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Hindsight...and 11 weeks of injury

3/26/2018

2 Comments

 
I remember when I first heard the expression 'hindsight is 20/20' I thought, wow, that's brilliant. And I'm not being sarcastic. How often do we look back on a problem or concern once we have all the info and realize how much easier things would have been had we had this info in the beginning? This is pretty much me right now. It's probably why it's taken so long to put all of these jumbled thoughts together in a post (and in my brain). 

This is a long post. I wanted to mostly write it for me so remember all of the details down the road. I never suspected how many areas of my life would be intertwined with injury. So many emotions, so much unknown.

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On  the morning of January 14th I did what would be my last long run for months. If only I knew, I would have tried to remember every moment, every kilometre.

The run was bit further than scheduled as I'd tacked on 5K that I'd missed the day before. It had been a bad winter, and the day was typical with some snow, ice and salt making for iffy footing. The last 5-8K was done at a speedy pace as it was to meet up with and then run with a group, but honestly, nothing that happened during that run that alerted me to what was to come. No pop. No slip. No crack. Nothing.

Like many Toronto runners, my feet had been in either clunky boots or salt-stained runners for weeks. My long distance, track and walking shoes were about 3/4 through their lifespans. The same with my insoles. 

The end of December and first part of January saw me spending more time at the track preparing for the upcoming Ontario Masters indoor season. In the middle of all of this I'd done a long run on the track on an extreme weather day. This track only allows runners to run in a counter-clockwise direction, something I'd shrugged my shoulders to in the past.

Looking back, I'd come to realize that all of these factors were like puzzle pieces coming together creating the perfect storm of my injury. I remember attending the Gary Robbins / Ginger Runner's Where Dreams Go to Die movie screening that same evening and shifting in my seat because my leg and foot were sore.  I just figured it was just one of those little things that would go away...Little did I know that I'd still be having issues for months to come.
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Thinking the pain was delayed onset muscle soreness, I headed out for my walk commute the next morning assuming the movement would help eliminate the discomfort. My leg wound up feeling better, but my foot was still sore.

The pain was focused on the top of the foot basically between 4th / 5th metatarsals where they met the cuboid bone (see above). In addition, when I stood and rolled the outer toes against a hard surface, pain shot through my foot. There was no bruise or swelling that I could tell.

I didn't walk or run on day three, yet the pain remained.

I managed to see my family doctor on day four and she sent me for an xray which came back clear of any fractures. I learned that stress fractures often didn't show up until weeks later when they were healing so this didn't really bring me much comfort.

​By this point I was spending hours each evening Googling my symptoms. There didn't seem to be anything obvious when it came to symptoms from this area. Many different options. I started researching sports medicine doctors. The one I'd seen before and that my coach recommended was booking three weeks out. I couldn't fathom waiting that long... I couldn't fathom being injured that long! As I researched I realized it a shot in the dark and I might as well just book with the doctor I'd seen years ago and start counting down the days. 

I did no walking or running for days three to seven. In the second week out of frustration I decided to try walking again and did four 5K walks. The pain remained.

​While waiting for the sports medicine doctor appointment, I went to see an athletic therapist who did a full assessment and felt that it was a mechanical issue likely with a  tendon. He gave me a series of exercises to do and instructed me to do no planned activity if it hurt my foot.

This was the start of what would be six weeks of zero activity with the exception of things like walking around the grocery store. I was icing my foot several times a day and diligently doing my exercises. The pain worsened. I stopped the exercises. This was a very tough period of time. My Googling continued as I struggled to know if I was following the correct route.

I just wanted answers. I just wanted a plan. I just wanted to know!

​Not knowing what was happening or where to go to get those answers was incredibly frustrating. My family and friends really helped me get through this period of time with their support. I continued going to races to cheer and kept in close contact with all of my running friends.

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​Finally the day arrived for my appointment with the sports medicine doctor. At this point I pretty much put all my eggs in one basket hoping he would be able to help me. After an exam and questions, he felt that it was a stress fracture to my 4th metatarsal.

He gave me three options:
1. Re-xray to  hopefully confirm this,
2. Bone scan with better chance of confirming (but would take time to book and get results,
3. Just go ahead and treat as a stress fracture. 

I went for the repeat xray that day actually hoping something would show up to explain what was happening.  The doctor  was kind enough to allow me to wait for results.

​Again, nothing showed up.

After some hesitation about the toxicity side of things, I booked the bone scan. In the mean time I moved on to option 3 and  started treating it as a stress fracture. Given how I was feeling at that appointment, my doctor felt I would do okay without an air cast but I had to restrict exercise for six weeks.

I left feeling relieved that I had a diagnosis and plan. I also secretly hoped that since I was already almost a month in that it would mean less than six weeks more of time off.

Yup, insert hindsight here.

After about two weeks of being incredibly diligent with zero activity, I went for a short waterfront walk with my husband Erick. I got to the 2.5K turnaround when the pain hit my foot. I sadly agreed to sit and wait for Erick to go back to get the car. This was an incredibly frustrating turning point. I couldn't fathom the thought that I couldn't just simply walk back to the car. Seriously, I couldn't even walk 2500 meters?!

​I contacted the sports medicine doctor the next day and he agreed I should be fitted for an air cast. 

​The day I was to to get my air cast I went to Costco, maybe a few extra laps around the store than I should have. Nothing really. By the time I arrived at the appointment and removed my shoe and sock I was horrified to find my foot all bruised! The doctor looked at it in shock thinking perhaps I'd fully fractured it. After checking the foot he determined all was okay. With this new development he said he was starting to wonder if it wasn't a stress fracture, but regardless the air cast would help me. 

