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Old 01-24-2008, 12:05 PM   #1
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PTTD Surgery Recovery????

I am 26 years old, and I had PTTD surgery on November 16, 2007 due as a result from an injury sustained in a car accident. My arch collapsed when I was rear-ended, and I had to have bone grafts to reconstruct a new arch as well as lengthen the enflamed tendons, including the Achilles.

I was on crutches in a non-weight bearing cast for 8 weeks. I am now in a walking brace and walking on my own without crutches.

However, I am still getting bouts of extremely severe pain. So severe I am crying and taking a strong medication like Percoset doesn't even help. It is not daily, it is very sporadic. I'll have good days where I get by fine with just ibuprofen, then I'll have a flare up.

Anyone who has had this surgery--did you have a similar experience? How long was it before you were completely pain free and no longer experienced swelling? Did you have any temperature problems? I tend to be freezing all of the time now, especially that foot. Any advice? I've used ice and elevation for the entire 2 months I was in my cast. I take Advil or Percoset if necessary. Anything else?

Once you were fully recovered, were you completely active again? Were you able to exercise in a gym, walk/run/jog?

Thank you so much. I really appreciate any insights into this.

 
Old 01-24-2008, 07:50 PM   #2
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Re: PTTD Surgery Recovery????

Hi there,
I had surgery last May for PTTD, including repair of posterior tibial tendon and an Evans ostetotomy (bone graft wedged in). I was NWB for 6 wks, did PT for a few months and started "running" again around 4 months post-op, just as my dr had predicted. I didn't get to enjoy that for long, as my other foot developed the same problem. I'm scheduled for surgery on the other foot at the end of Feb. A few weeks ago I had pain in my surgery foot on the outside, where the bone graft went in. My PT said that it might have been scar tissue shifting...it hurt! However, it's gone now. I really don't have any swelling or pain otherwise. I still have a ways to go to get my foot to lie flat when flexed (if on stomach with feet pointed). No temperature problems... but my feet tend to be cold in general.

You're still only a few months out from surgery, so your circulation is likely not back to normal, so the temperature changes and swelling are probably connected. I know when I swelled up, there was more pain. I remember having good days and bad, sometimes it depended on the weather, sometimes on how I slept on it, how much I walked, etc. I also took Percocet for about 3-4 months, though the last few months it was less frequently (once a day?). My dr recommended that I take pain meds before PT. If you're in a great deal of pain with walking, maybe it would be helpful to use one crutch or use crutches for longer distances? The scar tissue does cause some pain...that's part of why the exercises in PT are so helpful. They apply the right movements and pressure to break the scar tissue up. Are you doing PT?

A few threads on this board you might find helpful is "Posterior tibial tendon surgery" and "Posterior tibial tendon updates". Lots of others have shared their experiences with surgery and recovery on these and that's what helped me through my last surgery. Know that it does get better, but it's a long, hard recovery. Keep posting, ask questions. Good luck!

 
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Old 01-25-2008, 05:49 AM   #3
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Re: PTTD Surgery Recovery????

Thank you so much for your response and information. I really appreciate it. I am not in PT, which I thought was odd, but my doctor said no. I trust his opinion as he is chief of podiatry at the hospital here in my city as well as part of the US Olympic medical team. Still I do think it's strange. They only recommend PT if I'm not making any progress, and I have made a lot.

I'll check out those other boards. Glad to hear you were fully functional again fairly soon. I've heard anywhere from 6 months to a year, so hearing 4 months is encouraging.

Good luck with your other foot and thank you again!

 
Old 01-25-2008, 04:08 PM   #4
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Re: PTTD Surgery Recovery????

