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How to Mend Your Posterior Tibial Tendinitis (Posterior Tibial Tendon Dysfunction or PTTD)

Updated on October 25, 2012

The Posterior Tibial tendon is a cord-like tendon that runs from a muscle in the leg, down the inside of the ankle and into the arch of the foot. This particular tendon provides a significant amount of support in the foot and helps to control the inward movement of the foot while walking.

Additional Information Treatment Options


Causes

What Causes Posterior Tibial Tendinitis?

Injury to the Posterior Tibial tendon may occur due to repetitive motion during activities such as walking, running, or climbing stairs. Wear and tear or aging of the tendon may result in degeneration of the Posterior Tibial tendon tissues.

Symptoms

What Symptoms Should You Expect?

The degree of injury may range from an irritated tendon, to a tear, or even a complete rupture of the tendon. You will initially notice some pain, tenderness or swelling along the Posterior Tibial tendon and over the instep of your foot. A serious tear or rupture of this tendon will result in the flattening of your arch. In this case you should immediately consult a physician if you have developed a flatfoot deformity.

Easy At-Home Treatments to Avoid Surgery

What Treatments are Available to Mend Your Posterior Tibial Tendinitis?

Tendon injuries typically require longer healing processes because tendons are tough, dense tissues that normally receive very little blood flow. Posterior Tibial tendinitis is a degenerative condition which means that you should not leave the injury untreated as this may result in a complete tear or rupture of the tendon.

Even with optimal healing there is always less elasticity in a previously injured tendon. In order to regain some elasticity in your Posterior Tibial tendon you should reduce scar tissue formation and ensure realignment of the tendon fibers through Blood Flow Stimulation Therapy.


ColdCure® Technology



As soon as your soft tissue is injured your body triggers natural events that isolate damaged tissue and prepare it for healing. The main symptoms you will immediately feel after injury - the swelling, redness (rubor), heat (calor), pain (dolor), and loss of function - are really just signs that your body is starting to heal.

Unfortunately when your soft tissue is swollen and inflamed the damaged tissue is blocking vital blood flow from coming into to continue the natural healing process. When your blood flow is blocked, the other healthy tissue in your body is starved of oxygen, nutrients and antibodies needed for your healthy tissue to thrive and for your injured meniscus to heal. This is why it's never good to let a new injury stay untreated for too long.

Using cold compression immediately following a soft tissue tear, re-injury, or surgery reduces pain and swelling and reduces the tissue damage that occurs with soft tissue injuries.

Click here to learn more about
ColdCure® Tehcnology



Blood Flow Stimulation Therapy



What can be done for your soft tissue when the swelling is gone, but the pain is still there? Once the swelling is gone our bodies are starving for the naturally occurring oxygen, nutrients, antibodies and energy available in our blood. Blood flow is like the life force of our bodies, and the healing process really takes off only when injured soft tissue receives proper blood flow.

If you want to heal quickly you need to keep your blood flow moving constantly, but you also need to make sure your body is actively getting rid of cellular waste and toxins. This is where BFST® comes in, but what exactly is BFST® and how can it help to accelerate healing?

BFST® is exactly what it seems - it's a therapy that substantially increases the flow of blood to your soft tissue without the need to exercise your already damaged tissue.

Think about your injured soft tissue as if it is a sponge that has dried out. Your damaged tissue is waiting there ready to absorb all of the benefits of increased blood flow but your body is unable to keep up with the demand of what your tissue needs. BFST® boosts your body's natural blood flow, delivering oxygen, nutrients, antibodies and energy directly to the source of your pain. Once you start receiving all of the benefits BFST® has to offer your injured soft tissue becomes like a sponge that now has enough blood flow within reach to soak up everything good that is in your blood flow. Increased blood flow through BFST® also acts as a cleanser for your tissue, whisking away all toxins and cellular waste.

Click here to learn more about
Blood Flow Stimulation Therapy

Treating Your Posterior Tibial Tendinitis

Products available on Amazon to help with your PTTD!

Using the Ankle/Achilles Inferno & Freezie Wraps

Surgery

When is Surgery an Option & What Surgical Prodcedures Mend Posterior Tibial Tendinitis?

There are a few surgical procedures that may be performed in order to heal various degrees of Posterior Tibial tendon injuries: tendon repair, tendon transfer (graft), or tendon debridement (tenosynovectomy).

