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Old 07-03-2011, 01:15 PM   #1
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Hi Everyone, I'm new to this type of communication. Here is my problem - I have PTTD of left foot and have been wearing an Arizona brace for 12 months. It helps but doesn't heal problem. I want surgery but am afraid it will complicate life possibly permanently. What should I do now? Your input will be much appreciated. Thanks!

 
Old 07-03-2011, 01:30 PM   #2
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Re: PTTD Sufferer

A lot of people here had the surgery. You are correct that the brace will not cure the problem. My ptt had multiple rips and the spring ligament was very lax. In my case, I was in pain, even when wearing a custom brace. I had ptt/spring ligament repair, tendon transfer, calcaneal/cotton osteotomy and gastroc recession at HSS in NYC. I am just about one year post op and doing well. You will know when the time is right. Be sure to get more than one opinion before considering surgery and most important, use a doctor that has had A LOT of experience with flat foot reconstruction. Recovery is long and frustrating. Not everyone has a good outcome so it is very important to choose your doctor wisely. In my case, I feel as if the surgery gave me my life back. It is a major decision. Good luck

 
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Old 07-03-2011, 04:07 PM   #3
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Re: PTTD Sufferer

Whatever you do don't delay surgerey too much if the conservative methods don't cure the problem. It's like putting a band aid on a gun shot wound. After a year and two months of dealing with conservative stuff I was in so much pain I had to have the surgerey. So thankful to be out of that horrible pre surgery pain. I actually enjoy my life now even though I am not 100% healed.
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Flat foot reconstruction surgery 3/1/2011~ Grateful I had this surgery and feeling better every week!

 
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Old 07-03-2011, 05:26 PM   #4
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Re: PTTD Sufferer

Quote:
Originally Posted by pttd View Post
Hi Everyone, I'm new to this type of communication. Here is my problem - I have PTTD of left foot and have been wearing an Arizona brace for 12 months. It helps but doesn't heal problem. I want surgery but am afraid it will complicate life possibly permanently. What should I do now? Your input will be much appreciated. Thanks!
I had my PTTD surgery was 4 weeks ago tomorrow. I learned so much from this healthboard. Be certain to consult with a board certified orthopedic surgeon who specializes in ankle/foot problems. KNow upfront that there will be no weight bearing for several weeks. I never heard of a kneewalker 'till I read about it on this website. The kneewalker is a big help to me. (rented it for a couple months) Main thing is to keep leg elevated high above your heart. I made a little nest beside the recliner with books, magazines, dvd player and my laptop, of course. You will need help..that's for certain. You'll get good advice from those who have been in your exact situation. Oh, physician will subscribe meds for pain. I recommend having a block. Good luck to you. Hugs, Zoeys Grammy

 
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Old 07-05-2011, 11:15 AM   #5
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Re: PTTD Sufferer

hello glad to read that u did go for the surgery - really no other option. i had mine in dec 10 & was non weight bearing for 7 weeks then weight bearing very slowly. was on my right foot - tendon repair, spring lig repair...etc. i was in knee walker 1st 3 weeks but caused my r knee to hurt so went into seated walker - used pillow for r knee & was better than knee walker (don't know why). in feb i started having left knee pain. to make a long story short the hopping around on the left knee cause 3 tears which had to be repaired by surgery...am now dealing with both knees in pain & 2nd round of cortisone shots (bursitis & tendonitis caused by the repeated involvement of being non weight bearing so be very careful about your knees while being non weight bearing. my foot still tingles & feels "asleep" dr sz due to the block at time of surgery - thanx doc!!
all in all tho still would have to have it done because i was in a lot of presurgery pain & could hardly get around. its no picnic now but at least am progressing some & better than pre-surgery. if knees get no better than physical rehab where they use ultra sound to "push" medicine directly into the knees - supposed to be miracle cure for bursitis - i certainly hope so. so hang in there - it can get worse before better but eventually will get well again.

