By far the best video on PTT. Thank you

@Biomechanicphysicaltherapy

5 жыл бұрын

brian swift Thank you!! 😊

Oh gosh! You are scaring me! I’m 53 and have been dealing with this for about a year. Thankyou for being so honest.

@Biomechanicphysicaltherapy

5 жыл бұрын

Wendy Quarles it might be fixable! Start by getting an aggressive pair of orthotics!

@kaliyepalata9973

4 жыл бұрын

@@Biomechanicphysicaltherapy I haven't and orthotics didn't work. Any advice?

@bw6078

2 ай бұрын

I've been dealing with mine for a year. How did you make out with yours? I see you were dealing with it quite a while ago.

Awesome advice...diagnosed spot on

I cannot thank you enough for making this informative video!!! I am so thankful 🥹😭🙏!!! I was misdiagnosed twice and not treated properly but your video is spot on! What a blessing you are for producing this educational video that’s light years better than the second rate podiatrist I saw.

@Biomechanicphysicaltherapy

Жыл бұрын

Hi, Thank you so much -- I am glad I could help. It makes it all worthwhile!

This was VERY Helpful ! Thank you !!

@Biomechanicphysicaltherapy

5 ай бұрын

You're welcome!

It was wearing my extremely comfortable and supportive hiking shoes for 2-3 years that allowed for this tendon to become so weak in the first place. From now on my primary shoe will be minimally supportive to allow me to maintain the strength in this tendon

@Biomechanicphysicaltherapy

4 жыл бұрын

Loud Noises Well I guess that is excellent proof that a high top lace up boot is a great way to rest an ailing tendon! Thank you. As an added point once the tendon is calmed down by resting in a high top lace up boot the strengthening program begins. You start out with isometrics and Thera band and progress on. Once it is strong enough you begin the transition into normal shoes. If you have a foot structure that always overworks the tendon then is when you would want to be in orthotics for the rest of your life. It may be that you only need orthotics for intense activity, it varies from person to person from activity to activity and foot structure to foot structure. Varying shoewear can help with overall proper performance and strength of the foot. The only reason to wear high top boots for the rest of their lives is if their tendon is already so shot that it cannot function.

Best video, really appreciate able,extremely simple and very helpful

@Biomechanicphysicaltherapy

Жыл бұрын

Thanks!

Excellent helpful information and advice for PTT. Thank you! I have gotten significant relief using the green superfeet and navicular sling taping. Please advise what the brand of the mid-high sneaker shown in the video. I truly need help with finding shoes and boots.

@Biomechanicphysicaltherapy

3 жыл бұрын

Hello @DBB I thought I replied to you but KZread is not showing it! The sneakers were HOKA.

Really good!

@Biomechanicphysicaltherapy

6 жыл бұрын

ingleschewy thanks!

thanks Dr Lisa for fab advice. whats your view on aircast boots to take pressure off tendon while it is healing?

@Biomechanicphysicaltherapy

6 жыл бұрын

joe scullion - Thanks! Yes aircast works great. Other braces - as long as they have the hard plastic uprights - work as well. They keep the ankle from caving in.

so helpful!

@Biomechanicphysicaltherapy

6 жыл бұрын

B. Bailey Thank you!

Love this - definitely the most informative video I've found thus far. My pain is located closer to the navicular bone and runs up my leg medially. I just saw a podiatrist two days ago who helped and gave me some loaner orthotics for my New Balance sneakers. She completely adjusted them and showed me how to wrap from the outside of my ankle and under my foot ...then up my leg ...and a second set of taping that runs horizontally around my calf (pulling from medial calf across my shin bone). All of this strapping...with the orthotics and my sneakers seem to be the best I can do to manage pain. I ordered the Airlift PTTD brace and the pain was not at all managed. Is there another brace to try.. or I need a higher arch shoe with the orthotics...or just continue as is? I'd also like to stay with low impact exercise (elliptical, rowing machine and spin class)...are those okay? Thank you in advance...I'm a Coloradoan living in Australia and struggling a bit with access to healthcare because I have to pay out of pocket for all of it.

@Biomechanicphysicaltherapy

4 жыл бұрын

Rachel Cooper I’m so glad I could help! It makes my day. Definitely while you’re trying to recover using taping and wearing the highest arch support you can tolerate will be great. What might work better for you since the ankle brace did not would be to wear a high top lace up boot like a Doc Martin. (in addition to the taping and the arch support!) That could help support the ankle. Also not as bulky as a brace. The best taping that I like for this is called the navicular sling and I think we covered it in this video. If not it is definitely covered in one of our other videos on taping. The navicular sling is done with McConnell taping and Jenny McConnell was Australian so that’s cool. Just be aggressive like this until your symptoms go away and then you can start backing down but always respect your pain. Icing will help as well. 15 minutes after exercise and if you have pain all the time do it a couple times a day. Low impact exercises should be fine but again if anything gives you pain then don’t do that. Try to add it back in later once you’re pain-free in only five minute increments. Everyone is going on about telemedicine right now because of the virus, if you would like to call or FaceTime if you have any more questions just let us know. I know there’s a big time difference but our telephone number is 703-723-7726.

@racoopUM

4 жыл бұрын

​@@Biomechanicphysicaltherapy You're amazing - thank you so much for this!! I wasn't expecting an answer within hours (and this was likely just because you were still asleep on that side of the world!) You have no idea how much your help means to me. Luckily the low impact exercise isn't giving me grief or pain...it's only been while doing any walking or standing. I've been trying to get weight off to help reduce the impact of weight on my joints, etc...but this injury bit me in the bum hard and I hated to think I could no longer do anything. I dealt with a fibula stress fracture last May (Weber-C...same leg) and had a few months of doing nothing and walking in a boot and then followed the guidance of a physio to do tons of exercises and then slowly increase my physical activity. I was just nervous I could be doing more damage or slowing the healing while I'm putting weight on it walking around or even when doing low impact exercising - so thank you for the reassurance of what I can/can't do. I tried the navicular sling this morning - I still had to add in the one that goes from the outside ankle to under the foot and up the medial portion of my leg to alleviate pain - but I can definitely tell a difference in the addition of the sling and I am adding this to the regime! :) I'll see how I go over the next couple of weeks (I'll try and be patient with this...I'm guessing this will take at least a few months of taping...and long term use of the orthotics?)..but I may take you up on FaceTime or a call. Again - thank you for all of this...I truly appreciate it.

