterior tibial tendon transfers. He is at the HSS.

I came acrossed your post and was wondering what your symptoms were before surgery?
I had a tendon repair on the outside of my ankle about 6 months ago and now i am in more pain than before the surgery. The pain now is also in the inside of my ankle with lots of popping and cracking. I counted 15 times in 10 minutes.
The Dr. did a new MRI and found bone bruising and swelling but was going to talk to an orthopedic radiologist. I go on March 2 to find out the news ,for my Dr. is now out of town until then.
Thanks and hope you are doing well,
heidi

Heidi

I had a complete drop foot so it seem as if it would be a different situation thn you. I could only push my foot down. I could not bring my foot up at all. Not even a bit. I had limited movement of my ankle from side to side. Circumferentially, I had a tremendous loss of feeling in my leg below my knee as well.

Hope that helps.

Hi all,
Thanks to all that have opened and maintained this thread. It was good to feel I was not alone by finding the people willing to share their experiences.

My surgeon has recommended the following surgical procedure for posterior tibial tendon dysfunction (stage 2: unable to perform the single-leg heel rise): a medializing calcaneal osteotomy as well as augmentation of the posterior tibial tendon using a flexor digitorum longus tendon transfer. Is this the most advanced surgical procedure practiced at this point in the US? And if so, where is it performed?

I also have fibromyalgia, at times with severe flares. Has anyone have this surgery procedure and fibromyalgia? How did it go? Did any one have a spinal "nerve block" performed before the surgery? Some say that fibromyalgia patients end up with more pain following surgical procedures.

Has anyone have a synevectomy (synovium removal) performed along with the surgery even if they did not have rheumatoid arthuritis?

Has anyone used these particular brands of rol-abouts: "Roller Aid" or "Turning Leg Caddy"?. If so, was your experience with them acceptable?

Hugs,

Helena

Helena:
I do not know about the 2 procecures specifically that you mentioned by the medical terminology you mentioned. I just know that what I had was a posterior tibila tendon transfer. basically, the surgeon rerouted tendons from one part of my foot to another so I could hopefully be able to move my foot up.

My surgery did involve a nerve block. Basically, I was wheeled into the surgery room laying on my back. They asked me to roll over and lay on my stomach. Then they put a pillow under my face and asked that I sort of get up on my knees (butt in air). I don't remember anything after that other than waking up for probably 10 seconds during the surgery with the curtain in front of my face (I was on my back) and trying to get my bearings. I remember wondering why I was still in the operating room. I asked the anesthiologist for more anesthesia (I do remember asking but I do know I felt absolutley nothing) and he said ok. I was kind of almost chuckling to myself because he said it could happen. I almost had a small urge to try and remain awake but thought better of it.

When I woke up again, I was in recovery. I felt nothing. I had almost no pain from then on in the hospital because I was on Morphine or was sleeping.
I also was terribly itchy from the morphine so they gave me Benadryl and that made me sleep all day. The worst part was that the IV liquids made me have to go to the bathroom constantly and I hated hated hated hated using a bed pan (your only option). To me, that was the worst part.

I hope that helps.

PS I rented the Roll-About. I used it in the hospital and thought it was great. However, when I got home, I really did not use it. The first 12 days I was in a plaster cast and did not get out of bed other then to go to the bathroom. The cast was VERY heavy. Then, that cast was swityched to fiberglass. I am on the second floor of a house with a small hallway. If I move to another room (rare) it is easier to use the crutches at this point. If my cast is not removed this week as I hope (3 weeks in this fiber glass cast), then I plan to move back to my apartment and use the Roll -About if and when I need to get out of the apt or if I need to move around my apt. If the cast comes off, I will be in a boot and probably won't need the Roll-About. The rental is 30.00 weekly. That plaster cast is so heavy that it would be worth it to have for the doctor's visits alone if you have help to get the Roll-About in and out of the car.

Let me know if you need more assistance.

Hi Helena,
I had the following surgery done on December 6th - Flexor digitorim transfer(tendon transfer), calcaneal osteotomy(heel shift) and synovectomy(tissue removal). I'm sure this is the most current method used in this country as the doctor that I had do my surgery is the one who wrote the textbook on the subject. His name is Dr. Roger Mann and he is located in Oakland, CA.
Good luck and blessings
Rita

Hi Rita,

Wondering how your foot is now since it is healed. Since the ice and snow, I have had a few hurtful moments with my foot-and glad it is all melting now. I reinjured it, no doubt, but nursing it along. I seem to hear more pain and more problems after surgery, so I still feel very unsure about jumping into surgery yet. It is healing some, but there is still problems-which eventually guess I will have to get something done. Is your foot good now?
My cat, fell about 8-10' and landed with his arm out and ripped the muscles/tendons from his shoulder. I had to get a specialist and he did a "tendon repair" on his shoulder and has screws too -so he could at least walk. He is doing good and since then he walks odd and I was hoping the tendon transfer you did.. that you would walk the same as before. Does it feel like it did before you had the surgery and are you walking the same?

Take care.
Betty

Hi Betty
I saw the dr. yesterday and he said to keep doing my foot exercises and that I can start walking around the house during the day without the boot, but to put it back on when my foot starts to hurt. Also no more sleeping with the boot on. Yes my foot does feel different than before, but I guess that is to be expected. It is stiff and a little painful along the incisions when I walk without the boot, but that is to be expected also as it has been immobile for some time. I am now wearing a support stocking instead of the ace bandage which is much more comfortable. I have to continue wearing the stocking also to keep any swelling down. The top center area of my foot is slightly swollen making my shoe on that foot tighter. The dr. said it is best to wear a lace up shoe because of the swelling. I have to go back in one month and if all is well, he said he would release me. All in all, I feel good about having had the surgery done. I will keep you posted as to how it progresses over the next month.
Blessings
Rita

Hello Helena,
I have had RSD for about a year now. It causes a lot of swelling, burning pain, discoloration, numbing of my foot, and cold temps in my foot and leg... The best way to discribe it is... It feels like liquid fire with shards of glass running through my leg and now into my hip. I am taking Cymbalta since about a month ago and it has helped somewhat. One of the things it has helped with is the swelling. After my swelling started to improve, I noticed that my ankle was bowing and my muscles in my calf and ankle were diteriorating. I called my Ortho and got an appointment for the next day (yesterday). After a long physical, he thinks that I now have PTTD. He said that he had not heard of this condition being connected to my RSD. While looking for any links to see if these two things were connected, I came acrossed your posting. I noticed that you have Fibromyalgia along with PTT issues. If you dont mind me asking, how long have you had both conditions? Which came first? And, do you, or your doctors, think they are connected?
If anyone else has similiar situations, Please feel free to give me any advice or possible links to help me with this. I truly appreciate it!

