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  1. #46
    Join Date
    May 2008
    Location
    northern Virginia
    Posts
    5,764

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    Pax, I'm glad your tendon problems are improving. Thanks for mentioning Olukai. I've seen some styles of their thongs at a few stores; I can't wear thongs without getting blisters on top of my feet but I may order one or two of their other styles. Some other sandals I've found with arch support are Vionic and Sole. Rockport has some but they all seem to have high heels. Also there's a store near me called Abeo that sells sandals and other shoes with three different insole/arch shapes. You walk and stand on a special mat in their store and from that they determine if your arch is high, neutral or low. I bought some sandals from them, haven't worn them yet.

    So. I went back to Dr #1 about 3 weeks ago. He said that the inflammation he had felt in the tendon prior to my wearing the boot was no longer there, and that I needed a few more weeks to adjust to walking without the boot. Gave me a handout with stretches and exercises to. I bought a Theraband for the exercises.

    He also recommended custom orthotics. Long story short*, I didn't get them and I'm not going back to Dr #1.

    A couple of weeks have passed since then, I've been using the Theraband, things are better. But there's still some pain in the same tendon, especially after I tried a 20-minute walk last week. I have researched different doctors, was about to make an appointment with one in Baltimore, but then I did a bike ride with someone who recommended a surgeon in DC who treated her broken foot a few years ago. I went to see him yesterday. I was told he tends to keep his appointments very short but if you tell him you have questions he will stay and answer them. I found this to be true. Overall it went well. He said that my foot looks good on the x-ray, did not think there is anything seriously wrong, and recommended PT and 30 days of Celebrex to get the inflamed tendon to calm down. I have a follow-up scheduled in 5 weeks and he gave me a script for an MRI if it's not better in 3-4 weeks. He works with a medical assistant who gave me her card so I can contact her if I have any questions.

    First PT appointment is scheduled for late next week. Just took the first Celebrex with my lunch. Am cautiously optimistic.

    Oh and Dr #2 said "cycling is good." He is the foot and ankle specialist at an "orthopedic surgery and sports medicine" practice. They don't participate in any insurance plans so they're not the least expensive option, but so far I like them better than the first place I went.


    *Custom orthotics, long story long: Dr #1 is at an all-in-one foot and ankle practice. Surgeons, podiatrist, PT, custom orthotics, small shoe store in the waiting room. On the surface this seems convenient, but..... For orthotics, they don't give you a prescription, they give you a form with specific insurance questions that must be filled out before you can see the orthotics person. Does your insurance cover them, if so what percent, is there a deductible, etc. Because they expect you pay up front before you get the orthotics. Combine this with the shoe store in the waiting area, and you feel more like a credit card than a patient. But wait, there's more. If you go through insurance they charge $1500 for the orthotics. Under my plan my out of pocket would be almost $1000. If you don't go through insurance they charge $530. And they repeatedly encourage you to go through your insurance. Holy crap. So I said, I really need to talk to the orthotics person, I am not even sure I want to get them. Amazingly, they did not make me pay to talk to her. She was very helpful and nice. I was very upset. I told her that I tried custom orthotics years ago and still ended up on the operating table. So for the time being she recommended OTC orthotics from Sole, for $50. They can be heat-molded using your oven or worn as-is. And Sole has a 90-day return policy if you wear them but don't like them. They felt like better support than the SuperFeet so I bought them. So far I like them. And BTW they are available from various stores including REI. And Sole also has various styles of shoes and sandals on their website.

    - Gray Trek Madone 4.7 road bike, mystery crack in top tube repaired by Calfee, Bontrager Affinity RXL saddle
    - Red Trek 6000 mountain bike, Bontrager Evoke WSD saddle

    Gone but not forgotten:
    - Silver Trek 2000 road bike
    - Two awesome and worn out Juliana saddles

  2. #47
    Join Date
    Nov 2009
    Location
    Indianapolis, Indiana
    Posts
    10,936
    Yikes NY Biker, do keep us posted, not fun at all!

    Sent from my SAMSUNG-SM-G891A using Tapatalk

  3. #48
    Join Date
    Jul 2005
    Location
    IL/FL
    Posts
    3,849
    I wonder when orthotics became such a racket? They have tried several times to get me to go that route, but I watched my sister in law sink a couple of thousand into "custom" orthotics that were so custom they had athletic tape attaching new pieces as needed. She went through the mill with that office, so I decided unless I got completely desperate I'd stick with superfeet and good shoes.