 
Old 07-05-2011, 03:06 PM   #6
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Re: PTTD Sufferer

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Originally Posted by pttd View Post
Hi Everyone, I'm new to this type of communication. Here is my problem - I have PTTD of left foot and have been wearing an Arizona brace for 12 months. It helps but doesn't heal problem. I want surgery but am afraid it will complicate life possibly permanently. What should I do now? Your input will be much appreciated. Thanks!
I had PTT repair surgery 4/8/11, amongst other procedures as well. Although it is a painful recovery, even at 12 weeks post-op I think I am far better off. Yes, it will complicate your life for a while. I have been told it can take up to a year to fully recover. The pain and recovery issues I have now are very different from the PTTD pain pre-op. Pre-surgery I had tearing ripping pains that generated up my leg into my calf area with every step. Now, post-surgery I have pain but each week it gets noticeably better. Recovery is difficult and sometimes slow, but in my opinion very worth it. My tendon was so stretched and torn that I had chipped my navicular bone (bone in mid-foot where tendon inserts). I was unable to lift my weight onto the ball of my foot, therefore, walking was extremely painful. I had to wear a walking boot and ended up non-weight bearing for almost 8 weeks prior to my surgery. I now can lift my weight onto the ball of my foot and walking is becoming much much easier. I know that there is still a long road ahead of me, but I am satisfied with my decision to have the surgery.

I wish you well with your decision. It is a long road to recovery, but my doc fully expects me to reach my pre-op potential, in time. Good Luck!!

 
Old 07-26-2011, 03:12 PM   #7
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Re: PTTD Sufferer

hi armstead. i haven't been able to function normally for 6months now due to posterior tibial tendonosis. i cannot perform a heel raise and i have pain that increases after being on my feet only 5 minutes! i would like to be able to talk to you more about your experience. i recently received new UCBL orthotics but they haven't helped so i'm really wondering if i have a tear. the pain is debilitating. the orthopedic doctor i was seeing didn't even order an MRI. he wanted me to try new orthotics first. my case is a bit complicated because i have already had flat foot reconstruction on this foot when i was 11. i am 26 now. also, my calf muscles are very atrophied but physical therapy has done nothing.

 
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Old 07-27-2011, 05:09 AM   #8
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Re: PTTD Sufferer

Sounds like you need to see a new OS. I would try to find the best one possible in your state who is experienced in this type of reconstruction.

 
Old 07-27-2011, 08:18 AM   #9
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Re: PTTD Sufferer

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Originally Posted by molliefrog24 View Post
hi armstead. i haven't been able to function normally for 6months now due to posterior tibial tendonosis. i cannot perform a heel raise and i have pain that increases after being on my feet only 5 minutes! i would like to be able to talk to you more about your experience. i recently received new UCBL orthotics but they haven't helped so i'm really wondering if i have a tear. the pain is debilitating. the orthopedic doctor i was seeing didn't even order an MRI. he wanted me to try new orthotics first. my case is a bit complicated because i have already had flat foot reconstruction on this foot when i was 11. i am 26 now. also, my calf muscles are very atrophied but physical therapy has done nothing.
I do understand your pain. I also suggest you seek out another physician. I had to get a second opinion because my first physician also wanted me to use orthotics first before doing anything. My second physician said it was too late for orthotics in my case. And it may be too late for orthotics in your case. Bottom line, you need at least an MRI to diagnose what is going on in your foot. I did not have reconstruction surgery and that may have something to do with your current problem. Be sure to look for a physician with experience in foot reconstruction as they may provide you with greater insight for your case.
I wish you luck and if I can help you further, please let me know.
Armstead

 
Old 07-27-2011, 02:14 PM   #10
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Re: PTTD Sufferer

armstead,

thanks for responding. i actually have an appointment now for august 3rd to see dr. parekh at nc orthopaedic duke medicine.i'm actually surprised they take medicaid.their website did not list medicaid. also from looking at their website, he has knowledge in flat foot reconstruction as well as posterior tibial tendon procedures. i know i need an MRI. i can't believe i haven't gotten one yet. i'm wondering if some doctors tend to want to push you aside because of being on medicaid?? awful... i actually don't even have 5 minutes pain free. it's more like 5 minutes manageable pain.. but after that, it escalates to severe pain. it's also extremely weak. i'm on morphine ER and that doesn't even take away half of the pain. my primary doctor gave me a referral to get fitted for a wheelchair. so that's depressing but good because i need one. now if this specialist cannot help me, i don't know who can! i will be insisting on an MRI (although him being a foot and ankle surgeon, i would think that would be one of the first things he does!) the only thing i haven't tried is one of those AFO's. i've read about people on here complaining of not being able to run anymore or be able to be on their feet more than a couple hours..and they get one of those braces. i don't even have 5 minutes.. so i don't know if a brace would do anything for me at this point.
everyone else out there,.. how bad was your pain before you had surgery or even if you didn't have surgery? did it put you in a wheelchair? how long did it take upon weightbearing for your pain to start up? i'm just really curious too see if there is/was anyone out there like me. my pain is mainly in the inner ankle area where the tendon inserts.
oh, and if anyone can answer this- in order for the tendon to be torn or partially torn..does it always have swelling??
thanks!

