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2011-05-03 6:27 PM

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Subject: anyone have posterior tibial tendonosis?
Any sucess stories? Is this going to change me for ever? Its been almost 3 months... I am so frustrated!


2011-05-03 6:53 PM
in reply to: #3480619

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Subject: RE: anyone have posterior tibial tendonosis?

I've had chronic posterior tibial tendonITIS...not been diagnosed as tendonosis, though.  It was, honestly, pretty bad for a long time...at its worst, it could wake me up at night.  I didn't know what it was...eventually saw a podiatrist and got orthotics, which made a huge difference.  About that time, I also lost a lot of weight, which ALSO made a huge difference...allowed me to start running.  However, I still can get a recurrence if I do too much activity barefoot or even in unsupportive shoes...PT tendons just can't take it.

What have you been doing to deal with the issue up to this point?

2011-05-03 7:08 PM
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Subject: RE: anyone have posterior tibial tendonosis?
Well since Feb when it started... ive seen 3 docs, gotten 3 x rays and an MRI... doctors 1 and 2 really did nothing... ive been taking aleve, soaking in warm epsom salt baths, icing, wearing a brace, stretching, strenghthining, using creams, massage.. its gotten better since the start but still not 100%. I had to drop out of my first half marathon. The 3rd doc im seeing has been giving me shots of anti inflammatory. A lot of ppl have suggested orthodics... including all 3 docs.... I've been wearing inserts... but they kind of hurt ... im afraid Im gonna shell out 450 for orthodics and hate them
2011-05-03 7:32 PM
in reply to: #3480660

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Subject: RE: anyone have posterior tibial tendonosis?

nicecat13 - 2011-05-03 5:08 PM Well since Feb when it started... ive seen 3 docs, gotten 3 x rays and an MRI... doctors 1 and 2 really did nothing... ive been taking aleve, soaking in warm epsom salt baths, icing, wearing a brace, stretching, strenghthining, using creams, massage.. its gotten better since the start but still not 100%. I had to drop out of my first half marathon. The 3rd doc im seeing has been giving me shots of anti inflammatory. A lot of ppl have suggested orthodics... including all 3 docs.... I've been wearing inserts... but they kind of hurt ... im afraid Im gonna shell out 450 for orthodics and hate them

For your situation, zero comparison between store bought and properly prescribed, dispensed, and fitted orthotics.  I've gotten to where I can run in off-the-shelf inserts, but that has involved a lot of trial and error and was after years of wearing very good orthoses from two different podiatrists.

I've also had a couple of less successful prescription orthotics.  One was on an HMO and only cost me $50...they were dispensed and fitted by a prothetician and they sucked...but they only cost me $50.  Another pair I had done in an ortho clinic on the spot...very cool...cost me $250 out-of-pocket, but they work best for walking...not ideal for running, unfortunately.

Also, consider a podiatrist if that isn't in the list of doctors you've seen.  When I was first trying to figure out what was wrong, I saw an orthopedist and he didn't know how to really properly x-ray the area, let alone treat it.  And if you can afford orthotics, try very hard to work with whoever is fitting them to get them to be as comfortable as possible.  Both podiatrists I saw were very good about that...the people who dispensed the other two pairs (the prosthetician and a cast room technician at the ortho clinic) weren't as careful and patient.

If you can't afford orthotics, the most successful off-the-rack pair I've tried were the Sofsole "Stable Runner" model, however they may be discontinued...I've been able to get a running store to special order them recently.  (I actually wear those on top of a pair of Dr Scholls gel inserts that also have some arch support to them, but I wouldn't recommend anyone else try my "Frankenstein" experiments with combining inserts...I didn't try it until I'd been wearing orthotics for years and understood where I needed support and how much).

Good luck.

2011-05-03 7:42 PM
in reply to: #3480619

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Subject: RE: anyone have posterior tibial tendonosis?

My case: this is all my personal experience, but see if any of it works for you

I developed PTTitis last summer, and it has never totally gone away.  I've avoided most anti-inflammatories - my orthopedist thinks the inflammation isn't necessarily a bad thing and will help it heal.  I ice it after every run, even if it doesn't bother me.  Physical therapy helped quite a bit - strengthening my core/hips/glutes to support my weight better and strengthening the foot muscles to take care of the problem.  At its worst when it first flared up my ankle would get very swollen and running was painful.  I took a few weeks off running when I started physical therapy, then started slowly with short runs every other day.  After about 6 weeks of rehab and slowly building my base running I was about 90%, only runs >10miles would bother it.  About 9 weeks after diagnosis I did my first HIM and the PTT held up very well until the last 400 yards, when they made us run on sand :-)   A month later I ran a 5k and for the first time in almost 4 months and didn't even think about the tendonitis - I finished the race feeling like something was missing, and finally realized it was the absence of the sensation on my medial ankle!