Take Care,
Misty

Is the posterior tibial tendon the one they refer to as the PT tendon? My doc thought I may have torn my peroneal tendon but it turns out I have tedonitis in the PT tendon. I searched for a picture of the foot to find out which tendon that might be because I forgot to ask him to be more specific during my appt. Thanks--Terri

There is a peroneal nerve and a posterior tibial tendon ....completely different but sometimes related. Google both and that might help. I had a peroneal nerve release surgery in my knee when a surgeon thought my drop foot was cause by the compressed peroneal nerve in my knee. When that did not work to correct my foot drop, I had several more EMGs and it was found that my foot drop was caused by lumbar radiculopathy. I previously had a herniated disc at L5-S1 with impingment and had surgery in 03. The disc herniated again but it was much more severe this time. The two herniations with compression on the thecal sac might have caused the nerve to become so crushed/impinged/compressed, the nerve might have just 'died'. That nerve might be the nerve that sparks the muscles to move my foot. I had a tendon stransfer in January with the hope that the rereouted posterior tib. can move my foot up and down. You might also want to look up 'double crush syndrome' and 'posterior tibial tendon transfer'.

Hope that helps.

There are 2 peroneal tendons, the peroneus longus and the peroneus brevis. The attach the perneus longus muscle and the peroneus brevis muscle to the foot respectively. Those tendons are on the outside of the foot. My outside ankle hurts and is swollen, that is why my doc thought it was the peroneal tendon. My MRI showed that I had tendonitis in the PT tendon and the peroneal tendons were fine. As I said I didn't think to ask the Doc what exactly and where exactly the PT tendon was. I asked the physcial therapist where I teach about it and she thought the posterior tibial tendon. However, when I do a google search for the anatomy of the foot and find pictures the posterior tendon is the inside ankle. That is why I asked if the posterior tendon is the one that docs refer to as the PT tendon. I got a shot in it last Friday and it already hurts again. I think more so than before. It just doesn't make sense to me if where I have the tendonitis is the posterior tibial and its on the inside.....why do I have swelling and pain on the outside.

Hi -
My foot would also swell on the outside, huge and buldging, but.. it was the inside tendon that is torn. I too got the shots, helped at first, but actually made things alot worse. After it all calmed down, I was going to do the surgery but over time.. I felt that I would be trading one pain for another. It was still usable, just when it hurts, I stay off. Now, a year later, it is actually much better.. took forever.. even the Dr. says once in a while some have been known to try to heal. There are still 2 spots that I know have not healed, as that must be the tear. Still, all in all, I am walking around and it hasn't swelled lately or anything. In the summer, with the heat, it tends to swell more. I've been talking to surelynine on this site and she did have the surgery. I feel eventually maybe I will have to, but until that time comes, I am still hoping it will somehow heal itself. Hope you can find some relief.
Betty

B51kitty,
So you had the same type of problem I have. Pain on the outside but with issues with the posterior tibial tendon on the inside? Did you do anything else but stay off it when it hurt? My swelling and ache/pain is an everyday thing now. And I teach preschool so I really don't see me being able to stay off from it. Plus I teach year round so the summer won't be a recovery time. Although I am thinking of changing jobs to where I won't be on my feet but that won't be until the end of July when my contract runs out. I'm just so frustrated with this foot. I had morton neuroma surgery in 2004, the PF surgery in Nov and now this.

Hi there. I have a daughter that has foot drop in the rt foot from an auto accident she was in about 9 months ago. As of now it doesn't appear that the nerves are regnerating and we have an appt with a dr about a tendon transfer and I was wondering how you are doing now. If i'm reading this right you had your surgery approxiately 2 months ago. Would you do it again? Are you able to bring your foot up at all now. My daughter foot drop is in the rt foot (her driving foot). I am concerned about her driving when the time comes.Thank you for all you answers. It sure is nice hearing from someone who knows what I'm thinking about.

Hi there. I have a daughter that has foot drop in the rt foot from an auto accident she was in about 9 months ago. As of now it doesn't appear that the nerves are regnerating and we have an appt with a dr about a tendon transfer and I was wondering how you are doing now. If i'm reading this right you had your surgery approxiately 2 months ago. Would you do it again? Are you able to bring your foot up at all now. My daughter foot drop is in the rt foot (her driving foot). I am concerned about her driving when the time comes.Thank you for all you answers. It sure is nice hearing from someone who knows what I'm thinking about.

I am sorry to hear about your daughter. Does she have any ability whatsoever to bring her foot up?

My surgery was only on 1/31 so I am not 2 months along yet. I am still in a cast (air cast at this point) so I do not know if I can bring but foot up but I can safely say I will not be able to do this for many many months. First, I need to get out of the cast and concentrate on putting some weiht down ont he foot and I am not quite there yet. Then I start working with a PT. At some point, I am sure he will start working with me to retrain the tendons to try and bring the foot up but there are no guarantees that that will work.

Where are you located? Just so you know, your daughter should see a neurologist as well as an orthpedic surgeon (actually several for different opinions). Your dauhter should have several EMGs spaced several months apart (I had 4) to ensure there is no improvement and no regeneration. You also need to determine if there is peroneal never damage or if the foot drop is assicated wirth a L5-S1 herniation as the diagnosis is they key to how you will solve the problem. Also, no surgeon should do a tendon transfer surgery until a minimum of one year after the accident/ incident. Some surgeons suggest waiting 1 1/2 years.

Let me know if you have other questions.

Surely aka Rita:

I read some of the posts about your progress again since I am further along in my own progress. I saw you mentioned in one post that when you were in the cam walker, you had heel pain. I am also in the cam walker and 5 weeks post-op tendon transfer. I was put in a cam walker one week ago (just liek you it was 4 weeks post-op). Although my surgeon said I could start to eventually put a small amount of weight on the left foot with the boot on (about 5-10% and proress over time), I have not been ble to. I have had tremendous heel pain. I am not walking or putting any weiht on the foot whatsoever but the heel really hurts.

Did you experience this? I am scared to even take off the cam walker and look (I am squeemish) and my surgeon is on vacation all this week. His colleagues are 'useless' (ok, I am exaggerating a bit but I want my surgeon to recommend something) . I am taking ibuprofen, per one of his assistants, with the hopes that if my ankle is swelling, it will be relieved that way. It's not working nor is the 2 ES Vicodin. I stopped taking the Vicodin because I would get too 'out of it'. When I did take it, it did not do a thing anyway.

I thought I could gget back to work sooner (the surgeon initially said 3 weeks post-op then when I saw him at 4 weeks post-op and I decided not to go back yet, he said I should wait 10 more days anyway). There is no way that with this heel pain I can go back Monday. I could never get ready and get in a taxi at this point.

I will see my surgeon when he comes back (I am going to make an emergency appointment to see him the day he gets back) but I am frustrated as I did not have any heel pain or any pain at all in the fiberglass cast.

Advice?

