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Old 09-10-2012, 08:27 PM   #1
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Question Posterior Tibial Tendonitis won't go away

Hi, I just stumbled upon these boards for the first time. I'm only 19 and I have had for PTTS for going on two years. I have tried NSAIDS, a cortisone shot, predisone, orthotics, and wrapping my foot everyday as well. I'm beginning to worry that surgery may be my only option, but am concerned that it could cause me to never be able to run again or otherwise limit my activity.

I am a very active person, and am in good shape; my feet also are not that flat. I'm not really sure what caused the tendonitis, which began to affect me December 2010.

When I found that I couldn't run anymore, I tried biking and martial arts to stay active, but now even those activities are causing me problems. I have already been dealing with juvenile rheumatoid arthritis since I was diagnosed at 14 and am very concerned that I regain as much of my range of motion and physical capabilities that the arthritis has left me.

I guess I'm wondering, (1) is there anyone else in this forum dealing with PTTS at such a young age (the majority of people seem to be above 30) and (2) of the people who have had surgery performed (any age), what has been the outcome in terms of your physical abilities?

(Surgery would probably involve the fusion of two bones which failed to fuse as I grew as a child; I believe the diagnosis may have been accessory navicula.)

Last edited by mllnmfalcon; 09-10-2012 at 08:30 PM.

 
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Old 06-19-2013, 11:09 PM   #2
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Re: Posterior Tibial Tendonitis won't go away

Hey I am 20 as well and am having some issues. I am curious of you had an MRI and what exactly it said?

 
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Old 06-25-2013, 02:21 PM   #3
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Re: Posterior Tibial Tendonitis won't go away

I had an x-ray only, I believe, which showed that a couple bones in my foot (around the navicular?) did not fuse properly as I grew and which might be part of the problem.

However, since I last posted in September, my tendonitis has become somewhat better. I stopped running completely, continued using ortotics regularly (until I realized they were hurting my back; now I use Superfeet), and started treatment for Lyme disease (which may or may not be part of what's causing the problem). I stopped wrapping my foot as often in order to try to strengthen it more. It is still a problem, but I do find walking and biking in supportive shoes to be helpful. Do you have a similar injury?

 
Old 06-25-2013, 02:34 PM   #4
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Re: Posterior Tibial Tendonitis won't go away

I tried to get rid of my tendonitis for 9 years. Sometimes it was a little better, sometimes worse. I could not get rid of it and finally had surgery. Which, sadly, has resulted in pain in the place where they put the new tendon, and also the heel where the surgeon cut the bone. It might change but for me surgery after 4 1/2 months has not made things better. I still have pain with walking, and I have just thrown away my hopes of doing a 5k race running. Ever. It may change but surgery is for when you do not have another choice, and then you do everything you can to get to a full recovery. Just you need to understand that it is a matter of whether not when.

 
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Old 06-25-2013, 03:16 PM   #5
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Re: Posterior Tibial Tendonitis won't go away

I cant say im having very similar problems but I have inner ankle issues, been to a few docs and it is most likely posterior tibial tendonosis. Got another opinion yesterday and this foot and ankle specialist wasn't sure because the MRI I got 2 months ago had a lot of swelling and it was hard to identify which tendon it was. I overused my ankle when I was studying in Europe, and being that I didnt want to access the healthcare there, I waited which was clearly a mistake. Only been about 8 weeks and I've gotten a good amount of inflammation down just not all. Hoping to rid this problem and was looking for people to compare to.

What exactly is ptts? Just tendonitis?

In regard to the 4 and a Half months, everything I have read states that it is a much longer recovery so I wouldn't base your progress on that short of a time period.

 
Old 06-25-2013, 03:58 PM   #6
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Re: Posterior Tibial Tendonitis won't go away

@punkin77: Thanks for the note about surgery. As for myself, I'm not considering surgery anytime soon, now that my foot seems to be getting better (if slowly). I'm sorry to hear that you've been dealing with this injury for so long! I've read that surgery can cause some initial worsening of the condition, or other pain. Hopefully, given time, it will all heal.

Last edited by mllnmfalcon; 06-25-2013 at 04:00 PM.

 
Old 06-25-2013, 04:27 PM   #7
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Re: Posterior Tibial Tendonitis won't go away

whoops see next post please, my comp screwed up.

Last edited by mllnmfalcon; 06-25-2013 at 04:33 PM.

 
Old 06-25-2013, 04:30 PM   #8
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Re: Posterior Tibial Tendonitis won't go away

@Td25: I have a similar story. I tripped when out for a run over winter break (Dec 2010) visiting family in California and (already having JRA and other ailments) wanted to avoid yet another doctor's visit. I went back to school and kept running, but found it very painful, and my right foot swollen beneath the inside of the ankle. I stopped running (mostly) and playing soccer, then finally went to see an orthopedist. He diagnosed me with posterior tibial tendonitis (what I'm calling PTTS); however, he only gave me short-term solutions and quick-action therapies, including a cortisone shot, and a course of Prednisone, which didn't work at all.

If any doctor tries to give you a cortisone shot in your tendon RUN. When I got a second opinion (after receiving said cortisone shot, which did nothing), I was told that this can tear up your tendon and make everything MUCH worse.

