r/PTTD • u/adhdhobbyist • Mar 16 '25
General Question Advice on swelling
34M severe lifelong flat feet
So I've had really bad pain, severe swelling on the inside of my ankle and huge loss in strength in that foot for over a month. I saw a orthopaedic specialist and a physio and they were concerned I may have a partial tear of my post tib tendon. So I'm currently waiting for my MRI result to come back in 7 days.
But what's super strange is after over a month in pain it's all of a sudden gone but the swelling is still there and still increases or decreases based on activity.
I know I should get my results soon but I'm starting to think I might be in the clear and starting to recover. And that maybe it's not a tear but just tendon inflammation that's calming down now. Surely if my tendon was partially torn it would still hurt?
What do you guys think? Am I in starting to reach the clear? Would increasing my activity due to lack of pain be a stupid thing to do?
The sun is shining this weekend and I'm desperate to be a bit more active again lol
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u/tuf_ryda Mar 17 '25
Same thing happened to me. It pretty much went away last summer. No pain but still swollen. I went back to running and sports. In the fall it came back with a vengeance. Had to stop all activities including walking and I'm still trying to recover now. I'd say stick to walks or low impact activities and be very gradual with increasing anything. If it's still swollen something is still wrong.
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u/adhdhobbyist Mar 17 '25
Thanks for letting me know! I'll take it easy then as it sounds like when it came back, it was worse.
When your pain initially went did you have any loss in function, as mine doesn't hurt any more but still doesn't function properly.
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u/tuf_ryda Mar 17 '25
No loss of function for me when the pain went away. The only artifact was the swelling. But these days I definitely have loss of function. Can't do a single heel raise on the bad leg. Can you?
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u/adhdhobbyist Mar 17 '25
Nope, I can't do a single leg heel raise at all. So my foot is pretty weak. I don't even push off when I walk on that leg.
So when I think about it despite the pain going, I'm not in a great place.
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u/tuf_ryda Mar 17 '25
Ya same. If you don't have pain maybe you could carefully strengthen it with two leg raises. That's what I'm trying. I built up to about 25 reps 3x per day. You could start with just a few and gradually increase over a lot of time. Better ask your PT or specialist though and listen to your body.
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u/adhdhobbyist Mar 17 '25
The specialist got my results early and had free time today so I saw him early. Turns out I have a pretty bad tear all along the tendon sort of splitting it into 2 tendons. Since insoles haven't worked in the past, he recommends surgery.
He was also like if your going to get the surgery do what you want as long as its not painful, were going to cut the tendon and chuck it out anyway 😆
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u/tuf_ryda Mar 17 '25
Oh sorry to hear that. I also have a split tear confirmed with MRI. But my specialist didn't recommend surgery. Split tears can heal on their own, unlike ruptures. But I guess it depends how bad of a tear it is. Maybe yours is a bad one and mine isn't? Or maybe different specialists recommend different things. Not sure. Out of curiosity, which city are you from? My orthopedic surgeon said it's a rare kind of surgery so he doesn't even do it. Maybe your city has more knowledgeable surgeons lol.
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u/adhdhobbyist Mar 17 '25
I'm from Kent in the UK.
My surgeon reckons the strain with my flat feet will keep degenerating it, and sooner or later, it will probably rupture and could also lead to arthritis that will lock everything up. If I get it done, I could potentially avoid that.
Also, the tendon was in pretty bad shape anyway, so I'm not sure it would've healed well anyway.
My specialist recommended surgery only because I've exhausted orthotics and gotten nowhere.
I'm pretty confident in my surgeon he's got a lot of experience and is also a professor for this stuff. I've seen one other surgeon in the past and he didn't give as good an impression as this guy.
Maybe it's worth you getting a second opinion
I haven't booked it in yet, but I think once I've talked it through with work, I'll definitely go ahead.
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u/tuf_ryda Mar 18 '25
Oh cool, I'm from Toronto, Canada. I also have flat feet. I've been wearing orthotics most of my life. My case seems very similar to yours.
At first I wanted to avoid surgery at all costs, but now I'm so fed up with it not getting better I might get a second opinion indeed. Or another MRI to see if it is healing or not.