Just found your video. Been in a cast for two weeks. MRI showed tears in PTTD with moderate PF. I looked into the brands of shoes you mentioned but have been unable to find the lace up boots you showed. Can you tell me where to look for those? G-d willing, I am desperate to get back to hiking. Thank you. And thank you for your video.

@Biomechanicphysicaltherapy

3 жыл бұрын

@Carrie Levine Basically any high top lace up boot with a lug sole will do. My current favorites are actually Free People brand, style is Taos. Dr. Martin’s are also good but sometimes the leather is a little stiff to tolerate. Hoka sneakers makes a lace up high top sneaker. Redwing and wolverine make nice high top lace up leather boots. Please make sure you have an orthotic or some sort of arch support in your cast if it is a removable one aka “cast boot”. If it’s a classic fiberglass cast then no problem but the removable casts are totally flat inside.

Great video. I was wondering if I could pick your brain on this subject. I have had problems with my left ankle for over 6 months now. I play tennis and have bowed legs and flat feet, so that is probably the reason why I'm in this predicament. A recent x-ray showed a spur on the bone which could be causing or exacerbating the symptoms. I was told I most likely suffer from Tibialis Posterior Tendinopathy. What can I do to be able to keep practicing tennis? Should I consider surgery to remove the spur?

@Biomechanicphysicaltherapy

3 жыл бұрын

@Marco Pagano Yes the boat legs and flat feet fight each other. Aggressive orthotics for running and then less aggressive orthotics for the rest of the time would solve your problem. I wouldn’t do surgery until I tried more conservative methods first.

Ankle brace in lieu of boots or taping works for me for pain relief. It has straps that seem to work similar to tape. Just throwing it out here. Tip - one strap is pulled tight the other is not. This corrects the ankle alignment. I use the Med Spec ASO brand.

@Biomechanicphysicaltherapy

3 жыл бұрын

I agree with you @ricky ricardo , thanks for adding this bit of advice

Thank you for posting the video, and for your time to explain the problem, I have that kind of pain in the right foot in my arch and it goes to my toes, but only when I run and after I stop and stretch is when it goes away I'm wondering if taping it , will help. Thanks again

@Biomechanicphysicaltherapy

2 жыл бұрын

Hello taping is usually only a short term solution because it tears up your skin. I would recommend getting an art support. He probably won’t tolerate a very high one in the beginning but will get used to it and then progress it to as high as you need to stop the pain. Don’t just ignore it though it can be a really bad problem go ahead and handle it now.

@tvamadeo8

2 жыл бұрын

@@Biomechanicphysicaltherapy I really thank you for your response,I will try to do, what you say and hopefully this works, god bless you.

Thank you for the video. I had the kidner procedure done on my foot for accessory navicular. You mentioned two shoes to get that were for pronation control to invert my foot. I went on brooks web site and Hoka sites but there are many choices. Which one do you reccomend? Thank you for your help 😎

@Biomechanicphysicaltherapy

4 жыл бұрын

The Fearless Fitness Hello the stability Hoka’s will control most for inversion. They do have lots of different styles these days! Be sure that whatever you get wearing the shoe decreases your pain. If it increases your pain you need more inversion. Whatever you do don’t tough it out! This is one pain that you should always respect.

@TheFearlessFitness

4 жыл бұрын

BioMechanic Physical Therapy thank you 😊

I use the altra provision shoes. They are slightly turned out as well as having an arch for pronation. I love them.

@Biomechanicphysicaltherapy

5 жыл бұрын

Izzy’s World thanks I will have to take a look at them and see if they meet my criteria!

@izzysworld6815

5 жыл бұрын

@@Biomechanicphysicaltherapy Great. I'd love to know what you think of the Altra Provision, once you've checked it out.

@Biomechanicphysicaltherapy

5 жыл бұрын

The Altra provision shoes look great! Nobody folded the shoes so I can’t tell if it only bends where the foot bends which is at the toes. So that would be the only thing to make sure that it doesn’t fold in half. It doesn’t look like it could possibly. So great job and thanks for the find!!

@izzysworld6815

5 жыл бұрын

@@Biomechanicphysicaltherapy hi. I'm glad you like them. Once I discovered the provisions, I bought version 2.0 and then the next version 3.0. they do not bend in the forefoot. They have a lot of stability and are very very comfortable to boot. Thanks for following up and your video has been such a huge help. Thank you.

Maybe this has already been mentioned in one of the older comments but I got IMMEDIATE RELIEF using an AirCast PTTD Brace. It's got an adjustable inflatable arch support which allows you to create as extreme an arch support as possible. This brace employs an adjustable strap that runs from the bottom inside of your arch and then up across the top of your foot, wraps around your ankle twice, and then attaches with Velcro. This strap mimics the taping that is described in the video. You can vary the pressure of the arch support by use of this strap -- and it's very strong so that you can apply a lot of upward force and then anchor the strap firmly around the top of the brace. The design is BRILLIANT. I've fallen in love (with it)! It is just a bit "clunky" but I wear it comfortably with my Keen Targhee II shoes. These are available from multiple suppliers and come for either right or left feet and four sizes. I've seen them on-line for as low as $30(US) with free shipping.

@Biomechanicphysicaltherapy

2 жыл бұрын

Thanks for your comment. Yes it is totally an excellent brace for this problem!