It takes 9-12 months for the full results to be seen after this surgery. I'm not sure I'd say I was fully functional at 4 months...I'm still making progress, but was able to return to most things. The strength is still not fully there and I'm about 8 months post-op. But overall, it's good and I'm glad I had it fixed. I'm a pretty surprised to hear that your dr isn't having you do PT. The point of it is initially range of motion, breaking up the scar tissue, etc (if you don't do it earlier, it can cause problems later), strengthening, getting balance back, etc. This is a pretty major surgery and I think it'd be hard to get the full benefits without doing some PT, or having a program to do at home. I'm no expert...just learned from other folks here, reading online info and going through it, but you might want to double check that with your dr and if he says "no", find out what you can do to help your progress. You went through a lot and want the best outcome, especially since you (and me) are young and have a lot of life to go yet with our feet!

Last edited by sunny77; 01-26-2008 at 10:07 AM.

 
Old 01-26-2008, 05:33 AM   #5
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Re: PTTD Surgery Recovery????

I will find out when I visit him next about PT or home exercises. I'm sure there are lots of things I can do at home. I work for the National Strength and Conditioning Association so I am surrounded by personal trainers, coaches and physical therapists. If my doc doesn't give me anything, they definitely can. So at point after surgery were you able to exercise again? I don't mean PT exercises, but like going to the gym exercises? Are you able to run? The doc told me I might not run again, but we haven't discussed it any further. Have you been on an airplane? Did your feet swell badly when flying? I'm a huge travel fanatic and my feet tend to swell on a plane anyway, so I was wondering about that.

Thanks again for your help! It's so nice to hear some hope for the future. This has been so discouraging as it wouldn't have happened had I not been in a car accident.

 
Old 01-27-2008, 07:16 PM   #6
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Re: PTTD Surgery Recovery????

I was able to run on the treadmill at 4-4.5 months. My PT suggested that I start by running a minute, walking 2 min, running 1 min...etc and gradually building that up. I did that a bit, but like I said before, started having issues with my other foot, so haven't been doing it. It felt a bit strange initially, but got better and felt soooo good to work up a sweat and be active again. I also tried the eliptical machine to see if I could tolerate that more w/ my other foot, but couldn't. I could feel the weakness in my surgery foot, but it didn't bother me unless I pushed it too long (like 20 min max). I lift weights, including hamstrings, leg presses, ads and abs (legs)...did that around the same time (though some was done in PT earlier on too) as the running.

Flying...yes, I went on a trip about 4 months post-op. I didn't notice much in the way of swelling at that point. It got a bit stiff and I had to be picky about shoes, but otherwise it was fine. I think someone, lesliekupe?, posted some stuff about flying after this surgery. You might be able to find it by searching for PTTD or under her name. Maybe instant ice packs or compression socks would be helpful?

I'm not sure if you're at the point of wearing shoes again, but you will likely find that some of them no longer fit. I can't wear some because my instep is higher, so it's too tight, or some have heels or too much height, making it painful. I had to spend a fair amount on new shoes that are made really well (like Merrells, Keen, etc.) and am in more lace up types of shoes now. Comfort is the name of the game now.

This surgery involves such a long recovery...it does get discouraging waiting, working hard, using/abusing the rest of your body in the process. I remember how tired I was each day after dealing with getting up and down the stairs (dragging my knee scooter w/ me, an extra 21#), in and out of the car/buildings/homes, and just the effort of doing all the things we take for granted when our bodies are working correctly, especially the feet! I'd be physically and mentally exhausted...and then all the questions people have. Ugh! So, I know what you mean. Hang in there though...you're through the worst of it and it can only get better! You'll be back at things before you know it, even if not 100%.

 
Old 01-28-2008, 04:55 AM   #7
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Re: PTTD Surgery Recovery????

Thanks so much. I'm so happy to know that I'll be able to run, workout and all that jazz! I hate being sooooo inactive!