Hi again! No my daughter cannot bring her foot up but she can push down. We have been seeing a neurologist and ortho surgeron and have had 2 EMGs done so far. She did have a fracture to her neck but it was C3/4. She had many fractures from the accident including a rt femur which they inserted a rod and the rt knee cap which had screws to help heal. The drs feel the nerve damage is from the break. Also from the accident she has a myositis ossifican(which means there is extra bone growing in her leg. It stops growing within 1 yr. We believe it has stopped) on the rt femur which I wonder if it compresses the nerve but the drs have said no. While searching the internet I read about Dr. Nath in TX who does nerve transplant but it has to be done within 6months of onset. I didn't find it until the 6months had already passed. The drs do feel she has some peroneal nerve damage. She has some nerve damage on the lf foot also but not as bad. She doesn't have to wear a brace on the lf ft. Her feet are still a little tender to touch but are getting better. She's not happy about the brace she wears on her rt foot because the shoes are very limited. She was only 17 when it happened and you know you have to look good. She is still going to PT but we think she will be discharged soon (which is good) but she'll go back to the same one if she has this surgery. I did read somewhere that it has to be approx 1 yr but I don't want to missed the window and not be able to have the surgery done. I hope you are doing well and this works out for you. I know it'll be a long haul but I'm sure it will be well worth it. I'm sure this will test your patience (and your supporters too) but stay postive. As I have been telling my daughter, this part is all temporary and we'll get through this. Hang in there



I am sorry to hear about your daughter. Does she have any ability whatsoever to bring her foot up?

My surgery was only on 1/31 so I am not 2 months along yet. I am still in a cast (air cast at this point) so I do not know if I can bring but foot up but I can safely say I will not be able to do this for many many months. First, I need to get out of the cast and concentrate on putting some weiht down ont he foot and I am not quite there yet. Then I start working with a PT. At some point, I am sure he will start working with me to retrain the tendons to try and bring the foot up but there are no guarantees that that will work.

Where are you located? Just so you know, your daughter should see a neurologist as well as an orthpedic surgeon (actually several for different opinions). Your dauhter should have several EMGs spaced several months apart (I had 4) to ensure there is no improvement and no regeneration. You also need to determine if there is peroneal never damage or if the foot drop is assicated wirth a L5-S1 herniation as the diagnosis is they key to how you will solve the problem. Also, no surgeon should do a tendon transfer surgery until a minimum of one year after the accident/ incident. Some surgeons suggest waiting 1 1/2 years.

Let me know if you have other questions.

Hello
Sorry to hear of your daughter's problems. I had my surgery on 12/6, and about a month ago I started PT. One of the 3 exercises that I have to do is flex my foot up and down. I do each exercise for 5 minutes 4 times a day. I am now also walking around the house without the boot for a half hour or so a few times a day. I am to extend my time out of the boot and also walk around outside over the next month. I have to wear lace up shoes as my left foot is slightly larger due to swelling. I wear a compression stocking all the time to help with the swelling. I do still have pain and numbness where my incisions are. The dr. said it was likely a nerve caught in the scar tissue and that I should massage the area with a wet wash cloth. I am doing as much walking as I possibly can without overdoing it.

Blessings
Rita

Lynn,
I too was experiencing heel pain when I first got my boot, and no heel pain in the cast. I used my crutches to assist me for probably a week or so, then went to using only 1 crutch for several days, then no crutches. The pain is getting to be less as it continues to heal. I ususally take ibuprofen when I go to bed, as that is when it really seems to hurt and feel stiff the most. It sounds like what you are experiencing is very much the same as my own experience. I guess you just have to be patient (something I don't always have a lot of) and it will improve. Take care and let me know how it goes.
Blessings
Rita

Hi Rita
It sounds like the surgrey is going to be successful for you. Have you had foot drop for awhile? Did you have to wear and AFO? That's what my daugher really wants is to get out of her AFO. She has to get men's shoes to fit over the brace and it makes it hard to fit the foot with the brace but then that size is so big on the left foot that she doesn't wear a brace on. It sounds like the recovery period for this surgery is going to take awhile but I'm sure it will be worth it! My daughter had to massage her rt wrist (it was broken in the accident:has a plate and screws) along with the bottom of her feet. They said to massage with different kinds of items and material. It helps the nerves get use to different feelings. It has helped her. The feet are still a little sensitive but so much better than they were. Thanks for sharing your story. It give my daughter and I hope. We have an appt next week so I'll let you know what the dr has to say. Keep up the good work!
Janet

Hello
Sorry to hear of your daughter's problems. I had my surgery on 12/6, and about a month ago I started PT. One of the 3 exercises that I have to do is flex my foot up and down. I do each exercise for 5 minutes 4 times a day. I am now also walking around the house without the boot for a half hour or so a few times a day. I am to extend my time out of the boot and also walk around outside over the next month. I have to wear lace up shoes as my left foot is slightly larger due to swelling. I wear a compression stocking all the time to help with the swelling. I do still have pain and numbness where my incisions are. The dr. said it was likely a nerve caught in the scar tissue and that I should massage the area with a wet wash cloth. I am doing as much walking as I possibly can without overdoing it.

Blessings
Rita

kidw/footdrop:

As soon as you mentioned about your daughter having the rod inserted inserted a rod and the screws put in the right knee cap, I thought peroneal nerve damage. You might do a oodle search on peroneal nerve damage and foot drop. I know a very thorough EMG (I stress thorough as my first EMG was not and I was initally incorrectly diagnosed with severe peroneal nerve damage to the left knee and had nerve release surgery in my left knee). would diagnose if the foot drop is from radiculopathy or from the peroneal nerve. Also, goodle nerve release surgery to the kneee with foot drop and peroneal. Has anyone suggested nerve release surgery?

Lynn,
I too was experiencing heel pain when I first got my boot, and no heel pain in the cast. I used my crutches to assist me for probably a week or so, then went to using only 1 crutch for several days, then no crutches. The pain is getting to be less as it continues to heal. I ususally take ibuprofen when I go to bed, as that is when it really seems to hurt and feel stiff the most. It sounds like what you are experiencing is very much the same as my own experience. I guess you just have to be patient (something I don't always have a lot of) and it will improve. Take care and let me know how it goes.
Blessings
Rita

Rita:
I went to the doctor on Friday. Thursday night I had emailed my surgeon (he is on vacation) about my heel pain and he said immediately see his fill-in doctor. The fill-in put a squichy piece of material act as a buffer in my boot. My concern was that initally he told me I should not be on my feet at all but then he said I should be healed and walking around so my foot won't drop (I told him mainly I am in bed elevating it). I told him I thought the cam walker kept it at 90 degrees. He said I should speak to my surgeon.

I got home and later that day I fell using my crutches. I don't think I did any damage and I have fallen once before and almost fell another time using my crutches. It scares me to think I might go back to work this week and cannot even get around using crutches. Did you fall using your crutches? I emailed my surgeon and raised my concerns, especially about work and falling and being on my feet. Last week my doctor told me that I could go back to work by Monday (initially pre-surgery, he said I could go back after 3 weeks).