@KTurra88

2 жыл бұрын

Do you still wear additional arch support/orthotics with this brace, or is it strong enough on its own as long as you have good shoes? PTTD is suspected in my left foot, and for a little while now, have been starting to feel sore in the inner arch/inner ankle area of my right now as well. Have been dealing with all kinds of pains in my feet since March, & I feel like the heel post on my custom orthotics is what is making them so uncomfortable, but other OTC inserts that don't have the heel post don't help either, perhaps due to not conforming to my foot the right way. Thank you in advance, I am so desperate and have tried so many different inserts and so many different shoes.

@Biomechanicphysicaltherapy

2 жыл бұрын

@@KTurra88 Hello if your custom orthotics are giving you problem I would try to just wear the brace without them. Yes it is hard to get a custom orthotic just right sometimes depending on the philosophy of the person who made them. A lot of times the peak of the arch is too close to the heel and not really in the peak due to the way they make them in the factory. Hold up your arch support to the bottom of your foot while your foot is in a relaxed position and see how well the contour matches. If it doesn’t match you can try to have the person who made them remake them.

What kind of tape to use, I see 2 different kinds. I tried KT Tape but it does not seem to be strong enough?

@Biomechanicphysicaltherapy

5 жыл бұрын

Just Micheal it’s McConnel tape. It comes in a kit; the white tape is to protect the skin and the brown tape is very strong. KT tape is definitely not a structural tape. This one will hold the arch up. A good old-fashioned pharmacy may carry the McConnell tape kit & of course you could probably find it on Amazon.

Thank you for this video - I am a little worried as I think I have had this issue for at least 4 yrs I think, but it feels like an off/on thing and not always a problem. Sometimes worse than others. I do yoga daily, and stretch daily, so I am wondering if that's been helping me cope better?? Although I am at a point I want to see a professional about it. What kind of specialist should I contact? NOTE: I live in Puerto Rico right now and don't have health insurance at the moment. Thank you for your time. I hope this message reaches you.

@Biomechanicphysicaltherapy

4 жыл бұрын

kelly feaster Hi Kelly it sounds good that the problem is just off again on again. The first thing I would do is get an arch support and stay in shoes. You might want to notice what makes it hurt and stop doing that and what makes it feel better and do that more consistently. If you handle the mechanics you may not need to have physical therapy which would be good since you don’t have insurance. If you do need a physical therapist I would make sure that they know about foot and ankle because one of the wrong things that can happen is if the physical therapist gives you to many exercises too soon it will make you worse instead of better. This is not a thing that needs exercise to get better in the beginning. If the yoga strengthens your arches it may be helping you cope with it but a lot of times yoga is barefoot and can stretch that tendon strongly. So I don’t know that the yoga is helping it might be something else.

@kellyfeaster6707

4 жыл бұрын

@@Biomechanicphysicaltherapy Thank you so much for your reply. I appreciate your advice! I will definitely get an arch support. Living in Puerto Rico, as you can imagine, I don't wear shoes often and I know that's bad!! But I will start to wear them because I am getting worried this is going to get worse and I am only 40, I can't imagine having issues forever. I will keep paying attention to what helps and what doesn't. I am so grateful for your advice. :)

I have similar regional pain with my ankle regularly collapsing inward when running. It was connected to tibialis anterior muscle/tendinitis? My arches are ok and I have base line taping to help support my cuneiform bones which are hopelessly hyper mobile. Now I’m really confused.

@Biomechanicphysicaltherapy

3 жыл бұрын

@Sarah Bear actually what you’re saying makes sense. If your midfoot is very flexible and your ankle collapses inward, those things would overwork the tibialis posterior tendon. The tibialis anterior is the much larger one that also connects to the top of the midfoot but it’s primary function is to pull your toes to your nose. The primary function of the posterior tibialis is to hold the arch up in order to make the foot a rigid lever. For instance without the posterior tibialis you would be unable to raise up on your toes.

My PTTD was diagnosed in 2008, in both feet. Progressed through the years to create multiple issues with other areas of the feet/ankles. Surprisingly, no comments I’ve read, mention a similar experience. Recently diagnosed w PTTD flare-up, after many years. Though, normally not advised, I went w Podiatrist recommended cortisone injection, given the major inflammation of the entire foot/ankle. Weakens the tendon, but that’s why it needs to be immobilized & non-weight bearing for the 30 days the cortisone remains in the body.

@Biomechanicphysicaltherapy

3 жыл бұрын

Yes you are correct generally Cortizone injected into a tendon causes it to weaken and deteriorate.

I got my son the Brooks Adrenaline GTS recently as the custom orthotics caused too much pain.

@Biomechanicphysicaltherapy

3 жыл бұрын

@Michelle Osborne yes orthotics can sometimes be problematic. There are as many ways to make orthotics as there are people who make them. It could just be that the orthotic is hitting too far back on the foot perhaps too close to the heel maybe that’s where he’s complaining of pain the other thing that happens is sometimes people make the orthotics too rigid. People with this problem prefer an orthotic that moves and decelerate abnormal motion rather than totally controlling it and making a hard stop. If you would like I can give you a little consultation via video if you could show me the orthotics that you have and your sons but we might be able to problem solve it. It is often a lengthy process to go from practitioner practitioner and buying multiple orthotics until you find just the right one. I’ll be glad to help if you need it. It’s probably best to call the office at 703-723-7726 in order to set up a time for us to video conference about it.

@mollymcgee3290

3 жыл бұрын

I agree I have a pair of brooks and they a good but expensive

Thank you so much for this video! ❤ I think I have this. It started 3 months ago, but my concern is that the inflammation continue, with edema in the ankle. Until now I use orthotics that are supporting the arch, but for the virus situation I cant get out to seek medical attention ¿Is it bad that the inflammation continue 3 months after? Hugs!

@Biomechanicphysicaltherapy

4 жыл бұрын

Liz C Support it as best you can with the orthotics, ankle support until you can have it evaluated. The amount of time it is inflamed can make the recovery longer & swelling last longer, but that is an aside problem. The most important thing is to prevent further damage to the tendon. And that you can do by protecting it from further harm with the support of your orthotics or ankle brace or your high top shoes and not doing so much that you irritate it. Things are opening up now so hopefully you won’t have to wait much longer. 💛

@lizc5205

4 жыл бұрын

@@Biomechanicphysicaltherapy Ohhhh, Thanks for your reply! ❤ All that you said to me is really a lot of help for my body and my mind. Thank you for your time, I'm going to take your important advice into account. Thank you Dr. for all that hope 💛. Hugs!

