Post PTTD surgery FWB foot pain

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I'm 50 year old thin female, 9 weeks post PTTD surgery to repair the tendon. I'm now supposed to be fwb in a sneaker and ankle brace. I can fwb standing still, but my entire foot and outer ankle is too painful when walking to not use a crutch.

Saw the doc yesterday and he doesn't know why the pain is still so intense and said I shouldn't need a crutch at this point. He gave me a 5day course of oral steroids to see if that helps.

My range of motion is good, and foot/ankle doesn't really hurt standing or when doc and PT moves and presses on it.

Anyone else have this issue when walking after surgery recovery?

I can shuffle along, but doc and PT want me to do a normal stride. Normal stride is so painful. I'm worried and depressed. I thought I would be doing so much better by now than I am.

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  • Posted

    Hi Kim,

    My condolences to you on your struggle with PTTD.

    I had PTTD after an ankle fracture with bad sprain. I suspect you may be one of the unfortunates that develop PTTD from sports or other demanding ankle activities like dancers, etc

    If PTTD does not resolve and gets worse some patients do indeed opt for surgery, although I would never even consider that unless absolutely all else failed and I was so desperate.

    You didn't state your attending doctor's qualifications, but I hope they are a foot and ankle specialist with lots of experience treating disorders like PTTD. If they are just a plain vanilla orthopedist or ortho surgeon then you may not be getting top shelf care for your problem.

    Oral steroids are not a good idea. They can inhibit healing progress, and their effect is short-lived if they help at all with pain.

    When recovering while NWB, my ankle was pain-free and range of motion and movement was quite excellent-- yet when I went to weight-bearing (first in a CAM boot, then shoes) PTTD became apparent.

    The fun began with walking-- the post tibial tendon was a bit painful for quite a while. Squatting, going down stairs, and heel lifts were very problematic activities because of PTTD.

    I believe the key to recovering successfully from PTTD is appropriate physiotherapy exercises to strengthen and stabilize the post tib tendon and ankle joint. Unless or until post tib is restored to healthy state (flexible and taut) I really don't thing full recovery is possible. PTTD tends to progress over time to a chronic and worsening condition if unchecked.

    There are some good PTTD and post tibial tendon videos online, not to mention some good articles.

    You might also want to check on prolotherapy, PRP, and the Graston technique for additional treatment options.

    Best of luck to you.

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  • Posted

    Thanks for your input, Kpower! I've had flat feet my entire life and walked/exercised alot and wore the tendon out. My doc is a foot and ankle specialist. I opted for the surgery because I was in constant pain and couldn't do any of my normal activities. Doc said when he was in there, my tendon had 2 longitudinal tears and looked like spaghetti strands.

    At 9 weeks, it should be healed. The tendon area isn't too sore, it's the outside of my ankle and my foot that are painful when walking.

    Doc said a short course of steroids would be diagnostic, to see if it's inflammation in the joint, not related to the surgery.

    I just thought I'd be walking pretty well with minimum pain by this point. It feels like this will never end.

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  • Posted

    Kim,

    That's very interesting that your pain and discomfort are on opposite side of ankle than tendon. I wonder if it could be a side effect of surgery somehow.

    Ankles seem to be prone to be irascible and unpredictable in presenting symptoms, sensations, and pain. There is such a bewildering array of soft tissue down there that it is not surprising so much can potentially go wrong. So what explanation does your doc have for this phenomenon?

    My hunch is the pain will diminish over time. If it doesn't improve fairly soon you will want to huddle with doc and come up with a Plan B. You don't want a delayed or diminished recovery.

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  • Posted

    Kim, I broke my ankle August 20th I am still in a lot of pain. Last night I accidentally slept on my plate it's terrible. Be patient it's not an overnight thing.

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  • Posted

    I will say that I am currently 13 weeks post op from the following surgeries:

    FDL tendon transfer

    Removal of accessory navicular bone

    Spring ligament repair

    Gastrocnemius Recession

    Calcaneal Osteotomy

    Removal of existing plate over 1st metatarsal.

    Fusion of 3rd TMT joint (previous Injury)

    I have been full weight bearing in a shoe for about 2 1/2 weeks.

    Even just the PTTD surgery can take upwards of 12 months to fully heal, with that being said expect the transition to full weight bearing to take some time. I also have a lot of pain in the outside of the ankle and it seems like it's pretty common. I recently was told by my doctor that my foot is as flat as before surgery and it appears the reconstruction has failed, these surgeries can be long and tiresome, try to be patient and I hope you find relief soon!

    Thank you,

    Cassidy

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