Help! Posterior Tibial Tendonitis

Firstly, NSAIDs are not the answer. Inflammation is a good thing. Let the body do what it's trying to do: protect and repair the affected area.

You need to address the cause rather than the symptom. But if you must run while still dealing with the injury, there is an easy sure fire answer for PTT. Go to your local drug store. Buy several rolls of self-grip athletic tape (preferably 3" width). Take a roll and wrap it twice around your foot and twice around your ankle / Achilles, such that you have one continuous wrap with the heel uncovered. It should look like this:

http://www.countrforce.com/images/anklewraplarge.jpg

Make it tight but not to where it cuts off bloodflow. Then go running.

Don't forget to fix the root cause at some point.

I found that using super feet insoles and rolling out the insides of my shins really helped. I was able to train through it with the help of these.

The only roller I found that was able to really get the insides of the shins was the roll recovery r8. It's the one that looks like its got scooter wheels on it. The thing is pricey but might be worth a shot.

Thanks for the responses so far. Both of your suggestions seem valid and helpful. Unfortunately, I really can't address any latent imbalances/weaknesses without getting rid of the inflammation first, and the inflammation still persists.

Let the inflammation run it's course. It is a GOOD thing. Continue training (cutting back and/or cross training as necessary) to promote blood flow. You can also do some self-massage behind the tibia. Finally, look at your form. Chances are that your run with non ideal posture (pelvis tilted forward, back arched, etc.), causing your glutes not to be sufficiently engaged and resulting in your calves having to pick up the slack. If they get overworked it often leads to PTT. Good luck.

I found that after a couple of months, light running started to improve things-- sort of "shake it up" I guess. I had to start with intervals of 100m on, 200 off, and work up from there. The next 3 months or so were alternately painful or OK, and now at a year out it only hurts when I get out of bed. It's a pain in the ass injury, but it'll heal up slowly.

I have dealt with ptt like that. You need to do some cross friction massage along the tendon. If you feel any knots along the tendon, massage them out. In my case, that helped substantially. Also, do a lot of calf stretches and eccentric calf drops.

Now in my case, all those things helped, but the issue would recur whenever I increased physical activity. As it turned out, I had a longitudinal tear of the posterior tibial tendon near the arch of my foot. It was obvious in hindsight because there was always pain when I pressed on that spot. The deceiving thing to the doctors I saw was that my foot was still very strong: I could do single leg calf raises without issue or significant pain. I ended up getting surgery. Given how long you've been suffering, it raises red flags. Good luck to you.

Hey Frankenfoot guy, I have just had a very similar experience to what you described here, and I've been searching through old threads on here for stories like yours. My surgery was a week and a half ago. I was wondering if you (or others seeing this who have also had ptt surgery) might be willing to share what happened in the aftermath of your surgery, and if/to what degree you were able to return to running.

don't listen to anyone who says inflammation is a good thing and let it run its course. there is a reason it continues to be inflamed: it's because you are somehow putting stress on the tendon still. It shouldn't be inflamed this long - acute inflammation should only last a few days UNLESS you are continually injuring it or UNLESS you've done something really serious like torn it.

It sounds like you might need to immobilize it more. Maybe you need a boot or something. Every step you take puts a little torque on this tendon unless you are immobilizing it. Keep it immobilized (whether by boot or something else - for me a really supportive pair of shoes was enough) for a few weeks and don't use it at ALL. Don't walk barefoot around the house, take stairs really easily, don't turn too fast, etc. Don't even touch it or test it - just let it heal. You might even need more than a few weeks.

Then start doing strengthening exercises SLOWLY - you don't want to risk hurting it again at this point. If you google it you can find some suggested rehab exercises - just don't do them until there is NO PAIN.

If it really is that bad and not getting better maybe you need an MRI to see if you've actually got a tear instead of just inflammation.

I'm only speaking from my personal experience (and i'm a vet who works on athletic horses - but many of the principles are the same) and every injury is different but this worked for me. I'm *finally* getting over a bout of PTT that started in January or so. I found, like you, aquajogging stressed the tendon but biking on a trainer was okay if I was delicate about it.

Jessica

and DONT run through this injury! If there is heat and swelling there is significant damage to the tendon, maybe even a partial tear. Running through it could just turn a partial tear into a complete tear and completely derail your running career.

How has your recovery from surgery gone? I am in the last stages of "conservative treatment" in a boot having had this issue for 6 months. MRI showed a partial tear a few weeks ago. I have had little to no improvement in my 2 weeks in the boot so far. I can still do calf raises without any real issue though, but the pain and swelling is persistent.

I had that surgery back in 1978, so I don't know how its improved since then.

I was as sprinter and when it finally turned incredibly painful, after a long time tolerating it, I couldn't walk. The surgery uncovered the tiniest tear that the surgeon said probably never would have bothered a non-athlete.

I did the 3 months in a boot. I never got back fully, but my entire technique was based in power off the back foot, and I could never quite get back on my toes at the same speed on that side. Perhaps with foreknowledge back then it could have been a focus.

Getting back on my toes was the issue.