Hi, thanks for the video - if you have a particularly aggravated case of Pttd and you managed to tape it well enough to calm it down, how long do you think it may take to calm down.. 1 week, 2 weeks, a month? I want to try it but don't want to go in blind, thanks for any help!

@Biomechanicphysicaltherapy

2 жыл бұрын

Hi. So you have already managed to calm it down? That would be a great indicator that it wouldn’t take too long. The secret is; Control the mechanics and decrease the inflammation both at the same time. If you can do that then it will take a shorter amount of time. In addition to taping I would wear orthotics and a high top boot and whatever anti-inflammatories your doctor has prescribed and that will be your shortest route. As far as predicting how long it takes if your symptoms are down within 10 days that it’s a good predictor that it shouldn’t take too long. Each person is different and it can take anywhere from a month to eight months!

@georgeowen9398

2 жыл бұрын

@@Biomechanicphysicaltherapy Hi thank you so much for the quick response. I've not managed to calm it down yet but i've had custom orthotics for the past month, and then last week i tried taping it for 2 days and there was a massive benefit (i think), when i took the tape off it reverted back to swelling and painful - so now i'm thinking of using the tape with the orthotics for a couple of weeks and assessing whether it helps reduce it. Would the plan then be to start slowly trying to strengthen it once all the inflammation is gone? Do you think there is any risk that by using tape on the tendon for an extended period time it negatively weakens the tendon and makes the situation work, or is that not a risk to be worried about at this stage? Thanks for any help

@Biomechanicphysicaltherapy

2 жыл бұрын

@@georgeowen9398 Hi no there is no problem with using the tape for an extended period as far as the ankle weakness goes. It’s sort of like the same thing as a cast. So yeah you could get a little weaker with it but you ve got to calm it down. The only problem with prolonged taping is it tears up your skin eventually. If you can get one of those ankle braces that are meant for post tib tendonitis they have a strap that you pull up on the inside similar to the tape, you could try that. Yes once you get the inflammation down and the mechanics handled then you would carefully add strengthening. It could be that your customer thought it doesn’t have a high enough arch or a big enough tilt.You can add tilt with a pronation control shoe. Aircast Airlift PTTD Ankle Support Brace, Right Foot, Large www.amazon.com/dp/B00P3D4FOQ/ref=cm_sw_r_cp_api_glt_fabc_8TJQQBEX3WJCX8ANEA0G

hi , I found this quite useful, thanks. I have been diagnosed with chronic posterio tibialis tendonapathy. I have had this injury for two years from overuse, had started suddenly playing a new sport for me basketball. I have had 4 physios so far and not much luck. everytime I make some progress, ( I reached to doing 10 single heel raises) I hurt the leg ( by maybe walking around shopping for 2-3 hours). Most recently I cannot walk without limping, and cannot do a single heel raise. Please could you advise if this means I need surgery. the pain has not reduced I have been resting for 2 weeks.

@Biomechanicphysicaltherapy

6 жыл бұрын

Are you wearing custom insoles and sturdy shoes that support your foot? Never sloppy shoes & never barefoot? The first thing that has to be done is fix the mechanics. If not, you have many alternatives before surgery. If you are wearing an aggressive insole (aka orthotic) and sturdy supportive shoes then surgery may be next.

@callshivi

6 жыл бұрын

Thank you for the quick response. I have been wearing Nike trainers all the time (www.zalando.co.uk/nike-performance-nike-revolution-4-neutral-running-shoes-n1242a1bz-q11.html?size=11&wmc=SEM44_EN_NAWBNARGNB_ZL.GO_PLA.&opc=2211&gclid=EAIaIQobChMIpZyOuI_x2gIV57ftCh3lowDhEAQYASABEgJDPPD_BwE&gclsrc=aw.ds) and bought these amazon 3/4 insoles (www.amazon.co.uk/Orthotic-Insole-Support-Plantar-fasciitis/dp/B00MV5O6NE) , I have been wearing these insoles since February. I do notice that pain is less wearing these but I dont know if these are correct. I only walk barefoot around the house. I have noticed the drop in my arch over the 2 years. Two weekends ago i wore flat sandals for 4-5 hours one evening at a party and I danced a bit (since then my ankle has been hurting so much that im limping) I have reduced to 0 activity since then, I walk maybe 20 minutes in the whole day to work and around the house. I do 2 minute hot/cold contrast therapy to ease the pain, but haven't seen much progress and im very worried. Please advice

@Biomechanicphysicaltherapy

6 жыл бұрын

callshivi OK so there is plenty of room for improvement and what you are wearing on your feet. Are you far from our clinic? you need aggressive custom orthotics ($180 with us) and an orthotic that will fit in shoes that you would wear to dancing. Hold off on flat sandals until your symptoms are thoroughly resolved. There are sandals that you can buy that will hold an orthotic and there are custom flip-flops. Test your Nike trainers with the bending test that I show in the video or it might be in the choosing shoewear video. Your shoes must not bend through the middle. Do not go barefoot until your symptoms are resolved. Orthotics at all times. Feel free to call the office and arrange an appointment to talk to me over the phone if you like. Our phone number is 703-723-7726.

@Biomechanicphysicaltherapy

6 жыл бұрын

Also your sneakers are neutral. You need a pronation control sneaker. An aggressive one like brooks beast or Hoka

Great video. Mine seems to hurt only when I “flex” my arch like when I do a short foot exercise. Is this something you’ve come across? The annoying thing is that it only comes back when I ramp up my running mileage

@Biomechanicphysicaltherapy

3 жыл бұрын

@Iqz yes it makes sense that it hurts when you flex your foot. And it also makes sense that increasing your mileage would cause symptoms. Have you tried an aggressive pronation control shoe like Hoka or Brooks Beast? Are you wearing arch supports?

