Posterior Tibialis Tendinitis

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12/02/2014 at 08:18

The scan I had prior to surgery showed there was a small tear in the tendon caused by overuse rather than a trauma.  Re: the ankle bone not sure but the scar goes from below the ankle bone, around it and finishes just above the bone. 

Hope this helps.

13/02/2014 at 08:11

I tore mine (partial tear) in a cycling accident and have been in an Aircraft PTT brace for three months, but no surgery. Get my assessment by the specialist tomorrow so hopefully I'll be able to report that the conservative (i.e. non-surgical) treatment has worked.

13/02/2014 at 10:12

I hope so too Debra - good luck with it.

16/02/2014 at 10:52

Argh! Went expecting assessment. Instead, I've now been booked in for MRI in the middle of March and assessment in April. Grr. It will be six months since I came of the bicycle and tore the tendon, by then. I had to stand on it for weight-bearing X-rays and it was fine. Fed up with the brace (which hurts - and the tendon stopped hurting some time back). At least he's confirmed I can do more cycling to add to the swimming and Pilates, and set the wheels in motion to get some physio started. Now got to start counting down another six weeks...

18/03/2014 at 08:42

Had MRI, had assessment (pushed the MRI people to write the report so I could make use of an earlier appointment). Been told I have permanent tendon degeneration and to wear orthotics all my life even e.g. walking around at home. We'll see.

Started physio and I'm doing the exercises I was set, three times a day. Walked one lap (1.5 miles) at parkrun on Saturday - very tempted to start running but I didn't. Intend to wait until I've been doing the exercises for at least a couple of weeks before trying a few minutes on the treadmill, probably (totally flat surface) then start building up very gradually and see how it goes.

Orthopod said if it goes bad again he'll consider surgery (moving flexor digitorum longus to replace the PTT) but then would give me only a 30% chance of returning to long-distance running...

25/03/2014 at 20:23
Hi
Thought I'd pop in with feedback.
I spent 8 weeks not running just bikes and swimming. Did a ten min jog on treadmill 3 weeks ago and felt niggle in the ankle so I stopped. Then had the similar nag for a few days. A further 3 weeks and walking a few miles seemed fine so I went out for a run. A slow 5k felt fine when running but today felt achey in general but still weakness in the ankle. So I'm no further forward.
Just thought I'd give the update.
This is a a nightmare to get rid of.
25/03/2014 at 21:48

samsunguser: are you doing exercises to strengthen it? I've had five MONTHS of rest and wearing a brace and now I've started rehab exercises.

25/03/2014 at 22:00

Hi Debra,

How is the recovery going?  I am very gradually increasing my mileage in my minimalist shoes.  Started with three three mile runs in a week then increased to three by four the next and so on.  Now at three by 11.  Still a bit of soft tissue ache but the bone seems fine.  All things being well I will go for a marathon in the autumn to make up for missing London this year. Over a stone heavier than I was this time last year.

 

SR

26/03/2014 at 08:15

Hi SR, congratulations on that progression - sounds like you are being sensible and being rewarded for it. Good luck with working towards that marathon. As for the weight, I'm sure it will drop off again as you do more running.

I'm not doing any running yet . However, I have progressed to starting doing single-leg heel raises (I'm starting with five, three times a day and will work up to 15), and gone from the thinnest thereband to the next one up for my other ankle exercises (extension, flexion, inversion eversion). I'm also doing lots of exercises to strengthen the internal muscles of my feet.

I walked one lap of my parkrun, so 1.5 miles, the other week when we had lots of volunteers (so I wasn't needed for any finish line duties), and walked 800m at 4 degrees incline and 4 mph on the treadmill on Monday - intend to repeat that a couple of times today. It's going to be a slow recovery, I fear - and I have no idea whether the tendon will be sufficiently functional to allow me to run properly. I can only wait, build up very gradually, and find out.

28/03/2014 at 01:01
SumoSue wrote (see)

The scan I had prior to surgery showed there was a small tear in the tendon caused by overuse rather than a trauma.  Re: the ankle bone not sure but the scar goes from below the ankle bone, around it and finishes just above the bone. 

