Question
I am 8 months post op removal of hyprocure that backed out and modified kinder. My tendon strength is almost as good as the non surgical foot so the tendon is functional.  I have had a very rocky recovery with a lot of foot pain/sensitivity by the incision area. I wear my custom orthotics and sneakers consistently. I could go two weeks and feel pretty good and then get a flare up consisting of pain from ANY shoe or sneaker touching the kinder area which increases throughout the day. I am still going fot PT.  This morning when I did the stretch I have been doing for about 2 months, I felt a searing pain by the modified kinder incision site. The pain subsided after a few minutes but a pain (level 4) persists when I walk or wear my sneakers.  I am sitting with my foot elevated and no shoe on and I still feel a mild throbbing (pain level 2). I am quite frustrated by the slow recovery.  The doctor that did my surgery wants to make a custom leather ankle height afo....but if my tendon strenght is good, I am concerned if that will really be a good idea.  I also have nerve entrament in the scar tissue from the hyprocure.  I had two cortisons shots and do scar tissue massage to no avail. The doctor who didi the surgery isn't concerned about the to numb toes or shooting pains in the toes when I do the scar tissue massage.  My pain flared up and the dr that did my surgery was not in so I saw his partner who suggested an osteomy and redo of the kinder.  The dr that did my surgery would not go that route at this point in time.  I went to a second opinion doctor who suggested I take anti inflamatories to start. He also feels that the tendon is functioning well.  If my pain continues a year post op, he would try the hyprocure - smaller size and check the modified kinder.  As far as the nerve entrapment, he said if the scar tissue massage does not help soon, he would use a thin needle with heat under twilight anesthesia to relieve the pain.  If the hyprocure ends up being redone, he would release the trapped nerve at that time.  He said that my nerve branches in a slightly atypcal pattern which is why the nerve was most likely involved. The second opinion dr did not feel that an osteomy was indicated at this point.  It would be his last resort. Any insights would be appreciated.

Answer
This Chicago & Elmhurst Podiatrist says.......

Dear Sarah,
I agree that 8 months is a long time. I would try the ankle brace for a few months-it will keep you from aggravating it-You can always do strength exercises to tolerance.
I am not sure why you were stretching the area if it was not hurting or stiff. Normally you want to avoid excessive pulling in that area to allow complete healing.
Hold off on the injection until you know there will be no additional surgery. I agree also to wait a few months, and try not to aggravate the area. Try also padding the area with a foam donut configuration, which would take pressure off the scar area. I also think ultrasound therapy around the areas of pain may help-especially the scar.The scar massage therapy will not work-but may help desensitize the area.
Another opinion at another location with a Board Certified Podiatrist would not be out of line. You can always return to the original podiatrists if the opinion justifies the above.
Hope This Helps
Good Luck!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

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