Multiple problems BilaterallyPosted by HunterB on 5/14/03 at 12:20 (118703)
I was diagnosed with an accessory navicular and posterior tibal tendonitis in both feet. I had surgery a year and a half ago. My doctor has put me in a UCBL orthotic. At this time, I have aquired additional problems. My doctor diagnosed refrocale calcaneal bursitis last week. He did this very quickly and shoved me out the door failing to address other areas of pain. My feet are burning and have a prickly feelings from the tops of my ankles to the tips of my toes on the top and bottom of my feet. Doing research on the net I'm fairly sure I have Interdigital Neuroma and Tarsal Tunnel Syndrome as well. Symptoms get better when I stay off my feet but they don't completely go away. My next step is going to my orthotist who made the UCBL devices and have him adjust my orthotics. What would anyone suggest I have him do to address these new problems? Does anyone think that this type of rigid orthotic may be exacerbating these conditions? Has anyone ever not been able to tolerate this type of orthotic? If so, are there any suggestions for other types that will address at least the two conditions, refrocale calcaneal bursitis and posterior tibial tendonitis. Thanks for any input.
Re: Multiple problems BilaterallyRichard, C.Ped on 5/14/03 at 13:52 (118717)
A UCBL orthosis can be difficult to get used to. If you do not have weak ankles, I don't know why a UCLB would be needed. Then again, I have never seen your foot. I think a straight forward (I would use EVA) orthosis should provide enough support to do the trick. I would think the UCBL would also irritate the retrocalcaneal bursitis as well.
The orthotist should be able to heat and adjust the orthosis to allow for the bursitis.
Not everyone can tolerate a hard orthosis. I would suggest having some sort of cushion added to the UCBL if it does not have it already.
Re: Multiple problems BilaterallyEd Davis, DPM on 5/14/03 at 15:43 (118751)
The part of the UCBL on the inside of the arch and heel can be a problem if TTS is suspected. What was done in the surgery that was performed?
Re: Multiple problems BilaterallyHunterB on 5/15/03 at 06:28 (118801)
Thank you both for your responses. The operation performed was a bilateral modified Kidner procedure with the excision of medial navicular accessory bone. Excision of the prominent medial navicular and advancement of the posterior tibial tendon. On both the right and left sides, other than the specific accessory navicular pathology and the associalted inflammatory granulation tissue right at the attachment, the remainder of the posterior tibial tendons appeared to be intact and no other pathology was identifiable, and the entire posterior tibial tendon from the inferior aspect of the medial malleolus, distal to the attachments was visualized on both sides. The operation was done 3/15/2002. The surgeon noted the right side accessory navicular was mobile, unstable and large. In addition to removing it, he sawed off 1cm of the most medial aspect of the navicular. On the left side, he noted the pathology was slightly different. There was only a small, 1-2 cm fibrocartilaginous osseous body at the attachment of the posterior tibial tendon to the navicular, and there was a fair amount of granulation tissue around that, all of which was removed. The current problems I am having are exactly the same on both sides. Now, I am feeling the intense burning and pin pricks from my foot to the top of my thigh in both legs. At times, the pin pricks are felt in my groin, arms, hands and fingers bilaterally. Am I getting worse?
Re: HUnterCarmen H on 5/18/03 at 09:05 (119169)
I say read up on Periphereal Neuropathy if you ahve tingling nad prickling and burning...can't hurt.
Re: Multiple problems BilaterallyBGCPed on 5/19/03 at 20:27 (119332)
I would go to see about the ucbl. This is just my opinion but sounds like your post tib tendon was toast. What did they do to address the function of your foot? Usually you have to have a pretty high level of ptt insuficiency (pretty damn flat feet) to get to that stage.
Having a ucbl is an indicator that your foot must be very bad function wise. That said, I have seen more than a few pt with that device that dont need or cant tolerate the ucbl. I would try to get a standard orthotic with a very deep heel cup, lots of hindfoot control and a bit extra heel lift b/l. Ask them to be cool with the amount of medial arch build up since your foot probably wont tolerate it well. Also get a pair of heavy motion control shoes like Brooks Addiction or New Balance 587.
Re: Rigid orthodic exacerbating the problemAna Maria on 5/24/03 at 19:23 (119836)
Hunter, I just posted a Feathersprings-Great product! and was curious when I saw your message. I believed that with my severe case of Plantar Fasciitis (I was ordered to three months of foot rest by my doctor--I literally did not walk for three months) would not be so under control if I had used hard orthodics. I truly believe that rigid orthodics do nothing to help you 'get over' feet problems. They may prevent them. But once you have them, the orthodics are too 'hard.' I thought, 'that is what got me here in the first place'--standing on hard, concrete surfaces for long periods. I swear by my Feathersprings, they are a flexible spring stainless steel orthodic that spring as you walk. You have to send an actual foot imprint to have them made. They are amazing! They take all the pressure off your feet. You can actually wiggle your toes in your shoes--which is impossible do without Feathersprings. Feathersprings also have a money-back guarantee (which my mom used with no problem in getting a refund). My husband and sister now have Feathersprings too! I have been using Feathersprings for five years now. Another suggesting are Birkenstock Super Noppys found at Happyfeet.com. Under slip-on sandals. They are my daily house shoe/slippers. I have three pairs! I can't live without them or my Feathersprings. The Super Noppy sandal has nobs on the insole. It's unlike any other Birkenstock sandal, because the Super Noppys are flexible. The Super Noppy sandals 'is like getting a daily foot massage.' The nobs also act like a cushion against my feet so I don't have to wear my Feathersprings orthotic. Happyfeet.com also carries a 60 day money-back guarantee. I'll try things with a money-back guarantee. No doctor was willing to give me a money-back guarantee on their expensive and hard orthodics. Added bonuses with Feathersprings: My feet were prone to bunions and since using my Feathersprings, my big toe has completely realigned straight. I don't think bunions will ever be a problem for me now. Also, my lower back problems went away once I started using Feathersprings. It's amazing how much is affected when you have feet problems. I got a lot of great advice on my PF not from a doctor but a friend who got her Masters Degree in Exercise Physiology. She treats a lot of geriatric patients with feet problems. Sometimes doctors just don't get it! My uncle is a doctor and he was surprised at the severity of my plantar fasciitis and he gives cortisone shots to patients with PF and that's it. I told him, well I followed the advice of icing and stretching and other exercises from my friend with a masters degree and you should see me now! Nothing artificial and expensive. I can even go barefoot for short times now! I hope you find this information helpful. Ana Maria
Re: Exercising and stretchingAna Maria on 5/24/03 at 19:34 (119837)
P.S. My friend with the Master's Degree in Exercise Physiology was emphatic when she told me about stretching and exercising my feet and calf muscles--do not, do not, do that until you are completely pain-free. The problem with many doctors (unfamiliar with plantar fasciitis) is that they advise you to start stretching the foot and strengthening the calf muscles and if you already have feet problems this will exacerbate the problems. First you have to heal the foot, then you can stretch and strengthen it. It was not until a year later (after getting PF) that I started to stretch and exercise my feet and calf muscles.