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Update after seeing ankle specialist

Posted by Pam B on 4/29/02 at 20:12 (081667)

Ok, here I am and here it goes......I have been diagnosed with, Posterior Tibial Tendonitis and the Achilles Tendonitis which as we know, I had prior to the PF/spur excision surgery in Feb....well in addition to both of them, I also have Calcaneal Cuboid Syndrome and he is fairly sure I also have Calcaneal Nerve Entrapment or TTS......he is not ready to concede defeat yet :) he wants me in PT three times per week for now.....I go back in three weeks to see what that does for me as my ankle is very weak which is understandable.....he stated that he sometimes does the steroid injections and casts the leg as soon as he does it but he is not sure that this will work in my case......he said there is a possibilty of more surgery but he is not ready to go in there an do anything at this point.....he said everything is way to inflamed to even consider it right now......he stated that he had a feeling when I seen him prior to surgery to rule out TTS that I was going to be very slow to heal......he advised me against going back to work right now until we have had a chance to aggresively proceed with the PT.......he wanted me to take NSAID but I flat out refused due to the stomach having its fill of them......and of course he said the best thing to use is the medrol dose packs but I cant take them either for the side effects which is going to make my healing time even longer according to him......so for now, it is PT and I see him again in three weeks......I will keep ya posted......thanks again for all the sound advice and for listening to my continuing saga :)

Re: Update after seeing ankle specialist

Joe S on 5/01/02 at 19:46 (082055)

Have you had an a nerve conduction velocity test. If your problem is neurogenic, then the nerve conduction velocity test may indicate that. Also, calcaneocuboid syndrome is fairly common after plantar fascial release. A properly made orthotic should help that. Calcaneocuboid syndrome cannot be predicted. Some people develop it and some don't. There is a neurosurgeon out of Harvard who speaks frequently on tarsal tunnel syndrome. His name is Lee Dellon. You may consider a literature search on him.

Re: Update after seeing ankle specialist

John h on 5/01/02 at 21:13 (082068)

The nerve conduction test is not to be considered a gold standard test for TTS. Many people will test positive on this test and have no nerve entrapment.

Re: Update after seeing ankle specialist

Pam B on 5/02/02 at 07:54 (082105)

My doctor and I choose to be conservative with this so I have not had any tests yet....PT is hopefully going to improve the strength in my ankle which will improve my overall condition....I go back in three weeks....I can say that as far as the cuboid syndrome, it has improved much since the surgery in Feb....at first the pain was more severe than the original PF pain....when I stood for any length of time, it felt like something inside on the sole of my foot was being ripped out of me :( I was freaked by it at first but there has been much improvement since Feb....not gone, but it is alot better....my main complaint is pain and burning in my ankle over top my foot from joint to joint and swelling/burning mostly just in front of and behind both joints and the shooting/electrical sensations that travel into my heel in addition to the stiffenss....he may order testing next visit but currently it is just the PT....thanks for the input, I appreciate it :)

Re: Update after seeing ankle specialist

Joe S on 5/01/02 at 19:46 (082055)

Have you had an a nerve conduction velocity test. If your problem is neurogenic, then the nerve conduction velocity test may indicate that. Also, calcaneocuboid syndrome is fairly common after plantar fascial release. A properly made orthotic should help that. Calcaneocuboid syndrome cannot be predicted. Some people develop it and some don't. There is a neurosurgeon out of Harvard who speaks frequently on tarsal tunnel syndrome. His name is Lee Dellon. You may consider a literature search on him.

Re: Update after seeing ankle specialist

John h on 5/01/02 at 21:13 (082068)

The nerve conduction test is not to be considered a gold standard test for TTS. Many people will test positive on this test and have no nerve entrapment.

Re: Update after seeing ankle specialist

Pam B on 5/02/02 at 07:54 (082105)

My doctor and I choose to be conservative with this so I have not had any tests yet....PT is hopefully going to improve the strength in my ankle which will improve my overall condition....I go back in three weeks....I can say that as far as the cuboid syndrome, it has improved much since the surgery in Feb....at first the pain was more severe than the original PF pain....when I stood for any length of time, it felt like something inside on the sole of my foot was being ripped out of me :( I was freaked by it at first but there has been much improvement since Feb....not gone, but it is alot better....my main complaint is pain and burning in my ankle over top my foot from joint to joint and swelling/burning mostly just in front of and behind both joints and the shooting/electrical sensations that travel into my heel in addition to the stiffenss....he may order testing next visit but currently it is just the PT....thanks for the input, I appreciate it :)