Tendon Repair

A procedure in which a surgeon repairs the Posterior Tibial tendon if you have chronic degeneration. The surgeon will make a small incision into the tendon sheath (the tissue encasing the Posterior Tibial tendon), and will either remove the damaged portion of the tendon or will repair the tendon with stitches or sutures.



Tendon Transfer (Graft)

A procedure that is usually performed when the Posterior Tibial tendon has degenerated or ruptured beyond the point in which a tendon repair surgery can effectively mend the tissue.



Tendon Debridement

This is a thorough removal (or debride) of all degenerated tissue in the Posterior Tibial tendon injury.



Serious cases of Posterior Tibial injuries that result in a flat foot deformity may require: osteotomy, lateral column lengthening or arthodesis.

Osteotomy

Is a procedure that allows the surgeon to remove a small part of the heel bone in order to realign the heel thus adjusting the arch.



Lateral Column Lengthening

This surgery allows the surgeon to remove and use a small portion of bone derived from the hip (that has a wedge-like shape) in order to realign the arch in the foot.



Fusing of Bones (Arthodesis)

This is a procedure in which the surgeon fuses one or more bones together in the foot in order to diminish or eliminate pain. Although this procedure may reduce pain and counteract the flat foot deformity, it will be difficult to move the foot or the joints that have been fused in a normal way

The terms Inferno Wrap®, Freezie Wrap®, and MendMeShop® are registered trademarks of In.Genu Design Group Inc.

The terms BFST®, Energy Web®, and ColdCure® are registered trademarks of King Brand Healthcare Products Ltd.

If you have any questions about PTTD please feel free to comment on our Lens. You can also reach one of our MendMeShop Advisors directly via phone or e-mail at service@mendmeshop.com

Please note that comments are directed by e-mail to one of our MendMeShop Advisors. This allows us to receive your comments and respond to your queries as soon as possible. If you do not see your comment as soon as you have posted do not be discouraged, your comment will most likely appear along with our response in due time.

We look forward to hearing from you!

The MendMeShop Advisor Team :)

Posterior Tibial Tendonitis Questions & Comments

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      anonymous 4 years ago

      @MendMeShop LM: Thanks Louise for your suggestions. Was some good "food for thought" there. I'm very pleased to say I have final got a date for my surgery. July 3rd. Couldn't be happier. Arthoscope plus ligament reconstruction. So bring on the opp and get stuck into the rehab and recovery and eventually back to doing what I love the most, playing sport! :-)

    • MendMeShop LM profile image
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      MendMeShop LM 4 years ago

      @anonymous: Dear Tracey:

      I feel bad it is taking so long for your surgery to happen and do also understand the pain and frustration you are experiencing from my own personal experience. Some scar tissue is actually healthy to help with the healing process. It is when you get an abundance or layering of scar tissue is when it can cause problems. But when you do finally get the surgery they may look at scraping the scar tissue away so they can do the mending they need to do to your ankle. If you are experiencing a lot of pain still when you are walking you should consider putting cold compression on the ankle after any form of activity. Our Freezie wrap is a great product for that it fits the ankle snuggly to provide true cold compression to help bring down the swelling and relieve you pain. Prevously I did mention the Inferno wrap and it will also help you pre surgery and post surgery in the healing stages.

      Here is what the Inferno Wrap does: The Inferno wrap produces electromagnetic energy the penetrates deep into the body, right to the site of the injury. It passes through the skin and fat layers. the energy is absorbed by the muscles, tendons and ligaments. This in turn creates vasodilation - relaxing of the vessel walls. blood flow increases, bringing more oxygen and nutrients to the injury site. The rate at which the body utilizes the oxygen and nutrients is increased - resulting in a faster recovery.

      It is a very good product and works well to help heal minor tears but it will help to maintain larger tears to prevent other issues to occur. For exasmple I have a tear in my rotator cuff in my shoulder it can only be repaired with surgery which i cannot do at this time. But I have been using it since last August to prevent a frozen shoulder and to maintain my range of motion and it has worked quite well for me.

      I hope you get your surgery soon to correct your problem and make you ankle feel better soon.

      Regards,

      Louise

    • MendMeShop LM profile image
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      MendMeShop LM 4 years ago

      @anonymous: Good Morning Tracey:

      I am sorry to hear you are still having ongoing issues while obtaining surgery for your ankle. As mentioned in my last post (in January 2013) there are therapies available to relieve your pain and prepare your body for surgery until you are able to have that procedure booked. These therapies would also be extremely beneficial during your recovery and rehabilitation after the surgical procedure.