    Electra Townie 7D

  4. #49
    Join Date
    Nov 2009
    Location
    Indianapolis, Indiana
    Posts
    10,936
    My first attempt at orthotics over 10 years ago felt the same way. My new ones from last year has been little less than a miracle...and after insurance I only paid 80. (They were 500 before - for the pair, not for each). So they are not all a racket and mine have prevented foot surgery 😎

    Sent from my SAMSUNG-SM-G891A using Tapatalk

  5. #50
    Join Date
    Feb 2005
    Location
    Concord, MA
    Posts
    13,010
    i remember when my insurance (from where I taught in AZ) paid for my custom orthotics in full, in 1987. Although they cured the plantar fasciitis, little did I know I was setting the stage for my back being a wreck now, from teaching high impact aerobics on concrete floors, covered by thin carpet.
    I have used Superfeet in my cycling shoes since 2011. I could not tolerate the fancy custom molded things that came with my shoes. Too thick.
    2015 Trek Silque SSL
    Specialized Oura

    2011 Guru Praemio
    Specialized Oura

  6. #51
    Join Date
    Dec 2010
    Location
    Boise Idaho
    Posts
    1,187
    I have a custom orthotic somewhere... The inserts I stumbled upon and really like are actually birkenstock insoles! As my knee gets worse though I can see my left hip dropping so should probably find the orthotic to before my back starts to get wonkie
    Sky King
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  7. #52
    Join Date
    May 2008
    Location
    northern Virginia
    Posts
    5,764
    So, Celebrex is helping though I did have a few days last week where my ankle hurt. Side effects are pretty much minor.

    First PT appointment was yesterday. It went well. The PT seemed impressed that I had my own Theraband -- I brought it to show her what I had and find out if I should get a different color (different resistance). She also seemed to like that I knew the names of the various tendons and muscles and that I'd noticed a difference in muscle mass and shape between my left and right lower legs after the surgery. There are a few exercises I need to do every day, some twice a day and one thing (ankle circles) five times a day. I'm able to do them all at work as well as at the gym, which is good.

    One weird thing -- in most of the tests she did, my right (injured) foot and leg were stronger than my left (healthy) foot and leg.

    One very interesting thing that she said, and that I wanted to mention to Pax and anyone else with ankle problems -- apparently strong hip abductor muscles are important for keeping your ankles healthy. I don't remember all the details of what she told me but I think it has to do with ankle stability. If your hip abductors are weak, your knees end up working more, which is not ideal. The abductors are the muscles on the outside of your hips (I always get adductors confused with abductors so I had her clarify for me). One of the exercises I'm doing specifically works the abductors, and I can really feel them working so I guess they do need to be strengthened.

    - Gray Trek Madone 4.7 road bike, mystery crack in top tube repaired by Calfee, Bontrager Affinity RXL saddle
    - Red Trek 6000 mountain bike, Bontrager Evoke WSD saddle

    Gone but not forgotten:
    - Silver Trek 2000 road bike
    - Two awesome and worn out Juliana saddles

  8. #53
    Join Date
    Nov 2009
    Location
    Indianapolis, Indiana
    Posts
    10,936
    Glad to hear the Celebrex is helping! It sounds like you're working with a good'un, keep her. May things continue to go well!

  9. #54
    Join Date
    May 2008
    Location
    northern Virginia
    Posts
    5,764
    A plot twist.

    I went to PT for 4 weeks, have been doing the exercises, the therapist noted improvements in various measures of strength and range of motion. But my ankle is not better. I am still very limited in the amount of walking I can do, and some of the exercises I was doing for PT made it hurt. The doctor had said that if it didn't improve I should go for an MRI and come back to see him. So I had the MRI last week and saw the doctor today. He looked at the MRI and said, it looks like a different tendon is damaged. Um what?

    In my crude understanding of the anatomy -- there are three tendons close together in a normal foot and ankle -- the posterior tibial tendon, the flexor digitorum longus, and the flexor hallucis longus. Back in the day I had a torn PTT. The surgery I had was a "tendon transfer," in which part of the PTT was removed and the FDL took its place. The location of the pain I've been having since January indicated that the current problem was where the FDL and PTT were attached. But on the MRI, that area looks okay -- and the FHL looks damaged.

    As a next step, I will go next week to have a long-acting anesthetic injected into the FHL. If this relieves the pain, it confirms the new diagnosis. Based on what I've read about the function of the FHL, and one particular PT exercise that caused pain, I suspect this will be the case.

    One good thing is that I'm still able to ride my bike. I have noticed some minor pain when I ride up steep hills. Based on today's developments, I think I need to be more conscious of my foot position when I pedal, to make sure I don't point my toes at all.

    - Gray Trek Madone 4.7 road bike, mystery crack in top tube repaired by Calfee, Bontrager Affinity RXL saddle
    - Red Trek 6000 mountain bike, Bontrager Evoke WSD saddle

    Gone but not forgotten:
    - Silver Trek 2000 road bike
    - Two awesome and worn out Juliana saddles

  10. #55
    Join Date
    Feb 2005
    Location
    Concord, MA
    Posts
    13,010
    Sorry to hear this, but glad you most likely have pinpointed the cause.
    2015 Trek Silque SSL
    Specialized Oura

    2011 Guru Praemio
    Specialized Oura

 

 

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