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I was called yesterday by my 50 year old sister in law who has just been diagnosed by her GP who has a specialist interest in MSK medicine, as having a linear tear of her Tib post tendon (close to the distal part of the medial malleolus). The diagnosis was made following an ultrasound scan. This was caused by a fall about 2 months ago. Since the incident she has managed to continue walking and running, although post activity pain increased, and now is unable to run, and walking/standing is now painful. Piain levels are now high with some visible inflammation. She controls the pain using NSAID's. I have not seen the foot and cannot comment on the mechanics of the foot.
The GP has recommended physiotherapy, supportive footwear, rest, ice and has dispensed a pair of medium density Vasyli insoles.
It is my view that she has overdone it since the injury and may need to immobilise the foot in a walking boot, for 4 weeks, whilst having physio. My question is, at what point does such immobilisation become appropriate?
Many thanks