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TTS/PF Patient Completes Triathlon 6 Months Post-Op

Posted by Scott2 on 7/30/01 at 12:11 (054811)

Hello Everyone,

I just wanted to hopefully provide some encouragement for all of you and let you know that I completed a short triathlon this past weekend that included a 5K run. (OK, I did a walk/run and moved slowly, but I made it.)

On February 16, 2001, I had surgery for TTS (distal) and PF. I have gone through what many of you have gone through or are going through. As to the severity of my condition, I cannot compare it to others because it is different for all of us.

But I can tell you that I went through every non-invasive treatment before surgery and dealt with this condition for two years. Very frustrating.

We all have different goals of getting back to 'normal.' For me, it was being able to compete in triathlons again as well as just being able to walk without pain or go hiking again.

Whatever your goal is, don't give up - keep working hard - and you can make it. I am not out of the woods and I do self-therapy every day including lots of stretching, icing, massage, heat, and strengthening. I still have weird days with my foot, but the pain is nothing compared prior to surgery so for me, it worked.

I just wanted to let you all know that there is a light at the end of what sometimes feels like an endless tunnel. I see many of your posts and read (and feel) many of your emotions.

This is an extremely challenging condition to deal with on a daily basis because we get so many conflicting messages from our doctors and the pain won't go away. There is no one way to cure it and it's different for each one of us.

Hang in there. If any of you have any questions for me, please feel free to ask, I will be more than happy to provide feedback.

Thanks to everyone on this message board - past and present for your support. I will continue to check and let you know how I am doing.

- Scott

Re: Distal TTS questions

Matt L on 7/30/01 at 16:27 (054839)

Scott, congratulations and I hope you continue to improve.

A question, you mention 'distal' tts. Where exactly is/was your pain? Was it a result of entrapment of the lateral plantar nerve? Where was the incision made during your surgery? I may have similiar problem.

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

wendyn on 7/30/01 at 22:21 (054883)

Congratulations Scott!!!

I am very happy for you, and particularly pleased that you continue to pop in and offer some encouragement!

Re: Distal TTS questions

Scott2 on 7/31/01 at hrmin (054893)

Matt,

My pain was all over the foot, but mainly the heel. I went through a 12 months of treatment for plantar fascitis until I saw another doctor and the nerves were called into play.

I could not walk for any length of time and it would flare up. I had little or no pain in the morning - resting helped it - which is the opposite of many people that sleep through the night and get really tight from plantar fascitis.

I had orthotics, two cortisone shots about nine months apart, stretching, ice, casting, cam-walker, night splint, orthotic adjustments, $500 worth of shoe purchases in search of relief, lots of ibuprofen, and the list goes on...

A distal tarsal tunnel release, and I'm not a doctor so bear with me, is a release (decompression) of the posteriot tibial nerve as it passes through the tarsal tunnel. Distal refers to the location from its origin (like your fingers are distal to your elbow).

The surgery was about a three inch incision on the medial (inside) aspect of the foot posterior (behind and below) to the ankle at an angle. When it was exposed, my doctor said it was definitely entrapped.

I had the plantar fascia release done also because there is a higher percentage for recovery and hey, might as well snip it while it's exposed. Actually it was the other way around as first only a plantar fascia release was going to be done, but it was obviously more than that.

So I do not have the really long scar that others have mentioned as the area of concentration was low in the foot (hence the word distal again).

Try this link out to read a little more in summary format. Much of what is presented here is exactly what I experienced as well as the various method of treatments used prior to surgery:

http://www.aofas.org/00summer/200007130735.asp

And as it also mentions, I still have weird foot feelings. I know it's early for my recovery, but I do not know if that will ever go away. I stretch and ice everyday and probably will for many years to come.

I have a not-so-great picture of the scar that I could scan and send to you if you want to see where the incision was made. It is a little blurry and close-up since I took it myself, but it may help you. Let me know via email if you want it and I will dig it out.

