It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Foot & Ankle Problems Message Board

  • PTTD advice

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 12-07-2008, 02:22 AM   #1
    bunzi
    Newbie
    (female)
     
    bunzi's Avatar
     
    Join Date: Dec 2008
    Location: burnie tasmania australia
    Posts: 4
    bunzi HB User
    PTTD advice

    Hi everyone- a few questions

    1. Has anyone had both PTTD and medial plantar nerve entrapment diagnosed together?
    2. I am wondering what makes a Richie brace so special from a regular AFO
    3. Is there anyone out there that has had surgery in Australia and can recommend a OS?

    I am 31 and have been struggling with these foot arch spasms for 8 months. Just got diagnosed with PTTD after an MRI about a month ago and the foot and ankle specialist surgeon told me to wait a few more months until my foot got more deformed than come back and see him?!?!? I wonder why I have to wait-- I have been on crutches for 3 months bc i can't handle the pain. i have a boot, an aircast airlift brace, had a steroid shot, take anti inflamatory and painkillers, am renting a wheelchair to get around but am thinking maybe i should get an AFO specially designed for myself - i have regular orthodics made and have been wearing them for a few months with no help. I have always been really active and now can't work or really do anything... and so i am getting severely depressed. Also this past week my other foot has started to bother me so I am so afraid I am really going to be immobile soon!
    I got a second opionion from just a general OS- he seemed more optimistic that i may heal naturally but again told me to wait another 4-6 months on the orthodics to see what happens. BUT WHAT AM I SUPPOSED TO DO IN THE MEANWHILE?
    Recently at a new Physiotherapists he suggested i have medial plantar nerve entrapment which i think would explain the location and pain sensations of the spasms i have been dealing with for so long.
    I am really frustrated (i have been to so many doctors and done heaps of research) and feel really alone so I am hoping being on here might offer some support. I recently moved to Tasmania which is pretty remote and am really far removed from family, friends and from doctors which isn't helping of course.
    thanks for any advice!

     
    Sponsors Lightbulb
       
    Old 12-08-2008, 03:26 AM   #2
    Cat Tan 46
    Newbie
    (female)
     
    Cat Tan 46's Avatar
     
    Join Date: Sep 2008
    Location: Singapore
    Posts: 3
    Cat Tan 46 HB User
    Re: PTTD advice

    Hi Bunzi,

    Just to share with you, I felt the same pain as you sometime in March 07, when X-rays result cannot tell what was wrong with my leg, I tried steriod, pain killers and even foot reflexlogy.... you name them and I have tried them all....... and the doctors are not able to cure me. It was only in July 08 (after 16 mths of suffering) this year that the X-ray result had shown that my arch had collapsed and my foot looks "deformed" that the doctor finally decided that I go for PTTD Operations to correct my foot. Recovery will be slow and painful....... I am into my 4th mth afer my Operation and I still walk with a limp and can still feel the pain and swelling. My Doctor says that it is normal to feel that way... it will take at least 6mths and for some even up to 2 years to be able to walk normal again.

    You may want to check with yr doctor at what stage is yr PTTD. I have read in the website.. for stage 1 PTTD, doctor will recommend corrective measures instead of Operations. It is only when the condition has progress to stage 2 then an Operations is needed. My condition was stage 2B, the doc had to take a piece of my pelvic bone to prop up my foot and also put a screw abt 4 cms long thru the bottom of my foot to support it. I was in hospital for abt 4 days and rest at home for 2 and half months. Hope this info will be of help to you.

    I felt frustrated just like you, especially when the pain comes. I have to give up my favourite hobby...running and not even sure if I will be able to do my long distance running again. But over the months, I have learnt to cheer myslf up .... when one has a will there will always be a way. So "CHEER UP !" as I believe you will find you way out.