Eek about the shoe thing! I'm a shoe freak. I have close to 100 pairs of shoes, they better fit. LOL I wear the comfort brands like Clarks and Dansko when I'm standing or doing a lot of walking, but I hope that I can wear my high heels and funky sandals to work (I sit all day since I'm a graphic designer, so no heavy walking) and dinner and things like that. Most of my non-comfort shoes are very open strappy sandal types, not closed up, so maybe they will fit. I'll be like Cinderella's step-sisters and make them!!!!

Good luck with your other foot. My other one appears to be fine. This whole thing happened from a car accident, so it should be okay.

Thanks again!

 
Old 02-02-2008, 03:11 PM   #8
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Re: PTTD Surgery Recovery????

Hi! Just checking through some of the threads and found this one.

What happened in the car accident that caused your foot problem?

About exercise.... I was able to do most things at three months post-op.... That sounds great I know... until you hear the next part. My bone graft failed after the 12/1/06 surgery and I wound up having to have a second surgery a few weeks ago... 12/27/07... and I was doing so well, too! : confused: Now I'm in a cast for fourteen weeks total. The first cast was on for two weeks, next one for six weeks (I'm in my 4th week now and doing great.), and then I will hopefully get a walking cast for another six weeks.... uggghhh.... But that's not really what you're asking I know.

The more direct answer would be that I was back to the gym at three months and taking three mile walks, or better, by my fourth month. I did get some swelling, but never any consistent pain. The only pain I had was on two occasions -- right around when we think the bone graft was separating.

I am 50 years old, fit, not overweight, non-smoker, etc.... but I do have a mild case of lupus. All things taken into consideration, my first recovery should have probably been taken much more slowly. I had my cast off at five weeks, was allowed "some" weight bearing, and then I was in full-blown PT at 7 1/2 weeks.

I truly believe PT is essential. A good therapist knows all the tricks to get you back to optimum physical health again. I do think I'd pursue that if I were in your shoes... so to speak. And speaking of shoes, let's see... After the first surgery, I had to buy a wider shoe because my ankle had collapsed, but other than that, my foot size never changed. We'll see what happens this time because I had much more work done. During the first surgery, they never put in any hardware... was told I didn't need it. This time, however, there are seven pins/screws holding everything together.

Each case is different, recoveries are different, but our unhappiness in having to dealing with any of this is the same, though, isn't it?


Quote:
Originally Posted by thefirstnoel519 View Post
Thanks so much. I'm so happy to know that I'll be able to run, workout and all that jazz! I hate being sooooo inactive!

Eek about the shoe thing! I'm a shoe freak. I have close to 100 pairs of shoes, they better fit. LOL I wear the comfort brands like Clarks and Dansko when I'm standing or doing a lot of walking, but I hope that I can wear my high heels and funky sandals to work (I sit all day since I'm a graphic designer, so no heavy walking) and dinner and things like that. Most of my non-comfort shoes are very open strappy sandal types, not closed up, so maybe they will fit. I'll be like Cinderella's step-sisters and make them!!!!

Good luck with your other foot. My other one appears to be fine. This whole thing happened from a car accident, so it should be okay.

Thanks again!

 
Old 02-03-2008, 06:47 AM   #9
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Re: PTTD Surgery Recovery????

Thanks so much. I'm so sorry you've had such an awful experience. That freaks me out big time. I figured once the graft was fully healed, it was healed. I see my doctor again on the 11th to hopefully remove the walking cast/brace and get back into regular shoes.

As for my car accident, well it was my first and only and I didn't think it was THAT big of a deal. I was rear-ended at about 25 - 30 mph. I walked away from it, and drove to work thinking I was fine. The pain hit an hour or so later, but it was primarily in my back, though a bit in my foot. As time progressed, both the back and foot were excruciating, but all docs thought my back was causing my foot and they couldn't find anything in my back except a muscle sprain. Finally I got fed up and saw a podiatrist and it was the reverse. The arch collapsed in the accident and enflamed the tendons, which threw my gait off so badly that the muscle sprain in my back was never allowed to heal. NOW my back is perfect and my foot is healing. LOL What a mess! Oh well I'm suing the guy, so that helps comfort me. It's just I'm very active, so this is driving me crazy. I live in Colorado, we all do outdoorsy stuff. LOL

My pain is very sporadic. Some days it's just barely there and days go by where I don't even take so much as an Advil. Others, like yesterday, were so excruciating I had to take a Percoset. I see a pain specialist though at the end of the month. And I will broach the subject of PT again, b/c I do find that rather odd.

