I am 25 years old and a marathon runner and triathlete. I began having problems with my left ankle after running a half marathon in April 2012. I have not run since April, and have exhausted non-surgical treatment options over the past 8 months (crutches, cam walker, custom orthotics, anti-inflammatory meds).
My posterior tibial tendon is inflamed and my arch has collapsed. I have recently been diagnosed with PTTD Stage 2.
I have scheduled reconstructive surgery of my foot for January 2013 (FDL Tendon Transfer, Evans osteotomy w/lateral column lengthening, calcaneal osteotomy, and gastrocnemius recession).
Even though I am certain that the surgery is necessary for me to resume my daily activities and moderate exercise without pain, I still have a lot of doubts.
Hi, I just had the exact same procedures as you two weeks ago today. I am older than you (38) and not nearly as active - a casual runner at best, but I have an active lifestyle with two young children to keep up with. My pain started in May after a fall playing soccer (not sure if it's related or just coincidental). My PT tendon was not torn, but was inflamed, and my arch collapsed. I was at the point that I was in pain just walking from my bedroom to my living room, despite every non-surgical measure I tried. I deliberated for quite a while over the surgery, and like you, knew that it was the right decision, but it took me a qhile to get there. I finally was at the point that I couldn't live with the pain, and it was seriously affecting my life. Not only could I not exercise, but every day activities were painful. So, I finally gave in and did it.
Can I say it's the right decision yet? No. I still have too far to go. So far I have no regrets but time will tell if I made the right choice. I was very fortunate that I have not had nearly the pain many experience after this surgery, so I feel very thankful for that. I had surgery two weeks ago today, and have not taken any painkillers in a week and a half, and I was able to go back to work full time yesterday (I work at home so am able to work and keep my foot elevated/rest). I actually feel very good, other than the lack of mobility, which makes me stir crazy and restless, but it is what it is, and hopefully worth it in the end.
My doctor did say I will likely never be able to run again, and honestly that was a tough pill to swallow. I'm not a serious runner, but I do enjoy it, and the thought of never running again still makes me sad, but, if it means I can resume a normal life and get back to some type of activity, it will be worth it. It's also disconcerting to hear that I'll likely never be 100% again, but like my doctor said, I was nowhere close to 100% before surgery, so if it gets me somewhere reasonably close, it will be worth it.
Good luck, I know all too well it's not an easy decision to make.
Thanks for your response NCgirl! I am a North Carolina girl as well . It is good to hear that your surgery went well and your recovery is also going well.
As you described, what ultimately has me leaning towards surgery is that I can't perform my daily activities without pain. For exercise, I swim and bike, but can only tolerate 30-45 mins before my ankle starts throbbing. This is a far cry from my previous level of activity (running ~40 miles, biking ~20 miles, and swimming 3-4 miles per week).
I understand that I will never be able to run marathons again, but would like to get back to running or even walking 3-5 miles a few days a week (just enough so that I can complete the running portion of triathlons).
In January, I start the final semester of my Phd in Exercise Physiology (how did this happen to me of all people????). My surgeon has told me that I will only have to take 2 weeks off of school, and then I should be able to work my way back into my normal routine. I feel that I need to get this surgery while I am still in school, before I join the "real" working world.
Lots of NC girls on here! I am 3 months post op and live alone. I had someone for the first couple of days but after that was on my own. It's not ideal but definitely doable. Depending on your housing situation (stairs etc) I would highly recommend a knee scooter, especially if you need to get around campus. If your mom can stay a couple of weeks you should be fine. I really only needed help in and out of the shower til I went into a boot after 2 weeks.
Good luck and ask away with any questions.
The Following User Says Thank You to ginger62 For This Useful Post: GoCANES (12-18-2012)
You are so where I was about two months ago. I knew surgery was the answer, but I had to fully convince myself, and I had a TON of questions!
1) Anyone have trouble swallowing all the pain pills? I have always been terrible at swallowing pills. Any pain med alternatives? (Patches, creams, liquids)
I was nervous about this too. I have large tonsils, and even Advil get stuck behind my tonsils sometimes. I was prescribed oxycodone and had no issues with it, they were teeny tiny. I had sores on my throat the first few days from the breathing tube thingy, and even with those I had no issues swallowing them.
2) I live alone and 800 miles away from my family. My mom is going to come down and stay with me for a few weeks. How long do you suggest she stay? 2 weeks? 3 weeks?
