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31 yo, PTTD no tear, just inflammation

Discussion in 'Ask your questions here' started by PTTDsufferer, May 27, 2013.

  1. PTTDsufferer

    PTTDsufferer New Member


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    Hello,
    I have had PTTD for about 15 months in my right foot. I have very flat feet and have played tennis for years, which i assume might have set me up for this. The last couple of years my right foot would get sore only when running on a treadmill, but when I moved to new york (Jan 2012), I had to walk a lot more all of a sudden and was stupid and didnt use arch support. So within 3 weeks my foot was KILLING me. Saw a podiatrist, who said my feet are flat and not very flexible (multiple things contribute i guess) , I got custom orthotics, wore a walking boot for 6 weeks, did stretch band exercises at home and it improved. I was able to walk, ride a bike, everything was good within a couple of months.

    5 months later (September 2012), I was stupid and tried to run at the gym, do exercise classes (jumping and impact involved), maybe 5 times in a 15 day period. This completely set me back and probably made me worse than where i was before. I also started a new job and my arch would start to get sore after walking for about 10 minutes. I have to walk 10 minutes each way to the subway everyday and also a good amount of walking around the office, to lunch etc. So In November 2012 I just put the boot back on for a month and tried to do the same recovery method, but this was not finding myself succesfull. I took off the boot in December, but I soon had pain in my arch everyday throughout and after work, in fact the muscle by my arch was an achy knot. My foot felt strong (could stand on toes) but ached all the time. I went to physical therapy for 3 weeks in January 2013, no boot anymore and could do all the exercises, my foot felt strong, but it still ached constantly. I stopped because the pain wasnt going away despite feeling that my foot/ankle was strong.


    In April 2013 I finally got an MRI, which showed mild-moderate tendonitis in the PT area and mild tendonits in the achilles, but i have a perfectly healthy tendon (no tears). I got my orthotic modified so it has a piece below the heel, raising it and with a flat bottom, also stabilizing my heal, and it is slanted to reduce pronating. I was also given 400mg naproxen. The pain killer and new orthotic instantly made everything GREAT, until i stopped using the pain killer. I was only told to take the pain killer for 14 days. The pain came right back. I then got a cortisone shot (near but not in the tendon) which did nothing for me.

    So I put the boot back, I have had it for a month and the aching is getting less and less (since i am putting 80% less pressure on it). I am hoping that the new orthotic will make a difference, but when I got it a month ago, i had significant inflammation, so I am hoping the boot for 45 days will eliminate the inflammation, and allow me to start from a clean slate. I am also wearing a ASO brace before i put the boot on because i still have to do a good amount of walking for work and the boot doesnt eliminate 100% of the pressure on the foot/ankle.

    My question finally, being that i just have inflammation and no tears, and a more stabilizing orthotic,shouldnt just getting rid of the inflammation and strengthening my foot/ankle allow me to walk every day without pain? I was fine until last summer walking around until I tried to run and do high impact activities, then inflammation set in again. Is it as simple as removing the inflammation for me?? My doctor suggested physical therapy again, but I am thinking I should only do that when the inflammation is gone, or else it "pisses off my arch", and the inflammation remains, which is what i felt happened in January with therapy.
    Should i get back on naproxen since it definitely helped - can i take it for a longer period? I dont think 14 days was enough?
    Would surgery help me, having a healthy tendon but once with inflammation? Or is surgery only typically for people with tears?
    Can anyone recommend a NYC surgeon I should talk to?

    Any advice, particularly from people who were able to get better without surgery, would be helpful! Thank you and i wish you all perfect health!
     
  2. PTTDsufferer

    PTTDsufferer New Member

    It wouldnt let me edit so this version might be more legible!!

    Hello,
    I have had PTTD for about 15 months in my right foot. I have very flat feet and have played tennis for years, which i assume might have set me up for this. The last couple of years my right foot would get sore only when running on a treadmill or walk for a long period of time.


    Jan 2012
    I just moved to Manhattan, I had to walk a lot more all of a sudden and was stupid and didnt use arch support. So within 3 weeks my foot was KILLING me. Saw a podiatrist, who said my feet are flat and not very flexible (multiple things contribute i guess) , I got custom orthotics, wore a walking boot for 6 weeks, did stretch band exercises at home and it improved. I was able to walk, ride a bike, everything was good within a couple of months.

    September 2012
    I was stupid and tried to run at the gym, do exercise classes (jumping and impact involved), maybe 5 times in a 15 day period. This completely set me back and probably made me worse than where i was before. I also started a new job and my arch would start to get sore after walking for about 10 minutes. I have to walk 10 minutes each way to the subway everyday and also a good amount of walking around the office, to lunch etc.

    November 2012
    I just put the boot back on for a month and tried to do the same recovery method, but this was not finding myself succesfull. I took off the boot in December but I soon had pain in my arch everyday throughout and after work, in fact the muscle by my arch was an achy knot. My foot felt strong (could stand on toes) but ached all the time.

    January 2013,
    I took off the boot, went to physicaly therapy for 3 weeks and could do all the exercises, my foot felt strong, but it still ached constantly. I stopped because the pain wasnt going away despite feeling that my foot/ankle was strong.


    April 2013
    I finally get an MRI, which showed mild-moderate tendonitis in the PT area and mild tendonits in the achilles, but i have a perfectly healthy tendon (no tears). I got my orthotic modified so it has a piece below the heel, raising it and with a flat bottom, also stabilizing my heal, and it is slanted to reduce pronating. I was also given 400mg naproxen. The pain killer and new orthotic instantly made everything GREAT, until i stopped using the pain killer. I was only told to take the pain killer for 14 days. Afterwards the pain came right back. I then got a cortisone shot (near but not in the tendon) which did nothing for me.

    So I put the boot back, I have had it for a month and the aching is getting less and less (since i am putting 80% less pressure on it). I am hoping that the new orthotic will make a difference, but when I got it a month ago, i had significant inflammation, so I am hoping the boot for 45 days will eliminate the inflammation, and allow me to start from a clean slate. I am also wearing a ASO brace before i put the boot on because i still have to do a good amount of walking for work and the boot doesnt eliminate 100% of the pressure on the foot/ankle.

    My questions finally...
    -Being that i just have inflammation and no tears, and a more stabilizing orthotic,shouldnt just getting rid of the inflammation and strengthening my foot/ankle allow me to walk every day without pain? I was fine until last summer walking around until I tried to run and do high impact activities, then inflammation set in again.

    -Is it as simple as removing the inflammation for me?? My doctor suggested physical therapy again, but I am thinking I should only do that when the inflammation is gone, or else it "pisses off my arch", and the inflammation remains, which is what i felt happened in January with therapy.

    -Should i get back on naproxen since it definitely helped - can i take it for a longer period? I dont think 14 days was enough?

    -Would surgery help me, having a healthy tendon but once with
    inflammation? Or is surgery only typically for people with tears?

    -Can anyone recommend a NYC surgeon I should talk to?

    Any advice, particularly from people who were able to get better without surgery, would be helpful! Thank you and i wish you all perfect health!
     
  3. PTTDsufferer

    PTTDsufferer New Member

    Probably my biggest question, if surgery is unnecessary right now, is should I be focusing on resting my foot completely? or should I be stretching/strengthening it?
     
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