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Nancy, strengthening the posterior tibial tendon and a PT question.

Posted by IanJ on 1/02/03 at 19:43 (104646)

Hi Nancy and all. Happy New Year and I hope we all heel well and stay healthy.

As promised here is the exercise my PT recommends to me to strengthen my posterior tibial tendon:

It's called Resisted Inversion and it's # C in this diagram:

http://www.sportsmed.buffalo.edu/info/medcoll4.html

So far I kind of like my PT but he's starting to hurt my arch by massaging. He hurt it the other day and I told him he did but he went ahead and massaged aggressively today. I told him it hurt when he did that. Is there some reason they think that massaging aggressively will help PF? Like will it re-damage the tissue so it reheals better? Should I tell him to stop that?

Thanks.

Re: Nancy, strengthening the posterior tibial tendon and a PT question.

nancy s. on 1/02/03 at 20:31 (104653)

hi ian: thanks for that post tib exercise. i did many different ones during my long acute phase, but not this one! although i'm a lot better now, i do have some difficult days, and i'm going to incorporate this one into my routine and see what happens.

what does your therapist say to you when you tell him the massage is hurting you? i would ask him to give you a thorough explanation of his technique and exactly what it is meant to accomplish. my own therapist spent many weeks doing gentle and then gradually more aggressive massage, but each case is different. when the massage became deeper and more aggressive, it was very painful for me too. but my therapist felt i needed it, to break up scar tissue and for other reasons i now can't recall. in the end, it helped me.

i would say it's not unexpected for deep massage to hurt -- it probably hurts more often than not, when an injury or chronic inflammation is being treated -- but if the pain is toward the unbearable end of the scale, perhaps he's pushing too hard too fast. also, does your pain from the massage continue after the session? it shouldn't be sore for longer than a few hours, as in setback city! have a dialogue with him about this.

good luck, and please keep us posted.

nancy
.

Re: Nancy, strengthening the posterior tibial tendon and a PT question.

nancy s. on 1/02/03 at 20:31 (104653)

hi ian: thanks for that post tib exercise. i did many different ones during my long acute phase, but not this one! although i'm a lot better now, i do have some difficult days, and i'm going to incorporate this one into my routine and see what happens.

what does your therapist say to you when you tell him the massage is hurting you? i would ask him to give you a thorough explanation of his technique and exactly what it is meant to accomplish. my own therapist spent many weeks doing gentle and then gradually more aggressive massage, but each case is different. when the massage became deeper and more aggressive, it was very painful for me too. but my therapist felt i needed it, to break up scar tissue and for other reasons i now can't recall. in the end, it helped me.

i would say it's not unexpected for deep massage to hurt -- it probably hurts more often than not, when an injury or chronic inflammation is being treated -- but if the pain is toward the unbearable end of the scale, perhaps he's pushing too hard too fast. also, does your pain from the massage continue after the session? it shouldn't be sore for longer than a few hours, as in setback city! have a dialogue with him about this.

good luck, and please keep us posted.

nancy
.