Hope this helps.

 

SumoSue and anyone else experiencing this:

What did you feel when you had a small tear in your tendon? I'm getting an MRI tomorrow. When I run, the very inner part of my ankle feels weak like it's going to give out, painful but not excruciating pain. It starts out as mild pain but gets more crappy feeling halfway through, and stays the same amount of pain the rest of the run. I'm sore after running (just that shin/ankle). And sometimes my foot starts feeling weak too, like under the arch but not as often as the inner part of my ankle. A small section of where a muscle attaches to my tibia has a burning sensation when I do the "runners stretch." It hurts and i'm limping when i stop running but it doesn't stop me from running if that makes sense. Wondering if theres a tear or just bad tendonitis. The MRI will show I guess.

 

28/03/2014 at 07:59

Megzie, the symptoms sound familiar, but like you say the scan will show that.  I was fortunate in that the specialist I went to understood that I wanted to get back into sport as quickly as possible but needed a long-term solution.

I got the results of the scan in the morning and he operated in the afternoon!

I'm back in full Ironman training with no issues - just slow, but that's nothing to do with the post tib.

28/03/2014 at 08:41

SumoSue: You were so lucky. I told my speacialist the same thing, but got a totally different response: I too have a tear - caused by a cycling accident when I already had some weakness in the PTT (had nursed it through five 50-mile runs and was about to rest it). Scan at that time showed a partial tear, but the surgeon just went for conservative treatment. Now it's five months on, MRI confirms degeneration and (still) a partial tear, I'm just out of the PTT brace, have been told at least a year from now to returning to running properly, that I need to wear orthotics for life (not helpful when I run minimalist) and that if he operates (FDL transfer) there's only a 30% chance of returning to long-distance running post-op! What did your surgeon do? Sew up the tendon and remove the degenerated bit? Do a FDL transfer? What? Who did you go to?

28/03/2014 at 15:12
SumoSue wrote (see)

Megzie, the symptoms sound familiar, but like you say the scan will show that.  I was fortunate in that the specialist I went to understood that I wanted to get back into sport as quickly as possible but needed a long-term solution.

I got the results of the scan in the morning and he operated in the afternoon!

I'm back in full Ironman training with no issues - just slow, but that's nothing to do with the post tib.

 

Did you have problems with weakness when you tore it? I had the MRI this morning...I know something is just not right. Seems every so often I take a step "wrong" and it sets off something in my leg..like major pain but just for a few seconds, then back to normal.

28/03/2014 at 16:20

Hi Debra, I can't tell you exactly what he did, he knows I'm not very good when he goes into gory details (I pass out as soon as I see a hospital sign).

I would assume he did as you suggest i.e. sew up the tendon, remove the degenerate bit. He hasn't enforced me into wearing orthotics as the last time I tried I finished up with blisters on blisters, although he did recommend a night split, but that was to try to stop the calf being so tight.

I went to Mr Hennessy at Spire Murrayfield Hospital on the Wirral, initially as a self-payer and then as part of BUPA.  No harm in getting a second opinion from any other specialist, especially since you've been out longer than I was with surgery and having to wait another year.

Good luck with it.

I'm away over the weekend so any further information you need, I'll let you know on Monday.

31/03/2014 at 09:21

Megzie - I had a weakness in that every now and again the foot would just give way and it felt very unstable, I also got a "burning" sensation for a few seconds then that would go.

Good luck with the results from the scan.

31/03/2014 at 13:51

SumoSue: well, I don't have insurance so I guess I'll just wait and see at the moment - felt okay for a 39-minute walk/jog parkrun. I'll just work up from here slowly and see what happens.

31/03/2014 at 14:50

Thank you! I get my results back Wednesday!

31/03/2014 at 15:03

Hope everything goes well for you both - I'm on holiday for the next couple of weeks but let me know how you get on Megzie.

Debra - it may be worth asking your doctor to refer you to a different specialist if things don't work out well.

31/03/2014 at 15:07

i will for sure! I'll post back Wednesday!


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