I am so confused I am doing things wrong.

hey all...

i have been diagnosed with pttd and have been using orthotics and going to pt for the past six weeks. nothing seems to be working. i am a teacher and am on my feet for 8 hours a day. i actually tracked my walking and i average about 2 miles a day. my pain actually began about 3 years ago, but i didn't feel it was severe enough to warrant a visit to the os.

the doc did mention the surgery many of you have had. he told me if i was any older (i'm 31) he would do the surgery immediately. i see him again on the 19th.

i am wondering how long you were in the hospital and off of work? also, how long was recovery? if i get some info from all of you, i am sure i will be able to make a more informed decision about what to do.

thanks for your help! (i've also posted this message on post tibial tendon surgery)

Janet
I had foot pain off and on for almost 3 years. About 6 months before I first saw a dr. my arch dropped and my foot and ankle were quite swollen. I saw an os who ordered an MRI and after looking at it, he said that an AFO would be of no use, that it really needed surgery. He referred me to another surgeon, as his specialty is knees. The dr. he sent me to (who literally wrote the text book on foot and ankle surgery that medical schools use) said the same thing. He also told me that I could put the surgery off for a couple of years, but if I did, I would end up needing fusion instead.
I wish your daughter the best and let us know how her appt. goes.
Rita

Lynn,
I couldn't imagine going back to work full time 3 weeks after surgery. Part-time maybe, and only if I had one of those rollabout units. No, I never did fall, but there were numerous close calls. Are you walking at all with your boot? I walked gingerly on it with the help of my crutches. Yes the boot does keep it at 90 degrees, and when you are finally allowed to take it off, the front of your ankle will feel quite stiff. Don't get discouraged. Before you know it you will be walking with only one crutch, then with none. It took me 3-4 weeks to get to that point. I kept my foot elevated at night during the first couple of weeks with the boot. Take care and keep us posted.
Rita

Hi teacher,
I was never in the hospital. My surgery was done in a same day surgery center. The surgery lasted about 2 hours, and I was there for 4 to 5 hours total. If you read the first several pages of this thread, I posted my progress updates. You might find it helpful.
Good luck
Rita

tchr4u

I was in the hospital 2 nights and my surgery was about 4 hours. If you are a teacher, you should have a tendon transfer during the summer. I have been off from work since the day of the surgery on 1/31. I was told I could possibly go back 3 weeks post-op but that day came and went. No way could I go then. I was going to go back today (last time I saw my surgeon he said wait 10 days). However with my heel pain last week and a fall this weekend (using my crutches), I won't go back tomorrow. I think I might wait another week.

Rita is further into recovery then me so she can tell you more about how she is doing since she had the surgery in early December 06.

If you have any more questions, feel free to ask. Do you have a foot drop? What were you diagnosed with? Did you have any accident or surgery in your knee every? Did you have an EMG yet?

Rita

I am not walking on the foot with the boot at all. I am 5 1/2 weeks post op. I am still using 2 crutches and keep it elevated when in bed. Did it take you you 3-4 weeks to get to using one crutch when you first got the boot put on or 3-4 weeks to use one crutch post-op? Are you still in the boot? I assume you still are. Are you still only fully walkin on it a 1/2 hr a day or is it more now?

Hi Everyone

Lynn-thanks for the heads up on the nerve release surgery. I'm going to start googling so that I have info for the dr appt.

Rita-thanks for your input also

I'm still kinda of learning this whole computer thing but I'm glad I found this site! We have an appt on Wed. so I'll let you know how it goes but from what I'm finding here and else I think it will have to be a min. of 1yr from her accident which May 20, 2007. But then that puts us in her senior graduating stuff ( ceremony, trips, etc.) so maybe at the earlist this summer. My daughter said she will feel better just knowing she will be able to have it done. Both of you keep up the good work! and Teacher hang in there!

Thinking of you all
Janet

Rita and Lynn
Thanks for responding...it seems everyone's surgery is a little bit different. Your experiences will help me make an informed decision next week when I see the os.
I was diagnosed with pttd...collapsed arch
I have not had an EMG.
Lynn...I am curious why you asked about knee surgey. I did have a proximal and distal bone realignment done on my left knee about three years ago. Almost immediately after the knee surgery is when I noticed the problems with my right foot. Love to hear your thoughts. I asked the os if the knee surgery could have caused this and he said he wasn't sure. Another reason I would like to go ahead and have the surgery done is I have infertility issues and we were planning to head to Kansas City (the nearest infertility clinic) this summer to begin infertility treatments. I would love to have the ankle situation resolved before I begin something this extreme. I would love to hear your thoughts on this also.
Janet...hang in there! Thanks for the words of encouragement. It is nice to know that others out there have the same problems! Congrats to your daughter and her impending graduation!

Rita and Lynn...thanks for responding. It seems that everyone's surgery is a little bit different.

Lynn...I am curious as to why you asked if I had had knee surgery. I had a proximal distal bone realignment done in my left knee about three years ago. About 6 months after that surgery is when I noticed the problem with my right foot. I would love to hear your thoughts. I have been diagnosed with pttd. The os says my ankle looks like that of an 80 year old 500 pound fat woman. I told him thank you! Seeing as I am 31, 5 11 and weigh 170...I am far from what my ankle says I am! I haven't had any other diagnostic work done except for an x-ray. Would love to hear your thoughts on all of this...another reason I would like to go ahead and have the surgey now is that I have infertility issues. We've been trying for 2.5 years without any success. This summer we were planning to head to Kansas City (the nearest fertility clinic) to begin treatments. I would like to have the ankle problem worked out prior to beginning anything else. AND if everything works out well, I don't think 30lbs of pregnancy would work well with my ankle at the moment. Love to hear your thoughts on this also!

Janet...hang in there! Tell your daughter she isn't alone and congratulate her on her impending graduation!

Thanks to you all...Amy Jo

Sorry...thought my first post was lost!!! I am not meaning to be redundant!

Peroneal nerve damage is caused by trauma or injury to the knee, fracture of the fibula (a bone of the lower leg), long-term constriction of the lower leg including habitual leg crossing, pressure to the knee and injury during knee surgery. A good indicator that you have peroneal nerve damage is is difficulty with dorsiflexion (lifting up the foot and toes) and with eversion (toe-out movements). Your doctor should do an EMG to test for activity in your different nerves (to see if the peroneal nerve is involved-in my case it was not so a nerve graft was not an option) and an MRI to look for compression along nerve.

What I read about knee issues and peronel nerve issues is that Peroneal Neuropathy is usually caused by a compression at the fibular head (that's in the knee) and it presents itself as a foot drop. (When they thought I had peronel nerve damage I had nerve release surgery in my knee).

