PTTD anyone? (Read 959 times)


    Anyone ever dealt with Posterior tibial tendon dysfunction?  This is the tendon that runs along the inside of the ankle and connects into the arch.  Long term affects of problems with the tendon are usually referred to as Adult Flatfoot since the arch of the foot begins to decrease as this tendon weakens.


    I was having pain in this area up about a third of the way up my calf on occasion..sometimes during running and on other occasions i would just feel it while driving or sitting on the couch, but the pain was usually more acute when running.  I've also, I believe, developed some plantars fasciitis which seemed to preceed the ankle pain.  I went to an Orthopod two weeks ago.  Xrays were negative and he felt it was just as I described and recommended rest, treadmill running, pain meds for swelling and over the counter arch supports.


    All of this started last year after a 4 or 5 month stint of some Achilles tendonitis in this ankle.  I think this is all a result of overuse on this foot.  I ruptured the Achilles in the other foot 6 years ago and the strength of that calf and foot has never returned to what it was.


    I'm wondering if anyone has dealt with PTTD and plantars and if there are any recommendations for arch support inserts, shoe recommendations, exercises, stretching...anything!


    I was frustrated last year that I couldn't increase my mileage like I had hoped in part b/c of the foot/ankle problems.  I tried giving it some rest this month and it's been a bit better but I'm worried i'm going to yo-yo again with increasing mileage and then backing off b/c of the pain and injury concerns...

    2013 Goals:  stay under 20 for 5k(19:39 best this year), min. 60 mi. / mo.


    "Who you are will show in what you do"

      Yep, I'm dealing with it.  I ran 1800 miles in 2011, and everything was going great, then in mid-November I started to feel the PTT.  I kept trying to run through it, but it was getting worse and worse, so I discontinued my running completely in the middle of this month. It's frustrating because I don't know what caused it.


      Not running is driving me crazy, but I am noticing steady improvement.  I still feel it, but I'm walking pretty much limp-free.  I am resolved to refrain from running until it is completely pain free, then to give it two more weeks.  That's going to be hard.


      Like you, I'm scared that it will flare up again when I resume running.  I'm just hoping the tendon and surrounding tissues will have grown stronger, and that if I don't run too hard or too long, I can build back to my previous status.


      FWIW, I did not go to a doc about this.  I'm self-diagnosed and self-treated.

      Well at least someone here is making relevance to the subject. - S.J.

      the REAL JZ

        So I submitted a video of me running on my treadmill to runningwarehouse.com (LOVE this site) for a gait analysis.  Here's the video if anyone else wants to chime in... http://youtu.be/75Op8rrbsI8


        I think this was at ~ 7.0 MPH...slower than what I would consider my preferred training pace but it's what I've been sticking too in trying to resolve my issues. 



        here's what Running Warehouse said...any comments?


        While watching your video we detected a mild amount of over pronation occurring in your right foot. Over pronation is the flattening of the arch, which in turn causes the the foot to roll excessively inward past the ideal position. During your stride, your left foot remained in a neutral position. As you have been diagnosed with Posterior Tibial Tendon Dysfunction (PTTD) in your right foot, this may be the reason why your there is greater over pronation in your right foot. Impairment of the posterior tibial tendon can compromise the structure of the arch of your foot, leading to flattening of the arch and subsequent over pronation.

        Typically, we recommend selecting a shoe with pronation control to support the foot that experiences greater over pronation. Therefore, we would recommend a small increase in the amount of support in your shoes. The Asics GT 2160's, which you are wearing in the video, are moderate support shoes. Therefore, you may consider trying a maximum support shoe to help prevent injury and ensure a more efficient gait.

        Next to each shoe on our website is a Footwear Performance Characteristic Grid which indicates where each particular shoe falls in terms of the amount of pronation control offered. Here are some of our recommendations for a maximum support shoe.

        Asics Kayano 18: http://www.runningwarehouse.com/descpage.html?PCODE=AKA18M2

        Brooks Adrenaline 12: http://www.runningwarehouse.com/descpage.html?PCODE=BGT12M2

        Saucony ProGrid Omni 10: http://www.runningwarehouse.com/descpageMRS-SOM10M1.html

        We encourage you to continue wearing the insoles to provide extra arch support. While maximum support shoes will offer additional pronation control, they may not provide adequate support for your arches. Extra arch support can often help prevent excess inflammation of the plantar fascia, decreasing pain from plantar fasciitis.

        2013 Goals:  stay under 20 for 5k(19:39 best this year), min. 60 mi. / mo.


        "Who you are will show in what you do"

        the REAL JZ

          Thought I'd share an update for those who are dealing with same/similar issues.


          I got a bunch of OTC arch supporting inserts, forced myself to NOT run for two weeks (save one or two 2 -3 mile jaunts on the treadmill), took Advil daily for about a week and then as I had pain periodically for another week and I'm happy to report that I'm nearly pain free!


          I'm getting a few twinges rarely over the past week in my posterior tibial tendon and any arch pain is minimal.  In fact, I can jump out of bed in the morning w/o hobbling for the first few steps.


          I've limited my running over the past week to slow pace and on the treadmill.  I just ran a few miles each of the past three days with no ill effects!  Going to continue with this course for another week and then try a run on the newly renovated highschool track. 


          Looks like I'll be able to pursue my 2012 goals and hopefully remain pain free!

          2013 Goals:  stay under 20 for 5k(19:39 best this year), min. 60 mi. / mo.


          "Who you are will show in what you do"

          Kate Waller

            This all is amazing. I am new to running and currently training for a 10K. I have had ankle pain most prominently on my left, but eventually in both ankles to the point of hobbling off of the treadmill. I tried the "run through it" thing... In trying to describe the pain, it's been like trying to nail jello to the wall -- on the inside, just slightly below the ankle bone, but will at times radiate to the sides of my calves or achilles area. Some training runs have been so painful, I couldn't finish. After some googling, and research, determined the best approach was to taper back. Got some new running shoes, which I learned I pronate in one foot but not the other. This store appeared to do all the right things, but apparently guided me to 'rollers' which are the wrong shoes. Back at the drawing board with a call to a PT, and going to return the controversial roller shoes, to purchase better ones at my local running store. In reading this blog,  Just wanting the body to match the momentum of my brain!