posterior tibial tendonitis, treatments?

[Coromandel1980]

hello there,

after about two months of thinking i had a sprained ankle a specialist diagnosed me with posterior tibial tendonitis.  i call it the tendonitis on my inner ankle. lol  he gave me a cortisone shot (not sure why he did that, heard it weakens tendons, however after two months my swelling was not responding to RICE or advil) but anyways, he prescribed me insoles for my arch, got those, been wearing them religiously since i saw the doc on tuesday.  he also said i need a good pair of shoes, with some stability and support.  just got my new balance shoes today, i was also told to put the insoles into my new shoes.  i'm doing that.

i was told to remain on flat surfaces, no sand, no gravel, hills, hiking etc.  rest when need be, ice, take advil.  is there anything else i should or could be doing to help get this healed up?  

never been through this before.  i was thinking ultrasound treatments or would those make no difference?  thanks board, any stories, suggestions, much much appreciated.

[Coromandel1980]

thanks again for  your prompt reply much appreciated!  okay, well if i don't see some improvement i'll ask about the boot.  :)  i was feeling left out thinking i was the only one that wasn't given a boot or cast.  good to know they aren't required all the time. hopefully these new shoes, arch supports and some RICE will help me out. i really appreciate your input!

[S. Kaul, MD]

Hi again!

Walking boots or casts may not be requires in all cases. The decision is usually taken on a case to case basis. If things do not seem to improve with your current treatment, you may discuss with your orthopedician if these would be a good idea in your case. Hopefully things would settle down soon.

Take care!

[Coromandel1980]

thanks for the reply!

so far my doc only said to wear my arch supports all the time, get some good stabilizing tennis shoes, which i did and have been wearing religiously and no gravel, sand, uneven grass surfaces.  ice, elevation, advil etc.  i keep hearing of everyone mentioning the boot, i wish he would have given me a boot, but he didn't mention it at all or physical therapy. ;/  in fact i didn't get much info out of him even when i called back.  he just said, not to over do it.  walk on flat surfaces, ice when needed and wear those arch supports all the time.  been doing all that, not feeling much difference yet but i think my feet are adjusting to the new shoes / supports, i never wore things like this prior.

i fell into the category of the dreaded flip flop wearer, which i promptly threw those out.  nothing but good shoes for me.  thanks for the advice, i guess i'll just wait this out to see if it gets better. i have no health coverage so physical therapy and ultrasound are unfortunately out of the question for me :(

[S. Kaul, MD]

Hi there!

Well yes, cortisone does have the risk of weakening the tendons but it is useful in resolving chronic inflammations such as tendonitis. Other than arch supports and RICE, immobilization is useful for resolution; and casts/ walking boots may be used for the purpose. Physiotherapy including ultrasound therapy may also be of some benefit. Management would also depend on the severity of the condition. In severely affected cases where conservative management fails, surgical options may be considered. You may like to discuss your condition in detail with your doctor.
Hope this helps.

Take care!

[achilles2]

Here is so good info:
http://orthoinfo.aaos.org/topic.cfm?topic=a00166

I hope this helps

achilles2

PS When my doctor though I had posterior tendonitis my foot was immobilized in a cast.