Anyway, the main thing I think you need to know is that surgery to the knee or leg can lead to peroneal nerve damage which can then result in foot drop. (The nerve runs right through the knee and leg so no wonder why injury to the leg would upset that nerve)! What concerned me was the statistics. I read some study that foot drop was found in .3 to 4% of patients after having a total knee arthroplasty surgery or proximal tibial osteotomy and it was found in 3 to 13% patients after proximal tibial osteotomy. Do some searching on the net using terms such as foot drop, knee surgery, peroneal nerve damage, etc. and see what you come up with. Always read. I have been reading about all of this for a 1 1/2 years trying to gather as much informaiton as possible so I can know what I am going through.

I think your OS was a jerk saying some of the things he said. I had a neurologist once tell me that I wouldn't have a herniated disc if I wasn't so overweight. Well, I was thin before the herniation and because of the herniation, I was not as active and put on weight (not much mind you). He should have been more compassionate and asked when I packed on my 'twinkie and ding dong weight'. :)

My thoughts: The knee surgery is possibly one of the causes of the peroneal nerve damage. The damage to the peroneal nerve was severe enough to result in a foot drop. You should have been told to get a MRI and an EMG. I would get second (third and fourth) opinions from another OS and a neuro. Ask them questions and see what they say. More information is a good thing.

I hope that helps.

Oh, I forgot to add one thing......I do not think any extra weight on your ankle (or your knee for that matter) would be good. Long story short, when I litigated cases for an insurance company on the defense side, I always argued at trial in herniaiton and ankle injury cases that the injury to their back and ankle could have been caused by the plaintiff's excessive weight. Mean, yes but that was my job (and I hated it).

Lynn
It was 3 weeks from the day that I got the boot that I was able to on it without the aid of crutches. At the end of that 3 weeks, the dr. gave me 3 simple exercises to do for 15 minutes 4 times a day. After 1 month of doing my PT the dr. said that I could walk around the house without the boot for about a half an hour a few times a day. He said to gradually work my way to longer periods without the boot and to also start to venture outside without the boot. Also I am to continue doing my PT. I have to wear lace up shoes as I still have swelling - I also wear a compression sock now instead of the ace bandage I was given with the boot. The back of my heel where the screw was put in hurts me now and then, so do the other incision areas as well as the front of my ankle and the top of my foot.
I go back to the dr. on the 3rd of next month at which time I will hopefully be able to stop wearing the boot.
I hope your heel pain improves soon. Don't be too afraid to try to put your foot down at least a little bit each day.
Take care
Rita

Hi everyone
Has everyone gotten their hr back from DST time change? I have googling alot about nerve release surgery and radiculopathy that Lynn suggested and I have many questions for the dr tomorrow. But one question that I can't find the answer to is how do you know if you had a thorough EMG as Lynn suggested? My daughter has had 2. The first one at the Rehab hospital 2months after the accident and the second one was done at the neuro dr's office 6 months after the first at the rehab. hospital. The neuro dr said there wasn't much change between the two. I'm just wondering how do you know if they were thorough enough?
Lynn- you seem quite knowledgable about all this. Are you in the medical field? My mom's a nurse and has been a big help through out all this. I think every family need at least a nurse in it! Luckily my daughter ( who was in the accident) had already decieded to do it!
Amy Jo- just a side note. I had problems getting pregnant also but went on to have 3 kids. Now ages 19,18, & 16. I had to go on fertility pills. Anyway just wanted to let you know you're not alone there either!
Thinking of you all.
Janet

Wow Lynn...you sure know your stuff! I will be doing some extra searching and see what I come up with!
Thanks for all your imput. I see the os on the 19th so I'll let you know what he says. I think you are right about getting some other opinions! Good luck to you...let me know how you are doing!

Janet...thanks for the encouraging words. Infertility is such a hard thing to deal with and not many people truly understand. It is hard to accept that as a woman you cannot do what every other woman in the country can do! I hope my story turns out as well as yours!

Thanks to all!
Amy Jo

Hi all!
Well, our dr appt didn't go so well but it was informative. He said that my daughter is not a canadiate for the surgery. She is still too weak in the legs.
We aren't sure is she is just weak or is this from the brain injury that she had. Even though mentally she seems fine (memory, talking, understanding)-it can still be a problem. He did say that the rt leg has weak planner flexation and weak inversion & eversion. The left foot the eversion is overpowering the inversion (so the foot turns inward-no arch.) We weren't too worried about that foot but he said it needs to be fixed before it becomes permanent. (He did say we should stay with our reg. ortho for that-we didn't have to change to him). It still early in her recovery from the accident (9months) nothing is out of the question yet but she still needs to get stronger hamstrings and quads. Here's hoping.
Hope all is going your way!
Janet

Hi Lynn,
I just read your notes and it sounds like things went well for you.
My story is:
I got pttd almost two years ago. My foot has changed shape, and my arch has flattened out some. But my biggest problem is actually my ankle instability. My foot is SO floppy, so when I stand it just flattens out, and the front of my foot points outward.
And I haven't been able to walk barefoot this whole time. I am 26 (this started when I was 24). Have been to several surgeons, Some were baffled. Almost all of them said I need a calcaneal osteotomy, a cadaver bone, and possibly a tendon transfer.
I am wondering how this would restore stability in my ankle. And I am also wondering if this would correct me MORE than I was before (before, when I didn't have any feet problems).
Do you know anything about that? And, Who is your doctor at HSS?
Thank you very much,
Jessica

Hi Jump
I know what the floppy foot is like. My daughter has foot drop in rt foot and her left foot isn't floppy but the top turns out. We just had an appt with the ortho and he said she has problems with the enversion/inversion (ankle going side to side) she has no arch on the left foot. We have to work on stretching it or there is a surgery that they can put a screw in the ankle (not fusion of the ankle) Anyway read your quote and the foot pointing outward caught my eye. Good luck!
Janet

Rita
Was curious how the doctor's appt went. I am going on Tuesday and I hope to get the ok to start putting some weight down. I had the surgery on 1/31 and still am non-weight bearing.

I did finally get my carbon compsite brace and had to buy a size 9 wide sneaker for the brace to fit. I normally wear a size 8. I had to buy 2 pairs of sneakers!

Kid

Sorry I didnt respond sooner....just got caught up with things. I cannot tell you how to know a thorough EMG is done other than get a second opinion. When I mean thorough, I mean one that tests all yours nerves. Apparently, before one surgery I had on my knee, I had one EMG. The results indicated a had severe peroneal neuropathy in the left knee. The surgeon stated I needed a nerve release surgery because of this. When my foot drop did not improve after this surgery, I saw another surgeon and had another EMG done. The doctor who performed the 2nd EMG read the first EMG results and stated not enough parts of my body were tested. Sibsequently, I had several more done after the second to see if my results changed. They did not. All EMGs after the first showed that there was no connection between the peronal nerve and my drop foot.

