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Old 02-04-2013, 10:08 AM   #1
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Question ptt both feet same time-why not improving-zero excercise 6 mos-help pls

I am humbled after hearing some other stories on the boards, but am asking for advice.

My QUESTION is at the end!! Thank you! I am 44, was fitness enthusiest (high impact/powerful classes/some running,etc..)...and out of nowhere w/in a month, felt like I wanted to chop BOTH feet off after a 5 minute warm up. Long story short, sports med MD, xrays ok, bone scans showed beg of arthritis top of my foot/front ankle (not the painful area, but it does feel like bone on bone-no flexion-gross). Conclusion: Posterior tibial tendonopathy (overuse/biomechanical dysfunction) my tendon killed when he ran his finger over it.... that causes pronation (I have NORMAL arches - my arches did not hurt unless I pressed on my fascia)....therefore whole area aggravated so retrocalcaneal bursitis "happened" (this is where it hurt the most!!! - sides of achilles tendon on back of my heel!! I could barely walk.). My achilles tendon did NOT hurt at all. 6 months of rest, rest - stretching doesn't seem to do much, if anything - custom insoles for my athletic shoes ($200) (I can't feel the strong arch support though, like my OTC insoles. I like to feel support almost up the insides of my ankle really (my Birkenstock sandals feel the best, but there is zero shock absorption ugh). I use all sorts of OTC arch supports (Powerstep, Birkenstock, Walking Co $$$). I rarely wear heels now. (what a frump!) I also have a major issue front of my shoulder (it was there in my 30s too....gets worse when not active, but doing push ups freaks it out - how can I even do YOGA?) Lastly, i have mild/moderate psoriasis on my scalp (considering psoriatic arthritis going on).

QUESTION 1:
Why, seriously, how can my PTT not have improved doing zero for 6 months? I press on the inside ankles (yes both) between the heel bone & the ankle bone and it is still pain! (I can still sense/feel the calcaneal pain, but it is much less - bec. I'm not working out!!!) I tried a 7 min. warm up on my feet doing plie squats last week (w/5lb weights in hand) before a Pilates class and wanted to chop my FEET off. It felt like a surge of hot fire around my ankles. I had to stop. QUESTION 2: M.D. gave me Mobic to try for a month. I haven't - opinions? QUESTION 3: I feel like I want to tape or wear a stretchy ankle brace (all the time). Will this help me or do nothing? Any recommendations? I'm on zero meds and have no previous injuries...Thank you in advance. God help me if I'm doomed to the pool! LOL

Last edited by Administrator; 02-04-2013 at 10:39 AM.

 
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Old 02-04-2013, 12:35 PM   #2
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

Your story is really really similar to mine. I'm 24 (was 22 when this happened), SUPER into fitness/running, no previous injuries at all. It was a matter of weeks from when my tendon first started hurting & it became debilitating. I am at 16 months no exercise (had surgery Dec 6th, so at 14 months rest pre-surgery). Mine is only in the left foot though, not both.

I sympathize- this injury is much more common in older individuals, it is NOT common in runners/athletes, and when runners DO get it, it typically heals after this much rest.

Currently (not much help to you , just so you know where I'm currently at) I am almost 2 months post-op with a posterior tibal tenosynovectomy. Really frustrated- I have been attending physical therapy and NOT seeing any improvement. I know it could still happen at this point, but it is super frustrating.

Best advice I have (because I'm almost a year ahead of you in a VERY similar situation) is get to a REALLY REALLY highly rated doctor. Like, not just "oh, he's a trusted, good doctor" but a REALLLY high rated one- I found a PDF article of the 23 best foot & ankle surgeons, basically they asked foot & ankle surgeons who they would want operating on them. Get a thorough opinion from an expert. I saw SO many docs with so many diff diagnoses and tried SO many worthless things. Now I'm hearing from the physical therapist that if I had gotten my surgery a lot earlier I would have healed better, but at this point waiting so long (which I had to- I didn't have a good diagnosis) I might not heal all the way. So- talk with someone, ask these type of questions, and get treated.

