Wednesday, May 21, 2014

Jose Abreu Suffering From Posterior Tibial Tendonitis

Jose Abreu and the Chicago White Sox received good news on Monday when a second MRI of the player's left ankle revealed inflammation and no tear. However, he was diagnosed with posterior tibial tendonitis, a progressive condition. 
This is not a new problem for Abreu, who has had issues with this condition going back to his days playing in Cuba. Even after spending time on the disabled list Abreu may not be 100% when he returns. Abreu, baseball's current home run leader, was sensational in his transition from Cuba to the major leagues in his first seven weeks. He was dealing with issues with his ankle going back to spring training. 
According to's Doug Padilla, Abreu has been suffering from inflammation in his ankle for the better part of a month, but the condition has been getting progressively worse. It got to the point where Scott Merkin of said Abreu was "playing on one leg." He has not played first base since May 8th. Moving Abreu to designated hitter was supposed to help, but that has not been enough to make a difference.
The left ankle injury Abreu had during spring training was in a different part of the ankle- front versus back- and shows a deeper problem with movement in the ankle. 
Abreu's ankle has been in a boot for several days and will be reevaluated tomorrow when the White Sox return for a homestand. 
The White Sox have an amazing medical team, led by Herm Schneider, who has some of the best results in major league baseball, so Abreu will be in good hands. 
With Abreu out, Adam Dunn and Paul Konerko will fill in. 
The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendonitis is a progressive condition that should be treated early before it worsens. 
The main cause for this condition is overuse. Symptoms typically occur after activities that involve the tendon, such as running, walking, hiking, or climbing stairs. 
Symptoms of posterior tibial tendonitis include pain, swelling, a flattening of the arch, and an inward rolling of the ankle. As the condition progresses, the symptoms will change. Traditionally when the condition begins, there is pain on the inside of the foot and ankle. The area may be red, swollen, and warm. 
Later, as the arch begins to flatten, there may still be pain on the inside of the foot and ankle. But at this point, the foot and toes begin to turn outward and the ankle rolls inward.
As posterior tibial tendonitis becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. The tendon has deteriorated considerably and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle. 
Because of the progressive nature of this condition, early treatment is advised. If treated early enough, your symptoms may resolve without the need for surgery and progression of your condition can be arrested. In contrast, untreated posterior tibial tendonitis can leave you with an extremely flat foot, painful arthritis in the foot and ankle, and increasing limitations on walking, running, and other activities. 
Treatment can begin with non-surgical approaches that may include:

  • Orthotic devices or bracing
  • Immobilization
  • Physical therapy
  • Medications
  • Shoe modifications
Surgery may be needed in cases where the condition has progressed significantly or failed to improve with non-surgical treatment. For advanced cases, surgery may be the only option.
References: Bleacher Report and Chicago Sun Times
If you are a baseball player with a foot or ankle problem, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Sports Medicine Podiatrist in CT
Podiatrist in Rocky Hill and Middletown, CT
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