There are many challenging aspects to this condition, the worst of which is the unknown. At first, i didnt know what it was... for four months. Then I was so relieved to begin treatment believing that Id be healed immediately. For one week i waited for a presription brace, then wore it for six weeks while I degenerated. I asked for more proactive approach and was told to wait. @six weeks I was given a cam boot. Three wks in I knew I was getting worse, asked for mri, told no, to wait and go to pt. Four more weeks of getting worse and paying copays for nothing. Finally, an mri. Doc says no tear, radiologist sees tear and arthritis amongst other degenerative changes. Doc says i can wear the boot for 8 more weeks or have surgery. So pre op tomorrow. I have stairs and a 16 month old. I am a hairstylist and he said i could go back to work in two weeks. Sounds lofty to me. What does everyone/anyone think? this message board is my new best friend.
What procedures are you having done? Recovery time really depends on the procedures. I was diagnosed with pttd/flatfoot in 1/2010. I had flatfoot reconstuction surgery in 8/2010 (repair of ptt, fdl tendon transfer, calcaneal osteotomy, kidney procedure and achielles tendon lengthening). I was NWB for 2 months and did not return to work for 4 months. I work in the medical field and my job requires me to be on my feet all day. In the beginning it is important to keep your foot elevated. Will you be able to keep your foot up? Two weeks seems to soon to be back to work. There have been some who have returned to work after several weeks but I believe their jobs were sedentary.
He says debridement and suture repair of tendon. Sounds like it will not be enough. Afraid tendon will fail again. My ankle is deformed.
I just found out that surgery is scheduled for 4/11. My 9 yr old has the next wk off for vaca so that is good. He can be very helpful but dont want to put too much responsibility on him. I couldnt stand not knowing if it was torn, couldnt stand not knowing when the surgery will take place. Now that those questions are answered, i have only more. How long will i be in the hospital? Is he doing enough to cure me? Realistically, when will i return to work? When will i drive? It is my right foot. Will i walk 5 miles ever again? Run, dance, hike, tennis, bike? I was very active and this injury does make everything come to a halt. My son misses our jogs through the neighborhood. I miss it. We used to take karate in a family class, all of us, and that was probably my undoing but will i ever feel strong again? My dr prescribed zoloft and if anybody knew how positive and well adjusted i am normally, they would find this ridiculous. ( my husband does ) but i am suffering from deprssion now as the world seems to be passing me by and my children grow bored of me sitting on the couch. I have such anxiety about the surgery, getting worse before i get better, if ill get better. The burden ill be to everyone. What will happen with work? I am self employed. What if im out for months? Will this destroy my career?
I had surgery in November for tendon (peroneal) debridement and tendon repair for a tear. It was done outpatient. I was NWB for 10 days then in a boot. I was home for a total of 7 weeks. When I returned to work I had to wear an ASO. Unfortunately, I work in the medical field and am required to be able to move quickly and in addition, on my feet most of the shift. I had lots of pain which I assumed to be normal but it turns out it was abnormal. When I went to see the surgeon in February, he told me it was abnormal and said I could only do sedentary work for 4 weeks. Ordered an MRI which did not really show anything new. When I returned to him in March, hoping to be released back to work, he would not let me due to residual pain. He gave me a shot of Cortisone/lidocaine in the joint and put me on Mobic for the inflammation. Hopefully I will be returning to work in April. He did say my case was very unusual. He said that normally by 8 weeks post-op there should be no pain and things should be great.
With your tendon being the ptt, do you have flat feet?
Yes. Genetic. Injury 15 yrs ago. Hairstylist 17 years. Rt leg shorter than left. Overweight, smoker. Female, still very active until 7 mos ago. Textbook, ud think. Just came home from pre op and surgery is cancelled barring 2nd opinion. He referred me to his mentor. Good. Wanted to just repair tendon and leave everything else a mess. I have arthritis now and he didnt even mention it. Oh boy now get to wait for appt with her. I am glad for this outcome today but still not a fan of the unknown.
So now that i am obsessed with researching this condition, i find out that i have a flexible flat foot as opposed to adult aquired. There is a totally different approach to this in the medical community. It is said that the existing deformity causes the pttd whereas in aaf the pttd causes the deformity. The difference is that at rest an arch appears. My arch appears even though it is slight. Why has no doctor looked for this, or asked, or mentioned it? My podiatrist wanted to repair the tendon but not the deformity. I dont think it wouldve worked, at least not for long. He wanted to repair the tendon and put me in a ritchie brace for the rest of my life. Maybe it would work but if i can escape the brace i will.