I agree 100% with your frustrations- you SHOULDN'T be this messed up after taking 6 months off the activities you love. I shouldn't be this messed up after taking 16 months off the activities I love. I have asked so many different doctors & no one has a really good excuse for how I even GOT this, much less why it won't heal.

Sorry for your bad experiences with this. It SUCKS to have problems walking- everyone understands that. I feel like a lot of people in my life don't sympathize with how badly I just want to RUN, and how frustrating it is to have limited capabilities to walk which is SO far from a 10 mile run :/


*hugs*

 
Old 02-04-2013, 03:23 PM   #3
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

I agree with everything Allykay wrote. You need to find a top OS and not be afraid to get a second and/or third opinion if needed. In my case it wasn't correctly diagnosed for close to 2 years. I also tried everything under the sun including 5 months of PT, boot for 6 weeks, rest, ankle braces, orthodics, robust orthodic. I started to think I was losing my mind and I was in pain.

If you've rested and babied your foot for 6 months and there hasn't been a big improvement it's time to seek another opinion. Also, be careful with weights. I was doing 5 lb weights on a balance object (half squishy ball). I had a real problem balancing and something felt off after that first training session. I really think things started to go downhill rapidly after that.

I wanted to add that I'm older (56) in excellent health, physically fit, slim, love to workout including dance, long rapid walks and up to 5 years ago did boot camp with one of my daughters. The resting made me crazy and in my case, didn't really help much.

You aren't alone. Wishing you all the best
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Old 02-04-2013, 06:04 PM   #4
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

OMG! I agree with what everybody said. You should have been feeling better if the diagnosis is correct. But it sounds to me that you might need surgery but all I can say is you do need to see somebody who specializes in foot and ankle surgery. I bid on this road for four years. Physical therapy a few times Abboud a few times I even wore a boot to sleep. Meds doctors various diagnoses . I saw a few doctors to make my final decision and I did my research. I'm now almost 9 weeks post op Pttd with the works six hours surgery five days in the hospital. And I live almost 4 hours away from the hospital but I was willing to do the traveling to find what I thought was the best one for me. I can't imagine having this problem with both feet. Years ago I started with orthotics in both feet but somehow I must've injured this one and it just went downhill over. Of four years. I am slim in my early 60s and in very good condition. I've been working out for six years with a trainer. I probably will not be on the treadmill ever again. But I'm glad I did this and now almost 9 weeks I probably only have five more weeks until I'm going to be upright and walking in a boot. You gotten some very wonderful advice. Find an orthopedic surgeon who specializes in ankle and foot. Keep us posted and good luck.

 
Old 02-11-2013, 05:54 PM   #5
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

allykay, thank you so much for responding to my post. I REALLY feel your pain.. You're a kid! I am sure doing your PT is better than not, so at this point that's all you can do. So did you have a tear of your post-tib? Is that why you got surgery? So you tried to rest for 14 mo's, then did you get an MRI or what that tipped the table so you needed surgery? Could you raise up on your toes. I CAN! I, as you do there, live in an area with outstanding medical care all around. I went to a "really good" doctor, not the best of the best. I'm afraid to go to a podiatrist, i.e. NOT a M.D. I think my doc thinks mine is related to arthritis "stuff" because he could hear my creaking!! tendons when I pointed my feet, then in that position, flexed my toes back and forth. (he didn't say the word arthritis, but prescribed a one month arthritis med) I was trying not to have to take it. I haven't. Maybe that's what I have and why I am not healing. Did the back of your ankle hurt? the bursa between your achilles and heel bone? I hope you haven't gained weight, like I have (mostly from eating my sorrows away). I've gone from a seeing my flat ab muscles to a fluffy muffin top w/added back fat! GROSS :O (now I'm looking at green coffee beans online.....I'm laughing at myself.....I'm so pathetic) write back if you'd like and let me know how you are doing.

