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DR Z , PEARL OR WANDER PLEASE.

Posted by seth vorhees on 11/21/03 at 16:15 (138283)

dr z,

i have post tib tendonoits and have tried orthoics, ice, str3ecthing pt and i just had a cortisone shot yestreday. My poditrist has taken me out of work because i am a mail carrier and walk 4 miles a day and i could not do it anymore. He also put me in a velcro soft boot cast for 3 weeks to rest the area. Do you think this could actually help and any other advice would be grateful.

thank you

Re: DR Z , PEARL OR WANDER PLEASE.

Dr. David S. Wander on 11/21/03 at 17:22 (138291)

Yes, I believe that immobilizing your foot in a removable cast is necessary, since he injected the tendon. A cortisone injection may relieve your symptoms, but it can also weaken the tendon, therefore the cast is very important. If you still do not have relief after the cast, you may want to ask your doctor about a custom made brace made specifically for posterior tibial tendonitis (ie Richie Brace, Arizona Ankle, etc.)

Re: DR Z , PEARL OR WANDER PLEASE.

Dr. Z on 11/21/03 at 21:26 (138315)

This will depend on the grade level of injury. The mri should be able to evaluate and determine the degree of tear if there is any. The boot cast is very helpful. IF there is a tear you will need a brace and or possible surgery to repair this problem. Get an MRI

Re: DR Z , PEARL OR WANDER PLEASE.

seth vorhees on 11/22/03 at 08:36 (138337)

I developed this gradually,over time. What would the symptoms be if thre was a tear in the post tib tendon? All that i have is localized pain and that is where the podiatrist injected the cortisone. Also when i am in this boot cast which is removable, do i need to use crutches to avoid weight bearing, because he did not give me any.

Re: DR Z , PEARL OR WANDER PLEASE.

Dr. Z on 11/23/03 at 00:01 (138426)

There would be pain with palpation. Pain when supinating the foot. Pain with standing on your toes. The MRI is still the confirmation of the physicians physical examination. There will also be swelling at the insertion and sometimes up into the ankle