Posterior Tibial Tendonitis
I am a 30 yr. old male who has suffered with chronic sprains to my left ankle for most of my life. Two years ago while being treated for another severe sprain, my ortho discovered a fibrous talocalcaneal coalition he said was most likely the cause of the sprains. Last year I began having pain ,swelling, and stiffness along the posterior tibial tendon and noticed my foot seemed to overpronate more than usual. I went back to my doc and was diagnosed with the early stages of PTTD. I was told to wrap my ankle and use my Aircast until the tendon flare-ups went away. He said there wasn’t much he could (or maybe would do) without surgery. He said I would need surgery for the tendon, a triple arthrodesis, and lateral ligament reconstruction. My job requires me to be on my feet for most of the day and right now I cannot afford such a long recovery from surgery. The flare ups are increaing in freguency and the brace doesn’t seem to be working. What would you do for a patient like me? Should I see another doctor? Sorry for the long message but wanted to give you as much info as possible. Thanks for help. RES
Best Answers
Vivian Abrams DPM
What your doctor has recommended is one possible treatment. Tarsal coaltions can be the source of the problems you described.Another conservative treatment I recommend to patients is the use of a short AFO (Ankle foot orthosis) that we refer to as a Richie brace. There are a number of different labs who have their own name for this, but that is the original. This incorporates a rigid orthotic and medial and lateral uprights that are velcroed in place. This can be make rigid or articulating. I have had very gratifying results with patients I did not feel were candidates for radical surgery and the afterwards.You might try calling a podiatrist and asking if they make these custom braces. Not all do. Good luck
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Vivian Abrams DPM
What your doctor has recommended is one possible treatment. Tarsal coaltions can be the source of the problems you described.Another conservative treatment I recommend to patients is the use of a short AFO (Ankle foot orthosis) that we refer to as a Richie brace. There are a number of different labs who have their own name for this, but that is the original. This incorporates a rigid orthotic and medial and lateral uprights that are velcroed in place. This can be make rigid or articulating. I have had very gratifying results with patients I did not feel were candidates for radical surgery and the afterwards.You might try calling a podiatrist and asking if they make these custom braces. Not all do. Good luck