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Posterior tibial tendon rupture?

Posted by Brenda G. on 6/07/01 at hrmin (050209)

Hi. After 8 months of PF with very little improvement (4 docs, ice, Nsaids, taping, stretching, orthotics), I was told today that I perhaps had ruptured my posterior tibial tendon instead of the fascia several months ago, and have been suggested to get MRI. Can anyone explain the difference in the symptoms I would have had if it had been the tendon instead of the fascia? I was also told for the first time that I will always have this flat-footed feeling and not regain the spring to my walk. I cried. Walking has always been my love, for stress reduction, weight control and pleasure. Can anyone give me any hope and/or experiences in this same problem? Thanks so much for any responses. Brenda

Re: Posterior tibial tendon rupture?

wendyn on 6/07/01 at 22:07 (050210)

I am not a doctor - I always thought that with a post tib rupture - you would not be able to stand on your toes (this was always something doctors have checked right away with me).

Can you stand on your toes?

Re: Posterior tibial tendon rupture?

Brenda G. on 6/07/01 at 22:14 (050212)

Hi. Thanks for answering so quickly. As for the toes, I was asked to do that back in January when I saw an orthopedic surgeon, I tried to comply and the pain was so severe that it was impossible. It is possible now to rock forward to the balls of my feet and get close to standing on the toes without too much discomfort. What do you think? Thanks again. Brenda

Re: Posterior tibial tendon rupture?

wendyn on 6/07/01 at 22:29 (050215)

I dunno - I'm not a doctor so what I think doesn't carry too much weight.

I have feet that are progressively flattening out - I've been having trouble (mainly with the right) since I was 11. (I'm 32).

I can still stand on my toes easily though.

Hmmmm. When's your MRI?

Re: Posterior tibial tendon rupture?

Brenda G. on 6/07/01 at hrmin (050216)

I'm seeing my podiatrist on Monday to discuss it. I've been using orthotics for 2 months and the nurse said it was probably time for an evaluation on its effect. I am a little better but still on Nsaids continuosly, and in constant pain, of course I stand 12 hours a day which is a problem. I've starting taping for the last 2 weeks and that seems to help me to get through the day. I tried taping months ago as suggested on this site, but until recently it seemed to increase the pain and inflammation. My 'standing' pain has decreased but my 'walking' pain is not much better at all. I find it hard to go 50 feet or more. Thanks again. Brenda

Re: Posterior tibial tendon rupture?

wendyn on 6/07/01 at 22:49 (050217)

Wow Brenda. If I had to stand on my feet for 12 hours I would be DEAD.

Seriously.

For me walking is easier than standing. I don't know if someone with a ruptured post tib tendon could stand for 12 hours a day. Doesn't sound logical does it?

Re: Posterior tibial tendon rupture?

Brenda G. on 6/07/01 at 23:02 (050218)

I thought the same thing. This tendon rupture theory was suggested by a podiatrist on the USA-Today podiatry helpline held today. He suggested the MRI and brought up the tendon thing, because of my slow recovery. I hope he's wrong.

Re: Posterior tibial tendon rupture?

Julie on 6/08/01 at 08:21 (050248)

Brenda, what is your job? I'm sure you've thought of this, but isn't there some way you could cut down on those 12 standing hours?

Is the taping giving you some relief now? it does take time to get the tension right. Perhaps you were pulling it too tight before.

Re: Posterior tibial tendon rupture?

Julie on 6/08/01 at 08:22 (050249)

I expect he is wrong. I don't see how you could possibly stand on your feet for so long it you had a ruptured tendon. Hope for the best.

Re: Posterior tibial tendon rupture?

JudyS on 6/08/01 at 12:25 (050273)

Brenda, the thing is that, if you stand for 12-hour days, you will quite likely not get better. That's the toughest pill of all to swallow but it's the sad reality for foot-pain sufferers. Many folks here have jobs like yours - ones that demand standing or walking all day and some have simply been forced to seriously consider either altering their job or changing jobs. I'm so surprised that your doc even lets you go to a job like that and still expects you to recover....to the PF/TTS educated here, that makes no sense.

Re: Posterior tibial tendon rupture?