      I feel you will also benefit from speaking with one of our Product Specialists, who may be able to shed some light on your current situation and provide some insight into returning to both basketball and tennis this season. Please feel free to phone our Product Specialists at 1-866-237-9608. We are available to take your call Monday to Thursday 8am-10pm (EST), Friday 8am-9pm (EST), Saturday 10am-6pm (EST) and Sunday 11am-6pm (EST).

      Wishing you all the best in getting your surgery date and back on the road to recovery for the new basketball season.

      Regards,

      Louise

      MendMeShop

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      anonymous 4 years ago

      @MendMeShop LM: so my injury is now well over 9 months old and have been on the 2 waiting lists since November and am still waiting to hear when my operation will be. I have been back to my local GP twice about the pain and the fact that i feel like its getting worse and hes just given me some pills to get me through till i get a date. But theres something about taking pills day after day for months on end that i don't really like. Like is that healthy for my body? I just wish they would give me a date for my opp so that i can start the process of recovering from what was ment to be a simple ankle sprain. My worst fear is that i am going to miss another full basketball and tennis season which is so frustrating. Basketball starts again in 7 months and i may not be ready by then.

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      anonymous 4 years ago

      @MendMeShop LM: So i saw the surgeon back in November and he tends to think that i have torn the ligament on the outside of the ankle just under the bone and therefore the joint itself has become unstable and cause the bones to roll inwards when i walk contributing to the flattened arch and possibly other problems on the inside of the ankle. He said because it has been so long since the initial injury that surgery is the only way, (it is now 7 months since the injury occurred). So i am now on the waiting list at two different hospitals and have been since November. Wasn't told how long i maybe on the waiting list for though. He said that when i go in for surgery he will do an arthoscope to check everything out and to see exactly how much damage has been done and go from there. I'm hoping to hear from them soon with a surgery date because i feel the ankle is becoming worse. It is becoming more painful to walk and drive a car and its feels very stiff and achey. So hoping to hear very soon. Like i said its been a good 7 months and would just love to have it fixed and be able to eventually get back to doing the things i love!

    • MendMeShop LM profile image
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      MendMeShop LM 4 years ago

      @anonymous: Hi John,

      What types of diagnostic tests have you received for these issue? That would be the first course of action to take. Whether it be an ultrasound diagnosis or M.R.I. - you need to determine exactly what is going on before specific treatments can be recommended.

      To answer your question in general terms - yes, the discomfort and pain you experience can be interconnected. To help prevent further issues from developing, it is imperative to talk to your doctor and obtain a proper diagnosis as soon as possible.

      MendMeShop.com

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      anonymous 4 years ago

      John Nov 25th 15.30 GMT

      Hi

      For the past 4 years I have suffered from pain in the arches of my feet and also a severe ache mainly in the back of my left leg at the top of the calf muscle below the knee.

      I think this could possibly be tendinitis, but the pain is at the top of my calf muscle, ie a fair distance from my foot. I have no pain in my ankle achilles area.

      I have tried ice packs, and electro flex, and whilst they reduce the pain slightly they are not leading to a cure. A hot bath definitely eases the pain and discomfort.

      I have also had a series of physio aimed at exercising and stretching the muscles. sadly this resulted in no improvement.

      I am interested to hear whether you think that the pain in my feet are linked to the pain in my calves.

      My GP informs me that I have poor blood circulation in my legs, and he is unable to detect pulses.

      Thank you in anticipation of your comments

      JH

    • MendMeShop LM profile image
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      MendMeShop LM 4 years ago

      @anonymous: Hi Tracey,

      Ultimately, recommendations for treatments will come after it is determined the extent of the damage to the tendon or possibly other soft tissue as well. At this point, the injury/condition has not been definitively determined.

      What we would recommend in the mean time is to refrain from any non-essential activities that are stressing the foot as this is likely worsening the situation. You can consider following the R.I.C.E. protocol - resting, icing the foot when it is inflamed, using very light compression when swollen, and keeping the ankle elevated during times of inflammation.

      You are welcome to follow up with us when you receive a thorough diagnosis and feel free to contact us with any questions or concerns in the mean time.

