Posterior tibial tendonitis

[sharileedahl]

Hi Anna. A couple thoughts for you...
1. Are you still seeing your physiotherapist. It MAY be important to address more than just your foot. For example, hip strength and / or your back can play a role. Basically a thorough assessment should be done.
2. Orthotics are a very valuable addition to a rehab program. An arch CAN be built up too much however I am sure that your podiatrist assesses specific things with your foot and general alignment to ensure that is not the case. But...don't be afraid to ask questions and have him/her describe what they are changing and why with the orthotics.
3. I LOVE Soloman shoes and yes they are good shoes. However....I do have a narrow foot. There are lots of good shoes out there but the most important part when choosing them is to ensure they fit YOUR foot. Also ensure that they fit well with your orthotics. If you are in an area with a good specialty running store, the sales people are very knowlegable about feet and which shoes would best suit your needs. (This is the case in Canada anyway....I would think it would be the same in Scotland as running is a pretty universal activity)

[annaren]

Thanks so much for your reply. I have stopped seeing the physio at the moment as my podiatrist advied that I lay off the deep massage, ultrasound and laser for a while to see if it calms down. He think that continual aggrevation of it is not helping. I have followed his advise hoping so much that he is right. I have also just gone to a good running store and got a pait of good trainers that take orthotics well adn are quite stiff in the middle - the shoe they recomended.
I am not sure why my other foot is not flairing up as well or infact why the firt one flaired up at all.
Do you see people with this type of injurying getting better? I so hope so.
Anna

[sharileedahl]

Yes, they definitely get better.
If ultrasound and laser were irritating your symptoms then likely the condition was fairly acute...i.e. fairly inflamed. In which case, it makes sense that deep massage would continue to irritate it.
In the case that the affected structures are inflamed, they need to calm down before moving on in the rehab process. Unloading these structures is important which is basically what you are doing with orthotics (and activity modification which your podiatrist should be able to help you with as well).
It really sounds like you're on the right track. Try to be patient but also stay active with this rehab process (keep asking questions; make progressions as possible based on what you're advised to do)
I would encourage you to consult a physio again as things settle down. Not necessarily for deep massage as you mentioned but for a full assessment of your back, hips, feet etc. It's important to know how to prevent it from recurring and quite often the answer is not actually just in the feet.
Good luck!!

[annaren]

Thanks so much for your reply. My podiatrist has envouraged me to do some walking as I have been using my bike to get around as much as possible and so he said he doesnt really know how it will react to the orthotics adn I need to build up the muscles needed. I followed his advise this week and although I wouldnt say it has got any worse so far the other foot which never hurt before has started to hurt. I actually feel quite confused as I dont what is causing it and why it is not getting better. I guess I am more anxious at the momnet as I have trip for my PhD to Poland next week where I will have to do a fair bit of walking in the forest.

[sharileedahl]

A couple things you may want to try that could help with increased walking on your trip...
1. hiking boots. Good running shoes allow you to roll over your foot which takes pressure off the healing plantar fascia better than unsupportive shoes. Hiking boots have a stiff sole that doesn't allow the foot to flex as much which is valuable for hiking (when on uneven ground / under the weight of a heavy backpack etc.). They are valuable when it comes to healing plantar fascia (even when not hiking) because they may allow you to walk longer when necessary without putting much increased stress on the foot. Although all tissue needs some stress to heal well (which is why your podiatrist is trying to get you to increase your walking a bit), the tissue needs to be supported well when increased activity is necessary (like your trip to Poland). Continue to wear your orthotics in your hiking boots as well.
2. Hiking poles allow you to take a little pressure off the lower extremities. The alternative is a cane....I just said hiking poles because I am used to dealing with a clientele that shudders at using a cane but feel they still look athletic / outdoorsy with hiking poles instead. If you opt for a cane, talk to you podiatrist or local physiotherapist to ensure you are walking with it correctly.

Unfortunately needs for life don't always jive with rehab needs. So these are just two ways that may allow you to do what you need to do while decreasing stress to those healing feet.

As for the other foot...it's hard to say from here but it is not uncommon to end up with some issues on the other side due to compensatory reasons. Basically, the body is not stupid! If something hurts, it tries to find ways to move that feels a little better. Unfortunately those compensations can lead to other issues. If you are actively dealing with the one foot, the other one will inadvertently be addressed so you don't have to fear that you are "falling apart"!

On a side note....what's your PhD....why are you walking in a forest in Poland? Sounds interesting!