Posterior Tibial Tendon Surgery and running after surgery - Foot Problems Message Board

smile2006 · 08-02-2008, 09:13 AM

Hello- I will be having surgery to correct a torn posterior tendon that including cleaning out the tendon, replacing it with the FDL tendon and realigning the heel bone. I tore this tendon falling quite hard down a flight of wooden stairs and jamming my foot into the wall at the bottom. I am a runner and this is devastating to me. Are there any runners out there who have had this surgery and are able to run again as they did before the surgery? I've run thousands of miles in my life injury free and to be injured this way really stinks

My surgery is in a little over a week. Also, is it realistic to think I'll be able to return to work after one week??? I'm a university professor and the new term is starting. I'm worried because I have to move around alot to get from here to there and I really won't be able to elevate as consistetnly after the first week.

sunny77 · 08-02-2008, 08:13 PM

Hi there,
I had PTTD in both feet/ankles, so small tears, stretching and irritation in the posterior tib tendon, but luckily no complete tear/rupture of the tendon. Because my tendons were able to be repaired, I didn't have the FDL transfer. I did have an Evan's osteotomy in both (put a bone graft/wedge in the outside of the foot...and no hardware was needed). I returned to work at 3 wks post-op both times and like you, I am not at a desk job. I was in my car, driving, going into homes, facilities, etc. and could not consistently elevate or ice during the day. I found that I was tired and often napped when I got home for a few weeks after going back. And of course I iced and elevated then too! I took pain meds pretty regularly still, though I was careful when I took them. Everyone has a different pain threshhold, so it's hard to say how your foot will be feeling and what you'll need medication-wise.

One thing you might want to look into is a knee scooter...it'll make getting around campus and standing a lot easier...there are brands like Roller-Aide, Turning Leg Caddy (I had both times, loved it), etc. and can be found at medical supply stores...but if you want to use one, I'd jump on it quickly because it can be hard to find them.

I was a runner, probably nowhere near as serious of one as you, before surgery too. After the first ankle was done, I started "running" at around 4 months post-op. However, my other foot went bad during the recovery, so it made it hard and painful to run. So, the second one was fixed and I just started running a few weeks ago at 5 months post-op. It's really been over a year since I've been able to work out hard, break a sweat, so my muscles have gotten weaker...doing some PT to help with that. My dr told me that I'd probably never run a marathon after having surgery...not that I wanted to, but his point was more that anything extreme would not be in the cards.

Have you been given the timeline for the splint/cast/boot, how long you'll be NWB, when you'll start PT, etc.? Do you have a shower chair, cast cover, handheld shower head, pillows for elevation, etc?

Feel free to ask questions if you have any. I know there's another PTTD gal (kristim06) who is a runner as well and had exactly what you're having done...maybe she'll be able to answer some questions as well. Good luck and let us know how everything goes for you!

mjjenner · 08-02-2008, 09:13 PM

Hi
I had a posterior tibial tendon transfer, spring ligament (the one in the arch) repaired, and a calcaneal osteotomy (same as you will have). I was in a large bandage for two weeks, then in a cast for four more. It is important to keep the foot elevated -- toes above heart -- pretty much all the time. I was on crutches, non weight bearing for six weeks. I didn't work for the first two weeks at all. I began some light work from home for the next two weeks. I then returned to work and have been working since then only about 3-4 hours a day. I am at the end of my third week of PT and I go three times a week for two hours each session. I am still pretty tired. At the beginning of this week I would walk with one crutch and by the middle of the week can walk without crutches, although I still use one part of the day because it is difficult to walk without for long stretches. I have been in a heavy boot since the cast came off. I had my surgery on June 4th, so it has been just over 8 weeks. I will remain in the boot three more weeks and can then wear a shoe. I have to sleep in the boot for another 2 months.

I don't want to rain on your parade, but I don't think you will be back at school in a week. You need to ask your doctor what his timetable is. I am actually healing well and excited about my progress since physical therapy. I am to stay in PT for at least six more weeks and have been told full recovery takes 9-12 months. I am not a runner, but I am worried about just being able to take walks without pain and have everything heal right. I think there are runners on this board and they cantell you more about returning to running.

The first six weeks, I have to admit, were kind of tough. Lots of laying around. I had help (my mom was here) which was wonderful. I don't think I could have done many of the things she did on my own. I have a shower chair, shower wand, and the knee scooter. The knee scooter really came in handy in the past month.

Hope this helps you some.

smile2006 · 08-03-2008, 08:36 AM

Thanks for the replies. This has all happened so quick for me. I injured my foot with the fall down the stairs in February and messed around with it only to find it would not get better even with rest from running and cycling, two things I love. I finally went to the doctor mid-July and through an MRI and exam was diagnosed. My surgery is August 13 so I have little time to prepare. I am trying to get the surgery in before classes start. It will literally be one week after surgery and I'll be off to campus. This is not my preference but I thought it better to try to do it before the semester began then to start the semester and cut out on my students (no subs at the University level

) Waiting until December and winter break was not recommended plus it just plain hurts at this point. I have the shower thing taken care of and I ordered a cast cover. I was planning on just going with the crutches. I was told I'd be 7-10 days in a surgical cast which I guess is a half-cast around the back of the lower leg and some bandaging to allow for swelling, stiches out and then a hard cast non weight bearing for 3 weeks, a walking hard cast for three weeks and then a walking boot. Also, they are saying one night in the hospital, is that normal?

I've never been on crutches or had a cast so maybe I just don't know what to expect. I do expect everything to take 3 times as long! It's my left foot so at least I can drive. My husband knows he will be waiting on me alot but he hates that I hurt right now and he is a runner/cyclist too. It will be hard to see him go off when I can't. The doctor does say I will be able to run again although said many of his patients just decide not to after something like this. Anyway, the one week to classes concerns me. I hope to be totally off pain medication by that point or I know my thinking will not be up to parr to teach....is this a possibility?

mjjenner · 08-03-2008, 10:32 AM

I hurt my foot two years ago. It would get better and worse. I finally had a MRI that showed damage. They thought PT could help it, so I did that for four weeks, and it just got worse. It was so bad, I couldn't really walk without pain. I was wearing a boot anyway just to keep the pain down. So, I went ahead with the surgery. I was really bummed about not being able to do the things I love in the summer. The entire first two months I still had lots of time feeling down, but now that I am on one or no crutches, I see light at the end of the tunnel (although the light is way down there). It will be hard seeing your husband go off and running when you can't. But you can't go with him now, anyway, with the pain, so you gotta do what you gotta do (that's what I kept telling myself). I got angry at times that this had to happen, mad, frustrated, but that is all normal, too.

I spent one night in the surgery center's hospital room. That is standard to see if your pain is managed. The foot has lots of nerve endings and is very painful. I had a leg block and that controlled my pain very well. I never had really bad pain, just discomfort. I had never been on crutches before. I practiced a bit before surgery so that I could feel more comfortable prior to doing it with a sore foot that I couldn't put on the ground. Crutches are a pain. After the surgery, I was tired just after taking a shower and getting dressed. I was in bed with my foot elevated or on the couch with my foot elevated for the first month. I am 8-1/2 weeks now and I still keep my foot up on a chair beside me or up on the recliner when I am sitting.

I used pain meds for the first couple of weeks, especially at night. It is hard to sleep with the cast/bandage/boot. I still don't sleep very well and will occasionally take a pain pill just to help me sleep.

It's a long, hard road -- definitely doable, I'm just not certain about a realistic timetable for you to return to work. Keep asking questions!