     
    Old 12-08-2008, 07:57 PM   #3
    emmie54
    Senior Veteran
    (female)
     
    emmie54's Avatar
     
    Join Date: Feb 2008
    Location: Louisiana
    Posts: 925
    emmie54 HB Useremmie54 HB User
    Re: PTTD advice

    Hi, and welcome to the board. As Cat said, what stage PTTD you have does determine how aggressively you will be treated. That being said, PTTD is a progressive condition. You can slow it down in the early stages with orthotics, bracing, etc. but it can not be "cured" through PT or any other means. I'm not sure how it is where you live, but here in the U.S., the doctors are pretty much required to take the conservative route first due to insurance. The standard protocol is usually 4-6 months of conservative treatement before proceeding to surgery. So, while it is frustrating because you may have been dealing with it for a while before diagnosis (as I was. mine hurt for a year before I saw a doctor), the doctor still has to follow the conservative route first, in most cases.

    Did the foot and ankle specialist tell you to wear the boot? I wore a boot for six weeks and when it didn't feel any better they casted me for 6 weeks, the last month NWB. I would stick with a foot and ankle specialist. The general surgeon revealed how little he knows about this condition if he was optimistic that you would heal naturally. This condition just doesn't do that like some things do. Also, I would be careful with steroid injections. An injection into a tendon can cause tendon rupture.

    How was your nerve entrapment diagnosed? A nerve conduction study is usually required for a positive diagnosis of entrapment. Having had PTTD and subsequent surgery and now I have a peroneal nerve entrapment, the pain is similar, although my nerve pain is lateral, not medial.

    This condition is very frustrating, for sure. It's worse if you are secluded from doctors that can give you the care and information you need. Hang in there. There are lot's of PTT veterans on here and if you do a search on this board under "PTTD" you will get lots of information. Let us know if there are any questions we can help you with.

    emmie

     
    Old 12-08-2008, 11:20 PM   #4
    bunzi
    Newbie
    (female)
     
    bunzi's Avatar
     
    Join Date: Dec 2008
    Location: burnie tasmania australia
    Posts: 4
    bunzi HB User
    Re: PTTD advice

    hi emmie & cat- thanks for your replies and encouraging words. its good to talk to someone about all this that knows a thing or two.

    So you can never heal this problem without surgery? It seems from research i have done on the internet that if its early enough and you use orthodics and AFO braces sometimes it heals- no? Do you really think there is no hope? What about acupuncture? I read that the ART technique and Graston techique can help but there is no one in tasmania that does this. I have had great success with acupuncture healing different physical ailments before but I am nervous I may just be wasting alot of money of all these orthodics and braces and physio and acupuncture visits if it isn't going to help anyway. what do you think? I can't work now (i work outdoors on my feet) because of all of this so i am running out of money fast!
    i am not sure which stage i am in. I asked the orthopedic surgeon down here in tasmania... he said he didn't know- "the pain in the *** stage" The foot and ankle specialist I had seen in Sydney about a month ago before I moved down here didn't even assess my stance or toe raising or anything. He just pressed really hard on the painful spot and then said he thought I had a tumour and that i should get an MRI and walked out! I was amazed at the bed side manner but he is supposed to be one of the best foot surgeons in australia. When I came back to get the results he really just said there was nothing i could do to help it- don't bother with physio etc- it will just get more deformed than come back up here to see me. But he did suggest the boot to help me get around. The boot hurts though- its heavy and i feel like it pulls.
    I have tried to figure out what stage and I think i am somewhere between a high 1 or low 2. I can't get my heal even a little off the ground when i try to do a heal raise but my foot and ankle doesn't look like its collapsing that badly. the swelling isn't that bad. the mri says i have low grade and mild symptoms. but that intense pain is there-
    i am going to the neurologist next week to get the test for the nerve entrapment but the physio diagnosed me with it after I flexed and turned out my foot and attempted to straigten out my leg while lying on my back. on my good side- i feel the stretch in my calf on my bad side i feel it through my foot. also all of the people i have seen have been surprised where i am feeling the pain- it is more on the bottom of my foot arch where it meets the heel not really up in the ankle (although lately i have been feeling an aching below the bulbous ankle knob) so maybe the nerve issue could explain this?
    hard telling not knowing! I am also going to see a doctor who makes AFOs next week so maybe i will find out more info.
    i am so amazed at everyones stories on here- such nightmares of chronic pain for so long- what strength and resilence humans possess huh?

    one more question- there is no ankle and foot specialist in tasmania so i will have to fly off the island to melbourne or sydney to get surgery. how am i going to fly back after surgery?!?! do you think i should stay in a hotel or something after sugery?!?!

