Posterior Tibial Tendonitis- Old Orthotics or Bad Form?
So in the past I've had some issues with posterior tibial tendonitis, generally just some soreness that would go away with a few days rest. This time I had a few days serious rest and went out and tried to run again and made it only two miles before I had to turn back. I have custom hard orthotics that are probably nearing the 10 year old mark, though they've been refurbished several times since I got them, and I was told they could last forever (that seemed very unlikely, but they aren't really showing any signs of wear or other structural issues that I can see). Anyway, when doing a search on PTT I came across a thread where Leigh Boyle mentioned that improper running form, i.e. not fully striking with your foot, could be a cause. I don't come across many people who have PTT so I was looking for some opinions/advice as to whether I should consider my form first, or if it's more likely to be old orthotics that are no longer doing their job in supporting my arch. Any and all advice welcome 
Comments
usually PTT has less to do with how your foot lands and more to do with how you actually push off of it. it means that you aren't moving over your big toe. the result is that you twist your foot and then pull your toes up with your muscles (the PT for example) instead of letting the leg relax during this part like it's supposed to. without this compensation you'd either limp or trip over your foot.
as far as what the causes may be: 1) sure, it could be the orthotics. if they restrict your toe and ankle mobility by building up the arch, but that would have reared itself years ago if they're that old, 2) could just be normal motion restrictions in your calf and foot muscles due to the training load, or 3) could just be acquired run form (shortened stride and push off in the back half; everyone focuses on how the foot lands and forgets this part).
if it were me, you've gotta loosen up and heal that PT first before you make any shoe/orthotic alternations. check out athletestreatingathletes.com and go to the self muscle massage series on the right. find the post on the calf and there will be plenty of tips/video to work on your post tib. be sure to work on gastroc + soleus as well (the larger calf muscles). there are also stretches under the patellofemoral post that will help you stretch out your calf. get to work and lots of ice to get the muscle feeling better. then we can figure out the shoe/orthotic part??
I have orthotics and I've been using them less and less on a daily basis. I never used them in a running shoe.
I did the stretching Leigh recommended and I've been working on keeping my cadence up. So far I've been okay for a while. Definitely look at the stretching exercises she pointed out on athletestreatingathletes.com
@ Cary- Yep! That's the thread I was talking about. My orthotics were actually prescribed for my running. I only wear them during the regular day if they fit easily into whatever shoe I'm wearing. I'll definitely follow-up on the stretching.
Thanks!