      MendmeShop.com

      1-866-237-9608

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      anonymous 4 years ago

      I badly sprained my ankle 5 months ago playing netball. I had xrays taken the day after the injury occurred and they were all clear. I had swelling, excesive bruising and a lot of pain all over my ankle and the top of my foot. The first physio i saw didn't do any other scans. Told me to get of the crutches (after 4 day) and told me i should be walking by now. HE said just stretched ligaments. After the 7 week mark he said i would be fine to return to sport. Went to netball training and couldn't run. I felt like a pinching felling on the inside of the ankle. THe more i ran the worse the pain. Starting seeing another phsio. She noticed straight away that my arch had slightly dropped and there was still a lot of bruising to both sides of my ankle and top of my foot. Continued seeing this physio for the next 14 weeks with some small improvements but still couldn't run without experiencing the strong pain running along the inside of my ankle and around the joint. She sent me to my GP with a letter stating everything she had done and her thoughts that it may be a tendon that's damaged and asked for me to be referred to a specialist. The GP sent me for more xrays and has referred me on to see an Orthopedic surgeon. By the time that i see the surgeon on the 27th of November i will have been waiting a month and half to see him. My arch is still flattened and my ankle feels as though it rolls in when i walk. Still experiencing pain and swelling especially at the end of a day after work and still can't run. Can't wait for the surgeons appointment to hopefully start getting some answers. I'm 28 and not over weight. Love sports and being active and not being able to play sport for the last 5 months has been the worst.

      Any thoughts would be much appreciated. Thanks

    • MendMeShop LM profile image
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      MendMeShop LM 4 years ago

      @anonymous: Hi Carole,

      Before considering any alternative treatment therapies, you need to determine the current extent of the injury/condition first. This would be accomplished with proper, updated diagnostic testing referred through your doctor.

      MendMeShop.com

    • MendMeShop LM profile image
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      MendMeShop LM 4 years ago

      @anonymous: Hi Danielle,

      Due to the complications of your previous/current injury, protocol suggestions would be best left to those who are able to analyze the situation in-person - based on proper diagnostic testing.

      MendMeShop.com

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      anonymous 4 years ago

      i twisted my ankle about a year ago...didn't go to the doc...did the r.i.c.e. routine & the alphabet. may have re-injured while ice skating, but never noticed anything different. for about 3/4 of this year i started the foot-drop thing (no dorsiflection) & went to a sports med doc & therapy (only given exercises). no better. went to an ortho foot specialist & she rx'd custom orthodics - xray showed some pronation (i'll bet due to the injury & my compensation for that). after breaking in the insoles i'm probably aligning everything better, but still not much improvement to the dorsiflection issue. i'm 66...not overweight...eat right...work out, etc., some osteoporsis in my spine & i drink a couple of glasses of red wine several times a week. i've researched & now having to decide whom to go back to in order for more (and different therapy - ? manual stimulation) and/or an emg test, ct scan?? i don't have an unlimited income (upon retiring) so have kind of so-so! insurance. what would you folks suggest? much appreciated.

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      anonymous 4 years ago

      I've had constant problems that with my PTTs since a young age. I wore orthotics, did band exercises, did ultrasounds, etc all through adolescence. My left foot had always been worse. At 20, I had surgery done on my left foot, a tendon transfer, osteotomy, and lengthening of the Achilles' tendon. Immobilized in plaster cast for 8 weeks, boot and PT after that. I had fantastic results.

      Now 8 years later, I'm starting to have pain in the PTT of my left foot. I had a lot of pain and swelling last night after wearing sandals to an event where I stood for several hours (I know I shouldn't wear sandals, but haven't had a problem with them since the surgery, until now.)

      Do you know if this is normal so many years after the repair surgery? Like a "lifetime benefit" so to speak, before I start experiencing the old injury again? I saw a PA about it a few weeks ago, and he xrayed the foot and said all my hardware is still in place, no shifting at all. But didn't know much more, and my foot surgeon is very hard to get in to see (book an appointment months in advance).

      I can't imagine having to go through the pain of that surgery again, the recovery was nearly unbearable! Do you think a brace might help? Or more ultrasound? Thanks for your input!

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi Denise,

      You could talk to your doctor regarding the possibility of a CT scan under the circumstances.

      MendMeShop.com

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      anonymous 5 years ago

      I have 12 more days left until I see the Dr. again. I hope & pray that I do not need surgery! Just sitting here doing nothing is so hard!!

      I have a question: Since I cannot have a MRI (because of hardware in my ankle) what is the next best text to see if I need surgery.

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: In this circumstance, it would be best to obtain an in-person diagnosis from a trained medical professional who can properly examine your friend through various testing methods.

      A tendon injury is a possibility, as are the chances of other soft tissue related ailments as well.