@bunnyguy

3 жыл бұрын

@@Biomechanicphysicaltherapy Hi thanks for the reply. Yes I wear superfeets inside Kayano's which work. It is when I wear orthotics in more "fun" neutral shoes that the problems arise. Wearing the pronation control shoes give me other problems like front of knee pain so it is a balancing act.

@Biomechanicphysicaltherapy

3 жыл бұрын

@@bunnyguy Hi, I looked up the Kayano shoe, it says it’s a neutral shoe. So I would try pronation control shoe and custom orthotics. People with posterior tib pain often have a forefoot varus and no over-the-counter orthotic will correct that. If you want your mileage that’s what I’d recommend!

you seem to really know your stuff. QUESTION: My foot supinates and I still have PTTD from running. should I wear a shoe against pronation or neutral? I think the PTTD comes from a lower angle of dorsi flexion (the foot with PTTD is the one where I had lots of ligament injuries while playing tennis in my youth). what other reasons could there be when SUFFERING FROM PTTD while showing SUPINATION? thanks a lot!!!!! I REALLY appreciate it, no physical therapist could help me with it.

@Biomechanicphysicaltherapy

Жыл бұрын

Hello yes it is unusual to have PTTD when you have a supinated foot. It could definitely be related to the old ligament injuries which could be making your ankle a little bit unstable and causing your posterior tibial tendon to be overworked. Without seeing your foot I don’t think I would recommend wearing the pronation control shoe. A shoe with good structure & control but that is neutral would be good. A high top might be good but then you can’t really run in that. The trick would be to decrease the work of the posterior tib tendon perhaps by staying in hightops then do careful strengthening of the ankle and posterior tib muscle then move on to try and running after that. You basically need the post to your tendon to heal and become stronger in order to control the forces. Taping might help support the tendon without further supinating the foot. If your Achilles is tight it might be causing you to walk with your toe out like a penguin. Walking with your toe out can strain the poster tib tendon.

@David-rh2fe

Жыл бұрын

@@Biomechanicphysicaltherapy thanks so much.. will try all of your tips..

Hopefully I can compliment this a little! I'm an Australian PT who's passionate about trying to uncover the root cause of common aches and pains. I've put together a video on the broader issues I find set the Tib Post up to fail. These include things like ankle joint stiffness, tight hip rotators, weak hips, etc. Hope this helps as well! kzread.info/dash/bejne/rIpqxMSLkbHOqs4.html

Your funny! I appreciate this video. Thank u

How can you discount all the strengthening exercises that can be done to the musculature surrounding this area? It's disappointing to just see quick fix's like taping and arch support as your main treatment options. There are plenty of videos on youtube that highlight longer term and far more sustainable solutions to PTT.

@Biomechanicphysicaltherapy

5 жыл бұрын

Hello Alex Morose, Strengthening is definitely important -- but if it is done too soon it will only damage the tendon more. Strengthening is also well known and often used by physical therapists too much, too soon. It is critical that the mechanics that created the problem are handled first (tape, orthotics, arch support, shoes) and that the inflammation is decreased (iontophoresis, ice) and -- most importantly -- that the integrity of the tendon is improved (Laser, ultrasound, massage, healing time with support of said tape, arch support). I agree with you that strengthening is important and that it is not the focus of this video. Strengthening comes later in the process but it is definitely a critical part. Thank you for your input! (Sorry it took me so long to reply, your comment was censored and I did not realize it was neglected in the censor cache.)

@MicaelaAyers

5 жыл бұрын

This program of exercise also emphasizes the slow and careful work needed to avoid reinjury like BMPT states! kzread.info/dash/bejne/i59o0Mtqisayc7w.html

I'm diagnosed with pttd recently on stage 1,can I reverse this through wearing custom orthotics and strengthening Mai tendon? I'm so much worried..

@Biomechanicphysicaltherapy

6 ай бұрын

Hello, YES! You can reverse this. If you wear an aggressive custom orthotic it can allow the tendon to heal. You may need a period of immobilization. If you do, your doctor may have recommended wearing a walker boot. Do put your custom orthotic in your walker boot as it is very flat inside. Some docs disagree with me, but I stand very strong in my belief!

Hi - thank yu for this video. I have a question - I started wearing custom orthotics regularly in April 2021, then in December 2021 - I did some heavy squats barefoot (I know, big mistake after all that support). I've been in pain since then and have gotten higher orthotics as well. However, I find wearing them very painful and would like to go back to life without orthotics. I should say I'm quite active and like working out with weights and walking. Am I being realistic in thinking that I could manage without orthotics?

@Biomechanicphysicaltherapy

Жыл бұрын

It really depends on the type of foot you have. I would have to see your foot to answer that question.

@zannahbenjamin

Жыл бұрын

@@Biomechanicphysicaltherapy Thanks - i'm based in Hong Kong - but would love to a proper consult online if that's a possibility?

@zannahbenjamin

Жыл бұрын

@@Biomechanicphysicaltherapy Thanks - I'm based in Hong Kong, but would love to do a proper consult online if that's a possibility?

@Biomechanicphysicaltherapy

Жыл бұрын

@@zannahbenjamin You could do a telemedicine visit. I would probably need you to have someone there to hold the camera at funny angles or maybe move your foot for me. If you would like to do that you can call the office in the US at 757-917-7857 to set it up. You would need to talk to the receptionist in order to be able to schedule it as I don’t schedule my own appointments.

@sahfora3388

Жыл бұрын

I have early p t t d and ultrasound results show that I have inflammation around the post tib. I did get custom orthodox and I have a flexible flat foot and they are extremely painful and my arches feel a little bruised when I wear them. What i'm going to do is go into a walking boot for a month so when I have to walk a little farther than five minutes my tendonist being supported. After that I will get a richie brace. I don't know if my tendon is stretched beyond repair or there's a terror in it but because I overpronate badly on the affected leg my. Feeling is it stretched and I have to wait six months for an mri. I ice mine daily but still feel pain in the Tendon and I'm not sure if driving aggravates it because I can't wear a support while i'm driving because I need to dorsey flex and plant reflex for the brakes an acceleration pedal.