I think you're going to get a lot of different responses on this because everyone's recovery is so different. Based on my experience so far, I think it depends on a few things - 1 - how long you need pain pills. I only took them the first few days, but while taking them I was REALLY tired and dizzy/lightheaded. I was on my own for a few hours at a time, but wouldn't have wanted to be alone much more than that. 2 - your level of comfort getting around on your own (e.g., crutches or whatever your method will be to get around). I was not great on the crutches the first week or so and would not have been comfortable going out by myself. I'm getting better and much more comfortable now. 3- How much pain you're in. I've been very lucky to not have a lot of pain, but I know that is different from many.
I am two weeks out today, and am on my own pretty much all day, my husband leaves as soon as my kids get on the bus, and comes home around dinner time. I am very comfortable getting around my house on my own. But, I'm not as comfortable going out by myself, running errands, etc. If you have friends who can help you out, even to check in on you to see if you need anything that will help a lot.
Based on my own recovery, if I had to be on my own all the time now, I would be okay. But maybe you should say 3 weeks in case you need more help.
Whatever you decide, definitely plan ahead and have your mom set you up so you can get to everything you need once she is gone. I can make myself food as long as things are where I can reach them. I also found it easier to have my clothes easily accessible, rather than some things in my closet, some in the bottom drawers of my dresser, etc. My wardrobe is pretty limited right now anyway, so to have all my clothes I'm wearing now put away in the top drawers of my dresser where I can reach them is helpful. Moving a chair into my bathroom so I can sit down while drying my hair, putting on makeup, etc had made it easier.
The Following User Says Thank You to NCgirl96 For This Useful Post: GoCANES (12-18-2012)
No kidding on the clothes. I have been in sweatpants and tshirts for 3 months. Makes doing laundry very easy (except bending over to get that last dang sock out of the dryer).
Also, I stocked up on meal replacement bars. Pain meds can make you quite nauseous but calories heal (as I keep being reminded of...I am not a good eater) so maybe find a flavor you like and get a couple of boxes.
Are you having your surgery in the Triangle area?
Definitely talk to your dr pre-op and let him know about your pill problem. Some pain meds can be dispensed in liquid form, some can't, they have to be crushed. If crushed, you can mix with cold applesauce or pudding to get down. You can buy a pill crusher(inexpensive) at any drugstore.
If your Mom is able to plan to stay 3 weeks, I think that would be great. Dr has me NWB off my foot 23 hrs/day. If I HAD to do it alone, I could, but if you have your Mom able to help, let t her. Recovery will deinitely be easier. If you have any questions, just ask. Good luck!
Great advice! I have been reading these boards for months, but haven't posted anything until now.
Good to know that the oxycodone pills are small. I have had practice swallowing Mobic (NSAID) for the last few weeks, which are also tiny.
I was on crutches for several weeks when I first injured myself and have worn a boot off and on for the last 8 months, so luckily, I am prepared to maneuver on those. I am definitely going to get the knee scooter. No way will I be able to get around campus without it.
I am in grad school at the University of Miami, so I live in Miami (I was born and raised in NC, and my parents still live in the triangle area...I am home for winter break). It is still 82 degrees there. Even though the surgery is in January, I will be able to wear shorts, and t-shirts with ease. I have been receiving treatment up to this point in Miami. I finally found an orthopedic surgeon I can trust, so I am going to get the surgery there. It makes more sense for follow-up appointments.
Finding a surgeon you like and trust is in my opinion the most important part of this surgery. I currently live on the Outer Banks but travelled to Duke to see a surgeon there. More importantly though, I grew up in South Bend, IN during the "Catholics vs Convicts" era...but I won't hold that against you, haha.
I think you will ultimately be glad you are having the surgery. Once you get to a certain point it gets progressively worse so the earlier you tackle it the better. I wish I hadn't waited as long as I did. Keep posting, there is great support here. It made a big difference for me. Big Tarheel hug for you.
I have been slowly convincing my Mom that 3 weeks will be better than 2. My doctor doesn't want me doing anything for 2 weeks after the surgery. I think having her the third week will help me ease back into doing things for myself. I have some great friends, but we are all in grad school and insanely busy. I don't want to be too much of a burden on them.
How far post-op are you that you still need to be resting 23 hrs/day? I want to return to my classes and teaching during the 3rd week post-op (only 3 days a week, 3 hrs each day). Is this reasonable?
Wow...we could start a whole other chat about our football rivalry. ND gave us a catholic smack down this year.
In other news...