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      anonymous 5 years ago

      A friend of mine was just walking and heard a pop now she has pain in that area

      of her foot could it be that tendon?

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi Kate

      Promoting blood flow around an injured area to help the body heal itself is a concept that has been utilized for centuries. Oxygen and nutrients, carried within the blood, are critical for the body to initiate healing. Without proper blood flow, recovering from an injury or condition will be delayed greatly.

      This is the scenario that is likely playing now for you. Tendons receive very limited blood flow.

      Even though the concept is simple, improving blood flow can be difficult. Traditional methods require your body to move to promote blood flow, but that same motion that promotes blood flow can also lead to making your pain or condition worse.

      One modality I would consider in this case would be the Inferno Ankle Wrap.

      Within moments of applying an Inferno treatment, you can feel the healing sensation due to the increase in blood flow deep within the area. During a treatment, and for quite some time after you finish, your injured tendon will feel gently warmed and more relaxed. It's a very soothing sensation and extremely effective.

      Inferno Wraps contain a patented Energy Web which is flexible and shaped to conform to your body. This Energy Web emits a uniform wave of perfectly safe electro-magnetic energy over its entire surface. This energy travels deep inside your body and stimulates the blood flow needed to heal your injury. It is the electromagnetic energy that is crucial to the healing process.

      Electromagnetic energy waves are not Heat Waves. When they are emitted from the Inferno Wrap they penetrate right through your skin and fat layers until they get to your ligaments, muscles, and tendons. Once they reach this injured area, they are absorbed and quickly converted into heat energy... that's Heat - Right at the Location of the Injury.

      While the concept of electro-magnetic energy is slowly catching on in North America, the truth is, it is a technology that has been utilized in other societies for decades.

      If you have any questions, let me know.

      Paul

      MendMeShop.com

      1-866-989-6431

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      anonymous 5 years ago

      Hello,

      I had a small tear in my posterior tibial tendon approximately 7 months ago. I saw a consultant and had an ultra sound scan which resulted in my spending 6 weeks in a full plaster cast and another 4 weeks in a 'boot' to completely rest the tendon. Following this complete rest I had physio and spent a long time doing exercises to build up the strength again. On the consultant and physio's advice I've eventually returned to light training - cross trainer, bike and swim only - no running - but the injury has come back!! The thought of another stint in a plaster cast is horrendous. I desperately miss being able to do sports. I'm back to resting again, but what can I do to aid faster healing? At this stage I'll try ANYTHING! Please can you advise?

    • profile image

      anonymous 5 years ago

      hi i had an ankle sprain 4 weeks ago playing basketball and im almost sure i injured my posterior tibial tendonits in the sprain. my ankle feels much better and im still in a walking boot but i tried on some shoes and it feels like my arch is not what it use to be and my small toe has no room up front. i wear size 10 but my right foot the one with the ankle sprain feels like im wearing a size 9. is this just part of the injury that will go away over time or should i look into getting a mri to see just how bad it is?

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi Chris,

      Truly, only your treating physicians can make specific recommendations in this case as they are the ones most familiar with the injury and your health history.

      From our perspective, protection of the tendon is of the utmost importance at this time, so resting the tendon would be one consideration. In addition, upon approval of your doctor, utilizing a form of cold therapy could help reduce bouts of inflammation. One must remember to never apply ice or cold packs directly against the skin and this increases the chances of damage to skin cells. You should always wrap a cold pack in a cloth or use a specially designed wrap that comes with a protective layer.

      Thanks again for your posting and best of luck in your recovery.

      MendMeShop.com

      1-866-237-9608

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      anonymous 5 years ago

      hi I tore my Post tibial tendon in January of this year and I'm still awaiting an op to perform a tendon graft and osteomy. The surgeon has told me that I'll have to wait another 18 weeks for surgery and he left it at that. Is there anything I can do to relieve pain/swelling as he hasn't prescribed anything. I asked my GP and he said tha the hospital have to prescribe drugs, not him.

      Thanks

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi again Rebecca,

      One treatment consideration should be therapeutic Ultrasound.

      Doctors and therapists routinely prescribe therapeutic ultrasound as a primary treatment for soft tissue inflammation. Having been widely used since the 1940s, ultrasound therapy has an established track record in providing safe and effective treatments that canât be matched.

      Leading medical centers found at institutions such as Oxford University, Loyola University, and the University of Texas attest to fact that Ultrasound is not only safe, but very effective.

      Essentially, ultrasound will help anywhere you need increased blood circulation, reduced scar tissue, and a lowering of swelling/edema.

