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Posterior Tibial Tendonitis orthotic ?

Hello!
Have been dealing with a diagnosis of Posterior Tibial Tendonitis since June of 2015 in my left foot. This diagnosis was from my Podiatrist after an examination and x-ray. I work as an Licensed Nursing Assistant on a Locked Alzheimer's Unit, and I am on my feet for 8+ hours a night, constant fast walking, patient transfers, chasing escapees etc. Have gone through periods of foot sorness/aching in the past, and during one of these times, I happened to climb up a few flights of stairs and immediately was limping so bad, I could barely walk. Ankle was very swollen and tender to the touch. Friend who saw my ankle called it Pregnant Cankles! Had a similar flare up after a visit to NYC the year before climbing all the Subway stairs, but it resolved itself after a couple of weeks. I should add that I have had flat feet for my whole life and used to get ankle sprains very easily throughout childhood. With that said, I used to be a runner and never had any major issues with my feet. Podiatrist gave me a couple of different braces, soft strap-around one, to a Robo-Cop/Forrest Gump Magic Legs hard plastic one that I could not tolerate. Spent a couple weeks sitting on light-duty at work, rest, ice, elevating, epsom salt soaks to no avail. Spent time in Physical Therapy doing stretches, picking up marbles with my foot, some resistance band exercises, and a variation of the Graston Massage with no real lasting results. Tried getting motion control sneakers with over-the-counter orthotics, but nothing has worked. The only thing that helped, was when my Physical Therapist suggested I get an orthotic with a "medial heel posting" to help counter the over-pronation of my ankle/foot. So I purchased a Powerstep Orthotic with a 2 degree medial post. Though the arch support does aggravate my super flat feet, the posting does help. I have had to modify these OTC orthotics by adding a little more "height" to the heel post, but this sometimes led to some aching in my outer forefoot. My Podiatrist has been recommending a Custom Orthotic through his office for $450. I however was very, very surprised that my Insurance company, which is normally very good, would not cover one cent of the Orthotic since they deem it a "comfort measure" and have been told if I am not a diabetic it would not be covered. Sure, my Insurance will cover expensive braces, PT, and probably the surgery if I rupture the tendon, but not the little pieces of plastic that might avoid surgery, yeah, that is logical?! Now, I am at the point that during my work shift, my soreness is greatly reduced, although if I sit for more than 5-10 minutes, my ankle/foot tightens up and I will limp briefly as I start walking again. Interesting enough, have more discomfort just standing in one place than when I'm walking. When I get home after a full 8 hours on my feet, I limp after my drive home and need to ice the area. The next morning my ankle and even my achilles tendon seems tight, and yes, the mornings after a day off, my ankle is much less tight. So since my job involves being on my feet so long, will the tendonitis ever go away without me taking a longer break to rest or will it just flare up again once I start standing on them for hours at a time. Should I just bite-the-bullet and pay for the Custom Orthotics which will create the exact right height of heel posting to get me back to "neutral"? Have been told that OTC ones are just as good, would hate to pay all that money out of pocket and not have them help. Have been trying to lose weight, prob. 15-20 pounds overweight, but active. This tenacious tendonitis is so frustrating!! Any insights, suggestions would be great, thank you!

3074 day(s) ago

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