Hello, I run about 65 to 75 miles a week. What type of shoe would you recommend to someone that runs that much and is dealing with this issue?

@Biomechanicphysicaltherapy

3 жыл бұрын

Hello @Joy bosede You may have already discovered this, but a century race runner actually developed a shoe specifically for high mileage. That shoe is the Hoka. Hoka has now branched out and makes several types of shoes but if you go to an expert running store they should have that brand as it has become very popular. Tell them about your mileage and they should be able to tell you which of the Hoka’s was originally for that purpose. I started out with the Mafate speed and now love the Bondi. I however only run 20 miles a week! I believe the problem you are really going to have is that due to the shock absorbing material that they make the shoe with they do wear out. You are probably going to need a new pair of shoes once every two months!

@joybosede9864

3 жыл бұрын

@@Biomechanicphysicaltherapy Thank you so much for the recommendation! I’ll definitely look into getting a pair of Hokas. Hopefully, it will help relieve my pain.

So if I have had the pain for two years but have now finally been diagnosed and am now working on treatment is there hope for it to be fixed without surgery?

@Biomechanicphysicaltherapy

6 жыл бұрын

Under Ground Sounds yes, there is hope. It depends on how much tendon you have left. If you progress through your physical therapy exercises successfully then you most likely can avoid surgery. If you are unable to tolerate the physical therapy exercises and are unable to progress through them that is your indication that you may need surgery. The first order of business with your therapist is to decrease the pain then they will start with isometric exercises and then if you tolerate those OK they will progress you on to Theraband exercises. If this does not happen then you may have to have surgery. Hope this helps!

@undergroundsounds332

6 жыл бұрын

BioMechanic Physical Therapy Yes thank you very much, your amazing! Just wanted some reassurance. Been working on my foot alignment as well as the way I walk. Seems really strange to me to have to relearn such fundamental thing but due to my own research I have found many root causes as well exercises, massages, and other various treaments I can do that help. The biggest thing has been focusing on lifting my arch when standing and walking and walking withe emphasis on my toes and the side of my feet have really helped get rid of 2 years of inflammation. I still have feet and arch pain but I assume it from retraining my feet to do something they havent done correctly in a very long while. I think Ive caught it early enough. At least on my left foot. I guess Ill have to see with time if my right foot progresses because I can do theraband exercises but Im not sure if Im feeling the good or the bad type of pain. My feet can do the movements but my right foot really feels the exercise

@Biomechanicphysicaltherapy

6 жыл бұрын

Under Ground Sounds hi. Yes you can retrain the foot to a certain degree and I’m glad you have had success in figuring this out for yourself. In answer to your two questions, 1. sometimes you cannot make the muscles strong enough to hold your own foot up and you will always need arch support and really big arch support. Number 2. the pain is “bad” if it is in the tendon itself (right at that ankle bone) and good if it is in the muscle and does not last longer than a day. 👍

@undergroundsounds332

6 жыл бұрын

BioMechanic Physical Therapy thank you :)!

Which orthotics have the highest, most aggressive arch? I have custom orthotics but they are not high enough of an arch. Thanks!

@Biomechanicphysicaltherapy

Жыл бұрын

Hi, It is a common practice for practitioners to lower the arch in a custom device because they think patients in general cannot tolerate it. Usually the problem is that the arch is just not the right contour and peaks too close to the heel and not where your arch really is. I would go back to the person who made your orthotics and ask them to modify it. You paid for it, and they are expensive, you might have to convince them though! As for the highest arch in an over the counter insole, I actually don't know!

@michelemushall3601

Жыл бұрын

@@Biomechanicphysicaltherapy Good idea to go back and have my doctor modify them. Can acupuncture help with the pain?

@Biomechanicphysicaltherapy

Жыл бұрын

@@michelemushall3601 that is very variable, some say yes, some say no, try it & see if it helps you.

I injured my ankle rolled it and now I have medial ankle sprain and a separation of my accessory navicular... my doctor is treating it like an avulsion fracture

@Biomechanicphysicaltherapy

3 жыл бұрын

That sounds appropriate to treat it like an avulsion fracture. It will be nice if it can scar down and become stable without surgery. The accessory navicular is often a problem so if you were tending toward surgery it might be better just to have it removed now while you’re injured. If you treat it like an avulsion fracture you’ll have a couple of months of trying to recover and hopefully that’ll work but if not you go through the surgery and the whole process will have been extended by two months.

Please suggest me winter boots.I am suffer from accessory Navicular bone + posterior tibial tendon

@Biomechanicphysicaltherapy

3 жыл бұрын

Hi. Search for hi top preferably leather lace up boots that you can make nice and tight around your ankle. Make sure you have arch support hopefully custom in the boot. Doesn’t have to be a particular brand you just want those features.

@meenakshi032816

3 жыл бұрын

@@Biomechanicphysicaltherapy thanks for the suggestion ❤️

I am having PTTD for nearly 15 months now as i had twisted my feet on a treadmill. Been using high airway boots and special footwear, but the pain still persists. Is this curable or is it too late for it to get better.

@Biomechanicphysicaltherapy

3 жыл бұрын

Whether it’s too late or not depends on whether you can make any progress in rehab and how much tendon you have left. Arch supports are critical. High enough arch supports that really decrease the work of the tendon. So make sure you are wearing high top lace up boots as well as an aggressive arch support hopefully a custom orthotic that also has a little bit of a tilt to it. Physical therapy can speed healing provided they don’t give you exercises first. The first thing that needs to happen is you need laser & ultrasound & massage.

@irenejoseph5098

3 жыл бұрын

@@Biomechanicphysicaltherapy Thank you so much for your reply. Yes, I did have ultra sound sessions too. Can I wear an ankle binder before putting on my boots. I tried it once, but it hurt a lot the next day so I stopped it immediately.