 
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Old 07-27-2011, 03:17 PM   #11
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Re: PTTD Sufferer

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Originally Posted by molliefrog24 View Post
armstead,

thanks for responding. i actually have an appointment now for august 3rd to see dr. parekh at nc orthopaedic duke medicine.i'm actually surprised they take medicaid.their website did not list medicaid. also from looking at their website, he has knowledge in flat foot reconstruction as well as posterior tibial tendon procedures. i know i need an MRI. i can't believe i haven't gotten one yet. i'm wondering if some doctors tend to want to push you aside because of being on medicaid?? awful... i actually don't even have 5 minutes pain free. it's more like 5 minutes manageable pain.. but after that, it escalates to severe pain. it's also extremely weak. i'm on morphine ER and that doesn't even take away half of the pain. my primary doctor gave me a referral to get fitted for a wheelchair. so that's depressing but good because i need one. now if this specialist cannot help me, i don't know who can! i will be insisting on an MRI (although him being a foot and ankle surgeon, i would think that would be one of the first things he does!) the only thing i haven't tried is one of those AFO's. i've read about people on here complaining of not being able to run anymore or be able to be on their feet more than a couple hours..and they get one of those braces. i don't even have 5 minutes.. so i don't know if a brace would do anything for me at this point.
everyone else out there,.. how bad was your pain before you had surgery or even if you didn't have surgery? did it put you in a wheelchair? how long did it take upon weightbearing for your pain to start up? i'm just really curious too see if there is/was anyone out there like me. my pain is mainly in the inner ankle area where the tendon inserts.
oh, and if anyone can answer this- in order for the tendon to be torn or partially torn..does it always have swelling??
thanks!
I am so sorry that you are having so much trouble. I also felt that no one was listening before I found my second doctor. By the time I did see him, he could not examine my foot as it was too sore. I went on crutches for 3 weeks and then had to return after my foot was immobile for the 3 weeks just for him to be able to evaluate. I was non-weight bearing for 8 weeks prior to my surgery because I could not walk due to the pain. I used crutches. Yes, the pain was constant but much worse with any activity. I know that the recommendation is to use orthotics first before more aggressive measures are done, so it may even be a medicaid thing. Your problem may be that your PPT is too advanced for orthotics to help. I was in a boot and it did not decrease my pain. I am not sure if the brace will work for you at this point. A very supportive brace may be helpful.
My MRI did not show a torn PTT but I had a lot of pain over the midfoot at the insertion point. That area was very red, and extremely sore to touch. My ankle area was slightly swollen. The surgeon thought my tendon was inflamed not torn. He found it was torn from the midfoot to the tibia during the surgery. So, no there doesn't have to be swelling to have a tear, and swelling doesn't necessary mean it is torn. It really depends on whether the problem is from a recent injury or from use over time. A recent injury would have more swelling. The degeneration of the tendon over time from chronic stress has much less swelling.
I had surgery on both my PTT and my peroneal tendon, as well as other procedures. I am almost 16 weeks post-op and progressing slowly. I have tendonitis in the PTT again. I returned to work 4 weeks ago, and my therapist says it is from overuse. I mostly rest in between work days. I am part-time currently but will be advancing to full-time over the next 8 weeks. It is a long rehab road. From what others on this board have said, it can take up to a year to be back to pre-op status (pain-free). In my current situation, I can believe it will be that long.
I wish you luck, and keep us posted. I totally understand your pain. I wish there was a quick fix...
Hang in there!!
Armstead

 
Old 07-27-2011, 03:20 PM   #12
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Re: PTTD Sufferer

I didn't really have much swelling at all but my ptt was partially ruptured and spring ligament was very stretched out. Prior to surgery, as things went from bad to worse, my foot pancaked and when I stood it looked like my ankle was starting to cave in towards the floor. I was unable to walk for any period of time. After 15 or 20 steps, I got a sharp pain along the side of my foot (ptt) and into my arch. I went to a total of four doctors. One just said he could give me orthotics. When I asked him if they would really help. He said probably not. What a joke. The other doctors all agreed with the dx and had slightly different opinions about the treatment plan. Two of them only did 5 or 6 flat foot surgeries a year. The one I used is at a top ranked orthopedic hospital. The doctor I used is widely published and does 3-5 flat foot surgeries a week. I am now one year post op and am so happy that I had the surgery

