I've been reading your blog archives since I first started having
problems with my foot. It's kind of a long story, so I apologize in
advance for the length.
I am/was a runner. I ran anything from 5K through ultras. I had been
running in the same pair of orthotics for 4 years at that point and
never had a problem.
Then last May (2015) I developed PF in my right foot. I rested, iced, rolled
and it wouldn't go away. I saw a Sports Med Doc who eventually gave
me a US guided steroid shot into the PF. He had me run on it within
three days. I was fine until when the shot wore off
and then I was worse than before.
The pain was still bearable, I could walk but not run. In September,
one month after the shot, I was hiking and felt a pop in my arch just
in front of the heel but more towards the outside of the foot. The PF
got a lot worse after that.
I saw a podiatrist right after that. The area was red and puffy and
he noted that my ankle rolled in a little more on that side. I have
very high arches and roll in a little on both sides so I didn't make
note of that.
He had me fit for corrective orthotics. When they came back, they
inflamed my heel really badly. I started aggressively rolling and
stretching my arch (I think this is part of where I went wrong and
tore or worsened the tears). I kept having the orthotics adjusted
because they really hurt my right foot. They adjusted the left to
match, even though I was fine on that side.
About this time, this is late November now, I was at the gym and
couldn't do a heel rise. My foot was in almost constant pain, my
podiatrist was very dismissive and told me I was fine. He didn't
really seem concerned with my pain or inability to do a heel rise. He
told me that I shouldn't be doing them anyway with the PF (??) but
sent me for an ultrasound "for my peace of mind".
It showed that I had a full thickness partial tear of the PF and split
tear of the PTT. He put me in a boot and wanted to see me the
following week. Immediately the boot hurt, it had no arch support so
he put in lifts.
By the time I saw him the next week, my foot was painfully swollen and
it was discovered that I developed a blood clot in my calf. He took
me out of the boot and had me NWB. This was mid December. After that
he took one phone call from me telling me to stay NWB and that he
wouldn't see me until I was cleared by a vascular surgeon. I was
cleared, but that podiatrist didn't take or return my calls after
In the beginning of January, I started seeing a new podiatrist. She
ordered an MRI that confirmed the PF tear and showed a small
insertional tear of the PTT. She thought I needed surgery but her
colleague came in and said that it was small and he thought most of my
problem was from atrophy. He wanted me to go from the crutches to my
sneaker. In a matter of five minutes I had gone from needing surgery
to needing nothing, not even a boot.
I was confused and still in pain so I decided to see an orthopedist
foot and ankle specialist. He had me go from crutches to a boot,
which I thought was reasonable. He said that the PTT tear was small
and most of the problem was from the large PF tear. My arch still
hurt in the boot so he had me wear the orthotics I had gotten in
Nov/Dec in the boot.
Around this time, I started getting tingling and pain in my left PTT.
We thought it was compensation. Mid February I came out of the boot.
I was doing physical therapy twice a week and things seemed to be
improving. The PF pain was gone. I was able to do weak but pain free
single heel rises.
I kept having medial ankle pain whenever we would do any balance
exercises. I took a day trip walking around a city and afterwards I
had swelling all long the left PTT. I was very concerned and went
back to the orthopedist. He put me in an aircast PTT brace and told
me that he'd send me for an MRI if it didn't improve. I asked him why
this was happening and he said he didn't really know. I have very
high arches and that should protect the PTT.
Sorry, I know this is long, I'm almost at present day.
The symptoms calmed down and I stopped using the brace after about a
week. I kept trying to figure out why the left was hurting me. I
decided to try my old orthotics again, the ones from now five years
ago, and my left PTT calmed down immediately. The right one
aggravated the heal and irritated my ankle.
I thought the problem was that they were old and needed some tweaking.
I dug around and found the name of the podiatrist who had made the old
orthotics. He took x-rays and discovered that I have an accessory
navicular, which, he says, is very uncommon in high arched feet. He
has scheduled me for shockwave treatment on my PTTs. He wants to have
the old orthotics refurbished and has me wearing them with a gel heal
The shockwave won't fix the right foot where the arch falls a little
but he thinks that it will help heal the damage. The plan is to try
to stop it from falling further with my old orthotics. I've tried
wearing just the old orthotics but on the right foot, the one that
tore, they cause my arch and ankle to ache badly, and the outside of
my foot to hurt. Yesterday I was limping, my ankle swelled and
something by my lateral ankle sounded like a knuckle cracking when I
walked. Today I'm wearing the orthotics that hurt the left foot
because they are better, but not perfect, on the right.
My questions are:
Can they make me one orthotic to deal with the PTTD on the right side
but not make the same adjustment on the left? I think that's what
caused the problem on the left side.
Can orthotics really halt the progression of my arch falling?
Will I be able to run again if I have proper orthotics? Will anything
get me back to running?
Is having the accessory navicular removed a reasonable option? From
what I've read, they anchor the PTT down where it should have been
instead of doing a tendon transfer. If that's true, wouldn't it be
better to have that done before the tendon stretches out even further?
I'm really starting to lose hope that I'll ever be able to even go
about my day without one PTT or the other bothering me, let alone run
or hike or any of the other things I love.
Thank you so much for taking the time to read this. I appreciate any
advice you may have to offer.