      Injuries to tendons are excellent candidates for ultrasound treatments. Typically, these types of injuries are very slow to heal due to constant use and/or poor blood circulation. Regular applications of ultrasound therapy over the duration of the healing period has been proven to quickly and significantly reduce pain as well as recovery time.

      Feel free to contact us with more questions.

      Paul

      MendMeShop.com

      1-866-237-9608

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      anonymous 5 years ago

      @MendMeShop LM: Hi,

      Is there anything I can do to speed recovery? I don't think it's anywhere near a rupture, the tendon is only causing mild pain, but it's not getting any better, and has been the same for the last 3 weeks. I have done no exercise at all for a week and no change, so it's difficult to see which activities are making the difference!

      Any advice would be welcome.

      Rebecca

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi Rebecca,

      When dealing with any soft tissue injury, the initial goal is to prevent further damage from occurring, which ultimately sets back a potential recovery.

      Each time you overstress the tendon, you could potentially be causing more damage. Continuing to do so could eventually lead to further tearing of the tendon, more scar tissue build up, and under the worst-case scenario...a complete rupture.

      Light activity is certainly welcome in most cases, as this will gently enhance the extensibility of the tissue going forward. However, this is something your body will be able to best judge...if certain activities cause more discomfort, it is your body's way of saying you are overdoing it.

      Listen to your body and exercise general, common sense in these situations.

      Paul

      MendMeShop.com

      1-866-237-9608

    • profile image

      anonymous 5 years ago

      Hi, I recently damaged my posterior tibial tendon (I'm pretty sure) when I increased the speedwork in my running programme. It has been three weeks now and it is still not better (although much better than it was). I have been swimming, and cycle to get around (around 5 miles a day typically), and am also doing some yoga. My question is about this activity: my foot hurts slightly more after yoga, I can kind of feel the strain (about 2/10 when walking), is this likely to be delaying healing or is it ok to continue? I'd be gutted to have to give up my yoga practice as well! i also have pain after driving for more than 20 mins or so, would you recommend not driving? (it's not that much of a hardship).

      Thanks!

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi Kendra,

      It is Paul from MendMeShop.com following up.

      The best way to determine the extent of an injury to a tendon is though an M.R.I. You would be able to determine the degree of strain or the degree of tear with the results.

      Once the results are know, then a proper course of action can be developed and implemented.

      Healing times of course will vary on a case by case basis. Factors that will affect the time needed to heal include the extent of the damage, the prevalence of scar tissue, the amount of stress being placed upon the tendon on a daily basis, and even your diet (a diet that is high in acidic food can delay recovery from tendon injuries), and much, much more.

      If you have further questions, feel free to call our office toll free 1-866-237-9608.

      Paul

      MendMeShop.com

    • profile image

      anonymous 5 years ago

      Hello,

      I started running about a year ago (spring 2011) and slowly built up my mileage and speed. In January of this year (2012), I started doing some interval training and upped my running frequency to 5x per week. At the end of February, for the first 2-3 mins of running, I'd notice a dull, achy pain about 3 inches above the medial malleolus in my right lower leg. I ran through the pain, a big no no I realize now. After about 3 weeks of running through it, I was started having pain when walking, so I quit running altogether, but was still cycling and walking for exercise. At the end of March, I began having severe pain in the arch of my foot. I went to my physician immediately and talked to a pedorthist (who told me it was posterior tib tendon involvement) as well. Now i'm using some "Superfeet" over the counter insoles which have taken away my foot pain totally. I still am taking NSAIDS every 4-6 hours for my leg and ankle pain though, and icing it twice a day; it isn't severe, about a 4-5/10 when walking. I haven't exercised at all for about a week and a half (not even cycling) but am still having pain. What should my next steps be? How can I tell if my tendon is just inflamed/irritated, or if it is torn? How long will this type of injury take to heal?

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi again,

      The Inferno Wraps are exclusive to MendMeShop, so you can purchase one over the phone or online.

      Most physical therapist will do Ultrasound Therapy. If you went to you doctor you could get it prescribed and insurance may cover it as well. If not, you could always purchase a portable Ultrasound system, such as the one MendMeShop.com offers.

      Happy healing,

      MendMeShop

    • profile image

      anonymous 5 years ago

      @MendMeShop LM: Hi thank you for the reply.

