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A stubborn case of Post Tib Tendonitis/TTS

Posted by Bill on 4/07/03 at 18:41 (115610)

After 9 years of post tib tendonitis chronic pain and TTS release surgery (last Aug 2002), I'm still looking for an answer. I've have tried everything under the sun, including 5 pairs of orthotics and PT.

My inner ankle is visibly swollen and my most recent MRI shows increased signal at the Post Tib insertion. The TTS release surgery was supposedly a success. My surgeon said that he release a thickened fascia that was trapping a nerve, and that he thought that this was the cause of my pain.

Can anybody make a suggestion of what I should try next?

Re: A stubborn case of Post Tib Tendonitis/TTS

Henry C on 4/08/03 at 07:01 (115639)

What is your location? I suggest that you make a trip to Baltimore MD and see Dr. Schon. His phone number is 800-571-9820. He has extensive experience with TTS and foot and ankle injuries. At least he should be able to give you an assetment of your injury.


Re: A stubborn case of Post Tib Tendonitis/TTS

Ed Davis, DPM on 4/12/03 at 01:08 (115986)


TTS can be a vexing problem. Post. tibial tendinitis is an entity that is much easier to treat and have yet to encounter an 'incurable' case. If tibialis posterior tendinitis appears persistent, it is likely that one is actually dealing with TPD (tibialis posterior deficiency). Insertional tibialis posterior tendinitis is often associated with a pathologic accessory navicular bone.

It may be helpful if you can provide some detailed information about your course of treatment.

Re: A stubborn case of Post Tib Tendonitis/TTS

Bill on 4/14/03 at 08:29 (116082)

Dr. Ed,
Thank you so much for your reply.

On my most recent MRI, there was evidence that I do have a tiny accessory navicular bone. My doc said that it wasn't contributing to my pain/problem.

As far as my treatment, I have had all kinds of PT, injections, and orthotics over the last 9 years. Nothing has helped.

I had TTS surgery last Aug. 2002 based on a positive EMG showing a nerve entrappment. I had many EMG's over the years that were negative. My surgeon said that he released the upper and lower tarsal tunnel that was being trapped by a very tight deep abductor hallucis fascia. He was positive that this was the area of impingement and the cause of my pain. He said it could take up to two years to feel better.

It is still obvious that my inner ankle is swollen and extremely tender to touch. Any kind of repetitive weight bearing activity aggaravates my pain. I still have the exact same discomfort/pain as I did before the surgery.