@Biomechanicphysicaltherapy

3 жыл бұрын

@@irenejoseph5098 If you wear an ankle brace with your boots it should give more support. Maybe it hurts because it was too tight? But no, if it made it hurt worse I wouldn’t do it. You could try taping. We have a video on making an ankle brace with tape and then there’s also the navicular sling tape. I think the navicular sling tape is best for you.

@irenejoseph5098

3 жыл бұрын

@@Biomechanicphysicaltherapy Thank you so much for your prompt response. I really appreciate it. Grateful!!! I will definitely take your suggestion and try it out. 🙏🏼

i have had this off and on for 5 years. i stand for a living. i got custom orthotics but they don't help much and i can nver find the correct shoe. only thing that helps is the bulky lace up afos which day to day stink to wear

@Biomechanicphysicaltherapy

5 ай бұрын

Hello @jimbrow83 sometimes the orthotics are not aggressive enough, so maybe you can look at getting a device with an arch which is as high as your arch when you are not weight bearing on it and combine that with a lace up combat boot instead of using an AFO.

@jimbrow83

5 ай бұрын

@@Biomechanicphysicaltherapy can you recommend a device?

@Biomechanicphysicaltherapy

5 ай бұрын

@@jimbrow83 Hi so it would have to be custom. I would find someone - a PT or a Pedorthist - and explain and show them what you have been wearing so they can not create the same device.

How many days it will take to cure . I am runner plz help

@Biomechanicphysicaltherapy

3 жыл бұрын

@tecnical & logical track The best way to keep running is to find other ways to support the tendon. This means taping with a navicular sling style tape, wearing orthotics with an aggressive arch support, wearing pronation control shoes. Never go barefoot except in the shower. Reduce the work of that tendon as much as you possibly can. Ice when you irritate it, massage it to increase the circulation and handle the mechanical reason why it happened in the first place.

The name is brooks the beast but which series number or specific name ?

@Biomechanicphysicaltherapy

Жыл бұрын

I don’t know. You can probably Google it. I Would guess that all of the beast models have good structure.

@annieoakley9207

5 ай бұрын

I searched for Womens Brooks Beasts shoes but only Mens were found (in Amazon.)

Is accessory navicular and tib post pain connected?

@Biomechanicphysicaltherapy

3 жыл бұрын

Yes @Ma La, They are connected. Having an accessory navicular decreases the efficiency of the tendon. The tendon is pulling on an extra piece of bone that is not firmly attached and therefore makes the posterior tibialis tendon work harder. It can be managed non-surgically by using aggressive orthotics, possibly even high top lace up boots and if it’s inflamed physical therapy and taping. It is often also managed surgically by removal of the accessory navicular and reattaching the posterior tibialis tendon to the navicular itself.

@foowishamewican

3 жыл бұрын

@@Biomechanicphysicaltherapy thanks for the reply. I've had the issue for about 5 years. The only time it got better was prolonged rest due to other injury. Orthotics hasn't helped it and I've had cortisone which didn't help either. I'm having another one plus prp. If that doesn't fix it then yeah I think surgery is my only option

@Biomechanicphysicaltherapy

3 жыл бұрын

@@foowishamewican If you’ve only tried one persons pair of orthotics then you might not have exhausted that. There as many ways to make orthotics as there are people who make them and the arch needs to be very aggressive. They also need to have an angle to them. Do not get Cortizone injected in that area it will weaken the tendon. You could also try the navicular sling taping that will help you determine if your arch support is good enough. If the taping works even when you’re wearing your arch supports then your arch supports aren’t enough.

@foowishamewican

3 жыл бұрын

@@Biomechanicphysicaltherapy I've tried various orthotics and they are injecting into the area and not the tendon as I'm hypermobile

I think I have it, but I play basketball, is there any quick fix for this

@Biomechanicphysicaltherapy

4 жыл бұрын

Andre Johnson The quickfix is tape up your arch to hold the arch up and wear arch supports. As aggressive as you can tolerate. Basketball shoes off and fold in half and that is part of a problem. Be sure your shoes only bend at the toes if you’re wearing high tops lace them up firmly. Try not to go barefoot while you are recovering. The taping that I like the best for this problem is called the navicular sling using McConnell tape.

@andrejohnson8334

4 жыл бұрын

BioMechanic Physical Therapy thank you, I really appreciate it

@Biomechanicphysicaltherapy

4 жыл бұрын

And find someone with a cold laser. It cuts the healing time in half! Physical therapists sometimes have them, we do.

I have beaten posterior tibial tendonitis in 9 months! Read closely I am writing this because I would have died for someone to tell me this information when this first started when I though there was no way out. Now through all of these steps make sure to take Moringa, turmeric ,ginger and cocoa which are highly recommended for beating the inflammation (make sure to check with your doctor first to make sure these are safe for you to take 1st) and take collagen 1 and 3 preferably from green lakes or native path as well as tendoforte collagen from salt wrap or sparkling wellness which is a little cheaper. Now I was in agonzing pain with both ankles every time I would walk it literally felt like someone was shoving a staple through my tendon so it may depend on the amount of damage done with the time lapse needed on each step but I can only personally share my experience and if I would have done this the right way I probably could have healed a lot faster so here we go. Step 1. Relax your ankle for the first month to two always walk with a brace never unsupported as well as a shoe with a good orthotic always ( orthofeet reccomended) and ice to bring down infllammation I just shoved my foot in an ice bucket but any way is possible to help bring down the inflammation when walking supported gets noticeably easier its time for step 2.Step 2. once the inflammation stage starts to get better this is when stretching, rolling your legs and foot as well as taking longer walks comes into play but still always supported by an ankle brace or something just to keep you arch supported so the tendon can heal but take on a little pressure from the walking. Step 3. this should be at the 3 to 4th month time lapse once you are a professional at walking now comes strengthening a little bit more intensily with calf raises only off the ground I started with 5 the first day 10 the next until I finally made it to one hundred with out a problem from here you should be 65% improved if on any of these steps you do feel pain stop right away and go back to the earlier step you are not ready. Healing for me was a two feet ahead one step back process so be careful keep stretching and monitoring yourself. Step 4. Now when calf raises get easy start to use lotion and give your tendon a deep massage to tear up the tissue I would recommend watching a video on this first then as soon as soon as you are done walking or calf raises need to be done because the whole idea is that you are breaking up the scar tissue with the massage and realigning it with the exercise.Also start to motion your foot in a circle 5 times each way to improve mobility. By now you should be on month six and 85% better now its time for the final step. Step 5. Now at this point you should be more able to walk with out a cast unsupported not is when I started using the theraband I would point my calf down with the band on the ball of my foot and pull it in start with the weakest band start 5 then next day ten and until you can hit twenty then fifty by now you should be at almost 100%. Things to not do do not use n said cream I did this and luckily stopped and found out later it actually weakens the tendon long run. If your foot starts breaking down like all the tendons in my foot did stretch and stick in a bucket of ice every night eventually won't have to but from steps 2 to 4 this was a nightly ritual. Subliminal and mprphic fields may help speed up the process as well I definitely recommend sapien medicine for the fields. Like I said this can be done in a good amount of time if done right. Any question feel free to ask Good luck!

