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Monday, February 24, 2020

Posterior Tibial Tendon Braces

Hi Dr. Blake,

I sprained my ankle about 8 weeks ago.  I had very little pain, swelling, and bruising and was walking on it the next day.  I then realized that I had lost significant range of motion in my foot which concerned me, so I took it easy for about three weeks, only walking as needed but not walking for exercise.  A month after the injury I was still concerned about the limited range of motion ( up, down and side to side).  I was also concerned about my inability to raise my heel off the ground when standing only on that leg.  I had watched a lot of youtube videos about sprained ankles and that didn't seem to be a symptom.  

So, after a month I went to a podiatrist who confirmed that I had a grade one sprain of the ATF.  I told him I was concerned that I couldn't raise my heel when standing on that one leg, but he didn't say anything about that.  Now, eight weeks after the injury, my foot is basically pain free although it still appears slightly swollen and bruised on the ATF side.  I can now raise my heel off the ground easily when seated (not weight bearing) but can only raise it an inch or two off the ground when standing on that one leg.  At least it is improving slowly.  

I just did some research online and learned that my symptom is likely due to PTTD.  That may also explain why I have been having a feeling of pulling under my foot (sometimes when I walk) basically where the back of my arch meets the underside of my heel.  It looks like that is right about where the PTT wraps under the foot.  

I have been wearing the blue powerstep insoles but am thinking about switching to the red ones that offer even more arch support to hopefully take more pressure off the PTT.  Also, I found a couple PTTD braces online, and I was wondering if I should get one of them to wear for a while.  Wondering if you would recommend one of those and if so, which one and for how long?  Here are the ones I found-

I already have an ASO brace and could use that, but I'd rather get whatever is best for this.

Thank you for your help!!  I really appreciate it.

Dr. Blake's comment: 

The above Bioskin brace was touted as a good one for his Stage 1 PTTD by one of my patients. Aircast and Richie's are for advanced cases which I hope you are not. See my video also of posterior tibial taping with leukotape, a good alternative to braces usually. Rich

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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.