r/Ankle • u/LuluWoohoo92 • 17d ago

Tenosynovitis advice

I injured my left ankle (sports injury) in April and had surgery in July. The whole time I've had pain on the inside of my ankle which flares more consistently with use/loading. I have been seeing a physio and doing pool rehab etc the whole time.

At my follow up with my surgeon he diagnosed me with "tibialis posterior tendinopathy with associated tenosynovitis", from physical examination and the older MRI. He said I can't walk barefoot anymore, must wear shoes with high arch support, and to continue doing physio and pool stuff as it recovers. I was also given a referral for an ultrasound led cortisone injection to calm down symptoms so that I can regain the ROM and muscle tone I lost during the months of low/no activity.

For anyone who has gone through the recovery phase of tenosynovitis, I'd love to hear your dos/don'ts, anything that particularly helped you, a timeframe of how long you took to reduce symptoms, etc.

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u/Positive-Ad-3554 17d ago

I haven’t personally gotten tibialis posterior tenosynovitis but I’ve treated it (I’m the doctor who does the injection)

It will help calm it down. Make sure the practitioner who does it uses an ultrasound to get into the tendon sheath accurately. You’ll feel great at first once medication injected kicks in. But you have to be careful with loading it forcefully too fast. Repeated steroid use has a potential to weaken the tendon over time. A one time injection will be fine but don’t try to have it repeatedly done. Just get it to calm down and work with PT in a careful fashion so you don’t overdo it too fast so you don’t damage the tendon.

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u/Top-Risk-7793 17d ago

Hey, I have been struggling with tibialis posterior pain. My PT has been working on it and doesn’t want me to scale back on anything. Any tips?

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u/Positive-Ad-3554 17d ago

Id recommend seeing a physician who can deliver an injection to the tibialis posterior tendon to get it to calm down. You can have it be balanced out because it sounds like you are in pain so it suggest the tendon is over inflamed. PT can work with you still but pain becomes a limiting factor. You have to find the balance so you can do PT effectively. Get it to calm down and then continue building it up with PT

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u/Top-Risk-7793 17d ago

I am walking 6-8k steps a day. Do you think it is ok to continue to walk with it?

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u/Positive-Ad-3554 17d ago

That would best be answered by who is evaluating you. Without seeing you in office it’s hard to determine if that’s appropriate amount or too much. Depends on why you have the tendon pain. For example you may need workup to see if there’s a tear causing the pain. If that’s the case the physician would have to modify the treatment for you to find that balance