How bad was your foot condition before you got surgery? My foot has been feeling a little better...of course it is because the semester is over and I am staying off my feet at home. I was so sure about getting the surgery a few weeks ago, but now that I have a date set, I have new doubts.
GoCanes- our lifestyles sound pretty similar. I was between 30-40 mpw before my post tib started giving me problems (Oct 2011 is the last time I ran *tears*), and I am a graduate student at UNLV, teaching intro to psych.
I got reallllly lucky & only ended up needing a tenosynovectomy (no arch collapse or anything), but I thought for a while I might need a tendon transfer. What has your doc said about running again?
The first time I went to my current orthopedist, who is a foot and ankle specialist, (after 5 months of being misdiagnosed and improperly treated by a general orthopedist), he told me that he would give up "extreme" exercise, running, for the rest of my life, instead of getting surgery. He only recommended surgery if I couldn't do my daily activities without pain, which is where I am at now.
In that same appointment, I asked him if I would be able to run again with the surgery and he said yes! That possibility is not my entire driving force for the surgery, but it certainly gives me hope of returning to a normal life.
From what I have gathered, you typically don't have problems with the posterior tib without having issues with the rest of your foot. Reconstructing my foot should take the pressure off of that tendon, enough to get me back to moderate running (10-20 miles per week).
I have my fingers crossed that my surgery turns out that well!
So, you still haven't been able to run, even after your surgery?
Ya know, I've gathered the same about general foot problems, but ortho after ortho has consistently told me I don't have any biomechanical problems. I'm pretty sure it was the shoes I was wearing to run in at the time- newbalance 400-something, & I'm a heel striker. I just think I need more support.
The guy who eventually did my surgery was shocked that mine didn't heal without operating. It was some inflammation & a small tear really high up into the ankle. We tried conservative treatment from Oct 2011-Oct 2012 before finally finding the guy I felt comfortable with operating on me. My surgery was Dec 6th, & my doc is REALLY confident that I will be able to get back to running completely. I'm already partial weightbearing (putting weight "as tolerated" while holding the rest of my weight on crutches).
For me, I kept it elevated 23 hours a day (for the most part) the first week. I also iced it as much as possible during that time. The first few days, I was exhausted, so it was not difficult to stay in one spot for that long. I gradually started getting my energy back. Over this past weekend, which was about 10 days, I got out a lot more. We spent a fair amount of the day out on Saturday and Sunday, but a lot of that was car time. This week (2 weeks), I feel pretty much back to normal energy levels. If I am not up and around, I have little to no swelling, once I'm out and about for a while, it swells some, but as soon as I elevate the swelling goes right back down.
I think your plan makes sense, if you have your mom here the extra week, she can help you settle into the routine you'll have once you're on your own. The other thing is, my doctor said I'd be ready to switch from the surgical splint to the fiberglass cast at 2 weeks, and that makes a huge difference because it's so much lighter and easier to deal with. I'm not getting mine until Friday, so can't say that's true, but I'm hoping!
I had the same doubts as you once I actually scheduled the surgery. I had days where the pain was awful, and days where it was never completely gone, but was more manageable. So I'd wonder if I was making a mistake by going through with the surgery. But, I'd look at the days I had less pain and realize those were the days where I did very little and was off my feet a lot. I couldn't imagine spending the rest of my life like that.
The Following User Says Thank You to NCgirl96 For This Useful Post: GoCANES (12-19-2012)
That is really interesting that resting for a year didn't heal anything. You might be right that your shoes were the culprit. I think that switching to Newtons (mid-foot striking) from Nikes that I have been heel-striking in my entire life caused extra pressure on the tendon.
I really hope that the surgery you had and switching to more supportive running shoes will fix your problem. Boy do I know how hard it is to give up a running career at such a young age. Definitely keep us posted on your progress!
GoCanes,,,I'm one week post op. Each dr has their own recovery protocol, and recovery is based on how invasive your surgery will be. At one week post op, I feel SOOOO much better, stronger, at pain level is low. I find, that anytime my foot is down, swelling is bad, which increases pain. If I had to do everything for myself at this point, I certainly could, and just deal with the pain. My dr's concern is he wants everything to heal and bind together, as much as possible. Returning to your class schedule, part time, I believe I'll be doable, as long as you can elevate and rest when you get home.
GoCanes, The time will FLY by! You have the holidays to look forward to, that will make the time pass quickly, and before you know it, you'll be well on your path to recovery! I found a lot of good advice on the boards. Your dr can explain surgery and recovery plan, but those who have actually gone through it are great sources of info, as well. Looking forward to your recovery!