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POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Posted by GLORIA on 2/19/00 at 00:00 (016037)

I HAD A RUPTURED PTT IN MY LEFT FOOT. THE PAIN WAS TERRIBLE. IT TOOK FOUR PODIATRISTS AND TWO ORTHOPEDIC MD'S TO FIND OUT WHAT WAS WRONG IN THE COARSE OF 5YRS.

THE MD I WENT TO IS A SPECIALIST (FOOT&ANKLE) SUPPOSED TO BE THE BEST, IN A TOWN 110 MILES FROM HOME.
THE SURGERY INCLUDED THE REMOVAL OF THE PTT AND GRAFTING TWO SMALLER TENDONS FROM THE OTHER SIDE OF MY FOOT. THE HEEL BONE WAS BROKEN AND MOVED A CENTIMETER AS TO CATCH THE NEW GRAFT, AND A SCREW WAS INSERTED IN THE HEEL TO HOLD IT IN PLACE. I WAS TO BE IN A CAST FOR 6 WEEKS AND A WALKING CAST FOR 6 WEEKS. RECOVERY TIME 4 MONTHS.

WELL IT WAS A YEAR JAN. 25, 2000, AND IF MY FOOT IS ALMOST WORSE OFF THAN IT WAS BEFORE. HE SAID THE TENDONS WEREN'T STONG ENOUGH AND MY FOOT IS COLLAPSING. I HAD TO HAVE THE SCREW REMOVED FROM MY HEEL, IT STARTED BACKING OUT. BUT I AM HAVING SO MUCH PAIN IN MY HEEL, THAT I CAN'T WALK ACROSS THE FOOR BARE FOOTED, AND I HAVE TO SET DOWN TO TAKE A SHOWER.I HAVE HAD ALL TYPES OF THERAPY, I AM IN TWO BRACES ONE ON EACH FOOT . THE RIGHT FOOT IS IN A BRACE AS A PREVENTIVE MEASURE, TO KEEP IT FROM DOING THE SAME THING. I HAVE NOW PLANTER FASCITIST IN IT.

IF THAT WEREN'T BAD ENOUGH BECAUSE OF ALL THE OVER COMPENSATION TO MY RIGHT SIDE, IN ENDED UP WITH A TORN MENNISCUS IN MY RIGHT KNEE.

THE ORTHO FOOT MD SAID THE ONLY THING LEFT TO DO IS A BONE FUSION OF MY FOOT.

I AM SO SICK AND TIRED OF ALL THE CRAP I COULD SCREAM!!! I CAN'T EVEN GET THROUGH THE GROCERY STORE, CLEAN HOUSE,JUST EVERYDAY THINGS.
I HAS REALLY TAKEN A TOLL ON ME AND MY HUSBAND.I HAVE GAINED SOO MUCH WEIGHT BECAUSE OF INACTIVITY. IT HAS BEEN 6 YRS SINCE THIS ALL STARTED.I HAVE SET ON MY BUTT FOR THE PAST YEAR,EITHER IN A CAST AND KEEP IT ELEVATED,NOW IT IS BECAUSE THE PAIN AND SWELLING I ICE ALL THE TIME IT SEEMS IT DOESN'T DO A WHOLE LOT OF GOOD BUT I KEEP DOING IT . HOPING IT MAY HELP.

THIS IS GETTING VERY DEPRESSING. I AM NOT SURE WHAT I AM GOING TO DO NEXT. MY OPTIONS DON'T SEEM TO BE TOO GREAT.

I WAS WONDERING IF ANYONE OUT THERE CAN REMOTELY RELATE TO THIS. OR HAVE HAD PTT SURGERY OR BONE FUSION DONE.

SORRY THIS IS SO LONG BUT THIS IS ONLY PART OF THE PROBLEMS.

THANKS
GLORIA


Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

john h on 2/19/00 at 00:00 (016047)

gloria: sounds like you are in hell! if it were me i would go to place like Mayo or Johns Hopkins and get the best evaluation and advice available from their top Foot and Ankle Surgeon. your problems seem to be beyond a poditrist and i would mortgage my house if that is what it took to make sure i had the very best advice i could find. i have had to frieds (both doctors) who recently had ruptured tendons repaired and replaced. both are runners. one in his late 50's and the other eary 40's. Both are back to running and in excellent shape. another friend fell and she dislocated her elbow. the local doctor screwed up badly and she ended up at Mayo to correct their screwup. Good luck!

Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Mike W on 2/19/00 at 00:00 (016048)

Hi Gloria,

I am sorry you have had such a long and painful problem.

I can't offer any opinion on surgery or bone fusion. I can offer some advice on icing and stretching and strenghtening the muscles of the legs. I have seen several people post about icing for several hours at a time. This is in my opinion (and many Doctors)is wrong and can be counter productive. Ice should never be applied diectly to the skin. It is best to ice several times per day for no longer than 5-10 minutes concentrating on sore spots (not the entire foot) followed by 5-15 minutes of rest.

Casts and inactivity promote muscle atrophy. The only natural way to reduce tension on a tendon is to improve the elasticity (flexibility and strength) of the related and opposing muscles. The Tibialis Posterior Muscle plantar flexes the foot and inverts (points it inward )the foot at the ankle. For the amount of time you have been injured your leg muscles are probably very weak. As you know tendons do not heal very fast however, don't give up because the related muscles can be improved and faster than you may think.

I do not want to come across as a self promoter but I have developed a new devise and technique that helps improve every muscle in the legs called Personal Foot Trainers. I can not say if they would be appropiate for you but maybe you could show the information to your doctors or physiotherapist for their opinion. Scott has given me a web page http://www.heelspurs.com/a/pft/ which describes it.