    The general OS near me insisted on the steroid shot even though i was spectical about it bc i had read about the tendon rupture possiblity but he said it would be fine - but just one no more. he also said that the surgery he would try first would be a tenosynectivity (sp?) and it was pretty straight forward sugery that he could do. what do you think? the foot and ankle surgeon in sydney said i would need a tendon transfer.

    thanks again! hope this finds you feeling pain free! Bonnie (bunzi)

     
    Old 12-09-2008, 10:31 AM   #5
    emmie54
    Senior Veteran
    (female)
     
    emmie54's Avatar
     
    Join Date: Feb 2008
    Location: Louisiana
    Posts: 925
    emmie54 HB Useremmie54 HB User
    Re: PTTD advice

    Bonnie, I'll try to answer all of your questions but if I leave anything out let me know! PTTD that is Adult Acquired Flatfoot is a degenerative progressive condition and is different from an injury to the PTT. There is someone else on here that has a minor tear due to an injury. It is possible for those cases to scar over to the point that there are no symptoms. Tendon tears, as a rule, do not "heal" per se, they scar over. Adult Acquired Flatfoot is usually caused by a structural problem with the foot. The posterior tendon fails but the theory is that the failure is secondary to another problem of a structural nature. That is why surgery is usually required to reconstruct the foot and put it in a more neutral position. Whatever you do, do NOT allow a surgeon to do a simple tendon repair. There is a very high failure rate with that. A tendon transfer is required for best results. In addition to that there is usually bone work done to support the arch. In my case they cut my heel bone and slid it over. Sometimes a bone graft is used laterally to correct the alignment. Sometimes there is a combination of several procedures.

    Also, don't let the fact that a huge tear did not show on the MRI lull you into thinking your PTT may not be damaged badly. Mine showed a "small tear" but when he got in there it was so stretched out it was, in my doctors words, "mush" and had to be thrown away. The fact that you can't do a heel raise supports the need for surgery, IMO. I couldn't do a heel raise and I had virtually no swelling. Also, I didn't hurt in the PTT area at all. All of my pain was lateral where my ankle was impinging on the bone.

    I think the doctor is just following protocol in waiting for a few months to see how you do. I do question his "tumor theory", though. That sounds rather bizarre. You may feel better getting a second opinion from an orthopaedic foot and ankle surgeon.

    Regarding flying, your doctor would be the best person to answer this but I would think the change in pressure in the plane would create pain and swelling. You will definitely have to have the foot elevated for the first few weeks (toes over nose) so that may be a consideration as well.

    Personally, I don't think accupuncture is going to give you any long term results but if it helps with pain, go for it! I don't mean to be doom and gloom about this...just don't want to see you drag on and on hoping for a cure that more than likely won't come without surgery. I would wear the boot, though, to give yourself every opportunity to control your symptoms. You may like the brace better. I got to the point where the brace wasn't enough and had to go to the boot. Then to a cast, then to a cast NWB. It's possible that you can control your symptoms enough that you can work and wait until there is a more convenient time to have surgery. I know someone who actually put their surgery off for TEN years with bracing and orthotics, so it can be done. Your pain level and quality of life issues will determine how long you want to deal with this. Me, once I found out that surgery was most likely inevitable, I just wanted to get on with it. Everone is different and you have to determine what is best for you.

    emmie

     
    Old 12-09-2008, 07:25 PM   #6
    hurts2walk
    Senior Member
    (female)
     
    hurts2walk's Avatar
     
    Join Date: Jul 2008
    Location: Minnesota
    Posts: 236
    hurts2walk HB User
    Re: PTTD advice

    Welcome to the board bunzi. Emmie is so good at explaining things and has done a great job answering your questions. I have dealt with nerve entrapment and pttd. About 7 years ago I was diagnosed with tarsal tunnel and had surgery for nerve release. But my real problem was structural. I have flat feet with pronation and that was causing the nerve entrapment. And after years of walking on those flat feet I ruptured the posterior tibialis tendons in both feet. I had surgery for tendon transfer and osteotomy about 3 months ago. So I feel your pain!!!!!!! Good luck with the EMG test...it is a strange one! If your MRI showed tendon damage I don't think anything will really help except surgery....sorry to say. I put my surgery off as long as I could but the pain was unbearable. I have another surgery to do on the other foot and I will say it is not easy....it is very challenging to say the least but I am hoping to get a normal life back someday!