What I learned from this was that it is critical to get an accurate diagnosis before deciding how to proceed with any surgery or course of treatment. I really thought such a test (like an EMG) could only be read one way and although it could be, the test itself was not 'through' enough. It's almost like an MRI....the MRIs can really only be read one way but if they don't take the right pictures, well, you won't get a proper diagnosis.

By the way, I am not in the medical field...a combination of working in the personal injury defense field and reading a lot about back and leg/foot injuries got me to this point.

Hi everyone
Has everyone gotten their hr back from DST time change? I have googling alot about nerve release surgery and radiculopathy that Lynn suggested and I have many questions for the dr tomorrow. But one question that I can't find the answer to is how do you know if you had a thorough EMG as Lynn suggested? My daughter has had 2. The first one at the Rehab hospital 2months after the accident and the second one was done at the neuro dr's office 6 months after the first at the rehab. hospital. The neuro dr said there wasn't much change between the two. I'm just wondering how do you know if they were thorough enough?
Lynn- you seem quite knowledgable about all this. Are you in the medical field? My mom's a nurse and has been a big help through out all this. I think every family need at least a nurse in it! Luckily my daughter ( who was in the accident) had already decieded to do it!
Amy Jo- just a side note. I had problems getting pregnant also but went on to have 3 kids. Now ages 19,18, & 16. I had to go on fertility pills. Anyway just wanted to let you know you're not alone there either!
Thinking of you all.
Janet

Amy Jo
How did your OS appointment go last month?

Jessica
My OS at HSS is Dr John G. Kennedy. So far, I have found and spoken to 2 people who had the surgery from him and another person I met at my PT office. All are doing very, very well. His bio is online.

Lynn...I visited the os on March 19 and he was very frank with me. He told me again that he is not used to seeing pttd this bad in someone my age. I had tried two months of pt and had purchased custom made orthotics. Nothing worked. He basically said that as severe as my pttd is that only surgery will help correct it. I knew he was right after all the research I have done and from speaking with all of you. I went ahead and scheduled my surgery for April 24. I am anxious to get the surgery out of the way so that the healing can begin.
I would love any advice or do's and don'ts that you have learned about through your experience!

Lynn, hope your appointment went well. Keep me posted on your progress!

tchr4u, I am very curious, what's you symtom, besides of pain, do you have a flat foot? how does your X-ray look? and what exactly you do for you PT. and lynn1991NY, how do you recover so far? Is your cast off yet? are you going for any PT now and if so what exercise you do for your PT?

tchr,
What exactly is your surgery called?

I have my appt on Tuesday so I will find out then if I can walk yet with weight or not.

In terms of dos and don'ts post-surgery, you need to get everything you use regularly next to your bed. I have my laptop, makeup, water, medication, hand cream, phone, clock, tv remote, and cell phone with charger.

How long will you be in casts and how long will you be non-weight bearing?

tchr4u, I am very curious, what's you symtom, besides of pain, do you have a flat foot? how does your X-ray look? and what exactly you do for you PT. and lynn1991NY, how do you recover so far? Is your cast off yet? are you going for any PT now and if so what exercise you do for your PT?

Cindy
My surgery was 1/31 and my cast is off but it's been on and off (mainly on) since the surery. When it has been off, I have been in a cam walker. Initally, the cam walker was irritating my heal and foot but I figured out what was wrong so I can wear it again instead of the cast. I can technically wear a brace now but if I am non-weight bearing, I see no point to wear my brace with the sneaker. I might be weight bearing as early as Tuesday. 2 weeks ago, my surgeon said I should start trying to bring my foot up (even though it visibly won't move, I should try) about 5 minutes a day. He stated that I should discuss PT starting with him when I see him Tuesday.

I am not sure what PT I will have but I know it will be 2-3 times a week for 2-3 hours each time. There won't be much I can do when I start PT I am guessing aso I am sure it will be a lot of the PT working on me (although I cannot imaging what he can do either). I am sure the pain will be great.

ha ha ha ha ha, you sure are a veteran, knowing what you are doing and how to take care of all of your needs. I am highly disorganized thank god I have a butler (my husband) to take care of my needs.

My surger was on Feb 15, 2wks after yours. My pod actually cut me open didn't find anything like he said (tendon tears) then he sewed it up. (can you believe it?!!!) any way, my cast is off March 20, the pod told me that I could do anything I wanted. everything went down hill, I think I lost all my strengh with the cast. my body couldn't handle it. felt worse each day walking and standing. hesitantly went to PT one time to do flex exercise to bend the foot and make some circular movement after I double checked with my pod. shotting pain bad that night. Found some ecentric excises did 3 times works wonder for my strength, can even raise my foot on the ball, but my body couldn't handle it, more and more fatigue, sneezing, cold all the time. so I stopped everything all together, have to be bed ridden for a few days. Now I regain my strength gradually and waiting for my PT next wed. the jerk (pod) still didn't want to listen to me to get me the hydrotherapy and anything I wanted to try, he said I didn't feel good because I had depression, but because of the foot, at least I got his secretary to send me to the PT center I want with ultrasound machine and pool and they will do the evaluation first before they work on me. will see what happened. Went to see a naturopathic doc, whatever it is makes sense to me. she told me i need to improvement my general health as well, gave me a list to do everyday and some nanogreen (taste fresh veggie and fruit and it work! felt good after that) to try to help me regulated which she said it very important for my health the reduce imflammation. to sum up the list, mainly drink enough water, take breakfast, diner no later than 8pm and sleep 10pm, take time 15-30 to totally relax listen to nature, music etc....( guess for people like me that jumps around not calm enough) also pay attention to alighment/posture, work on hip as well. because my diet is very healthy, she didn't give instruction on that. I will call her back in one week to see how it works for me. oh, her hydrotherapy is to put my foot alternatively in hot and cold water. she said maybe I'd be ok after 1 week. of course, I am very skeptical about that. will see

any way, I can't handle weight-bearing activity very well still.

lynn,

seems you get a way better doc than I do. let me know how you progress and how your PT is going. i forgot to mention that I am going to pick up some Traumeel oil to rub my ankle area. she said the oil is good for pain? or imflammation area, she also told me to buy Castor oil to put on before I put my foot in the hot and cold water. what the heck, I'll try and do anything to be on my foot again. also, I massage my foot a lot, helps the pain down, esp. after moving my foot and exercising on it. again, let me know about your progress.

lynn...I am having a post tibial tendon reconstruction with a calcaneal osteotomy. The os told me I would be in a cast for 6 weeks and a boot for another 4. It seems you have been in a cast for a lot longer than that. Did you have some problems that kept you in a cast (other than the boot rubbing)? How has your pain been? I am looking to return to school within a week and a half...with lots of help of course. Trying to get myself prepared to manage the pain. What are you taking over the counter that I would be able to take while at work?