Brenda G. on 6/08/01 at 22:04 (050305)

Hi.Thanks to you both for responding. I just got home from another 12 hour day. My job is that of a pharmacist. That is why I'm standing so much. My sister, a pharmacist also, had PF a year ago and recovered in a couple of months with motrin and Birkenstocks. I believe the difference for her is that she has an 8 hour shift instead of 12. I also attribute the tenacity of my case to the fact that after working 12 hours, I would return home and get up several times a night with my mother who was at my home under hospice care. I don't think my feet were getting any rest from one day to the next. Of course every doc I've seen has stated that I should take 6 weeks off but it's an impossiblity. I do agree that it seems impossible for me to do even what I do, even though I'm in pain, if I had a ruptured tendon. My greatest pain now is in the arch, I feel like I'm standing on a bar. Does this sound like normal PF pain? I feel flat footed, no spring, and I limp, doesn't that feel like normal PF pain also? Thanks again.

Re: Posterior tibial tendon rupture?

Dr. Marlene Reid on 6/08/01 at 22:13 (050308)

Rupture of the tendon is often misdiagnosed for PF. The pain is usually in the arch and goes towards the medial heel, where PF is ususally felt. Most people have partial ruptures, so it would be possible to stand on your toes. An MRI that is read by someone experienced with foot MRI's is the best way to diagnosis it. Treatment would depend on the severity of the tear, if present. Some form of immobilization will likely be required.

Re: Posterior tibial tendon rupture?

Brenda G. on 6/08/01 at 22:27 (050309)

Thanks again. I see my podiatrist Monday afternoon. I'll post after that.

Re: Posterior tibial tendon rupture?

josh s on 6/09/01 at hrmin (050312)

HI Brenda,

You might like to search this site under posterior tibial, there's quite a bit of anecdotal and medical info onboard.

I've done a little research on posterior tendon rupture and the 'disease' called posterior tibial dysfunction. This dysfunction apparently has 4 stages, rupture is stage 4. It is my understanding that if you have ruptured and attempt to stand on you toes on one foot you will fail.

I listed five good web pages on posterior tibial dysfunction on the treatment/symptoms section recently. Go there, go to the fourth next set of messages under 'I don't know' by Wendyn, follow the thread to the end and open 'Re:I don't know' by josh s.

I emailed a doctor Terry Mueller from St. Louis who specializes in PTD recently and he told me that he was happy to discuss PTD with anyone at any time. I'll post again on this thread with his e-mail.

Re: Posterior tibial tendon rupture?

Julie on 6/09/01 at 00:40 (050313)

Oh, Brenda, please don't say that it's impossible for you to take time off your job, because that is what you really need to do. I agree with Judy that you can't get better if you continue as you are, and you are risking a long-term, chronic disability with the attendant possibility that you may have to give up work altogether: it has happened. I urge you to consider how to get a good long rest from standing all day: sick leave? Temporary disability? Do think about it.

Re: Posterior tibial tendon rupture?

wendyn on 6/07/01 at 22:07 (050210)

I am not a doctor - I always thought that with a post tib rupture - you would not be able to stand on your toes (this was always something doctors have checked right away with me).

Can you stand on your toes?

Re: Posterior tibial tendon rupture?

Brenda G. on 6/07/01 at 22:14 (050212)

Hi. Thanks for answering so quickly. As for the toes, I was asked to do that back in January when I saw an orthopedic surgeon, I tried to comply and the pain was so severe that it was impossible. It is possible now to rock forward to the balls of my feet and get close to standing on the toes without too much discomfort. What do you think? Thanks again. Brenda

Re: Posterior tibial tendon rupture?

wendyn on 6/07/01 at 22:29 (050215)

I dunno - I'm not a doctor so what I think doesn't carry too much weight.

I have feet that are progressively flattening out - I've been having trouble (mainly with the right) since I was 11. (I'm 32).

I can still stand on my toes easily though.

Hmmmm. When's your MRI?

Re: Posterior tibial tendon rupture?

Brenda G. on 6/07/01 at hrmin (050216)

I'm seeing my podiatrist on Monday to discuss it. I've been using orthotics for 2 months and the nurse said it was probably time for an evaluation on its effect. I am a little better but still on Nsaids continuosly, and in constant pain, of course I stand 12 hours a day which is a problem. I've starting taping for the last 2 weeks and that seems to help me to get through the day. I tried taping months ago as suggested on this site, but until recently it seemed to increase the pain and inflammation. My 'standing' pain has decreased but my 'walking' pain is not much better at all. I find it hard to go 50 feet or more. Thanks again. Brenda

Re: Posterior tibial tendon rupture?

wendyn on 6/07/01 at 22:49 (050217)

Wow Brenda. If I had to stand on my feet for 12 hours I would be DEAD.

Seriously.