​Hindsight...blah, blah, blah.
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​This became my boot phase.

The boot was a love hate thing. It felt so wonderful to secure my foot inside those inflatable boot sides knowing it would keep it immobile and give it an opportunity to heal. The hate part? I had to find a shoe to wear that would be high enough to match the thick-soled air cast. I wound up using three insoles in my stretchy Reebok Floatride with the laces kept fairly loose. (Although I didn't actually plan it, the shoe did match the boot fairly well!) Lying on the couch with a boot and shoe on made it really hard to get comfortable and just felt wrong. Doing stuff around the house was totally cumbersome. Stairs were impossible and had to be taken one by one until I figured out a side-ways boot position and started challenging friends to races (no one took me up on that). I developed new sore spots. My back and hip from walking differently. My other foot from the friction of the tighter shoe. The boot was very flat on the inside and my foot missed my Superfeet insole support. Walking outside was actually fairly easy and I got around with relative ease although I was still restricting my activity. Oh, and if you want the attention of runners just arrive at a running event with an air cast. Ha ha! The pain over the three weeks in the boot remained, but I crossed my fingers that things were healing. 

The bone scan was time consuming but also somewhat of a treat to hang around for 2.5 hours between scans in a coffee shop. Again all my eggs went into one basket as I waited on results of the scan. It took over a week for the results to arrive back at the doctor's office which was incredibly frustrating. 
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Finally the day before I was to drive 10 hours to New York I had an appointment for bone scan results and a recheck. 

The bone scan revealed no stress fracture. Admittedly I felt like I was suddenly back at the start.
Do not pass Go, do not collect $200. 

The sports medicine doctor assured me that the rest period and last few weeks in the air cast had not been for naught.  He was now suspecting my cuboid or a tendon.  He said I could go with or without the boot, whatever felt better. I could start cross training. He gave me a prescription for a couple weeks of anti-inflammatory, recommended a new, more substantial shoe insert and gave me a prescription for physiotherapy.

I left feeling a bit more positive.

I ordered two pairs of the new inserts, retired three pairs of running shoes (walking, long run and speed work) replacing them with new ones and got the prescription for NSAIDS. Given my lack of benefits and that the injury had already been costly thus far,  I'd have to pass / wait on the physiotherapy part and try to get by with my own treatments. 
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I headed off the New York the next morning, the boot packed in a plastic bag-check bag (oh, the irony!) in the hatch of my friend Maria's car. I drove many pain-free hours on the way there, wandered in and out of coffee shops and revelled in the feeling of free feet. 

Over the next four days I left the boot in it's bag and didn't hold back when it came to trekking around the city. My foot did hurt a bit at the end of each day, but considering I travelled 5K, 15K, 15K and 5K over those days, I was actually rather surprised it didn't hurt more. 

Once home I excitedly continued walking as well as cycling over the next week and a half. 

On the last day of my two week course of anti-inflammatory I decided it was time.
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I ran.

I knew I needed to take it easy. I doubted I would even have any endurance after 10.5 weeks off. I started running. 50 metres, 250 metres, 1K, I felt good. 1.5K...Hmm, I'm not out of steam. How is this possible? My workplace is 3K away. I decided to keep running because I could...or to prove I could. I did it, 3K without stopping except for stop lights and didn't keel over. I was pain free! I RAN! I iced my foot just to be sure. I started wondering, what if I could have been running sooner? 

Annnd wouldn't you know, the pain started sneaking back in later that day and into the next. It continued over the long Easter weekend. Not horribly, and seemly in a different spot, but almost always hovering there. Well, now I knew that I couldn't have run sooner. Sigh. I walked a bit over the weekend trying to not feel too disheartened. 

So, now what?


I wish I could have ended this post and journey with the photo above as the happy ending to my injury story. Alas, the story continues. My hope is that I can continue to cross train until the pain goes back to what it was before New York. I also realize I did what I said I wouldn't and started running the same day my anti-inflammatory finished and after two weeks of cross training. I think back, was I ever fully without pain even before New York? How was I to know now what brought back the pain? My heart says it was the run. Again, I am scratching my head.

My next set of races loom ahead. I'd recently decided I'd walk the first 5Peaks race of the season, and maybe walk-run Mississauga half and even Sporting Life if I had to. Now I'm not so sure of any of those. I will have to reevaluate in the weeks to come. So much for saving money by registering early--this only works when you can actually participate in the races! The only race I've been able to do in 2018 was a 600 metre mini-meet on the track! 

All I can do is keep on trekking and try to stay positive. In almost five years of running this is the first major thing to take me out. I guess I should be relieved with all those injury-free years. 

​Onward...
2 Comments
Allison link
4/2/2018 10:50:42 pm

Ugh to this post. I wish I could fix your foot for you:(

Reply
Courtney link
4/3/2018 02:08:06 pm

Oh, Cathy. I'm so sorry to hear that your pain came back after your run. That false sense of security we get from those first pain-free runs are often tougher than the first bouts of pain. At least, that was my experience this time around. The rollercoaster of "I just ran!" to "Crap, now I hurt again." to "But I'm not in pain today! I can run!" is really, really tough to navigate. You're one of the most positive people I know, and seeing you handle this with grace with such a motivator to me. Hope to see you soon!

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    Cathy V

    Running. Design.  Family. Dogs. Gardening. Food. Crochet. Canadian. 
    ​Order varies. 


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