I'd definitely be getting another opinion. If the underlying issue isn't resolved, then a debridement alone won't fix the problem for good. Your story sounded so much like mine! My problems stemmed from a badly bruised/sprained left ankle a few years ago that I got while in karate class. I was 2 months away from getting my black belt and have not returned since. I have stage 1 PTTD. My tendon is fraying along the medial malleolous. My arch is slightly collapsed now. I've had tendonitis flaring up over the past 18 months on and off putting me in the cam walker every time. My foot is still flexible too, but my OS says feet heal very slow and once there is tearing, just every day walking is enough to aggravate it continuously. It's very frustrating first hearing that this may never go away without surgery. I was very active. I am no longer. It's hard to predict what will become of this once diagnosed. And, there are varying avenues doctors want to take to "fix it". Worse, for me at least is I am not even covered under my healthcare for any treatment with it.... so I have the aspect of added expenses every time I have to be seen about it. I figure I will probably just make the cam walker my permanent left shoe.
I feel your frustration and your worry. I hope your second opinion yields better my fulfilling answers.
So his mentor doesnt accept my insurance. He referred me to his associate in the same office for a 2nd opinion... in 3 wks. I am in so much pain, it sounds like 3 yrs. I have been told by so many ppl to see an orthopedic surgeon in boston for another opinion, so i was able to make an appt for this monday!
I cant believe this isnt covered by ur insurance. Whats up with that?
It looks like you have similar foot dysfunction characteristics to me. I had the surgery 5 months ago on my left foot with a posterior medializing calcaneal osteotomy, 1st TMT fusion (midfoot), and gastroc release. I did not need the posterior tibial tendon transfer/repair due to sufficient tendon strength and my pain was due to hereditary flexible flatfoot, not primary tendon degradation.
I work in healthcare and researched this condition exhaustively before I chose to have surgery. I would surely seek out the opinion of a specialist foot and ankle orthopedic surgeon. I previously saw a podiatrist and from my experience prefer an OS to perform this complex surgery.
Only having a direct repair of the tendon, will not effectively treat the structural changes in your foot and may leave you with the potential need for future surgery if symptoms persist. From my research the standard of care, if flatfoot deformity is present with structural alignment changes, is a surgical plan likely to include bone re-alignment procedures as well as soft-tissue procedures.
I hope your upcoming surgical consult addresses your concerns and allows you to chose the best surgeon possible to help you into the recovery process.
The Following User Says Thank You to dubpt For This Useful Post: severity777 (03-23-2012)
So at my appt with os, he said tendon repair would have failed. He told me to try otc rigid orthotic for six wks and if no better, than he will do the whole reconstruction. My foot has felt a lil better lately so its hard to imagine that i need this procedure, but the pain is shifting to outer ankle and i fear that this is just a stage of progressing deformity. I will try the orthotic but wondering if anybody has had success with that.
I tore my ptt when I fell 10 feet out of an airline catering truck. My problem got progressively worse before they finally diagnosed me with stage 3 ptt. They tried everything to avoid surgery, cam walker boot for a month, 2 months of pt and custom orthotics. I think that is standard procedure. Nothing seemed to help me, and my OS said I would just have to deal with it. I had a club foot and adult acquired flat foot syndrome from the torn tendon. I got a second opinion from a more experienced OS and he decided to do surgery. I had ptt repair, FDL tendon transfer and calcanal osteotomy. I am 3 weeks post op and I think I made the right decision. Those orthotics help some, but in my case it didn't offer enough help.
So i went to my accupuncturist who has helped me avoid surgery in the past today and he pulls my fooot, we hear a pop and he says he cured me. He says he popped a cyst that was stuck between my ankle bones. My mri did show a cyst. He says now i just have to heal the tendon. It felt great at first but now it hurts wayyyyy more. Im so confused.
Your chiro is not able to know if the manipulation had any affect on the cyst without an MRI. He just created a joint pop from a manipulation such as is commonly performed in the spine.
Adult acquired flafooot is a progressive condition that will only worsen over time. If conservative treatment such as orthotic use, physical therapy and bracing does not improve your function than surgery likely will be the next step. The other option is to live with the pain and attempt symptom management with bulky braces such as an Arizona AFO. If you choose to prolong having the surgery, your condition may progress to an advanced stage that requires more invasive procedures such as ankle fusions.
I am 5 months post-op and glad I had the surgery and plan to have the calcaneal osteotomy screw out in 5-6 weeks. It has been a tough road to recovery having to take 4 months off work and trying to help with my now 11 month old twin boys when I was more limited, but we made it to this point. I am back to work and walking very well, with a current focus on improving my mild lack of strength and balance issues.
I would have to agree with everyone else about that. My OS told me that once a tendon was torn it is like a torn rope that will continue to Frey and get worse. He told me that I could wait, but I was still young and had a very good chance for success if I didn't wait too long.
I know this surgery is overwhelming at first. Take your time and make the best decision for you. Also read the many posts by debincali and the many others on here. It will give you great encouragement to know you are in good company. Just make sure that you have a good OS that you feel comfortable with, that makes a big difference!