Posterior Tibial Tendon Insufficiency

Posterior Tibial Tendon Insufficiency

The Warrantee Runs out at 40


In early May 1996, I was walking to work when something in my left foot gave way. I didn't think much of this: it hurt a bit, but that has happened before. The pain goes away within minutes or days as the bones readjust or settle or something. I hadn't actually stepped on anything: there was simply the flat sidewalk near the Murray Hill train station that I had used for several years to commute to work. I was wearing my usual Berkinstock sandals (Arizonas, I believe.)

Two weeks later, the ankle still hurt. I checked with my physician. He elicited pain in various ways, and declared that I had sprained my ankle. Keep it cool, wrap it in an ace bandage, and it should get better in a couple of months.

Over the months the pain went away, but the ankle was unreliable. The arch had cave in a bit. I put off dealing with it until, in February, I went on a ski trip and found that my foot could no longer fit in my Solomon boots without considerable pain. (This was after paying for the lift pass and making all the other arrangements needed to ski. I was disappointed that my son would be skiing without me.) You know it is time to fix a medical problem when it interferes with your life.

I got a referral to an orthopedist. He examined the foot, thought it was a problem with the tendon, but declared that it was out of his area of expertise.

We hunted around, getting recommendations for foot orthopedists. I visited one in Passaic. He checked it out, and quickly declared that I had Posterior Tibial Tendon Insufficiency. I could have an MRI to confirm the diagnosis if I wished, but he didn't need it. He was certain. He told me all about it. He also instantly slapped me in a removable cast, which I clunked around in until my surgery.

We searched the Net and found a survey paper that confirmed all he had told me.

We went to Dr. Jonathan Deland of the Hospital for Special Surgery in New York. He does about two of these per month, probably more than anyone else in New York. The hospital has a world-wide reputation for excellence in treating problems like this.

Description of PTT insufficiency.

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