Thanks for helping!!!!

cindy...I have a great deal of pain of course, and an extremely flat foot. No tear yet on the tendon, but doc says only a matter of time for that along with arthritis.
For pt, I did a TON of exercises with my foot: Jumping on a trampoline on my toes, using a rubber band (pt rubber band) to provide resistance as I move my foot in (5 sets of 20) and then move my foot out. I also practiced balancing myself on a balance board. All this to help strengthen my tendon. Keep in mind though, once a tendon is stretched, there is no way to tighten it unless through surgery. I went to pt with pretty much the understanding that everything I was doing was going to prepare me to handle surgery better.

I bet if you search online you could find many different exercises to do!!!

All, I just joined the board and have been catching up on the posts I found it interesting that there is so much talk of nerves and EMG’s. I ran in a 10 k on Thanksgiving 2005 it was rather cold and I probably didn’t warm up/cool down well enough. Any way over the next several days my left foot/ankle began to hurt and didn’t go away a little swelling on the inside. I went through family practitioner, Motrin, a couple of weeks later to a general os, immobilized for 4 weeks, he thought that it was a tendon thing. No change, in for an MRI, showed a couple of hot spots near the navicular, but the os referred me to a foot and ankle specialist. The foot and ankle specialist said immobilize again and get a EMG/NCV test. Off to the neurologist I went. The neurologist only did the affected foot, but found no reaction (couldn't find any reaction) for the nerve that goes into the foot. The foot and ankle specialist diagnosed tarsal tunnel and I had a release done in March 06.

Recovery went well for several months I started running a little and switched more to cycling for fitness, however September/October I started to have the same thing come back. I went back to the foot and ankle surgeon and he sent me to a physiatrist in his office that specializes in nerve related injuries. She did an EMG on both feet and turns out they are both “slow” but are about the same as far as reactions go, however foot pain isn’t going anywhere. She sends me to PT and the therapist start talking about posterior tibial tendon dysfunction, and fallen arches/flatfoot and the like. I do the therapy for two months, and really didn’t make any advances. I am wearing custom orthotics and stretching and massaging on my own and don’t really know where to go from here. The physiatrist thinks that it is nerve related although it’s well past the initial healing time and the EMG’s are similar. The PT described my tendon as “boggy” and “crackly”, and he called my foot rigid. It feels like when I walk that my left foot is just sort of there and if I don’t have on shoes I feel very unstable, lately my foot has been throbbing and burning towards the end of the day. I am trying to gather the courage to make another appointment with the foot guy to discuss, however I tend to go into defensive mode anytime I’m around doctors so I guess my question is what should I be asking/expecting when I do go in. Any input is appreciated, thanks.

cindy...I have a great deal of pain of course, and an extremely flat foot. No tear yet on the tendon, but doc says only a matter of time for that along with arthritis.
For pt, I did a TON of exercises with my foot: Jumping on a trampoline on my toes, using a rubber band (pt rubber band) to provide resistance as I move my foot in (5 sets of 20) and then move my foot out. I also practiced balancing myself on a balance board. All this to help strengthen my tendon. Keep in mind though, once a tendon is stretched, there is no way to tighten it unless through surgery. I went to pt with pretty much the understanding that everything I was doing was going to prepare me to handle surgery better.

I bet if you search online you could find many different exercises to do!!!

Thank you for your response. You folks are tough cookies. Such endurance for pain. You should get a gold medal from your students. Sounds like a high time for your foot surgery. Saw last night the movie "Freedom Writer" about how a high school teacher (Hillary Swan (?)helped her troubled students. very uplifting movie. gives very good energy. highly recommend.

I am a newbie in this "pain and suffering" tendon business and I don't like it a bit. I don't care they said how hard how you can't, my mind is set that I will be good again. My first pain appeared Sept 25th last year. Everything is first time for me. Now you have problem after the doc does his deed, you are on your own. doc doesn't want to hear your problem. so I am pretty much have to figuring out myself what's happening to my foot with the surgery, what should I do and how much shall I do, aftering waiting for a while with no vail. I am waiting for my PT and want to know how your body react to them. hum, wonder I should purchase a trampoline. How do you feel about it? Actually I am doing some exercise myself since I am feeling stronger. I want to know everything about recovery. I want to heal myself back to my pain free independend life my "Operation Recovery" Just woke up one time last night with less pain. May be I'd be ok in a week ha ha ha ha ha ha. let's see. I know it takes long time (a year also?) for the tendon to heal and I'll have to be careful about my ankle the rest of my life. I told my husband (my hero) this morning that if i get to walk normal in a week without much pain, we'll go to the private island "Lani" where Bill Gates had his wedding and have him teach me golfing in the little free put green provided by the hotel. er, I am sorry. Well, I hope your surgery is a great success and we are here to hear your good news.

Bruce, don't put much high hope in the docs. based on what you said, they didn't have much clue of your problem and how to take care of you once for all. There're not much indepth info. about this condition out there. Took me tons of time to research after the surgery went wrong. Have seen 6 doc myself I kept asking why it happened (it's very important to find out what cause the injury, otherwise it wil come back to you again if you don't do the right thing to your body, you need to take care of the problem from the source, not just the pain), nobody really knew what caused my problem, 100lb, nerver do sports neither exercise (ha ha ha), didn't do anything to trigger it, just woke up one morning, vola, the pain. Any way, Bruce, what I am saying is, you are the best person you can depend on, go check out as many docs as possible, don't put on defensive mode, they regard themself god that knows everything and not to be challenged, just let them talk see whether you can put the bits together. And, do the research yourself. two books I can recommend "Fixing you Feet, prevention and treatments for Athletes" by John Vonhof and "The Repetitive Strain Injury Recovery Book" (about hands, but foundamental is the same) by Deborah Quilter. Hope you find your answers there. I found mine. Oh, I don't remeber the book mentioned about nerves, I just check only the section related to my condition. Lynn probable has an ocean of knowlege about nerves, maybe she has some inside. I actually have a question to ask her. The top of my foot was always tinkling at touch ever since the surgery, I wonder what's wrong and is it a bad thing. Any way, find out what you have, find out the reason and takle it. I know it's hard, but you can do it. by the way, what is a release (some kind of surgery?) and what kind of physical exercises you do?

Hi all
I just was released from my dr. last week. He doesn't want to see me again unless I have some sort of problem. My heel where the screw is hurts some. He said if it continues to bother me that he will remove it. It also seems that moving my heel bone over has made my foot slightly longer. I am having a hard time fitting into most of my shoes. My foot is also still somewhat swollen so I continue to wear a compression stocking. Dr. said that it may take 9 months for the swelling to go away. I also have a few other occasional spots of pain and also stiffness in my ankle. The pain I have now is much more tolerable than it was pre surgery and I am walking better although I don't yet have a lot of endurance. I am quite happy with my progress and hopefully when the swelling goes away I won't have to buy all new shoes in 2 sizes.
Take care
Rita

Hi, Rita

So glad you are coming back. I've been following your post-op from the begining. so exited to hear that you are doing so well with your surgery. Your doc sounds like a saint that took good care of you.

