Forums >Health and Nutrition>Post-Tib Injury - Very Frustrating
I am suffering from a Post-Tib issue that began 11-23. The initial trauma was not from running but I believe my ten mile run later on that night may have aggravated it although I really didn’t feel any pain until the last half mile or so. Went home showered went to bed, woke up the next morning and it was swollen and painful. I didn’t run but a couple of times over the next two weeks and then on 12-7 I ran a 5K. It was still bothering me but I had a good run anyways. All of December my ortho(not a sports doc) kept saying it was just a sprain, finally 1-10 I had an MRI done which only showed a little inflammation(I have been on prescription Naprosyn, prescription Ibuprofen and seven days of Prednisone(20mg)). Since the beginning of January I have been going to PT(from her assessment she agreed that it was a post-tib issue) twice a week and I have not been running. She has me doing a few exercises and she is doing ultra-sound on it. My ankle is still a little swollen (the inflammation we saw in the MRI) and I am still not able to run pain free.
So I want to know if anyone has had a PTT issue and recovered and how long did it take. I am getting pretty depressed from not being able to run. I love running but if I don’t get back to running soon I may have to go back to cycling and I really rather run.
Thanks in advance for your time!
Take my advice: Pull down you're pants and slide on the ice
Chief Endurance Dork
I can shed a little light on it -- I've treated lots of them over the years, but I'm not sure you're going to like what I have to say. ;-)
Posterior tibialis injuries are rarely tendinitis' or inflammatory processes. They tend to be a tendinosis which is a degenerative process as the collagen in the tendon breaks down. It takes a lot of work to get things to turn around and heal -- proper rest, supporting the tendon (splinting, orthotics or taping among others) ice, massage, conservative stretching, eccentric exercises.
Expect at least 3-6 months for healing time. And I would lean more toward the longer end of that spectrum. Doesn't mean you won't be able to run that whole time, but it won't be until later and it'll have to be modified.
I'm not the drug guy, but anti-inflammatories will work against the healing process of a tendinosis. They inhibit healing of collagenous tissue.
Good luck!
endurancenerd.com
Thanks for the reply.
Unfortunately it looks like it will be months before I return, it has already been over two months. I broke out my road bike Monday and started getting it ready. Hopefully riding won't interfere with the healing. I am still going to PT and as bad as I hate it I started back wearing some old orthotics I have just for support. As far as running during the healing process, my research has shown that pretty much no one has been able to run through it. I certainly don't want to get it almost well and injure it again.
Thanks,
Jeff
not bad for mile 25
I was hit with PTT trouble in late 2011. I took six weeks completely off of running in Feb. 2012, then carefully resumed. I detected zero improvement as a result of the time off. It abated somewhat by three months after that, and I was able to do a marathon in May. It persisted for a long time after that, however. The things that seemed to make it worse: Rest, even for a day or two. It would just stiffen up and hurt worse when I wasn't running. I did better when I started streaking, although the tendonitis was already much milder by then. In-line running seemed worse than trail-ish running or even playing Ultimate Disc. Stretching the toes back frequently during the day and when I went to bed seemed to help as well.
I did notice significant improvement when I started taking a daily multivitamin/multimineral. I can't prove correlation, but someone in another thread said that vitamin D helped their tendonitis. I'm still taking the vitamins, and a small (25mg) daily iron supplement.
Three years later, I occasionally have the slightest twinges, but I now consider it a 100% non-issue.
Thanks for the reply Led!
Yesterday I had Trigger Point Dry Needling(TDN). Not sure if it made any difference yet. I am hoping to cycle some tomorrow and hopefully it will not aggravate the tendon. I am having a hard time not exercising!
Thanks for the reply. Unfortunately it looks like it will be months before I return, it has already been over two months. I broke out my road bike Monday and started getting it ready. Hopefully riding won't interfere with the healing. I am still going to PT and as bad as I hate it I started back wearing some old orthotics I have just for support. As far as running during the healing process, my research has shown that pretty much no one has been able to run through it. I certainly don't want to get it almost well and injure it again. Thanks, Jeff
Cycling might be a good path for you in your recovery. Something LedLincoln noted, I've found to be true -- time off completely, as in doing nothing, is rarely helpful. Activity, but modified to prevent irritation is the key. Cycling may be "modified" enough to help. If you do get any symptoms on the bike, think about using a basic orthotic or shoe insert to support the arch in your cycling shoe. I don't usually recommend weight-bearing/running/walking orthotics for cycling (ones made specifically for cycling are best in the cases of most bike fitting issues) but in your case you can probably get away with it.