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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


1 Comment found

    Vivian Abrams DPM

    9 10

    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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