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Tuesday, July 4, 2017

Post Op Accessory Navicular and Posterior Tibial Tendon Surgeries

Dear Dr Blake,

I came across your website and hopefully you can help with some advice.

I am 44, male and had a operation in December 16.  I had an excision of accessory navicular on left foot with reattachment of of tibialis posterior tendon. I was suffering from inflammation and pain on the tendon for many years and got worse ever after having custom orthotics (two pairs).  (being overweight not helping).  I used to play a variety of sports – badminton, tennis and cricket and hoping to resume soon.  I did play tennis for 1hr at moderate pace last week and did not suffer any issues.
Dr Blake's comment: Functional orthotics are actually designed to make the posterior tibial tendon work better, so that is a problem we sometimes face when we are trying to support and prevent the tendon from being over-stretched. Post-op hopefully they will work better for you. 

I have done all the rehab, physio and still do some physio now when time allows.  I only get mild pain now but want to make sure I have full recovery.
Dr Blake's comment: Hopefully you are using level 6 theraband 2 sets of 25. I will send you the link below. 

The problem is that I have quite large (size 11 US) and wide, flat feet and find wearing insoles very difficult as they invariably do not fit my feet.  I have been wearing the attached in my work shoes (3/4 length, full length don't fit) and seem to work fine, although I can’t wear too thick socks.  I was advised by my physio that I should wear some sort of low arch insoles which would help.
Dr Blake's comment: Could you go back to the custom ones? They should work, although I know you are a bit leery of them. Taught to the doc who made them. Your photos show fairly wimpy orthos for a big guy. 

Do you have any recommendations for insoles that would fit my requirements as my current ones do not fit my trainers and more importantly I want to buy some trainers which I can wear during my sporting activities. (ideally will wear one pair for all, or running shoes)  Ideally I would like to wear trainers that have appropriate support without the insoles.  Any advice on trainers?
Dr Blake's comment: If you want to stay OTC go to Sole inserts since they have more support. Also, get the New Balance Cross Trainers about 1/2 size larger. They have good width selections. The New Balance 1260, 990, or 860 should be fine. But you want to pick the one that feels the most stable to you.  Hope this helps you. 

I hope you can help in this matter.

Many Thanks

PS You also do well taping for long activities for the next several months while you get your strength better.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.