@vanessalozano8233

Жыл бұрын

Thank you for taking the time to write about your recovery it's so nice to read about a positive outcome. I've struggled with this for 18 months after being knocked off my bike and landing badly but have only discovered that it was PTTD about 4 months ago. I've been going round in boom and bust cycles this whole time which has really ground me down. I think I'm still in stage 1 unfortunately as I still feel sharp pain in my ankles but I struggle to rest completely as the muscles in my legs and back start to complain. Can I ask, did you walk around much in stage 1 and did you wait for the pain to go completely before advancing to stage 2? Also how did you cope with set backs? I've always been an active person so I'm really struggling with being so sedentary it's been very challenging physically and emotionally. I do have customised orthotics on order and am investing in better shoes, also ordered some collagen! Many thanks for your inspiring story :)

@divinepurity8850

Жыл бұрын

@@vanessalozano8233 Beggining of stage one no ending Yes remember to always always where a ankle brace for a really good one it's thirty on Amazon there are cheaper options and always where an arch support when indoors your tendon is in the healing phase support is MOST CRUCIAL Yes its going to hurt sometimes its like a muscle but unfortunately it stings . My neck started getting messed up my back be a use the muscles aren't being used you have to get up sit down do air punches stretch your arms move because motion is lotion with out being on your feet . But your biggest effort right now is to wear a brace and arch support which cost around ten dollars on Amazon and take anti infflammitories like tart cherry moring cocoa tumeric ginger be open minded alot of these you can get for cheap in powder and alot of servings and tendoforte really did the trick. Rest but also sit up and move your arms stretch because if you don't move them they will start to rust lol the main goal is rest and a little bit of walking everyday not too much but a little until alot more is easier but don't over do it ! With support ankle brace or arch support the orthotics help but not as much your biggest investment is the ankle brace and tendoforte! Trust me keep faith and know that there is a way out It the journey and support of loved ones around me really made me a more awesome person life has to unfortunately beat us into a corner to get us to slow down and look inside for answers and not just out but enough with the philosophy lol any more questions or anything else I'm here for you have an awesome day and always keep your head up !

@vanessalozano8233

Жыл бұрын

Thanks for the speedy reply! I do have some ankle supports but didn't use them a lot, I get burning and tingling in my feet when I have a flare up (I think from the inflammation ) so i found ankle supports to be uncomfortable but i will persevere. I live in the UK but I've managed to buy tendoforte online so I will follow your advice. It's just nice to hear from someone who has come out the other end. All the best to you :)

@divinepurity8850

Жыл бұрын

@@vanessalozano8233 copper fit arch supports I used alot to walk around if the brace agitates it and all the best to you as well!

Over simplistic on diagnosis. There are other conditions causing arches to come down.

@Biomechanicphysicaltherapy

2 жыл бұрын

True. Differential diagnosis is a thing.

Hard arches made mine worse.

@Biomechanicphysicaltherapy

5 жыл бұрын

Yes, sometimes when it’s very sore the hard arches are too much to take ,so we start with something more flexible. The other problem that happens is that the arch is not exactly in the right spot then it hurts because of the impact in the wrong spot.I hope you got your problem resolved!

@sarasmith19

5 жыл бұрын

@@Biomechanicphysicaltherapy I have knots on my arch. Have been wearing compression sock and memory foam shoes. Doing exercises that the pt gave me to do and check in with her about once a month . Getting stronger . I will say that 45 years ago I wanted to be cute and didn't care about good shoes and worked on concrete floors . Just a warning to the younger folks.

@Biomechanicphysicaltherapy

5 жыл бұрын

Sara Smith Hopefully they will listen! The most important thing for this tendon is not to let it get too far!

Normally I'd agree with using the highest arch support but this causes other problems. Namely, plantar faciitis. The high arch support puts pressure under your foot which causes the problem.

@Biomechanicphysicaltherapy

Жыл бұрын

Hello @bfee20021 actually a high arch in your insole does not cause plantar fasciitis. Not at all. Wearing a supportive arch support decreases the work of the plantar fascia. Wearing a shoe that folds in half, going barefoot, or excessively and repeatedly loading the planet fascia is what causes plantar fasciitis.

@bfee20021

Жыл бұрын

@@Biomechanicphysicaltherapy It happened to me. So, instead of using insoles with max arch support, I use, and recommend, shoes that have medial posting. They 'move' the entire foot laterally instead of something jammed up under the arch.

@Biomechanicphysicaltherapy

Жыл бұрын

@@bfee20021 Yes often feet that have a problem with plantar fasciitis will need medial posting. Not all, whether or not you need media posting depends on the specific foot.

@allysonvollmer7223

4 ай бұрын

how would being barefoot cause plantar fasicitis? people run barefoot all the time where I live for their whole lives.... no issues. @@Biomechanicphysicaltherapy