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Does physiotherapy help alleviate pain in the foot caused by posterior tibial tendinopathy?

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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 11561 Questions

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Posted on Sat, 20 Oct 2018 in Bones, Muscles and Joints
Question: Hello. My otherwise healthy 82 year old mother has been suffering from posterior tibial tendonopathy (tear) with flatfoot syndrome for over a year. It remains painful for her to walk on her left foot regardless of the shoes she wears. Her doctor opposes surgery but doesn't really offer any hopeful suggestions. He says it probably was due to the effect of years of pronation of the foot. Have you heard anything of ways to help this condition? Physiotherapy also does not really help. Thank you.
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Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
Surgery is the best option.

Detailed Answer:
Hello,

The best way to heal a torn tendon is surgical repair.
If it is an old tear then a surgery is even more necessary. If due to her physical condition a surgery is not possible then a rest with the help of a knee brace or knee supports is needed so that she can walk properly without a pain.
In addition to it she may need pain killers, hot compress and physiotherapy.

Hope I have answered your query.
Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Praveen Tayal 1 hour later
Thank you. We don't understand why the orthopedist is so reluctant to do surgery, even if the condition was provoked by an antibiotic over 1.5 years ago. She has tried a "boot" which she cannot use because it is too heavy. It doesn't help her to use a cane to help her foot. She just had a successful partial knee replacement on the other leg but her left foot condition gives her no peace when she walks.
How would a knee brace help the tibial arch condition?
doctor
Answered by Dr. Praveen Tayal 11 minutes later
Brief Answer:
Details below.

Detailed Answer:
Hello.

A knee brace will provide stability to the knee and can help in a painless walking. The instability in the knee joint due to tendon tear will be reduced. The pronation of foot can be helped with the boot only. A light weight fibre based boot can help in reducing the weight of the boot.

Hope I have answered your query.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal 18 minutes later
Thank you. Now what are the views on the so-called dangers of the surgery? For example, my mother's doctor told her that there is no guarantee the surgery would work and it could fail to correct the problem, and even result in the condition worsening. If this is the case, why would surgery be recommended for this condition if the chances of long-term success would seem to be so poor??

There was one other point: that her pain and recovery now from the partial knee replacement raises issues of putting weight on her legs, where now she experiences soreness on both legs down the thighs. Not to mention her own fears about surgery, etc. In any case I do look forward to your insights as always. Thanks.
doctor
Answered by Dr. Praveen Tayal 7 hours later
Brief Answer:
Details below.

Detailed Answer:
Hello,

If her doctor has suggested that the chances of having a successful surgery are low then it can be due to other degenerative changes, in the knee or weak tendons or a very old injury with a chronic inflammation which makes the tendons fragile and surgery difficult. This can be assessed after MRI scan and a physical examination.

All other conservative treatments have been tried and there has not been much improvement. In such a case it is best to use a knee brace and regular physiotherapy can help in restoring some of the mobility.


Hope I have answered your query.
Let me know if I can assist you further.

Regards,
Dr. Praveen Tayal, Orthopaedic Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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