One of my clients has been in a wheel chair for 10 years and had no movement or muscle tone in his left leg when I began working with him. After a few months we started seeing major improvements and he is now up in a walker several times per week with a goal (and hope)of walking again.

I hope this information helps and that you can find a solution.

Mike W



Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Dr. Zuckerman on 2/19/00 at 00:00 (016063)

Why it tooks so long to dx your problem is beyond me. It usually takes about ten minutes for a dx. The problem is that you need to know how to look for this.

The surgery you had seems to have failed completely. A fusion is what is next for you. You need to find a doctor that does alot of this tyope of problem. In my practice I have two PODIATRIC FOOT SURGEONS wwwwho trained at the University of Pa. for four yours. Did you know that most MD FOOT AND ANKLE SURGEONS have only an additional six monts of training in the foot and ankle in addition to the three or four years of other training. I have no idea where you live so I can't recommend anyone for you.


Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

GLORIA on 2/19/00 at 00:00 (016069)

HE IS LAOCATED IN INDIANAPOLIS. I HAVE TO TRAVEL TO INDY TO GET A FOOT AND ANKLE SPECIALIST.
IN YOUR OPINION WILL THE FUSION ELEMENATE ALL THIS PAIN I AM NOW HAVING, AND HOW LIMITED WOULD IT MAKE ME?
I AM STARTING TO HAVE A GREAT DEAL OF PROBLEMS WITH THE FACIA IN MY OTHER FOOT, IF SOMETHING DOESN'T GIVE SOON I AM GOING TO BE IN A WHEELCHAIR.
THANKS, GLORIA

Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Wendy S on 2/22/00 at 00:00 (016215)

Please describe or provide an illustration of this injury. I have gone from plantar fas. to a heel spur and now while playing basketball hurt my heel worse. It feels as if I have tore or ripped something from my arch thru to my heel. The DR thinks it is achilles tendonitis but I believe it is something to do with my heel.

Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

john h on 2/19/00 at 00:00 (016047)

gloria: sounds like you are in hell! if it were me i would go to place like Mayo or Johns Hopkins and get the best evaluation and advice available from their top Foot and Ankle Surgeon. your problems seem to be beyond a poditrist and i would mortgage my house if that is what it took to make sure i had the very best advice i could find. i have had to frieds (both doctors) who recently had ruptured tendons repaired and replaced. both are runners. one in his late 50's and the other eary 40's. Both are back to running and in excellent shape. another friend fell and she dislocated her elbow. the local doctor screwed up badly and she ended up at Mayo to correct their screwup. Good luck!

Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Mike W on 2/19/00 at 00:00 (016048)

Hi Gloria,

I am sorry you have had such a long and painful problem.

I can't offer any opinion on surgery or bone fusion. I can offer some advice on icing and stretching and strenghtening the muscles of the legs. I have seen several people post about icing for several hours at a time. This is in my opinion (and many Doctors)is wrong and can be counter productive. Ice should never be applied diectly to the skin. It is best to ice several times per day for no longer than 5-10 minutes concentrating on sore spots (not the entire foot) followed by 5-15 minutes of rest.

Casts and inactivity promote muscle atrophy. The only natural way to reduce tension on a tendon is to improve the elasticity (flexibility and strength) of the related and opposing muscles. The Tibialis Posterior Muscle plantar flexes the foot and inverts (points it inward )the foot at the ankle. For the amount of time you have been injured your leg muscles are probably very weak. As you know tendons do not heal very fast however, don't give up because the related muscles can be improved and faster than you may think.

I do not want to come across as a self promoter but I have developed a new devise and technique that helps improve every muscle in the legs called Personal Foot Trainers. I can not say if they would be appropiate for you but maybe you could show the information to your doctors or physiotherapist for their opinion. Scott has given me a web page http://www.heelspurs.com/a/pft/ which describes it.

One of my clients has been in a wheel chair for 10 years and had no movement or muscle tone in his left leg when I began working with him. After a few months we started seeing major improvements and he is now up in a walker several times per week with a goal (and hope)of walking again.

I hope this information helps and that you can find a solution.

Mike W



Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Dr. Zuckerman on 2/19/00 at 00:00 (016063)

Why it tooks so long to dx your problem is beyond me. It usually takes about ten minutes for a dx. The problem is that you need to know how to look for this.

The surgery you had seems to have failed completely. A fusion is what is next for you. You need to find a doctor that does alot of this tyope of problem. In my practice I have two PODIATRIC FOOT SURGEONS wwwwho trained at the University of Pa. for four yours. Did you know that most MD FOOT AND ANKLE SURGEONS have only an additional six monts of training in the foot and ankle in addition to the three or four years of other training. I have no idea where you live so I can't recommend anyone for you.


Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

GLORIA on 2/19/00 at 00:00 (016069)

HE IS LAOCATED IN INDIANAPOLIS. I HAVE TO TRAVEL TO INDY TO GET A FOOT AND ANKLE SPECIALIST.
IN YOUR OPINION WILL THE FUSION ELEMENATE ALL THIS PAIN I AM NOW HAVING, AND HOW LIMITED WOULD IT MAKE ME?
I AM STARTING TO HAVE A GREAT DEAL OF PROBLEMS WITH THE FACIA IN MY OTHER FOOT, IF SOMETHING DOESN'T GIVE SOON I AM GOING TO BE IN A WHEELCHAIR.
THANKS, GLORIA

Re: POSTERIOR TIBIAL TENDON RUPTURE AND SURGERY

Wendy S on 2/22/00 at 00:00 (016215)

Please describe or provide an illustration of this injury. I have gone from plantar fas. to a heel spur and now while playing basketball hurt my heel worse. It feels as if I have tore or ripped something from my arch thru to my heel. The DR thinks it is achilles tendonitis but I believe it is something to do with my heel.