      I had physio therapy using the ultrasound i can't quite remember for how long it was not continious, after that i used a strenghthing band, then i requested to be immobilised for a month in a moon boot and after that got told to do stretches and keep strenthening the tendon.I have had ultrasounds witch have shown lots of tiny tears and a lot if scar tissue. Where do i go to get an Inferno Wrap? and do i have to go back though the process of seeing a doctor to get ultrasound treatment again.

    • MendMeShop LM profile image
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      MendMeShop LM 5 years ago

      @anonymous: Hi Samantha,

      What types of treatments did they do to help the tendon heal in 2008? The body's natural way to heal an area is to put scar tissue on the area. The problem with that is scar tissue is not as flexible as normal, healthy tissue. So, when you do too much exercise or twist the wrong way, you can potentially re tear the old tendon injury.

      Taking pain killers is basically just masking the symptoms of the injury. It is not helping to heal the injury.

      I would highly recommend Ultrasound Therapy to help treat your ankle. An ultrasound device, which is used for soft-tissue injuries essentially emits sound waves, which penetrate up to 4 inches below the surface of the skin, and basically massages your tissue on a cellular level. This massaging effect triggers several natural healing processes, including the natural break down of scar tissue. This massaging on a cellular level also creates some slight warmth as a by-product of this process. Any warmth generated will bring extra blood flow into the area to provide much-needed oxygen, nutrients and antibodies.

      Soft tissues will heal naturally with ultrasound, but damaged tissue also needs enough blood flow to get nutrients, anti-bodies, oxygen and all of those wonderful naturally occurring elements in the body. This is why increasing blood flow while healing is essential!

      A Blood Flow Stimulator like our Inferno Wrap will help to get rid of toxins and cellular waste within the injured tissues while encouraging the flow of oxygen and nutrient-rich blood (something your body needs to heal) directly to your damaged tissue. The Inferno Wrap will also stimulate the production of collagen, which is a building block for healthy tissue. Extensibility of the damaged tissue in your ankle will also be enhanced through a gentle thermal effect, which will reduce your risk of further injury or re injury.

      I hope I have answered all of your of your questions today. Should you require more information you can also check out Mendmyknee.com.

      Regards,

      Danieca

      MendMeShop Adviser

      1-877-876-4588

      Service@MendMeShop.com

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      anonymous 5 years ago

      Hi i have had multipul ancle sprains and 1 of witch in 2008 pulled the tendon slightly off the bone and witch was not treated strait away(i was unaware at the time) until i did it a second time i have been diagnosed and ive had imobilisation in 2008. Orthotics strethening continually, been to a surgen whom said it wasn't bad enough to operate there was a period since then that it has been okay since i wasn't exercising like i normally would. so i started exercising again for about a year now and the pain is straight back to how it used to be and nothing had fixed it completely i can't run or walk with out pain and is there anything that will help me apart from being on pain killers the rest of my life im only 19.

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      MendMeShop LM 7 years ago

      @anonymous: Hello Bo,

      It sounds as though you may need to consult your physician or orthopedist to address the changes in your sonâs arch and determine whether the changes he has experienced in the last week are helping him or hurting him. Correcting any sort of arch issue stemming from overpronation is always a difficult and somewhat lengthy process because you are basically trying to alter the naturally inclined bio-mechanics of your sonâs feet. It is difficult for me to say whether the changes your son has undergone are positive or negative because I am not a medical professional and Iâm also not completely familiar with what is going on or what your physician has planned, but it may be a good idea to monitor all of the changes going on in your sonâs feet during this process. One method of charting any progress â and ultimately assessing whether the posterior tibial tendon (PTTD) has been damaged in any way â is diagnostic testing via an MRI. This particular test is ideal when determining whether there is any soft tissue damage in the affected area, however I am sure in your sonâs case you will want to do a bit of research and consult his pediatrician before getting an MRI. These tests can sometimes be a scary thing for a young child â so although I certainly canât guarantee that an MRI will work in your sonâs case, I can at least say that this is an option that should be explored a little further.

      Now when it comes to rehabilitation of any soft tissue injury that your son may have â well that process can also have some inherent limitations. The best way to soothe pain and/or shorten healing time for a soft tissue injury for anyone (young or old) is to apply the R.I.C.E. method right after an acute injury has occurred or as soon as some swelling/inflammation is apparent. Rest, ice, compression and elevation will do wonders in getting rid of swelling and inflammation, and will also have a hand in decreasing the amount of scar tissue that forms once the tissue starts to heal.