     
    Old 12-09-2008, 08:29 PM   #7
    emmie54
    Senior Veteran
    (female)
     
    emmie54's Avatar
     
    Join Date: Feb 2008
    Location: Louisiana
    Posts: 925
    emmie54 HB Useremmie54 HB User
    Re: PTTD advice

    The EMG/Nerve conduction is indeed a weird test! They stick you in different places and watch your foot flop around like a fish. Sort of interesting actually.

    Last edited by emmie54; 12-09-2008 at 08:33 PM.

     
    Old 12-11-2008, 03:49 AM   #8
    bunzi
    Newbie
    (female)
     
    bunzi's Avatar
     
    Join Date: Dec 2008
    Location: burnie tasmania australia
    Posts: 4
    bunzi HB User
    Re: PTTD advice

    emmie and hurts to walk- your messages have been so helpful- i really appreciate your honesty, openess and long answers to all my questions- thanks for taking the time and energy!!!
    and it motivated to call a foot and ankle surgeon in melbourne- which is much closer to me than sydney although still an hour plane ride. this guy comes highly recommended and they have squeezed me in on wednesday-- this wednesday! at first she said july and then i told my story and she said how about next week. which is great so i booked tix and am ready to go.

    is there any advice you could give me when visiting him- questions i should ask etc?

    i feel like when i saw the other foot and ankle specialist i was really unprepared and wasted my precious time with him.

    thanks again

     
    Old 12-11-2008, 10:58 AM   #9
    emmie54
    Senior Veteran
    (female)
     
    emmie54's Avatar
     
    Join Date: Feb 2008
    Location: Louisiana
    Posts: 925
    emmie54 HB Useremmie54 HB User
    Re: PTTD advice

    If he recommends surgery I would find out about the flying issue, make sure he knows that you don't live nearby so they may want to keep you a bit longer in the hospital for pain control. I would ask how long the surgery wil take, what is the expected hospital stay, what type anesthesia will they use. (a popliteal block is wonderful in addition to your anesthesia), how should you handle emergency follow-up phone calls, etc. since you don't live nearby, how many follow up visits are usually required, expected recovery timeframe, PT recommendations, cast changes and most importantly, long-term outcome. I'm sure I forgot some things so maybe someone else can jump in.

     
    Old 01-07-2009, 03:45 AM   #10
    bunzi
    Newbie
    (female)
     
    bunzi's Avatar
     
    Join Date: Dec 2008
    Location: burnie tasmania australia
    Posts: 4
    bunzi HB User
    Re: PTTD advice

    well i went to melbourne to the foot and ankle specialist and he doesn't really think i have PTTD - tendon injury that he thinks has the ability to heal. what he did think was i have nerve entrapment.

    i finally went to the neurologist today for nerve conduction studies and viola- i have tarsal tunnel syndrome. so who knows maybe i have both or maybe i was just misdiagnosed?!?
    i have been on endep an antidepressant that is also a nerve blocker (foot and ankle specialist in melbourne recommended it) and as soon as my regular doctor increased the dose i haven't had the stabbing pain anymore! i am able to walk with the boot on but NO crutches-- the first time in months. so at least i am able to get around a bit which is helping with my depression.
    the neurologist says i need surgery but no one seems to want to perform surgery on me!
    when i have been doing research on Tarsal tunnel nerve release surgery it seems to have a really poor success rate- less than 50 percent despite the relatively superficial surgery.
    does anyone know anything about Tarsal tunnel surgery and the complications? or a good surgeon-- even in america- i will willing to go over there for it?

    thanks all- hope everyone made it through the holidays with a smile despite the pain.

     
    Old 12-16-2009, 08:56 PM   #11
    footprint
    Junior Member
    (male)
     
    footprint's Avatar
     
    Join Date: Dec 2009
    Location: United States
    Posts: 13
    footprint HB User
    Re: PTTD advice

    To all ,
    this is my first post. First, i wish everyone gets well!