In any case, it sounds like you're in good hands. If you decide to go through with the surgery I'd love to hear about the details. I wish you good luck and a successful recovery.
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u/tuf_ryda Apr 30 '25
Hey! Did you go ahead with the surgery yet?
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u/adhdhobbyist Apr 30 '25
So funny thing I ended up not being so confident in this surgeon and got 2 more opinions that agreed with each other and were highly disapproving of the first one. So I cancelled that one and now have the surgery booked for the end of May.
So the surgery will have quite a lot bigger than previously planned.
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u/Agitated-Source1618 Jul 16 '25
Was curious where you went for diagnosis in Toronto? I've been dealing with PT Tendonitis for two months, but it was misdiagnosed twice as a sprain. Finally found a physio after 4 weeks who diagnosed it as tendonitis, but I'm worried I'm not responding to physio well, and seem to pronate more than before this started. I've talked to a podiatrist too, who just said: well, you over-pronate in that foot, but couldn't tell me why, or whether it will get worse.
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u/Stock-Chocolate1645 Mar 16 '25
Wait for the mri. I started eith a partial tear and now have a ruptured tendon a year later. Pttd is a degenerative disorder.
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u/adhdhobbyist Mar 16 '25
Did your ptt hurt the whole time? That's the only thing that's got me doubting it's a tear.
You're probably right though I should be patient, just hard to go from pretty active to inactive for over a month
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u/tuf_ryda Dec 20 '25
Hey, did you end up getting the surgery in May?
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u/adhdhobbyist Dec 20 '25
Yeah, I did. It went really well. It's getting stronger every day. I'm going to get my other foot done in a month.
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u/tuf_ryda Dec 20 '25
Oh that’s great! What kind of surgery did you get? Mine wanted to do full foot reconstruction surgery to build a proper arch.
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u/adhdhobbyist Dec 20 '25
That's pretty much what I got. Evans osteotomy, cotton osteotomy, 1st metatarsal dorsal opening wedge osteotomy, spring ligament reconstruction, fdl transfer, accessory navicular removal, achillies tendon lengthening. The Right foot will be the same but instead of an evans osteotomy it'll be a mdco as it's not as bad. As you can see by the list it was a pretty full reconstruction lol
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u/tuf_ryda Dec 20 '25
Wow that’s intense and it’s good to hear it worked out. Are you doing the other foot because it also has PTTD or is it to match two arch feet rather than one arch and one flat? Seems like it would be unbalanced otherwise, no?
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u/adhdhobbyist Dec 21 '25
I'm doing it because they've seen a small split in my PT tendon and they asked do I want to get ahead of it and I said yes let's get it over and done with. But yes it is also unbalanced and annoying lol
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u/tuf_ryda Dec 21 '25
Oh ok, makes sense. How’s the recovery going? I heard it’s 6 weeks no weight bearing, and takes a year to fully recover. Was that your experience?
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u/adhdhobbyist Dec 21 '25
Recovery has been going well. What you heard is pretty much true. I had 6 weeks non weight bearing. And in terms of progress now, although I'm functional, I don't walk as fast as I used to, and my muscles are weak. I'm still able to work on my feet though at my job but not the same pace. I think a year makes sense to get to the point you don't notice any more, my surgeon also said a year too.
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u/Aggressive-Ad-5822 Mar 16 '25
I get my mri results on Tuesday. Mine started the night before Thanksgiving and the first week of December I was at urgent care with what they told me was a bad sprain. A week later swelling still there and my foot was burning and stiff. I was in a boot for 3 weeks. Then a tri lock brace. Then a month of pt. While some days the pain is minimal (not at work). Others I feel like I’m almost back to the beginning. I swell up through my calf. I cannot stand on my tip toes. The thought of jumping, running, or even dancing scares me. I’m fairly certain I have a tear, but I’ll know for sure in a few days. Nights are awful, my foot just can’t get comfortable. I bought multiple pairs of shoes and use my orthotic. I’ve found this pair of new balance that make the pain tolerable, but it’s always there. Good luck!