Tibialis Posterior Tendinitis

Ilanchess

New User
I've been diagnosed with Tibialis Posterior Tendinitis today. Has anyone ever had something similar? And how fast did you begin hitting after?
 
What did your doctor tell you?

The problems with tibialis posterior tendinitis are that it takes time for the initial inflammation to go down, and a modification the activities/ modification of the footwear to prevent a recurrence. There are also leg exercises to help strengthen the muscles to prevent a recurrence, but after the inflammation has subsided.
 

dberke

New User
I have the same ankle tendonitis. I got it a couple years ago from increasing my running distance too quickly. (Tough way to learn that lesson.)

I went through lots of anti-inflammatory drugs, icing, 1 cortisone shot, and lots of rest. I found that a good set of orthotics made the biggest difference. I have a custom made set that honestly isn't as good as a brand called "Sole". You heat them up in the oven and they conform to your foot. You have to take out the original insole in your sneakers to get them to fit. I also wear an ankle brace when I play. (McDavid or ASO are the best in my opinion...the type that laces up and have the figure 8 straps.)

Now I play 3 times a week for ~1.5 hours at a time and have no problem. Every once in a while it acts up a bit and I just take an extra day off.

I think the best thing was the insoles to give some support to your arch. The brace definitely is good, but I can play without it. At this point it is just a psychological thing.

Good luck. Be smart about it and give it some rest before you play a lot.
 

Suezee

New User
I am a physical therapist and see this problem in my practice. If you can find a good PT in your area who understands foot pathology and can fabricate orthotics for you, that would be a good thing. Typically, posterior tib tendinopathy is caused by over-pronation, and a good therapist might also be able to identify other contributing factors. (Weakness, muscle imbalances, tight muscles). I would hope that they would look at your mechanics all the way up to the hip, because weakness and tightness patterns there can also contribute to over-pronation. Regarding over the counter orthotics: I plan to look into those "Sole" ones that were recommended. The only thing about those is that I would want to add some posting to the bottom of your foot before the heating process so that they are molded into a more ideal, rather than dysfunctional foot posture. In my practice, if someone has just mild foot dysfunction, I find that the SuperFeet orthotics help most people. (In fact, that's what I wear). We never really know if orthotics are going to work until we try them, so before I have someone shell-out $300, I have them try the Superfeet ($44), maybe with or without a little posting additions from me. Alot of the time, that's all that is needed, but if my patient needs more support, then we go with the custom orthotics.

You might want to check out my post on "tendonitis vs. tendonosis" to get some more information on the pathology. Good Luck!
 

Suezee

New User
One more thing...once the soft tissue of the foot starts breaking down, I find that in the early phases, orthotics alone are not enough. I often need to tape my patient's arch, in combination with the orthotics, until most of the pain goes away, then we tape just for sports, then you wean off the tape. It's usually a two to four week process to get to the orthotics alone. I am currently taping my son's arch (he has an accessory navicular bone). I will try to film it and post it on you-tube so perhaps you could learn to tape your own arch.
 

Ilanchess

New User
My doctor told me to

get rest
ice 2 times/20minutes a day
take aleave twice a day
wear tennis shoes all the time
wear my brace (ASO) as much as possible.


My first practice is this Friday and he told me that I could practice, but just avoid doing serves and overheads.

Also he said I should start doing some biking this week gradually.

I stopped playing tennis on December 25 and since then haven't played and have been getting rest. Also I just started icing and taking anti-inflamm. a couple days ago, do you guys think that I will be ready to hit on Friday? I'm really nervous about it because I'm a freshmen at a community college and I've never hit with the team before and it doesn't seem right to miss the first couple practices.

I will look into shoe orthotics and ask my doctor about them.

Any further comments will be much appreciated.

Thanks.
 

Ilanchess

New User
Also,

dberke how long did it take you since getting Tibialis Posterior Tendinitis to play again?

And is it okay to play if there is still some swelling?
 

dberke

New User
I'm not the best person to answer this because I got the tendonitis when I was running and not playing tennis. As far as running (3-6 miles) I'm never running again. I went through months and months of PT, etc and never got to the place where I could go jogging comfortably.

I started playing tennis regularly (3 or 4 times a week) about 2 years after my original ankly injury. A month in, the tendonitis came back. I was smart this time and stopped playing for a week...maybe 10 days and started wearing the brace and orthotics. Now it's not a problem at all.

The trick is to be smart and not play if your ankle hurts. (easier said than done) If you catch it early, it is pretty easy to cure. If you run for months on it in pain (me) it take a long time to get back.

As I said before. Orthotics, rest, ankle brace, and stretching calfs/ hamstrings should do it.

I was reading the Pete Sampras book and found out that Pete had the same type of tendonitis when he switched to a different shoe. He then finally wen to his famous Nike Oscillates and evidently it was one of the things that made it better. This story made me feel pretty good because I'm not the only one who is dependent on the right mix of footwear, orthotics, etc.
 

Ilanchess

New User
Update:

I started to do some light running and biking and was fine, but today we had our first team practice, and 5-10 minutes into practice my ankle started hurting.

Now it hurts when I walk.


I thought for tibialis posterior tendinitis you shouldn't have any pain when you exercise, only after?

So is it possible I have some entirely different injury?

This is soo frustrating, I waited three weeks to rest with no tennis and came out today to play and started hurting in 5 minutes.
 
Did you get that orthotic?

If you need one, but didn't get evaluated/ didn't get it, the same underlying foot angle problem will cause you to almost immediately have the same pain.
 

PD1978

Semi-Pro
I have it as well.
I’m a MD. Going to take at least 8 weeks off from playing tennis and get corrective insoles. I have flat feet.
 

PD1978

Semi-Pro
Ugh mine is taking a very long time to heal. Getting MRI to make sure it’s nothing more serious. Haven’t played tennis in 8 weeks.
 
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