    Problem: bilateral PTTD, 57 years old male. as everyone knows the pain and limitations are terrible. Two orthopaedics tell me do a FDL tendon transfer with calcaneal osteotomy. No mri done before giving this advice One podiatrist says the do subtalar implant or possibly talonavicular fusion.

    I have read a lot of the posts but it seems like i don't find anyone saying they are better.

    Can anyone out there comment on whether they are improving from PTTD tendon transfer, or from talonavicular fusion, etc.

    emmie54. i noticed your wisdom on several posts. can you comment?

    also If we are allowed to suggest a dr or a dr or hosital,i will go anywhere for the right treatment.

    Thanks, all, footprint

     
    Old 01-09-2010, 10:03 AM   #12
    stephcola
    Newbie
    (female)
     
    stephcola's Avatar
     
    Join Date: Jan 2010
    Location: Augusta,Ga. USA
    Posts: 1
    stephcola HB User
    Re: PTTD advice

    I have also just been diagnosed with PTTD but just in left foot. I Have gone to 5 drs. in last 2 years and noone could figure out my problem. I started out with an injury. They said it was arthritis. I live in Ga. and just flew back from San Antonio - great group and was finally diagnosed, Great to know I wasn't crazy - bad to know surgery was on the horizon. I have stage 2 - I don't know what stage you have. I am brand new to this forum so I do not know whether you can mention Dr. names or not. What I will tell you is that I flew cross country to an excellent foot and ankle orthopaedic specialist and after his diagnosis, travelled yet again 5 hrs. to a major medical center to another excellent ortho foot and ankle specialist. These drs. are senior in their field and all they do are foot and ankle. Surgery was recommended because I am in good health, physically fit, 54 but....I do not want surgery personally. I cannot do the down time now. I have family responsibilities and a house with 16 steps up to bedrooms and a husband who travels for work. I have been given very good odds at using a custom AFO otho brace (which I do not have yet) - not cheap I have been told - but who cares - it's not surgery. The doctors I have met with are tops in this field and I am going this route first. I have read more posts on all the forums and have done more research thatn I thought was humanly possible. Everyones situation is different. I still have a relatively "good " right foot. If that take the weight bearing while the other is NWB, i will certainly have another bad foot. I feel the 6+ months of bracing is worth it for me. If surgery is on the horizon - so be it. If you find out that it is ok to give out Dr.info, from the webmaster, post another inquiry and I will give you names. One dr. who has gotten fantastic reviews in NY did not take my insurance so I had to pass.

    I know I am new to this but what I have learned is that we all have to be our own advocates. We need to research doctors and treatments and do not stop until you feel you find what works for you. It has taken me just about 2 years since I injured myself and I finally feel I am headed in the right direction.

    Like all of you.....It is nice to find a place where others understand your pain and what we all go through. Most people have no patience for me when I tell them my feet hurt.
    I hope this helps..

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    PTTD Post Op - A few questions MasonQ Foot & Ankle Problems 46 02-20-2011 04:40 AM
    Non-Surgical PTTD - personal story stuwil Foot & Ankle Problems 4 12-18-2009 06:19 AM
    Newly diagnosed PTTD patient needs info romangirl03 Foot & Ankle Problems 106 11-16-2009 08:58 AM
    PTTD Surgery 03/06/09---1 week post op Tracie1204 Foot & Ankle Problems 88 11-02-2009 10:11 AM
    Surgery Recovery Time and Advice Paddlejunky Foot & Ankle Problems 7 01-26-2009 05:03 PM
    PTTD in Both Feet important question..... kristim06 Foot & Ankle Problems 12 10-16-2008 09:40 AM
    Ankle Braces For Good Foot post PTTD dtjag1 Foot & Ankle Problems 2 04-09-2008 02:24 PM
    PTTD Surgery Recovery???? thefirstnoel519 Foot & Ankle Problems 39 02-11-2008 03:43 PM
    Subtalar joint implants to correct Pttd jana65 Bone Disorders 0 01-18-2008 04:52 PM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 07:21 AM.





    © 2022 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!