      One thing that is important to keep in mind/be aware of is the natural state of a childâs soft tissue, and a childâs general response to therapeutic devices designed to treat soft tissue injuries will be noticeably different compared to an adultâs healing time. Most children naturally have the ability to âbounce backâ from injuries such as damage to the PTTD, because as children grow they naturally produce more collagen and other things necessary for healing soft tissue injuries. This very fact â that children are always growing/producing collagen and other great things â is also one of the major reasons why portable ultrasound therapy that is designed to get rid of scar tissue shouldnât be used by anyone under the age of 16. Although a child will naturally heal much faster due to their constant state of growing, it is still unknown how ultrasound therapy interacts with tissue that is growing.

      That being said⦠Blood Flow Stimulation Therapy (BFST) from a heating device such as our Inferno Wrap is a safe and effective alternative for long-term treatment of a childâs soft tissue injury. The energy emitted from our Inferno Wrap is 100% child-friendly.

      As I mentioned before... regardless of the state of your sonâs PTTD I still encourage you to consider some sort of diagnostic testing method to gauge the effectiveness of any efforts your son undergoes to correct/alter his foot structure. I hope that some of the information Iâve provided above is helpful for you and your son in finding a way to effectively deal with the changes he is going through, and if you have any other questions or concerns about PTTD or treatment for this condition or any other soft tissue injury please feel free to give us a call toll free at 1-866-237-9608 or send us an email to mendmeshop@gmail.com

      Sincerely,

      MendMeShop

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      anonymous 7 years ago

      My 3 year old son has cerebral palsy spastic diplegia and toe-walks due to tight heel cords. He also overpronates and out-toes but does have a slight arch. He was recently casted in walking casts to help stretch out the heel cords. When the casts were taking off to be changed after a week, I found that his arches were stretched out instead of his heel cords. As a result, his navicular bone is now very prominent. His walking is now very unstable and I'm noticing that the navicular bone is almost touching the ground when he walks and his pronation has definitely worsened. I wonder if the posterior tibial tendon has been damaged and how do we find out.

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      MendMeShop LM 7 years ago

      @anonymous: Hello Fred,

      I am quite sorry to hear about the grief you have been through with your PTTD. It sounds as though you are suffering from a very complex injury that requires a considerable amount of care and attention. The pain that you were experiencing after your original Osteotomy procedure (during the recovery process) must be a result of the scar tissue built up around your PTT as the tendon attempted to heal itself. Tendon injuries often require a quite lengthy healing process, and without proper blood flow or realignment of the tendon fibers the area may generate scar tissue (tough, dense, inflexible tissue) to mend the injury. Ultimately it is the scar tissue that is causing you pain. In this case therapeutic ultrasound treatments will aid in getting rid of this pain and truly healing the damaged tissue around your ankle and foot. Ultrasound treatments will essentially soften your scar tissue, allowing for proper healing of the injury.

      I recommend that you discuss the merits of ultrasound therapy with your physician, and also ask them whether there are any alternatives that you may explore before resorting to an Arthodesis (ankle fusion). Ankle fusions are quite invasive procedures and although it will take care of that pain you are feeling it will also decrease the mobility of your ankle joint - which seems like such a severe solution for pain management.

      Either way, I do not recommend that you halt or decrease all of your activity in hopes of this particular injury healing itself (especially with the scar tissue apparent in your injury). After gathering some information from your surgeon you may have more options available to you, and it may even be wise for you to get a second or third opinion/diagnosis from a few different physicians or sources.

      I hope I have been helpful and have adequately answered your questions. Should you require any additional assistance please do not hesitate to contact us again.

      I sincerely hope you are able to find a solution that treats the pain that you are experiencing and heals your injury.

      Best of luck to you Fred,

      MendMeShop

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      anonymous 7 years ago

      I had Osteotomy on my right foot for PTT rupture. It cured the problem but healing took months and the post-pain during recovery was nearly unbearable. I couldn't work for 3 months. I swore I wou.ld never have my left foot done but now left foot PTT pain is causing me to reconsider. Orthotics helped at first, but a Riche brace and a boot cast both seem to make the pain much worse. Now I can hardly stand the weight of an ice-wrap or ice bag. The surgeon says the MRI indicates that an ankle fusion is needed. He says multiple bone screws and Achilles tendon lengthening and some pulverized bone grafing are needed. My question-- I don't know how I will endure the pain. Is there no other less painful solution? If I sit in a wheelchair for 6 months, might things naturally heal on their own? What will happen if I refuse the surgery?