 
Old 02-12-2013, 04:13 AM   #6
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

Thank you for your kind words. I feel so much better just hearing that others understand my frustration. Actually for me, since I am in an inert state, I am relatively pain free but feel like my ankles are sooo week and fragile. Did you actually feel PAIN down/throughout your PTT? I'm trying to understand how that presents itself, even though my sports med M.D. said that's what it is. My PAIN is in my retrocalcaneal bursa area though! When I bend down in the shower to get my shampoo I feel a quick shooting "feeling" (more nerve-like) along my PTT. Was your pain exactly on that tendon? I hope you recover fast at this point! So I can't tell from your post, did you have surgery?

 
Old 02-12-2013, 05:28 AM   #7
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

Quote:
Originally Posted by allykay View Post
I found a PDF article of the 23 best foot & ankle surgeons, basically they asked foot & ankle surgeons who they would want operating on them.
Good tip -- I recognize several names menioned regularly on this board!
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Old 02-12-2013, 10:20 AM   #8
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

Quote:
Originally Posted by newchallenge View Post
Actually for me, since I am in an inert state, I am relatively pain free but feel like my ankles are sooo week and fragile. Did you actually feel PAIN down/throughout your PTT?

Was your pain exactly on that tendon? I hope you recover fast at this point! So I can't tell from your post, did you have surgery?
Not sure who your questions are for, but I'll go ahead & answer

1. I am also relatively pain-free AS LONG AS I don't walk too far. When I walk longer distances (i.e. go to the mall- we're not talking marathons here, lol) I do get pain.

2. My pain is up in the ankle- along the PTT, but higher up into the ankle, NOT in the foot.

3. My pain is DEFINITELY ache-y, not at all nerve-like. My dad has had severe, chronic nerve pain, so I am very familiar with what it looks like. Mine is very muscular.

4. I had a tenosynovectomy Dec 6th. Am currently in physical therapy 3xs/week.

& pescavus- thanks, yeah, I'd definitely pass that PDF along to anyone I knew with foot pain- no point in wasting time bouncing around from surgeon to surgeon- find a good one asap

 
Old 02-12-2013, 11:54 AM   #9
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

allykay- I looked up that PDF just for curiosity sake, and noticed there was actually a dr on the list from St Louis Mo (where I'm from)! Now I didn't see that dr mentioned, though I have heard wonderful things about him, but my dr works under him in the same office. Even though I've already had the surgery, it totally validated my choice for using the dr's and group I did!
And it's also amazing how many dr's I've seen mentioned on this board on that list!

I showed my mom the list since she's currently looking into PTD surgery, and she found that really cool.

Thanks for that recommendation!
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Old 02-12-2013, 01:32 PM   #10
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

So glad I found dr. Deland in NYC , world expert. He operated on me on Dec. 7. I liked the PDF. Thanks. Really enlightening.

 
Old 02-26-2013, 08:43 PM   #11
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Re: ptt both feet same time-why not improving-zero excercise 6 mos-help pls

Allkay, My daughter had the same experience with pain in both feet and heels, with no relief after 1 1/2 years of rest, PT and exercises. Her Podiatrist said she had PTT and since no progress with the therapies, she needed surgery. Before surgery they did an MRI and discovered that her tendons were perfectly fine and she didn't need surgery. She then went to a neurologist, 2 OS, 1 Sports Med Dr., a Rheumetologist, and had every test you can think of, EMG, bone scan, and everything was negative but the pain persisted. Then she started getting other pains in her body, in her hips, hands and forearms and a doctor wanted to do more tests. It turned out she had Lyme Disease and Bartonella. The Bartonella is a common co-infection that ticks carry along with Lyme and Bartonella causes foot pain in both feet. Something else I found out about Lyme is that steroids--which are prescribed for arthritis, make Lyme disease worse. My daughter's symptoms got alot worse after doing a steroid pack prescribed by the rheumetologist. Anyway, since you have the shoulder pain and pain in both feet, not just one foot, maybe you should get tested. There are alot of Lyme boards that can recommend the best Dr. in your area and testing--due to some of the tests having a high false negative.

 
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achilles, ankle arthritis, bursitis, tendon pain, tibialis posterior



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