 
Old 07-27-2011, 05:09 PM   #13
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Re: PTTD Sufferer

roxygirl1,

i'm glad you had the corrective surgery with good results. i don't know if you have seen my other posts, but what makes my case complicated is that i already had flat foot reconstructive surgery when i was 11 years old. after the surgery my parents and i always noticed my calf muscles were smaller than the right-(some type of complication from the surgery..idk) and then over time, my foot started to lose it's arch again and overpronate..again. when i was about 9 years old, when i first saw a podiatrist, he said he had never seen overpronation/flexible flat foot this bad in someone my age. that's why he and my surgeon decided it was best to do the reconstructive surgery early to prevent major problems down the road. obviously, that didn't work. i had the same surgery done to my right foot at 17 and that one turned out much better. not perfect but loads better than the left.
it's frustrating because i have never met or talked to anyone that has had this surgery as a child and still had problems down the road.
the pain is so bad now that i can only take 12-15 steps (like you said) at a time. basically be up and down around my room very minimally.. and even that causes extreme pain by the end of the day. i'm on pain meds that make me so tired and depressed feeling and don't even work that well but it's better than nothing. like a catch-22. i'm not able to take care of my 2 year old son by myself. so when my husband goes to work his part time job, my MIL has to take him to her house. which.. this is kind of off the subject, but, does anyone know any resources for someone like me? i'm basically at least temporarily disabled because i can't take care of my son by myself. but, what if my MIL is not able to take him soon? my husband is working on getting a full time job and i know my MIL can't take my son all day. is there any government resources out there to help me with this?? what does a person do in my situation?? my husband can't quit working and i'll pass out or have a nervous breakdown if i try to take care of my son 24/7 with this injury and pain.
sorry for all the venting and the crazy subject changes.

 
Old 07-27-2011, 05:27 PM   #14
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Re: PTTD Sufferer

well my ptt pain is definitely from overuse/over time. mine is not swollen. i think it swelled up a little early on.. like months ago when the pain started real bad and hasn't stopped. i was diagnosed with pttd in 2010. had two flareups. one lasted a week. the other lasted a month. went to physical therapy both times and the pain went away. then february of this year, after a flight with my 2 year old to florida the pain came back with a vengeance. i was stuck in FL (long story) with no insurance so i had to put myself on crutches. was on crutches for 3 months. no weight bearing. i was hoping this would make it let up some but no, it only got worse. then finally got on medicaid here in NC.. got an aircast brace myself online. it only helped a tad. then saw an orthopaedic doctor who told me to try new orthotics since mine were 6 years old. got those. they are UCBL. feel great but aren't helping the pain. i still have to use crutches when i go out to try to take some of the weight off but i can't take total weight off because after the 3 months of only putting weight on my right foot, i ended up with an overuse injury on the bottom of that foot! the last thing i need is to completely crap up my right foot which has always been "the good foot". so i'm waiting on my wheelchair...
now, what exactly was torn from your midfoot to your tibia? i'm a little confused about that.. the peroneal? does that usually have issues along with the pttd?
at this point, i would like to try anything..even if it aided in my functioning a couple minutes like a boot..an AFO... considering how bad it is -and i told the first ortho doctor this-and i came into the room on crutches!... why would he not want me fitted for a custom made brace right away?? it took a month for medicaid to approve me getting new orthotics...so, why wouldn't he try something that's more likely to work? so stupid..

 
Old 07-27-2011, 07:09 PM   #15
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Re: PTTD Sufferer

I was trying to explain that even though my MRI said that my PTT was 'only' degenerating, the tendon was actually torn from the midfoot insertion site to almost the tibial insertion site. Even 16 weeks post surgery I have to be careful. Although I can walk, my gait is deliberate, and slow at times. I cannot easily get around obstacles yet. I am sure it will come in time. And, no, problems with the peroneal tendon do not usually happen with problems with the PTT; it was just my luck...
I was also on crutches for about 4 months and can identify with your "other foot" starting to have problems. Mine is sore off and on. I really hope I do not suffer issues with that foot too.
Hang in there!!
Armstead

 
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