For me walking is easier than standing. I don't know if someone with a ruptured post tib tendon could stand for 12 hours a day. Doesn't sound logical does it?

Re: Posterior tibial tendon rupture?

Brenda G. on 6/07/01 at 23:02 (050218)

I thought the same thing. This tendon rupture theory was suggested by a podiatrist on the USA-Today podiatry helpline held today. He suggested the MRI and brought up the tendon thing, because of my slow recovery. I hope he's wrong.

Re: Posterior tibial tendon rupture?

Julie on 6/08/01 at 08:21 (050248)

Brenda, what is your job? I'm sure you've thought of this, but isn't there some way you could cut down on those 12 standing hours?

Is the taping giving you some relief now? it does take time to get the tension right. Perhaps you were pulling it too tight before.

Re: Posterior tibial tendon rupture?

Julie on 6/08/01 at 08:22 (050249)

I expect he is wrong. I don't see how you could possibly stand on your feet for so long it you had a ruptured tendon. Hope for the best.

Re: Posterior tibial tendon rupture?

JudyS on 6/08/01 at 12:25 (050273)

Brenda, the thing is that, if you stand for 12-hour days, you will quite likely not get better. That's the toughest pill of all to swallow but it's the sad reality for foot-pain sufferers. Many folks here have jobs like yours - ones that demand standing or walking all day and some have simply been forced to seriously consider either altering their job or changing jobs. I'm so surprised that your doc even lets you go to a job like that and still expects you to recover....to the PF/TTS educated here, that makes no sense.

Re: Posterior tibial tendon rupture?

Brenda G. on 6/08/01 at 22:04 (050305)

Hi.Thanks to you both for responding. I just got home from another 12 hour day. My job is that of a pharmacist. That is why I'm standing so much. My sister, a pharmacist also, had PF a year ago and recovered in a couple of months with motrin and Birkenstocks. I believe the difference for her is that she has an 8 hour shift instead of 12. I also attribute the tenacity of my case to the fact that after working 12 hours, I would return home and get up several times a night with my mother who was at my home under hospice care. I don't think my feet were getting any rest from one day to the next. Of course every doc I've seen has stated that I should take 6 weeks off but it's an impossiblity. I do agree that it seems impossible for me to do even what I do, even though I'm in pain, if I had a ruptured tendon. My greatest pain now is in the arch, I feel like I'm standing on a bar. Does this sound like normal PF pain? I feel flat footed, no spring, and I limp, doesn't that feel like normal PF pain also? Thanks again.

Re: Posterior tibial tendon rupture?

Dr. Marlene Reid on 6/08/01 at 22:13 (050308)

Rupture of the tendon is often misdiagnosed for PF. The pain is usually in the arch and goes towards the medial heel, where PF is ususally felt. Most people have partial ruptures, so it would be possible to stand on your toes. An MRI that is read by someone experienced with foot MRI's is the best way to diagnosis it. Treatment would depend on the severity of the tear, if present. Some form of immobilization will likely be required.

Re: Posterior tibial tendon rupture?

Brenda G. on 6/08/01 at 22:27 (050309)

Thanks again. I see my podiatrist Monday afternoon. I'll post after that.

Re: Posterior tibial tendon rupture?

josh s on 6/09/01 at hrmin (050312)

HI Brenda,

You might like to search this site under posterior tibial, there's quite a bit of anecdotal and medical info onboard.

I've done a little research on posterior tendon rupture and the 'disease' called posterior tibial dysfunction. This dysfunction apparently has 4 stages, rupture is stage 4. It is my understanding that if you have ruptured and attempt to stand on you toes on one foot you will fail.

I listed five good web pages on posterior tibial dysfunction on the treatment/symptoms section recently. Go there, go to the fourth next set of messages under 'I don't know' by Wendyn, follow the thread to the end and open 'Re:I don't know' by josh s.

I emailed a doctor Terry Mueller from St. Louis who specializes in PTD recently and he told me that he was happy to discuss PTD with anyone at any time. I'll post again on this thread with his e-mail.

Re: Posterior tibial tendon rupture?

Julie on 6/09/01 at 00:40 (050313)

Oh, Brenda, please don't say that it's impossible for you to take time off your job, because that is what you really need to do. I agree with Judy that you can't get better if you continue as you are, and you are risking a long-term, chronic disability with the attendant possibility that you may have to give up work altogether: it has happened. I urge you to consider how to get a good long rest from standing all day: sick leave? Temporary disability? Do think about it.