We may not have the same problem, but here's what has worked for me so far:
-If it hurts (sharp pain) stop what you're doing.
-No running, no dancing, no high impact activities
-Walking, biking, and swimming help
---the first 2 may cause some swelling at first, but I ice 20 min., 20 off and take ibuprophen if necessary. Taking NSAIDs like ibuprophen can hurt your stomach, so look into a topical analgesic like Voltaren gel (prescription only) as well.
-Wear good shoes
---don't go for a ton of soft cushioning (e.g. Nike, Asics) I worked selling sports shoes for four years and I can tell you that Nike shoes are pretty but generally crap for your feet
---look into inserts (i.e. orthotics). If you don't get a prescription, I recommend Superfeet. Dr. Scholls from CVS won't help.
-Strengthen your feet
---ask a doctor or PT how to wrap your foot, but only do so when absolutely necessary. Otherwise you'll just weaken your foot. Same goes for braces, etc.
---try walking barefoot (carefully) in a clear space indoors
---do calf raises (from standing position, rise up on the balls of your feet, then relax down again. It sounds stupid, but do 30 of those and you'll feel it. Start small.)
-Above all, listen to your doctors. Note: doctors plural. I would get more than one opinion if I were you, which it sounds like you already have.

Dude, this really sucks, I know. But I think we can do it

Let me know if you get any advice from docs which I haven't listed above. I'd love to try something new and push my foot toward complete recovery.

 
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Old 06-25-2013, 04:43 PM   #9
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Re: Posterior Tibial Tendonitis won't go away

Very similar stuff I have been doing-got custom orthotics, good motion control shoes, I do PT with ultrasound, stretching, and some strengthening now. Took meloxicam I believe last month until about June 5, then laid off anti inflammatories until yesterday when a different ortho wanted to get rid of more inflammation and prescribed naproxen and voltaren gel. I do bike, and walk trying to increase slowly.

Basically I've only been treating this for two months now and it didn't come about badly until mid April, got back home around April 25 which is when I took immediate action. I know people, including yourself have been dealing with it quite a bit longer so I really can't complain. I had a ton of inflammation when I got back that its finally starting to look decent again.

I am personally hoping to see good progress over the next month because the inflammation is much better now. One thing I do recommend which the doc yesterday told me was to do an extreme amount of calf stretches because that was a root of the problem. Also maybe eccentric excercises could help you a well.

I'm curious what you feel when you walk? I wouldn't even consider high impact activities at this point because my ankle simply wouldn't hold up and I'm not naive to the situation.

Lastly, I am surprised you haven't had an MRI, although they aren't tell all they could help.

 
Old 06-25-2013, 04:58 PM   #10
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Re: Posterior Tibial Tendonitis won't go away

I second about the cortisone shot. I ahead one about 6 years ago and it made everything feel great. Of course, the tendon was further damaged by the shot, so after 3 months the effects wore off and everything was worse. For me, orthotics helped for a while, having a boot for two months helped for a time. Just could not get the posterior tibial tendonitis to settle down properly. And while it was torn, I could not hike, bike, or even walk more than a supermarket distance without some serious ache. I just got back from a 3/4 mile walk on a track, ankle feels not great. But I was so sad watching runners casually zip by. I envy their freedom, which they seem to just have and not be mindful of in any way. My son who was with me said, you will be able to do that eventually. I so hope he is right.

To add to the remedies which can help with posterior tibial tendonitis issues, stretching is important. The Achilles tendon is usually tight, which puts further strain on the tendon, so keeping it stretched well is useful.

 
Old 06-25-2013, 05:09 PM   #11
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Re: Posterior Tibial Tendonitis won't go away

I actually received a cortisone shot in April and was wary of its issues but these docs tell me it is only a little cortisone and mostly a numbing agent.

Be patient I have read so many posts about people not returning to even a decent feeling until after 11 or 12 months.

Very curious what your MRI said because you keep saying tendonitis but also mention a tear. I know these are completely different issues so I'd love to hear what the actual diagnosis was. Mine was technically 'mild hypertrophic posterior tibial tendonosis' with some other issues, but now the doctor might not be in total agreement with that after he examined the MRI.

 
Old 06-25-2013, 06:20 PM   #12
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Re: Posterior Tibial Tendonitis won't go away

The first doctor I saw may have ordered an MRI, the more I think about it the more I think he must have. I think that was how he originally made the diagnosis. I ought to remember this, but in my defense, I've had a lot of MRI's in my short 20 years.

When I walk these days, I feel little to no pain unless I'm wearing flimsy sandals or other "inappropriate footwear" like heels (I know I shouldn't). Sometimes after walking I have aching or sharp pain accompanied by swelling located about 1-1.5 in. below the inner ankle. When I walk I may also feel a tightness in that area.

It sounds like your injury may be different: more centered around the ankle itself. Nonetheless, I'm sure a lot of the same things may apply in terms of treatment and recovery.

I appreciate the suggestion of stretching and eccentric exercises. I have been trying to incorporate more stretching into my daily routine.

As for your ankle, do you feel pain in the joint itself?

Also, with naproxen, be careful. I took it for a 1-2 years for my JRA and developed stomach problems. The docs have probably warned you about that already, and I doubt you'll be taking it long enough to do any serious damage, but keep that in mind.

I'm glad the inflammation is going down! Keep up the good work

 
Old 06-25-2013, 06:29 PM   #13
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Re: Posterior Tibial Tendonitis won't go away

Quote:
Originally Posted by punkin77 View Post
I just got back from a 3/4 mile walk on a track, ankle feels not great. But I was so sad watching runners casually zip by. I envy their freedom, which they seem to just have and not be mindful of in any way. My son who was with me said, you will be able to do that eventually. I so hope he is right.
I feel your pain, punkin77. JRA made soccer and running very difficult for me, but the tendonitis made those activities all but impossible. I go to a school where people are always running and I miss it so much! What with my JRA, PTTS, and back injuries, I get really jealous of all the other people my age who can do things that my body just won't anymore, especially since I'm so young.

Have faith though, your son has the right idea. I was considering surgery, as I mentioned above, until my foot suddenly started getting better. I've plateaued now, but the experience has given me hope!

 
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