I’m looking for any advice here. Six weeks ago, long run/race (50 mi) - no unusual pain. Took a few days off, next few easy runs I developed a somewhat sharp pain in my anterior tibial tendon (~3-inches above foot, on shin) which was noticeable when dorsiflexing (cyling, pulling up on pedals, or especially when walking during the “pulling the toes up toward the sky phase.” So of course, I backed off on running but continued to hike/cycle. After two days of that abuse, I could hardly walk due to the pain.
After 2-weeks of inactivity, but no improvement: Got an MRI, which indicated a partial tear to the AT tendon. The foot/ankle ortho thought it might heal in 4-6 weeks. He put me in a short leg cast for 4-weeks. He took it off last week (at 4-weeks) and said see how it feels, if still a problem come back for addition cast/immobilization. So, I’ve been out of the cast 1-week now. I’m taking it very slow (not even thinking of running/toe clips just yet), just getting used to walking, developing some strength again. My concern: I still have some pain (now it’s more on the medial part of ankle where tendon attaches), and slight pain when I dorsiflex. Walking on my heels is definitely something I can’t do without pain/and with limited strength.
Question: Is the best path to recovery to continue taking it easy and hope for further healing (trying to limit aggravating the tendon isn’t easy, since it’s used for walking, etc.). Or maybe a few more weeks in a cast w/b best. Argh! I have ART next week…
Anterior tibial tendon tears are somewhat unusual - I’ve only repaired 2 complete ruptures (and the ends retract pretty far apart as well). Partial tears do heal, but take time since the tendon under significant traction and use (hence your complete immobilization in a cast). Would be nice if your specialist had in-office ultrasound to see?
Thanks for the response. I saw an earlier AT problem posting that you responded to, and was hoping you’d see mine as well. My options for ultrasound: I could see a local sports MD that I know uses such a diagnostic tool, unfortunately, it will take 4-6-weeks to get an appointment, as I initially would have seen him for the problem (but didn’t want to wait so ended up seeing the foot/ankle ortho). But, having no real alternative, I’ll make the appointment and wait (hopefully, this could resolve in the next 4-6 weeks).
In the meantime, would you say it’s best to just completely immobilize it a few more weeks in a cast (a cast really isn’t the end of the world I found out)? Or, limp along, trying to not aggravate it too much with the assumption it will slowly heal on its own. I just get the sense that if I’m put in a cast for 2-3 more weeks, that would more likely do the trick, rather than gently coaxing it along,and trying not to aggravate it for several weeks to come.
Any advice/opinion you could provided would be highly appreciated.
Your tendinosis/tear not likely healed in 4 wks with the BK cast. I’d probably stick with his rec for another 2 weeks in a cast rather than try to “coax” it along - that isn’t usually very successful.
Your tendinosis/tear not likely healed in 4 wks with the BK cast. I’d probably stick with his rec for another 2 weeks in a cast rather than try to “coax” it along - that isn’t usually very successful.
Thanks much for your opinion/advice…will go the conservative, cast route, and cross my fingers.
Cheers