Good luck and I'm so sorry about your relapse so to speak. That really sucks. Thanks for answering my questions.

 
Old 02-04-2008, 08:16 AM   #10
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Re: PTTD Surgery Recovery????

That's just it... when the graft is healed, it IS healed. In my case, that graft wasn't healed when the surgeon sent me to physical therapy. I thought it sounded like things were being rushed, but what did I know? This time around, my new surgeon probably thinks I'm some sort of a nut case when I ask a zillion questions.... lol.... Oh well......

[QUOTE=thefirstnoel519;3424052]Thanks so much. I'm so sorry you've had such an awful experience. That freaks me out big time. I figured once the graft was fully healed, it was healed. I see my doctor again on the 11th to hopefully remove the walking cast/brace and get back into regular shoes.

 
Old 02-04-2008, 10:39 AM   #11
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Re: PTTD Surgery Recovery????

I reread your previous post and if you were only in a cast initially for 2 weeks, no wonder you had problems. That is really awful. I was in a cast for EIGHT weeks with crutches and no weight bearing and now I've been in a walking brace for a little over a month. I can't believe they only put you in a cast for 2 weeks. Can you sue?

 
Old 02-04-2008, 11:27 AM   #12
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Re: PTTD Surgery Recovery????

I think I see what you were looking at. My first surgery was 12/1/06 and the second one was a little over a year later on 12/27/07. I was in a cast the first time for five weeks, told to bear weight a little at a time at that point and grradually build up until I started physical therapy at only 7 1/2 weeks.... Even that is waaaaaaayyyy too soon. I am in good shape, but I am 50 years old no matter which way you cut it, and I also have a mild case of lupus (thank God it's mild.). There's a whole bunch of other stuff that went on if you want me to share it. And, in answer to your question about suing.... I'm pretty confident I'd have a good lawsuit. We'll see what happens after this cast comes off in a little over two weeks. This has all been going on for over two years.


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Originally Posted by thefirstnoel519 View Post
I reread your previous post and if you were only in a cast initially for 2 weeks, no wonder you had problems. That is really awful. I was in a cast for EIGHT weeks with crutches and no weight bearing and now I've been in a walking brace for a little over a month. I can't believe they only put you in a cast for 2 weeks. Can you sue?

 
Old 02-04-2008, 04:22 PM   #13
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Re: PTTD Surgery Recovery????

Still yikes! Well good luck with your recovery. That is an awful thing to go through, especially twice.

 
Old 02-04-2008, 05:33 PM   #14
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Re: PTTD Surgery Recovery????

Yeah, YIKES is right! Lol! Once was bad enough. The weeks before the second surgery were horrible around here... I was pretty ugly knowing what was coming! I'm surprised when I read in these boards that some people are out of their casts and in therapy early on like I was the first time, yet they don't have the bone graft failure I experienced. Some of them didn't even have any hardware... how about you? I should, and probably will, start a thread on this issue... but I'm just curious right now. The docs told me I had a very severe case of PTTD originally, so maybe that's part of it. One thing I'm soooooooooo happy about is that I have been pain free for about 90% of this... even in the days just after surgery. Don't know what that's about either, but I'll take it!

 
Old 02-05-2008, 09:28 PM   #15
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Re: PTTD Surgery Recovery????

I was in a splint for one week, cast for 6 weeks, and a boot for 6 weeks, started PWB at 8 weeks progressing to FWB over a period of two weeks. Yikes, 2 weeks?

emmie

 
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