Question
QUESTION: I had a successful flat foot reconstruction surgery 16 months ago.  I am having problems with my other foot.  About three months ago, I had PT for insertional Achilles tendonitis.  The past few weeks, I have been having pain along my PTT.  The pain is similar to the pain I had when my surgical foot started to go south.  I have been wearing custom orthotics and good shoes for the past few years.  I just started another round of PT.  My Achilles tendon/calf is extremely tight,preventing me from getting to neutral.  Is it possible that PT can help prevent my foot from ending up like my surgical foot?

ANSWER: Hi Stacy,

Yes PT can help.  I would also consider better support with a device known as an ankle foot orthosis. Several well know types include the Arizona brace and the Ritchie brace.  Those may be excellent options for you.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
http://www.fixfootpain.com
Dr. Katz's Facebook Page
http://www.facebook.com/profile.php?id=100000260088035

DISCLAIMER: This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem. It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice. Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan. No doctor/patient relationship is created or established here and may not be inferred through answers on this site. The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site. The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.

---------- FOLLOW-UP ----------

QUESTION: Thank you for your response.  As the surgical foot worsened, I wore an Arizona brace.  The brace helped for a few months but even wearing the brace, my foot became progressively worse.  I would hate to have to wear a brace for the rest of my life.  I recently started PT.  I am hoping that it will help. I saw a local podiatrist who gave me an rx for pt. If pt doesn't help stretch the tendon, he said that he may want do do a gastroc recession. The Dr. who did my surgery was in a major orthopedic hospital in NYC. He is actively involved in clinical studies about ptt. One of the many proceedures the surgeon did was a gastroc recession because he said that I was so tight that I was in contracture.  If pt does not work, would a gastroc recession make sense?  Is the gastroc recession complex enough to warrant a 2 hour trip to see the Dr that did my surgery on the other foot?

Answer
Hi Stacy,

A gatroc recession is an option but it would be difficult for me to make that call just through this correspondence.  If you have had success and you trust your previous surgeon, I think it is reasonable to return to that same doctor.  However, I would imagine that you could obtain some other opinions from doctors closer and see if they are a good fit for you.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
http://www.fixfootpain.com
Dr. Katz's Facebook Page
http://www.facebook.com/profile.php?id=100000260088035

DISCLAIMER: This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem. It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice. Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan. No doctor/patient relationship is created or established here and may not be inferred through answers on this site. The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site. The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.