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Foot & Ankle Problems Message Board

Foot & Ankle Problems Board Index

Hi all, new to the boards and my first post. I'll try to keep this as short as possible without leaving out key details.

Came down with arch pain back in January of 2016 and was diagnosed with post tib strain by a Pod. Got cortisone injection in arch and was popping Advils for a month before it calmed down. During that time and 7 weeks of no running, I mysteriously developed heel and lateral ankle pain(not to mention tinnitus in my left ear from what I suspect was the ototoxicity from the high dose NSAIDs). Did all the usual icing, stretching, PT and no relief! NSAIDs not effective either, nor custom orthotics and various different shoes. The PF pain is mostly on the lateral branch. Mild relief in the heel from Strasbourg sock. I work at UPS and for the most part am on my feet 8 hours a day on hard surfaces and walk anywhere between 3-5 miles with stepping in an out of a truck about a 150 times.

1st US of heel in early July showed nothing unusual of PF. Went for MRI end of July and report came back as thickened PF with mild edema as well as Peroneal Brevis and Post-tib tendinopathy. Dr put me out of work for 6 weeks and walking boot four weeks. During which I had 2 rounds of PRP and no relief. Doc extended my disability another 6 weeks and I tried EPAT once a week for 3 weeks. Still no relief! Always a tight feeling at peroneals near ankle and the burning tiredness feeling on lateral PF. Lots of calf tightness and I have been rolling and stretching like crazy and continued with rehab excercises.

Had a 2nd MRI at a different location 2 months after the first and shockingly it came back as normal with no findings?!? Doc then imaged the peroneals via US on both good and bad foot and didn't find anything out of the ordinary and both looked almost identical!

Running is one thing and I miss not getting out there but at this point I would be happy just to stand and walk without any pain. All in all, I have seen 2 orthos, 2 podiatrists and 1 sports med doc. I go back to work in a few days and even though I would like not to, I NEED to! I'm not getting any better with rest either.
FWIW, I have had flat feet my whole life and have basically worn the same shoes for work and running for a few years now. My work boots always had an OTC soft orthotic with arch support in it. I did however notice my arch in the bad foot has lowered somewhat more over the past 2 years during which I had stopped working out in the gym and concentrated solely on running and the occasional hiking. I used to do quite a number of heavy calf raises, squats, deadlifts and plyometrics at the gym on a weekly basis and after I stopped is when I noticed the lateral portion of my left foot appeared to slowly get thicker and the arch dropped. I'm not sure whether that extra mass has pushed the inner foot arch lower and/or a degenerated post tib tendon has done so. I've switched over to wearing Altras and like how the zero drop feels better along with the wide toe box. I can no longer comfortably wear my Asics Kayanos and Gel foundation work shoes with the elevated heel. Surprisingly, walking barefoot on asphalt with little to no heel strike feels the best with almost zero issues!

FWIW, I should also like to add that X-rays of my back showed a grade 1 Spondylothesis. I've had low back pain since 1992 due to spondylolysis at age 16 but have learned to deal with it over the years. I'm wondering how much if all could be nerve related from the back and/or a nerve entrapment in the foot?

Would nerve entrapment of the foot show up on MRI? I have a 4 week post EPAT follow up with the podiatrist and will bring up cryosurgery for possible nerve issue in the foot.

Sorry for such a long post! Thanks for reading and I appreciate any responses!

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