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Post Tibial Tendonitis in runner caught early- hope??

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Old 07-16-2012, 03:41 AM   #1
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Post Tibial Tendonitis in runner caught early- hope??


I'm a 34 year old female - a VERY active marathoner - and was just diagnosed with Post Tibial Tendonitis in my left foot 2 days ago. A month ago I noticed pain in my Achilles area when running. It was hard to place the pain, and it wasn't that bad, but I stopped running. I had run for a week without my Superfeet insoles (brilliant move) which I've used for years. I attributed the pain to that, and replaced them. When it happened again a few days later, I decided to take time off from running to recover. 3 weeks later I felt confident I'd given myself enough time to recover, and went for a 2 mile jog. Slight pain, but not bad. So I did it again the next day, same thing. Then pushed it to 4 miles the next day, and noticed it felt bruised and tender underneath my ankle around the Deltoid ligaments (inside of the foot). I started researching online, and diagnosed myself with a mild ligament strain and made a doctor's appointment. She referred me to an Orthopedic, who diagnosed me with PTT, gave me a wedge for my shoe, prescribed 6 weeks of physical therapy and some Voltaren gel to rub on. I was told to come back if it didn't go away after physical therapy and he'd put a boot on me.

I had never heard about this condition before Friday. I was expecting to take a couple weeks off for a ligament strain, and then go back to normal. Now I see, after spending hours combing the internet, that this is VERY SERIOUS, and if for whatever reason I don't respond to conservative treatment, I'm looking at surgery and not only an end to my days of running, but also mobility problems for the rest of my life.

I guess I need some hope, these sites are filled with terrible surgery stories and not many success stories. I'm willing to do anything to recover/avoid surgery. I'm icing, taking Motrin and using the cream. I'm trying to stay off my feet. I have a boot from a previous Plantar Fascia partial tear that I started wearing part of the time this weekend, after reading everyone's posts. Is this extreme? I have an appointment to see a foot/ankle orthopedic surgeon next week. Should I see a podiatrist instead? I guess I'm just terrified and feel terrible for everyone who has had to go through what I've read about.

Thank you for reading this.

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Old 07-16-2012, 12:25 PM   #2
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Re: Post Tibial Tendonitis in runner caught early- hope??

I don't have much to offer but my own experience - I had pttd surgery in May after a three year old injury failed to properly heal. I was in a boot and did 3 months of PT in 2009-2010, but my foot never felt right and it got progressively painful with any walking outside of my daily routine. I had to stop using the treadmill, and eventually could not make it around a city block without pain.

I went to a foot ankle orthopedic surgeon in December 2011 who basically said that I had pttd stage 2, and that there were some "conservative" treatments we could try, but was forthcoming in the fact that those efforts are mainly to satisfy insurance companies and that surgery was inevitable. I used custom orthotics for about four months with no real improvement, and decided to bite the bullet in May and have the surgery. I had a tendon transfer, achilles lengthening, a bone graft from my hip, and a calcenael (sp?) oestomy. Four large incisions on the foot, three "notches" in the achilles, and one in the hip for the bone graft. I took pain meds at a slowly decreasing rate for the first week and a half, and now take one as needed if I "walk" a lot in a given day. I also expect I will need them when I start PT.

So now I am a little over 8 weeks out. I came out of the surgery in a bulky, uncomforable surgical splint and was told I would be non weight bearing (NWB) for eight weeks. At three weeks the splint came off and the stitches were taken out (very painful) and I was put in the boot again, for five more NWB weeks. I purchased a commode (only have a second floor bathroom) and knee scooter on line (started to use it when I got the boot, so worth the $$). I also got a hand held shower and borrowed a shower chair. ALL worth it, very necessary.

I am now putting partial weight while in the boot and am supposed to be FWB within the next three weeks, in the boot. Then I go to a shoe which will also be time for me to start PT. My doctor waits until weight bearing in a shoe so that the bones can build back up some while still in the boot.

One thing I will say is that even though I went through a similar recovery years ago, I wasn't prepared for the emotional toll this has taken. It's very hard to depend on others and to feel at times like this won't ever end. It's really important to celebrate every milestone along the way!!!

There are people who are able to run again, though they'll tell you it took a long time, a lot of patience, and a lot of work.

One thing I would say without hesitation is that you need an orthopedic surgeon, preferably one that specializes in feet/ankles. From what I have read on these boards, podiatrists are not the best option for this very complicated condition and surgery.

I hope this isn't discouraging, but what I have seen on line is that the conservative treatments generally are an exercise in futility. I really hope you beat the odds, please keep us posted!!

Last edited by ljt77; 07-16-2012 at 12:28 PM.

Old 07-16-2012, 06:03 PM   #3
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Re: Post Tibial Tendonitis in runner caught early- hope??

First off, welcome to the boards. I have used both a podiatrist for flatfoot reconstruction surgery and now I have been see a ortho - foot and ankle specialist (workman's comp). Truthfully, if it were not that I am currently being treated under workman's comp. I am sure which doctor I would go to. The important thing to remember when it comes to surgery is how many of these procedures have they done per month? Do you feel comfortable with him/her? Do you trust the doctor? I believe that many people once they are fixed stop coming to the boards. For me, although conservative methods were tried, surgery was the only viable option (turned out my accessory navicular bone had fractured off and my ptt was ruptured. Post surgery, recovery was long and at times frustrating. Just about at the one year anniversary my foot felt normal and better then it had felt in a very long time. Unfortunately, I got hurt at work leading to surgery on the same foot as the other surgery and I am going to be having a third surgery. Had it not been for the work accident, I probably could have gone back to running (nothing like what you do).

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