- s

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

Julie on 7/31/01 at 02:56 (054903)

Scott2, thanks so much for telling us your terrific success story. I'm very glad for you!

Scott 1, if you're listening, maybe the Success Stories board needs more prominent flagging? Scott2's story - and several others that have been posted recently - really belong there.

Re: Success Stories

Scott R on 7/31/01 at 06:33 (054909)

If ya'll could highlight, copy, and paste the success/failure/horror stories over to that message board when you see them I would appreciate it.

Re: Success Stories

Julie on 7/31/01 at 06:56 (054910)

Will do, Scott. That's a good idea. I'm pasting Scott2's as we speak.

Re: Disappeared!

Julie on 7/31/01 at 07:00 (054911)

No I'm not! The Success/Horror Stories board is gone!

Re: Distal TTS questions

Matt L on 7/31/01 at 07:29 (054913)

Thanks for the information Scott. My situation is and isn't similiar. I had a TTS release in '96 (pain was primarily medial) and a partial plantar fasciotomy in '99. The past year, oddly, I've had nerve pain laterally (on the outside of my right foot in front of the heel to the toes, and to a lesser degree on the lateral side of the ankle). Surgeon feels it could be the lateral plantar nerve, or one of its branches. So, I'd like to find someone who has had a confirmed case that is similiar. Continued good luck with your recovery.

Re: hate that run/walk crowd :-) More details on distal.

elliott on 7/31/01 at 07:47 (054916)

Just a joke from an injured runner hoping to get back one day. Congrats!! Must have felt really good. Really happy for you. Hope you can keep it up. Just a warning: please don't come back too fast, as, aside from the usual residual symptoms, recurrence of TTS problems can't be ruled out.

On a technical note, I believe a distal TTS release actually would be past the distal end of the tarsal tunnel, as the 'release (decompression) of the posterior tibial nerve as it passes through the tarsal tunnel' is a description of the standard release. There is a technical definition of what exactly the tarsal tunnel is, and while I don't have it handy (if someone's really interested, I'll dig it up), I recall it's the area bounded by the flexor retinaculum (also called the laciniate ligament, with a few permutations as to its spelling) forming the roof and the key tissue released, the calcaneus and ankle bone, and a tendon or two. The standard release would start at the top of the tunnel and extend a bit past it, to cover the three branches of the posterior tibial nerve as it splits in or near the tunnel. The scar would be kind of a curved L-shape running behind and below the ankle. Even the standard release would typically go a bit past the tunnel in order to ensure release of things like the first branch of the lateral plantar nerve. 'Distal' would imply a release even further along one of the branches (e.g. medial plantar nerve if incision is further along medial part of foot, or lateral plantar nerve if incision travels under the foot). There's also the medial calcaneal nerves heading to the heel, but when they alone are released orthos usally give that its own name rather than call it distal.

Re: Distal TTS questions

eileenc on 7/31/01 at 11:32 (054964)

It's great to hear about successful outcomes!

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

Jana on 7/31/01 at hrmin (055002)

Really glad to hear how well you are doing. It does us wonders to hear one positive story.

Who did you surgery a podiatrist orthopedic? Can you tell me a little bit about your postop experience? I have bilateral carpal tunnel and am concerned about using a wheelchair or crutches after surgery. I will not be able to use either because of the required use of my hands. How long was it before you could hobble to the bathroom? (Really I'm only concerned about the minimum life requirements at this point. :-) ) how long was it before you could really bear weight and get around enough to live your regular life? Prior to surgery how long could you stand without pain? Did you have pain on the inside of your ankles as well as on the bottom of your feet? Was the inside ankle pain worse at night/first thing in the morning?

Did your symptoms change over the two years? When I was first diagnosed, I had only plantar fascia pain. Six months or so ago (a year and half after the initial diagnosis of PF) I started having inside ankle pain and requested an NCS which came back positive. The doctors seem to be conflicted as to which surgery to do, PF release or TTS release. How did you make that decision? Finally, how long was that postop before you knew the surgery was a success?