Everything would have been ok, I think, but I badly sprained my other ankle a week later (hit by car).  I couldn't run without pain in that one for 4 months.  When I finally started training, my PTT flared right back up.  I went back to rest, ice, strengthening exercises and slowly building my base - that was almost 3 months ago, and I'm about 98% now - just mild discomfort at the beginning of a run and the occasional sensation in that area that it just isn't quite right.

Mine may be more mild than most - I've only been to the orthopedist once, and no one has recommended orthotics yet.  The extensive internet searching I did definitely left me with the feeling that there are 2 approaches:

1) get the orthotics, will control the pronation that is stressing the weak PT muscle.  Root of the problem not really solved, but as long as you can run pain free, then you've reached your goal.

2)patience, careful evaluation of your running shoe selection, strengthen the PT and your core strength.  accept that you have a weakness, work on it and you may be able to solve the primary issue (or at least make it manageable)

Just my experience, don't take any of it as gospel - I'm no expert in PTT (not sure if the -osis is actually clincically different than the -itis, both terms seem to often be used synonymously despite technically having different definitions).  I've taken approach 2 because it seems to have worked for me and I like the idea of fixing the weakness.  However, I'm sure if I was having a different experience, I would give approach 1 a shot.

2011-05-03 9:26 PM
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Subject: RE: anyone have posterior tibial tendonosis?

Thanks for the responses. I really do appreciate it.

itus I believe is inflammation and osis has to do with degenerative changes in the tendon... I think I got the worst out of the 2 :-/

But anyway.. I'm going to go for the orthodics.. everyone swears by them



2011-05-03 10:14 PM
in reply to: #3480660

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Subject: RE: anyone have posterior tibial tendonosis?

nicecat13 - 2011-05-03 7:08 PM Well since Feb when it started... ive seen 3 docs, gotten 3 x rays and an MRI... doctors 1 and 2 really did nothing... ive been taking aleve, soaking in warm epsom salt baths, icing, wearing a brace, stretching, strenghthining, using creams, massage.. its gotten better since the start but still not 100%. I had to drop out of my first half marathon. The 3rd doc im seeing has been giving me shots of anti inflammatory. A lot of ppl have suggested orthodics... including all 3 docs.... I've been wearing inserts... but they kind of hurt ... im afraid Im gonna shell out 450 for orthodics and hate them

 

For me it did not get better till I stopped running.  When I first started feeling the pain I ignored it.  By the time I got to the doctor and had an MRI he said the tendon was partially torn.  I was in a boot for a month then a month of PT and then it still hurt when I ran so I took another 2 months off.  The pain was still around a little but I ran through it for 6 months by taking 3-4 days off when it got bad and limiting mileage.  Eventually it got worse again and I took 6 months off completely from running and 3 from biking.  About 4 of those months I still had noticeable pain by touching it or stretching.  After I was completely pain free for a few weeks I started doing my PT exercises again.  I started up running slowly and have been pain free now for 1.5 years.  I still do the exercises but less frequently.  I also increase my mileage really slowly now.

 

 

2011-05-03 11:28 PM
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Subject: RE: anyone have posterior tibial tendonosis?
2011-05-04 12:51 AM
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Subject: RE: anyone have posterior tibial tendonosis?
nicecat13 - 2011-05-03 7:26 PM

Thanks for the responses. I really do appreciate it.

itus I believe is inflammation and osis has to do with degenerative changes in the tendon... I think I got the worst out of the 2 :-/

But anyway.. I'm going to go for the orthodics.. everyone swears by them

Good decision.  I was gonna make the comment earlier about the seriousness of it being tendonosis...glad you're taking it seriously...my tendonitis was bad enough at its worst that I used a cane sometimes...it became a real quality-of-life issue.  And then I got really good orthotics from a really good podiatrist and it turned things around almost immediately...and just a few years later, I'm running marathons and have finished a couple IMs.  Hope it works out for you.

2011-05-04 7:06 AM
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Subject: RE: anyone have posterior tibial tendonosis?

18 weeks of Physical Therapy and Custom fitted othonics.

Have not had a single foot issue since then. PT improved my stride and posture, Orthonics keep everything in alignment. wish I had done it years ago.

2011-05-04 12:01 PM
in reply to: #3480701

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Subject: RE: anyone have posterior tibial tendonosis?

2nd the Sof Soles. I bought the heat moldable running ones for around $25.00.  I was having pain on the outside of my right ankle that run up along the fibula to my knee.  



2012-12-19 8:14 AM
in reply to: #3480619


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Subject: RE: anyone have posterior tibial tendonosis?

Tendonitis and tendonosis are completely different conditions, and with the ~osis you will need to either (a) take a rest for a few months or (b) get into a program that gives you specific rehab exercises to repair the tendon.  It can be done, but the techniques are mostly still in the research stages and haven't made their way into mainstream medical community, at least in the States.

One online resource would be an ebook called Target Plantar Fasciitis and Posterior Tibial Tendonitis.  It gives a good overview of both tendonitis and tendonosis, and what to do for both.  A google search will turn up the blog, which also has some good free info and (if I remember correctly) a test you can take to see which condition you actually have.


HTH.

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