Forums >Health and Nutrition>Posterior Tibial Tendon Tear Recovery
Has anybody been able to make a full recovery from a partial longitudinal tear of the posterior tibial tendon? How did you overcome it?
I am 34 and doctor advised this is the type of thing he sees in somebody much older and heavier. Is it that rare of an occurence in runners? Running is everything to me and this injury is destroying me.
I haven't run any substantial amounts since since July after coming off a marathon training cycle. I spent time in a walking boot, got custom orthotics, and have been doing physical therapy for months. The pain isn't high level, but it is persistent, even without running.
I know surgery is an option, but the FDL transfer does not seem like a great solution. After seeing an MD ortho, I consulted a podiatrist for a 2nd opinion and he advised switching to harder orthotics ... frustrating after just paying $100's for the more flexible type.
Mother of Cats
I'm not sure you want to follow my model but....
Back starting in the summer/fall of 2019, my right post tib started burning, though it still worked decently. I saw a podiatrist and a PT, and both assured me that it was something I could train though as long as I could do solid single calf raises, which I could. So I ran on it. Had some good races on it.
The burning would come and go - I thought it was nerve, so just ignored.
Then in the fall of last year I had an MRI done on the ankle since the burning wouldn't go away. The MRI indicated a) torn ligaments on the outside of my ankle, and b) a longitudinal tear down the full length of the post tib. Essentially, I now have two posterior tibial tendons on my right ankle, traveling on each side of a bone spur on the inside of my ankle. An musculoskeletal ultrasound confirmed this, and also showed that both tendons were now perfectly healthy, with good blood flow.
We actually decided not to do anything about it. The tendons were healed and healthy, and were apparently a necessary adaptation to my bone spur. We treated the torn ligaments with PRP, and as those have healed and tightened my ankle stability has improved and the PTT burning has vanished (knock on wood).
My pair of PTTs on the right side seem to be working pretty well now. No complaints. Right ankle slightly weaker than the left, but I'm working on that. I'm 46 and run 50-70 miles a week.
So a bit of an odd story but maybe gives a bit of hope. I should note that I have been diligent about doing strength and stability work with my ankles each day. I do a total of about 20 minutes of various exercises, including wobble board work, single leg standing work, and single calf raises every day. I don't think I'd be where I am now without that daily work.
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Thank you for the details on your recovery.
Did you or do you currently use orthotics?
Nope.
SMART Approach
You likely have tendinosis at this point where the tendons are diseased and deranged. I am ok with orthotics if you need them but to switch to another type is not the answer. Address the cause not always the symptoms. Have you had your walk or run form analyzed? I would recommend. You may have to correct this or address this to alter the load stresses to encourage healing response. If hips are weak, iit can affect your foot strike. Also, this will take a commitment and likely long term like Darkwave mentioned. Heat (I like Epsom soaks and far infrared heat), movement/loading and strength is required. You have to load the tendon but not overload. I utilize H-Wave and MarcPro devices when I work with these conditions as it loads tissues witnout irritation. Those diseased tendons need to remodel and heal. Obviously, what you are doing has not helped if persistent pain.
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You likely have tendinosis at this point where the tendons are diseased and deranged. I am ok with orthotics if you need them but to switch to another type is not the answer. Address the cause not always the symptoms. Have you had your walk or run form analyzed? I would recommend. You may have to correct this or address this to alter the load stresses to encourage healing response. If hips are weak, iit can affect your foot strike. Also, this will take a commitment and likely long term like Darkwave mentioned. Heat (I like Epsom soaks and far infrared heat), movement/loading and strength is required. You have to load the tendon but not overload. I utilize H-Wave and MarcPro devices when I work with these conditions as it loads tissues witnout irritation. Those diseased tendons need to remodel and heal. Obviiously, what you are doing has not helped if persistent help.
I have had my run form analyzed and I do have some hip drop and overpronation. I have been doing heel raises, calf stretching, inversion/eversion with band, as well as an assortment of hip/glute strengthening exercises.
Just trying to figure out best course of action from here.
This, I think I agree with this.