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Tendonitis, not PF??

Posted by Brandon E on 4/06/01 at hrmin (043837)

Hi. I have had pain in the central arches of both feet for 16 months. The pain is NOT greatest in the morning, but rather my feet feel best in the morning and worse as I am on my feet. I have stopped running and tried all conservative treatments (ice, stretching, custom orthotics, taping, rest, ibuprofen) with absolutely no improvement. X-Rays showed negative for bone spurs. MRI showed negative for fascia problems, although the doctor noted that a tendon (I think it is the posterior tibial tendon) was slightly smaller than normal. The doctor diagnosed me with 'tendonitis' and prescribed physical therapy. The physical therapy didn't help. One other interesting thing. My feet hurt even if I have been sitting for an hour or two.

Can you give me any direction? I am suffering and have pretty much been told that I will live in pain for the rest of my life. Could this be true?

Thank you very much. Brandon E

Re: Tendonitis, not PF??

Dr. Zuckerman on 4/06/01 at 13:15 (043838)

A life time of pain isn't a good picture. Could you give Dr. Z more information .

Re: Tendonitis, not PF??

Brandon E on 4/06/01 at hrmin (043844)

Dr. Z., I would be happy to give you more information. I'll give you info that I think is important, but please ask me for other info if I haven't supplied enough.

I used to run 20-30 miles per week. Even though I was in good shape, I weighed 190 lbs at 5'11' (I'm stocky). I was preparing for a 13 mile race so I somewhat sharply increased my training the weeks before the race. I ran the 13 mile race well and with no pain. The next day I had my first foot pain (in the central arch of my right foot). That was Nov. 1997. I iced, took ibuprofen, rested, and was back running pain free in a few months. One year later (Nov. 1998), the pain returned. I did the same treatment and was back running again in a few months. One year later (Nov. 1999), the pain returned. I did the usual treatment, but this time, the pain was here to stay (and still is here). I haven't run in 16 months or so and have done all of the typical treatments for PF (with absolutely no results).

The pain can be described as an almost burning pain in the central portion of both arches. I feel best in the morning and worse as the day goes on. It hurts most if I go to the grocery store or a video store (where I am standing for a while). I have a desk job and do little walking at work. Surprisingly, my feet will hurt while I have been sitting for an hour or so.

My feet are size 12 and 4E width. My arches are 'normal' (not flat, not high). I have been wearing orthotics for a year and they have not helped at all.

I'm not sure what other info to give you, and I realize you are limited since you can not see me. Pleas let me know if there is any other info that can be of help.

Thank you,

Brandon E

Re: Tendonitis, not PF??

wendyn on 4/06/01 at 13:50 (043845)

Brandon - does your pain move up into your ankles or lower legs? Any numbness or tingling in your legs or feet?

Re: Tendonitis, not PF??

Brandon E on 4/06/01 at hrmin (043846)

I have no pain in the ankles and lower legs. I have no tingling in my legs or feet. But I would describe the arch pain as kind of a burning pain.

Brandon E

Re: Tendonitis, not PF??

Dr. Zuckerman on 4/07/01 at 14:12 (043929)

Hi,
It sure sounds like posterior tibial tendon injury or dysfunction. If this is in a chronic stage and braces or orthosis haven't helped then surgery to repair the tendon needs to be looked into.

Has any one suggested that the tendon needs repair. Sometime the tendon covering is damaged and not the tendon.

Re: Tendonitis, not PF??

Brandon E on 4/09/01 at hrmin (044094)

I have seen an ortho. surgeon for this ailment and he did not suggest surgery. He presribed physical therapy for it. The physical therapists had me do some calf stretching and excercises that seemed to work out (and irritate) the tendon. I stopped doing the excercises because I was not sure if they were beneficial or detremental.

I am a little confused about what type of doctor is the correct one to see for foot ailments - a podiatrist or an orthopedic surgeon. I know that the competence of the doctor is very important, but who do you believe is better qualified to handle this situation, a good podiatrist or a good orthopedic surgeon?

