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Ankle, Posterior Tibial Tendon interesting case.
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Ankle, Posterior Tibial Tendon interesting case.

Absolutely frustrated!  Ankle issue involving the posterior tibial tendon.  Standing on the ball of my feet (tip toes) causes pain.  Dorsiflexion (while doing martial arts) also causes pain.  However, resting (sitting on floor) max plantarflexion and max dorsiflexion does not cause pain.

Last July (2012) I sharply rolled my ankle, two days later it became a little achy and stiff.  I then tried stretching it (floor leaning calf stretches and stair calf stretches)... and it got worse.  It became hard to walk without pain.  Went to general practitioner prescribed motrin and I kept it in a walking boot for 4 days straight.  I was able to return to martial arts with no problem.  Then I injured it again and it has since become inflamed.

I've had - Xray, MRI, and Ultrasound (for corticosteroid shot) as well as physical therapy, more immobilization, and now neuromuscular massage.

In order of the experiences thus far:
1. Xray originally in July 2012 to make sure there was no damage + walking boot and motrin
2. In October 2012, after being able to return to martial arts there was a mild injury (quick movement avoiding stepping on my son's toys that caused the tendon to be painful again)
3. Visit to the doctor then orthopedist referral
4. This was followed by physical therapy - only thing that helped was the manipulation of the ankle joint.  But I still could not do a calf raise on the weight machine without pain.
5. MRI next and showed the posterior tibial tendon was inflamed.
6. My orthopedist said I needed a corticosteroid and that it would be "decisively curative."
7. Ultrasound + corticosteroid injection (Feb 2013) I was back in the boot for 5 days.  He said to only wear it when I got outside, that around the house I didn't need the boot.  At the end of 5 days I put the boot on FULL TIME for 2-3 days because it still didn't feel better.
8. At this point my ankle was very achy and tired of being in the boot so I started doing yoga - child's pose (plantarflexion) followed by downward dog (dorsiflexion) and it helped a bit.
9. NOW I'm doing neuro-muscular massage.
10. This weekend/today the tendon feels slightly inflamed again.

I still can't achieve standing/weight bearing dorsiflexion or plantarflexion without mild pain.  I think the lack of pain is due to the the corticosteroid shot.  I feel it would have started feeling inflamed a lot sooner if not for the shot.

The X-ray and MRI showed nothing major other than being inflamed.  There is extra space between the ankle joint from the dislocation.  There was no tear or damage.  The doctor performing the ultra-sound commented on how the tendon was embedded in the tissue, and I'm not sure if that's "regular" or "scar" tissue.

Important History:
Three screws in ankle (outside) from 1990.  Dislocation (interior) from 2001.  After dislocation I have never been able to achieve full range of motion of the ankle.  However, I've been practicing martial arts since Feb 2008 without any ankle problems from the activity.

I am tired of feeling like I'm getting put into the medical/insurance treadmill.  It's coming up on 8 months now, I just want to be able to return to normal activities already!
1711789_tn?1361311607
Hi there!

Well, management with tendonitis largely depend on the severity of the condition, tendon(s) involved, associated symptoms and comorbidities etc. Management is largely conservative in most cases consisting of rest, anti-inflammatory medications, walking supports etc. The prognosis may vary between individuals and the recovery time could be anything between a few weeks to a few months. Interventional/ surgical measures may be considered when conservative management is ineffective with increasing severity of symptoms. I would suggest discussing the situation and the suggested management plan in detail with your treating orthopedician.
Hope the information is helpful.

Take care!
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