I have a question, you mentioned about some tingling in your foot before? how is it doing now? I have tingling at touch on top of my foot, I'd wonder whether it will go away.

again, so nice to hear from you. please keep us posted of your progress.

Hi Cindy
Yes I do still have tingling and numbness from my incision to my toes on the outside of my foot. The dr. said it is most likely nerves caught in the scar tissue and to massage it with a wet wash cloth. I've had nerve damage before that lasted for several years. I sure will keep you all posted. It helps to have the support and information.
Blessings
Rita

I had the surgery for a torn tibial tendon last July. At the point that I found an ortho that knew what was going on the tendon had shredded. It pays to get 2nd opinions. I am still dealing with problems. My ankle is so swollen. I have a bee sting kind of pain. I just had an MRI last week and I am awaiting the results. The tendon transfer is working fine as I can move my foot from side to side. The swelling is incredible. I am grateful to be in something other than a cast or a boot but I have found that the only shoes I can wear are DANSK clogs. (and only the ones with backs)

AS far as the tingling sensation that you mentioned at the transfer site, my PT told me to expose that area to as many types of sensations to desensitive the area. It worked for me. You need to retrain the nerve sensations.

Thank you folks for the tips. I massage my foot quite a lot. I started my "offical" PT yesterday, mine, almost let them to do the cortisone (?) injection on me. My PT mentioned something other than cortisone, I thought there are several names for that. any way, i took a breath now. I stopped them less than a minute after the injection started. mine mine mine, already been screwed up for one time. can't be careful enough to watch out what's been done to me.

Rita, what kind of exercises are you doing? do they help? and daniell, what happened to your foot? why your ankle is swellen? Did you have a surgery already?

Thanks for the advice-I'll try that. Sorry to hear you're having trouble with swelling. Have you tried wearing a compression stocking, it really helps me.
I did 3 little exercises for 5 minutes each 4 times a day. I'll try to explain them to you.
1. While sitting, put your feet flat on the floor and turn your injured foot out as far as possible, then turn it in as far as possible-do not move your heel.(the dr. likened it to moving a pile of sand from onespot to another) 2. Now put the ankle of your injured foot on top of your other knee and raise your foot up and back towards you keeping your heel stable. 3. Then sit so your leg is either dangling, not touching the floor or resting straight out in front of you and flex your foot toward you as far as it will go, then pointed down as far as it will go. These simple exercises really strengthened my foot in no time. I still continue to do them, although not as often. They really help when my ankle is feeling still.

Rita et al.

Just an FYI - my F&A OS and prosthetis (sp?) said that repeatedly injured and/or surgically repaired/altered feet will frequently increase in size and or width on the affected and non-affected foot. I believe it as I went up 1 1/2 sizes in legth and 1 size up in width on the "bad" foot and the not as bad foot went up 1 width and 1 size. I guess I now have a more stable base or perhaps I just have huge gunboats. Ah, now what to do with all my old favorite shoes?!

jane

I was told all kinds of things before they found out it was the tibial tendon. Can you move your foot towards the other foot? If you can't....... it is the posterior tibial tendon that is the cause. It seems a simple test but that is it! When they did an MRI it showed a tear, when the ORTHO got inside it was shredded. I had been walking around for a couple years in a brace, several casts etc. and going to other dr.s and getting the wrong diagnosis. I did a web search and found an MRI of tibial tear. I looked at the foot and thought that "looks like mine" . I know what you mean about being defensive when you go to see a dr. I live in Virginia too, so I decided I was going to go to somewhere like UVA or MCV or Johns Hopkins. I just wasn't getting anywhere with the local Dr. Go and make an appointment with the head of the ortho department, at the teaching hospital nearest to you. Hope that helps.

Thank you Rita for the PT info. I am doing the similar exercises but shorter than 5 minutes each. somehow, I haven't felt anything for these exercises yet. so far, I found pool exercises are very good to loosen up the foot but my screwed up body can't handle the cold, can't sleep with all my muscle tight up.

Can any of you handle as much walking/daily life as much as before when you could walk pretty normal? My surgery was on Feb 15th. my heart sank to the ground when I got shooting pain after I let loose and went to several places, doing some unloading as well because I felt pretty good yesterday morning. I felt better and better each day with less pain with all kinds of stuff I am doing, now a major set back. am wondering when it's the end of it. don't know what to do any more. maybe a passive approach, let nature takes its course. Rita and Daniell, how do you feel walking around or standing still?

Well I am still limping some and have pain, but in different locations and less severe. My husband has commented on how much better I am walking. I can't stand on my foot for very long yet or take a long walk. It sometimes feels like my foot is kind of a foreign object attached to my ankle. I totally expect it to take 9-12 months for it to completely heal. If my heel doesn't stop hurting soon, I will probably choose to have the screw removed.

Thank you Rita for your input. It's very helpful. I guess I have to prepare for a way longer recovery although all it's already passed all time frames the docs and PTs told me. I've overdone my foot twice because of what I was told and also what I learn that if you don't use it, you lose it. hard to find the balance, by the time pain comes already too late. have to start all over from zero actually negative again. it's a full time job to get yourself back to normal. I have to be very careful now. have pain on the bottom of my foot and toe. really worry whether I'd develop plantar fasciitis. the least thing I want is another problem to deal with. I am checking on some night splint to wear at night. One good news is that part of the tingling sensation's gone with I think tons of massage. I am thinking these few days when I am home bound that maybe I should focus on strenghthening other parts of my body first before I do much weight bearing and mainly exercise in a heated pool our friend offered me to use. will try and see

I wrote last week (6 weeks after surgery) that I just began weight bearing (walking in boot with crutches). It I. getting better,day by day. I wanted to ask those of you who have gone through this stage- how many times a day and for how long each time, did you do your "alphabet exercises". Also, did anyone get pains that feel like you have a splinter in your foot, on the outside near the toes (no where near any incisions)?

Leslie

Surelynine, Sorry it is still hurting. Mine still hurts too. Inside Ankle swells so much in summer, very hurtful. Made a appt. with another Ortho. Just wondering how much it may have mended on its own. Any other ideas...Anything.. to help, just I do not want my heel broke, moved over and the screws. Surely, there has to be another way.. I am going to keep searching. I am going to ask if he can just go in there and somehow tighten them up without doing all the other. I'd be game for that. I cannot do without my feet at home nor at work, as I have lots to do both places and not much, if any, help. I still have the limp on bad days and keep it proped up alot. It was fairly good painwise all winter, but this summer, sure makes it swell. Hoping you'll get better soon! Betty

Hi- I had appt. with a new dr. He thinks my foot/feet are very fixable. He would recommond trying short AFOs for both feet. He says in 4 months, my feet will be fine. I am hoping this will fix it. Hope you are feeling better. Betty