I live in the Fort Worth/Dallas area if you happen to know of anyone good down here.

Thanks Dr. Z.

Re: Tendonitis, not PF??

Dr. Zuckerman on 4/09/01 at 17:09 (044111)

I will ask people on this board for a recommendation in your area. You need either a board certified foot and ankle orthopedic doc or a three year trained board certified podiatric foot and ankle specialist.

Re: Tendonitis, not PF??

Dr. Zuckerman on 4/06/01 at 13:15 (043838)

A life time of pain isn't a good picture. Could you give Dr. Z more information .

Re: Tendonitis, not PF??

Brandon E on 4/06/01 at hrmin (043844)

Dr. Z., I would be happy to give you more information. I'll give you info that I think is important, but please ask me for other info if I haven't supplied enough.

I used to run 20-30 miles per week. Even though I was in good shape, I weighed 190 lbs at 5'11' (I'm stocky). I was preparing for a 13 mile race so I somewhat sharply increased my training the weeks before the race. I ran the 13 mile race well and with no pain. The next day I had my first foot pain (in the central arch of my right foot). That was Nov. 1997. I iced, took ibuprofen, rested, and was back running pain free in a few months. One year later (Nov. 1998), the pain returned. I did the same treatment and was back running again in a few months. One year later (Nov. 1999), the pain returned. I did the usual treatment, but this time, the pain was here to stay (and still is here). I haven't run in 16 months or so and have done all of the typical treatments for PF (with absolutely no results).

The pain can be described as an almost burning pain in the central portion of both arches. I feel best in the morning and worse as the day goes on. It hurts most if I go to the grocery store or a video store (where I am standing for a while). I have a desk job and do little walking at work. Surprisingly, my feet will hurt while I have been sitting for an hour or so.

My feet are size 12 and 4E width. My arches are 'normal' (not flat, not high). I have been wearing orthotics for a year and they have not helped at all.

I'm not sure what other info to give you, and I realize you are limited since you can not see me. Pleas let me know if there is any other info that can be of help.

Thank you,

Brandon E

Re: Tendonitis, not PF??

wendyn on 4/06/01 at 13:50 (043845)

Brandon - does your pain move up into your ankles or lower legs? Any numbness or tingling in your legs or feet?

Re: Tendonitis, not PF??

Brandon E on 4/06/01 at hrmin (043846)

I have no pain in the ankles and lower legs. I have no tingling in my legs or feet. But I would describe the arch pain as kind of a burning pain.

Brandon E

Re: Tendonitis, not PF??

Dr. Zuckerman on 4/07/01 at 14:12 (043929)

Hi,
It sure sounds like posterior tibial tendon injury or dysfunction. If this is in a chronic stage and braces or orthosis haven't helped then surgery to repair the tendon needs to be looked into.

Has any one suggested that the tendon needs repair. Sometime the tendon covering is damaged and not the tendon.

Re: Tendonitis, not PF??

Brandon E on 4/09/01 at hrmin (044094)

I have seen an ortho. surgeon for this ailment and he did not suggest surgery. He presribed physical therapy for it. The physical therapists had me do some calf stretching and excercises that seemed to work out (and irritate) the tendon. I stopped doing the excercises because I was not sure if they were beneficial or detremental.

I am a little confused about what type of doctor is the correct one to see for foot ailments - a podiatrist or an orthopedic surgeon. I know that the competence of the doctor is very important, but who do you believe is better qualified to handle this situation, a good podiatrist or a good orthopedic surgeon?

I live in the Fort Worth/Dallas area if you happen to know of anyone good down here.

Thanks Dr. Z.

Re: Tendonitis, not PF??

Dr. Zuckerman on 4/09/01 at 17:09 (044111)

I will ask people on this board for a recommendation in your area. You need either a board certified foot and ankle orthopedic doc or a three year trained board certified podiatric foot and ankle specialist.