Facing Probable Foot Surgery

[Catwoman]

Well, I have a dilemma of sorts. I am about to break down and go to the ortho doc - have resisted for many years. I have severe over-pronation coupled with an ankle injury which leads me to think I have posterior tibial tendon dysfunction (mouthful). I read the test for this is if you can stand on your tiptoes on said foot. I can't. One of the fixes is surgery which is purported to only work half the time. My feet problems are getting progressively worse with the years and of course, my job, teaching first grade, requires me to be up and active all the time. ...sigh...The dilemma is surgery and possible fix or nasty, ugly shoes with a bad limp for the rest of my life....Thanks for reading my slightly self-pitying post.

[lhamo]

I think you should see a good orthopedist before diagnosing yourself. Feet are one of the most complex parts of our bodies and you could be wrong. And I'd get a second, and maybe a third, opinion before you get surgery. DH went to a local hospital here in China a few years ago with severe back pain, and they discovered he has a serious condition (spondyolisthesis -- say that three times in a row fast!), and handed him admission papers and said he needed immediate surgery. I FREAKED OUT (to put it mildly), and started frantically doing web research. Discovered that yes, sometimes surgery is indicated, and often it is "successful" in that it stops the slippage of the vertebrae they fix together, but that doesn't necessarily end the pain either immediately or in the long term. Found enough evidence that surgery was controversial to convince DH to wait, and when he was seen by a specialist back clinic in the US a few months later they told him that his situation wasn't that serious yet and that he should try physical therapy first. He did, it helped, and eventually he had a lower pain level and was able to lose a significant amount of weight, after which the pain was gone. Anyway, I guess what I am trying to say here is that even if surgery is recommended it might not be the first thing you want to try. But first you should try to get a proper diagnosis from someone trained to understand the foot/leg.

I also am a serious overpronator. In my case it is because I have "Morton's Toe". I just tried and I can't really stand on my toes on one foot on either foot for more than a couple of seconds -- not five anymore, and not a ballerina. And I don't have an ankle injury. Again, I think you should see a specialist before you start freaking out too much.

Good luck!

lhamo

[Catwoman]

Thanks Lhamo - good advice to calm my insomniac ponderings... Things always do look a bit better in the mornings!

[razz]

May I suggest that even then you do the research to ask the right questions and perhaps talk to more than one specialist. Hope that you find a good solution.

[sweetana3]

I would take old shoe design any day over a contested surgery that I was not totally sure about. I agree with the previous posters that getting a wide variety of opinion on such a critical issue is best.

[cdttmm]

Personally, I would be wary of having a surgery that currently only works 50% of the time. I would get a second (and third) opinion as previous posters have suggested. And even if all three docs make the same diagnosis and all three recommend surgery, I would probably wait as long as possible (not just weeks, but years if I could) in the hopes that the research and procedures for this would advance. Just a thought. Good luck, Catwoman!

[CathyA]

I've had many problems with my feet - overpronation/fasciitis/morton's neuroma/hammer toe, etc. It was also made worse by having a knee meniscus repair, which then caused a worsened pronation.
Anyhow...........Definitely try orthotics first, and stretching exercises for the lower leg/foot.
And definitely find a good podiatrist and get his/her opinion about things. And try to find a doctor who other people have had good experiences with.
I had surgery for hammer toe and a bone chip about 15 years ago, and it took a long time to heal completely. A couple years ago, my podiatrist wanted to do surgery for the hammer toe, and I said no. The pain has since subsided.
So get some good info from a podiatrist (I didn't have any luck with an orthopedic doc), and try some alternative things first. Orthotics can do some amazing things.
Like Sweetana, I would wear "ugly" shoes before having surgery. Also......in my experience, a good tennis shoe is what podiatrists recommend.

[leslieann]

In my little experience, not like yours, or Cathy's or lhamo's, a podiatrist was far too eager to cut my feet for several little things that turned out to be liveable. Well, not just one podiatrist, two. But a second opinion and a third suggested to me that waiting was okay, and it turned out okay. I don't have lovely or perfect feet but they work, and the yoga I am doing seems to be helping my flexibility. No big diagnoses, though, just plantar fasciatis and osteoarthritis.

Orthopedic surgeons seem to specialize. Here we have the knee guy and the shoulder guy. Could you locate the foot and ankle guy in your town? And if your orthopedist refers to a podiatrist, well then.

I am always wary of anyone who wants to cut me. Especially if he or she has a big fancy outpatient surgery suite with a big mortgage.

Wow, I do have a conservative streak! Who knew?

[CathyA]

I guess it all depends on the specific doctor.....be they a podiatrist or an orthopod. I went to a supposedly very good orthopedic doctor for my neuroma symptoms, and he said I didn't have one. Then he sent me to the PT department and they made totally useless/flimsy orthotics for me, that I never wore, because they were useless after a week of them.
So......it really all depends on the individual doc and his abilities/reputation. But I agree that doctors are much too eager to cut, when P.T., orthotics, etc., can be even more useful.

[Gardenarian]

Hi Catwoman -
I have Hallux rigidus, which is arthritis of the big toe joint, and my doctor advised surgery to remove the bone spur there. After a lot of thought I have chosen not to have the surgery. I am going to have physical therapy, which may keep the condition from getting worse, and use shoe inserts/special shoes to deal with this. As I walk/hike several miles a day, this condition is really having a severe impact on my life, but the outcome of the surgery is unsure - a lot of people still have severe pain anyway.

With a 50/50 chance of success, I'd go with the ugly shoes. Remember, Zappos has free shipping both ways!