Posterior tibial tendonitis-anybody have it?

Sort of related (as in it's a possible overuse injury from swimming/kicking): has anyone struggled with pain on the inside of their knee(s)? I don't feel pain when swimming, but I feel pain just on the inside of one knee, right between the femur and the tibia, whenever I walk very far. Have done PT, gotten a cortisone shot in bursa, used orthotics, all to no avail. I have this fear that when I kick I might torque my left knee a little as I rotate. No idea how to fix this (Ande?). Though why this would suddenly flare up now, after almost 9 years of swimming, seems suspect. I am glad I do not have the problem with ankles/feet/plantar fascitis. I have heard that it is very painful and very hard to resolve, especially if you are a runner.

Jan, I too have been battling tibular tendonitis since September. I have cut out all running and no longer use fins. I cant even push off the wall hard or I go into a weird cramp that feels like the tendon is pulling my calf into my heel. After PT, ultrasound, orthotics, icing and no results, I got a cortisone shot in one ankle last week. It is working well, so far- now I only have pain and cramping in one leg. I dont know how long it will last, but I am hopeful for the first time in months. Any improvement for you since your post? dot

Jan, I too have been battling tibular tendonitis since September. I have cut out all running and no longer use fins. I cant even push off the wall hard or I go into a weird cramp that feels like the tendon is pulling my calf into my heel. After PT, ultrasound, orthotics, icing and no results, I got a cortisone shot in one ankle last week. It is working well, so far- now I only have pain and cramping in one leg. I dont know how long it will last, but I am hopeful for the first time in months. Any improvement for you since your post? dot I'd love to know if this cortisone will last! I've mentioned my gimpy foot here lately, and it sounds a lot llike what I see described here. It started as plantar fasciitis, so I got off running--I'd been training for a marathon--did stretching, icing, cortisone shot, acupuncture, blah blah blah.... And just as the PF started to let up, the top of the foot and the ankle began to act up. :cane: The only place I can get any intense workouts is in the pool and thank God for that! However, I too have noticed that kick sets irritate the foot and so does too hard a push off the wall with the affected foot. I think my body has settled on the work-around of using the good foot to do most of the push-off. With kick sets, I try to alternate back kick (with streamlined arms) and also doing streamline kick w/out the board which seems for some reason to alleviate the discomfort. Fortunately, so far, the pain I get in the water is only mild compared to what happens after only a few mins. of running (as opposed to being able to do most of my masters' workouts--which, granted, are short by some standards). If I didn't have the swimming and no running either, you wouldn't want to be around me. (Picture this: :badday: )

Some folks have resolved their plantar fasciitis by wearing something called the Strassburg Sock. It keeps the ankle dorsiflexed while sleeping. Tip: start slow--do not pull the toes tight towards the shin. Gradually increase the amount of ankle flexion. See: http://www.thesock.com Hope it helps. mjm

Sort of related (as in it's a possible overuse injury from swimming/kicking): has anyone struggled with pain on the inside of their knee(s)? I don't feel pain when swimming, but I feel pain just on the inside of one knee, right between the femur and the tibia, whenever I walk very far. Have done PT, gotten a cortisone shot in bursa, used orthotics, all to no avail. How is your hip and glute strength? Most people with knee problems don't have the strength in the hip/glute area and it causes too much stress on the knee. Try a "clamshell" exercise--just google it and you can find a video.

How is your hip and glute strength? Most people with knee problems don't have the strength in the hip/glute area and it causes too much stress on the knee. Try a "clamshell" exercise--just google it and you can find a video. Been doing the clams, the reverse clams, because yes, I was told my hips and glutes weren't strong. Last week I returned to the hamstring curl machine in the gym and was alarmed to see that I couldn't do more than 8 at a time (no weight on machine other than what is preloaded). Does it make sense that I can swim and kick so much and only be using the front of my body, i.e., have no strength in my hamstrings or butt? Zounds! Anyone else notice they have strong fronts and weak backs of their bodies, even with a lot of swimming?

Most females are quadriceps dominant--the quads do most of the work and activate more quickly than the hamstrings (possibly part of the reason why females may have more ACL tears than males). You are likely getting most of your force from the quads when you kick--the "down" part of the kick and not much from the posterior muscles (hams and gluts)--the "up" part of the kick. I would venture a guess that strengthening your hamstrings will improve your kick.