Where you live and who did your surgery?

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

JudyS on 7/31/01 at 19:08 (055005)

Jana, have you decided to do the surgery?
Who, what, when, where? ! ?

Re: Distal TTS questions

Betty on 8/01/01 at 16:29 (055121)

Eileenc,How long did it take for you to get full recovery?

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

MikeC on 8/06/01 at hrmin (055645)

Hi Scott,

I've just been diagnosed with TTS and am weighing my alternatives. I'm a tennis player and golfer, and from what I've heard re this condition, I'm through with those sports, forever. Of course, I'm very depressed. Any words of wisdom or advice to the newly afflicted.

MikeC

Re: don't give up unless surgery fails

elliott on 8/06/01 at 14:34 (055651)

and then don't give up.

Re: Distal TTS questions

Matt L on 7/30/01 at 16:27 (054839)

Scott, congratulations and I hope you continue to improve.

A question, you mention 'distal' tts. Where exactly is/was your pain? Was it a result of entrapment of the lateral plantar nerve? Where was the incision made during your surgery? I may have similiar problem.

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

wendyn on 7/30/01 at 22:21 (054883)

Congratulations Scott!!!

I am very happy for you, and particularly pleased that you continue to pop in and offer some encouragement!

Re: Distal TTS questions

Scott2 on 7/31/01 at hrmin (054893)

Matt,

My pain was all over the foot, but mainly the heel. I went through a 12 months of treatment for plantar fascitis until I saw another doctor and the nerves were called into play.

I could not walk for any length of time and it would flare up. I had little or no pain in the morning - resting helped it - which is the opposite of many people that sleep through the night and get really tight from plantar fascitis.

I had orthotics, two cortisone shots about nine months apart, stretching, ice, casting, cam-walker, night splint, orthotic adjustments, $500 worth of shoe purchases in search of relief, lots of ibuprofen, and the list goes on...

A distal tarsal tunnel release, and I'm not a doctor so bear with me, is a release (decompression) of the posteriot tibial nerve as it passes through the tarsal tunnel. Distal refers to the location from its origin (like your fingers are distal to your elbow).

The surgery was about a three inch incision on the medial (inside) aspect of the foot posterior (behind and below) to the ankle at an angle. When it was exposed, my doctor said it was definitely entrapped.

I had the plantar fascia release done also because there is a higher percentage for recovery and hey, might as well snip it while it's exposed. Actually it was the other way around as first only a plantar fascia release was going to be done, but it was obviously more than that.

So I do not have the really long scar that others have mentioned as the area of concentration was low in the foot (hence the word distal again).

Try this link out to read a little more in summary format. Much of what is presented here is exactly what I experienced as well as the various method of treatments used prior to surgery:

http://www.aofas.org/00summer/200007130735.asp

And as it also mentions, I still have weird foot feelings. I know it's early for my recovery, but I do not know if that will ever go away. I stretch and ice everyday and probably will for many years to come.

I have a not-so-great picture of the scar that I could scan and send to you if you want to see where the incision was made. It is a little blurry and close-up since I took it myself, but it may help you. Let me know via email if you want it and I will dig it out.

- s

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

Julie on 7/31/01 at 02:56 (054903)

Scott2, thanks so much for telling us your terrific success story. I'm very glad for you!

Scott 1, if you're listening, maybe the Success Stories board needs more prominent flagging? Scott2's story - and several others that have been posted recently - really belong there.

Re: Success Stories

Scott R on 7/31/01 at 06:33 (054909)

If ya'll could highlight, copy, and paste the success/failure/horror stories over to that message board when you see them I would appreciate it.

Re: Success Stories

Julie on 7/31/01 at 06:56 (054910)

Will do, Scott. That's a good idea. I'm pasting Scott2's as we speak.

Re: Disappeared!

Julie on 7/31/01 at 07:00 (054911)

No I'm not! The Success/Horror Stories board is gone!

