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Monday, February 28, 2011

A Football Player with Posterior Tibial Tendonitis - Cortisone Injections

Hello Gary,

I watched your video on youtube and it seems that nutrition is very important. I have been suffering for PT for the past 7 months. It started as a minor discomfort which I ignored and continued playing football. and running. It eventually got worse and I haven't been playing any football for the past 6 months. My foot was almost cured 2
weeks ago but still felt very weak.  Unfortunately, It went downwards again when I walked a lot last week using my normal shoes. I had to see some clients and could not afford walking in my running shoes.

I went to see my doctor again on friday and he injected some cortisones and said to come back in 5 weeks. I read loads of negative things about it but kinda got fed up having my ankle always inflamed. It has been 3 days now and I do feel better but my ankle seems to have lost muscle and my calf has a pulling sensation. Is that normal ?

I also ice it every couple of hours and make sure I eat well.

Should I start some basic exercises in the coming weeks? I have been resting my ankle for the past 3 days and trying not to walk too much.

Do you think this will ever cure? i am going to be 30 in 5 days and used to very active but I am getting very depressed now ....

Any ideas?

The best exercise to do, in addition to walking and gradually resuming running and activities like football is the exercise in the above video.  Do about 30 repetitions every 2nd day and gradually build up to about 60-100 continuous reps over a few weeks.  Keep doing them as a habit even if your ankle is 100%.  You can also take up walking on sand barefoot.  Walking and running across a grassy slope, either barefoot, or in a pair of snug running shoes will help strengthen the lateral and medial structures of the ankle.  Start very conservatively and never repeat the same exercise/activity on consecutive days - mix things up so that there is a variety of stresses on the legs and never the same the following day.

Nutrition is important.  In the case of tendons and ligaments, magnesium, copper, zinc, iodine and pyridoxine are most important.  Stress can be from multiple sources, including exercise, work, toxins (eg: smoking), relationships, financial, to name some.  Depletion of these nutrients hardens collagen which is the main constituent of tendons and other connective tissue structures.  This may be seen as conditions such as "Trigger Finger" or "Dupuytren's contracture".  While trigger finger is the most obvious manifestation, I see it often in more subtle forms, such as hard and inflexible leg tendons that are prone to chronic injury.  A lengthy period of stress is often the precursor of these injuries.

The best source of these nutrients, in as near to perfect combination is Dr Wilson's Adrenal Fatigue Formulations.  These are "Practitioner Only" products that are dispensed by prescription only.  Please complete the initial Adrenal Fatigue Assessment here and send me the results and we will go from there.

With regards to the cortisone injections you have had, it is interesting to note that the cortisone injected into the ankle by your doctor is a synthetic version of cortisol which is produced by the adrenal cortex of the adrenal glands.  It is fascinating to see how seemingly unrelated health issues (stress - tendons) may, in fact, be related!  There is a small but significant risk of future complications such as tendon rupture as long as several months from now.  Please read the articles in this search list.   Reduce the chances of suffering complications by a gradual buildup in physical capacities over the next three or so months and definitely get onto the adrenal supplements for at least three months.

There is no need to ice the ankle and do not take anti-inflammatory medication.  Read the articles in this search.

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Pete K. said...

Hi Gary,
I had a fairly severe ankle inversion sprain which caused some instability of the ankle. After 4 weeks in a boot most of the injury had resolved with the exception of very acute pain in the area where the PTT is. I went to a doctor and he gave a me a .1cc injection of cortisone to the area near my posterior tibial tendon. Afterwards I did some research on my own and came across your site. Is that a dosage that I should be concerned about? Is there anything I can do at this point to minimize the risk of further injury to that tendon?

Gary Moller said...

Before I answer in detail, can you tell me if the injection relieved the pain?