I have been battling posterior tibial tendonitis in both feet for over a year. At least that's what I've been told it is. Basically it's pain on the inside of my foot below the ankle bone. I've been to two podiatrist, one orthopedist and three physical therapists. I've tried strengthening PT, resting PT and none of it's done any good. Usually swimming is a recommended exercise for people with feet problems like plantar fasciitis. Well, would you believe that swimming aggravates my feet. It appears the flexion of kicking and the pointed toe position of flutter kicking are what causes the aggravation. Basically I'm only good for about a half an hour before things start getting ugly. I can only pull so much without aggravating the tendonitis in my elbow. *** stroke is actually the least aggravating stroke. My feet are a set up for problems in that I pronate severely. Yes, I have custom orthotics-they haven't helped, in fact the problem in the one foot didn't start until after I'd gotten the new orthotics. Anybody ever have this? Anybody ever get rid of it? I'm really sick of this. I can't swim for a couple of weeks because of stitches (mole removal) but I'd like to get back in the swim of things after that. Thanks for any advice or sympathy. Jan I too have PTT. I got a partial tear in my right foot a little over a year ago playing football without my orthotics. This injury has proven to be a huge problem. From the research I've done, and in speaking with several orthos, I've come to the realization that once it tears, theres a 99% chance it's not going to heal. It seems that due to it's location and the fact that it holds up your arch, that once it tears it just degenerates until you have surgery. My doc advised me to stop doing anything that hurts it, and come back when it gets to be too much. He said it could be 2-3 yrs before surgery makes sense. (I'm not in enough pain yet) I've found that swimming does irritate it, but I just try to ignore the pain because I need some sort of cardio. Like you I can't do just pulls, as I have a bummed wrist that will flare up when I overdo pulls. I understand your frustration, and hope that you're able to get on without too much pain. Here's to hoping for some advances in soft tissue tears real soon!

Hi, Joel, I just found your post. Mine was so long ago I didn't think anyone would resurrect it. I'm sorry you've joined me in the ranks of people afflicted with this damn disorder. Yep, I've still got it. I think I've been to at least five doctors and about the same number of PT's. The PT's all start out so optimistic believing they'll somehow "cure" me. Yeah, right. If they could I wouldn't still be suffering. The MRI's don't indicate a tear-just inflammation. I while ago I saw Highly Respected Orthopedic Foot Surgeon who told me they don't usually do surgery unless the person is walking on the inside of their feet. The guy had the bedside manner of a toad which further impressed me. I mean, jeez, if you get to the point of walking on the inside of your foot the rest of your body has probably pretty well collapsed from foot enforced inactivity. Last year I tried a custom Richie brace which was also a bust. They never could get the thing adjusted so I could tolerate it for more than a couple of hours. After about five tries at adjustments I gave up. So where am I now? Well, I'm still swimming. Sometimes I think it bothers my feet, sometimes I think it doesn't. I usually only swim three times a week because I'm so prone to overuse injuries-read tendonitis. I've been told I have the lousy combination of loose ligaments and tendons, hence the "flexible flat foot", and tight muscles. One might think flexible is a good thing but with feet that's not necessarily so. At this point my orthopedist is willing to refer me to the foot surgeon in his practice but I don't take surgery lightly. I almost died from hysterectomy complications. At the same time I'm really tired of planning much of my life around my feet. They especially hate standing on concrete which makes thing like grocery shopping such a joy. Some nights by the time I've hit a couple of grocery stores, done some house cleaning and cooked dinner my feet are completely cooked. They claim surgery could leave me no better or even worse off. I think part of the problem is the clinical picture; MRI's and exams don't adequately reflect the life changing suffering this affliction causes me. I pick my volunteer activities very carefully and refuse to do any that require me to stand on my feet for hours-makes me real popular with the other band parents (son still in high school). I tend to feel guilty when I have to wimp out on something because my feet hurt or I know it's going to make them hurt for days or weeks (I should really say hurt worse-they ALWAYS hurt). I'm now going to see a neurologist next month because I think it's possible I could have developed tarsal tunnel syndrome from the swollen tendons pressing on nerves. I sometimes get burning and stinging on the bottoms of my feet. I completely agree that there needs to be more effective methods of treating soft tissue injuries. I broke my ankle once. Recovery from that was a piece of cake compared to this issue. My husband and I are currently doing a therapeutic fitness class at a local gym. It's led by a physical therapist and she of course thinks my feet problems will get better once I improve my hip flexibility, strength and body alignment. Yeah, right. Where have I heard that one before? The class seems good for keeping shoulder twinges away and making my hips feel nice and flexible but I'm not expecting any miracles in the feet department. Again my sympathies and if you find the miracle cure be sure to let me know. Jan

Jan, almost 4 years ago I sprained my ankle by accidentally kicking a dowel on a stool just in front of the outside ankle bone. Since then I've been through 4 doctors, 2 surgeries, 1 cortisone shot, 16 weeks in a boot, 3 weeks on crutches, 3 alcohol-based injections and 5 weeks of PT. I am finally feeling more normal. I can finally kick after almost 3 full years of not being able to. One thing I did when it was really bad was tape the ankle with horse wrap while swimming (athletic wrap that stretches will work as well but the horse wrap was cheaper to buy). It helped to stabilize the ankle more and the pain was less. The alcohol-based injections were a wonderful thing. It seems that I had an impinged nerve due to the 2nd surgery. The injections helped to deaden the nerve so I don't feel the pain any more. After that I did PT and it helped to heal it more. I'm at about 95% now. I can kick, albeit slowly, but I am moving forward. In fact, right now my shoulders are messed up and all I can do is kick. I wish you luck. I know what it feels like.