Re: Distal TTS questions

Matt L on 7/31/01 at 07:29 (054913)

Thanks for the information Scott. My situation is and isn't similiar. I had a TTS release in '96 (pain was primarily medial) and a partial plantar fasciotomy in '99. The past year, oddly, I've had nerve pain laterally (on the outside of my right foot in front of the heel to the toes, and to a lesser degree on the lateral side of the ankle). Surgeon feels it could be the lateral plantar nerve, or one of its branches. So, I'd like to find someone who has had a confirmed case that is similiar. Continued good luck with your recovery.

Re: hate that run/walk crowd :-) More details on distal.

elliott on 7/31/01 at 07:47 (054916)

Just a joke from an injured runner hoping to get back one day. Congrats!! Must have felt really good. Really happy for you. Hope you can keep it up. Just a warning: please don't come back too fast, as, aside from the usual residual symptoms, recurrence of TTS problems can't be ruled out.

On a technical note, I believe a distal TTS release actually would be past the distal end of the tarsal tunnel, as the 'release (decompression) of the posterior tibial nerve as it passes through the tarsal tunnel' is a description of the standard release. There is a technical definition of what exactly the tarsal tunnel is, and while I don't have it handy (if someone's really interested, I'll dig it up), I recall it's the area bounded by the flexor retinaculum (also called the laciniate ligament, with a few permutations as to its spelling) forming the roof and the key tissue released, the calcaneus and ankle bone, and a tendon or two. The standard release would start at the top of the tunnel and extend a bit past it, to cover the three branches of the posterior tibial nerve as it splits in or near the tunnel. The scar would be kind of a curved L-shape running behind and below the ankle. Even the standard release would typically go a bit past the tunnel in order to ensure release of things like the first branch of the lateral plantar nerve. 'Distal' would imply a release even further along one of the branches (e.g. medial plantar nerve if incision is further along medial part of foot, or lateral plantar nerve if incision travels under the foot). There's also the medial calcaneal nerves heading to the heel, but when they alone are released orthos usally give that its own name rather than call it distal.

Re: Distal TTS questions

eileenc on 7/31/01 at 11:32 (054964)

It's great to hear about successful outcomes!

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

Jana on 7/31/01 at hrmin (055002)

Really glad to hear how well you are doing. It does us wonders to hear one positive story.

Who did you surgery a podiatrist orthopedic? Can you tell me a little bit about your postop experience? I have bilateral carpal tunnel and am concerned about using a wheelchair or crutches after surgery. I will not be able to use either because of the required use of my hands. How long was it before you could hobble to the bathroom? (Really I'm only concerned about the minimum life requirements at this point. :-) ) how long was it before you could really bear weight and get around enough to live your regular life? Prior to surgery how long could you stand without pain? Did you have pain on the inside of your ankles as well as on the bottom of your feet? Was the inside ankle pain worse at night/first thing in the morning?

Did your symptoms change over the two years? When I was first diagnosed, I had only plantar fascia pain. Six months or so ago (a year and half after the initial diagnosis of PF) I started having inside ankle pain and requested an NCS which came back positive. The doctors seem to be conflicted as to which surgery to do, PF release or TTS release. How did you make that decision? Finally, how long was that postop before you knew the surgery was a success?

Where you live and who did your surgery?

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

JudyS on 7/31/01 at 19:08 (055005)

Jana, have you decided to do the surgery?
Who, what, when, where? ! ?

Re: Distal TTS questions

Betty on 8/01/01 at 16:29 (055121)

Eileenc,How long did it take for you to get full recovery?

Re: TTS/PF Patient Completes Triathlon 6 Months Post-Op

MikeC on 8/06/01 at hrmin (055645)

Hi Scott,

I've just been diagnosed with TTS and am weighing my alternatives. I'm a tennis player and golfer, and from what I've heard re this condition, I'm through with those sports, forever. Of course, I'm very depressed. Any words of wisdom or advice to the newly afflicted.

MikeC

Re: don't give up unless surgery fails

elliott on 8/06/01 at 14:34 (055651)

and then don't give up.