On Injuries

I signed up for the second of what will be my five July half marathons today (I’m spacing them out as donations come in to the project—- click the Donate button above to learn more!). And earlier this week, I took my first brisk walk in 7 weeks without my orthopedic boot. I still haven’t run a step since October 19th, but I am now making some good forward progress on my running road trip project and on getting back into shape in general, which is great. But as I work on recovery from my injury, I have more questions and frustrations than ever about what actually happened to me. Let’s talk about it.

I feel like I need to establish that I know what it’s like to be hurt, and what it’s like to be injured. My specific blend of anxieties and neuroses means I’m simultaneously a hypochondriac, and also terrified to ask for help or admit weakness, so its important to me to lay out a little bit about my injury history before I get into describing this specific problem. Like any middle aged runner, I know what it feels like to be “hurt” but still capable of running. Early this fall, my left Achilles was barking at me a bit, usually at the start of runs or when I was going up hill. I’ve had soreness in both hips for a while, but that’s actually improved as I upped my mileage. A lot of my issues stem from gait issues caused by my right knee (more on that later) and some arthritis in my right MCL. My feet have a tendency to cramp up on me. Etc. And over the past twenty years, there have been thousands of little dings that come and go, muscles that hurt a little (or a lot) for a few consecutive days and then go away, stiffness that I know will be there when I start running and then loosen up, and on and on. To be a runner means to always be dealing with at least a few things that don’t feel right or that cause some pain.

But I also know what it’s like to be “injured.” When I was living in Japan and studying judo, I did some combination of planting my right foot wrong while attempting a throw while my opponent executed his countermove just right, and I spun around on my right knee while the foot stayed where it was. I remember feeling it give out and the knowledge, while I was in the process of falling, that things were clearly in the wrong place down there. I hit the ground and things snapped back into place, but it was obviously, clearly, a problem. By the next day, my knee had swollen up like a grape fruit and was too stiff for me to ride my bike. I asked my judo sensei about going somewhere to get it examined and he sent me to what turned out to be some kind of acupuncturist. That guy helped the pain, but didn’t do anything about diagnosing the root issue. Every night, my knee was in pain no matter what I did with it—- the pain made me conjure the mental image of a stubborn nail getting pulled out of a board by a claw hammer for some reason, if that helps you empathize. After a few weeks, I was able to find a hospital in the nearby big city and get an MRI done—- I had torn my MCL and done some damage to the meniscus, but the ACL was OK. I didn’t need surgery (or at least, no one in Japan thought I did) but it was months before I could use the knee properly again. That was 20 years ago and that knee still gives me trouble driving long distances or when I step up my running mileage too quickly. So, I know what being “injured” is as well as being “hurt.”

OK, so, October of this year. I was training for the Indianapolis Monumental Marathon, and, a few weeks out, was pushing myself a little too hard to get my mileage up. I went for a long run on a Friday on a long, paved trail in town, and made a small mistake by pushing what was meant to be a 16 mile training run up to 18 miles. I made a bigger mistake on Saturday by doing a 4 mile run on some hills instead of taking a rest day. As a parent of a couple of little boys, I often end up slotting my training around my availability instead of where it makes the best sense for my health, so I pushed myself too hard over those two days. Saturday night, my right shin and ankle hurt, but I wasn’t too worried about it. On Sunday, I took my boys to a local park and ended up needing to walk for about fifteen minutes with the three year old on my shoulders—- I won’t say this was stupid, more like just the inevitable consequence of parenting. By the time we made it back to the car, my leg was in so much pain that I spent the rest of the day on my back on the couch with an icepack on it. I started putting positive vibes out into the universe that it was only something like shin splints or tendinitis—- hurt—- instead of something more serious—- injured.

Nothing improved or changed for the next several days—- pain and discomfort running from the outside of my right shin down through the ankle and then across my foot out toward the big toe. When I mentioned to a runner friend of mine, he was worried about the foot being involved and said I should get an x ray. I went to the clinic and got the x ray, which didn’t show any breaks, but the PA, who was googling my symptoms while we were talking, recommended I go to an actual orthopedist before I tried to resume running. The actual ortho did a second x ray and diagnosed me with a “healing stress fracture” in my foot, on one of the metatarsal bones. I was a little confused because the pain was mostly in my shin and ankle, but the PA at the ortho explained that this was likely some combination of referred pain or a separate injury being caused by me altering my gait to get pressure off the break. I was told I wouldn’t be running at all, let along running my marathon, for at least three weeks. They gave me a boot and a pair of crutches and off I went.

I spent four weeks in that stupid boot, trying not to put stress on my foot. In practice, that meant cutting out physical activity that I wanted to do but still putting more stress on it than I wanted to because the kids need baths, the house still needs cleaning, etc. I noticed more and more pain from my foot itself and less and less from the ankle. It was the longest period of my life I’ve gone without any kind of planned exercise. It sucked.

After my four weeks were up, I went back in to be reevaluated. The took another x ray and a different PA told me the stress fracture was healed. But she also said she “wasn’t convinced” I had ever had a stress fracture in the first place. Maybe it was a hematoma or some other kind of stress reaction. She was concerned about arthritis in my big toe, though, and told me to keep an eye on it. I was given permission to take the boot off, start very slowly ramping up my activity, and see how things went. Within a matter of days, my foot was in pain and visibly swelling, so the boot went back on and I got scheduled for an MRI. Two more weeks passed for that process. I got the MRI on a Friday. The weekend passed. Finally, Monday afternoon, I got the results back from the MRI—- no structural damage of any kind. The PA theorized that all the pain was because of the arthritis in my toe. Cool. Cool cool cool.

So, I have questions. Did I ever have a stress fracture? Would I have ever been told there was something wrong with my foot if I hadn’t gone for the pain in my ankle? My foot hurt the worst in those first few days without the boot—- had walking around in that boot for a month actually caused more problems that it solved? I bought some inserts for my shoes that are supposed to help with the arthritis and I’ve been walking around on them—- no boot—- for a few days. I’ve had a little bit of pain, but nothing like what I was feeling before. If I had bought the inserts in October, would everything have resolved itself and I would have run the marathon as planned? At the very least, diagnosing and treating things like this is clearly as much an art as it is a science. Three different people had examined the same injury and told me three different things. Where does that leave me now?

Looking on the bright side, the MRI did NOT reveal that I have a torn this or ruptured that. I didn’t have to have surgery to put screws in anything. I will be able to run again, sooner rather than later. And being injured and on the shelf gave me the time and motivation to put this project together. I’m trying to run and raise money for the National Diaper Bank Network—- if you’ve made it this far, I’d really appreciate it if you made even a small donation. You can use the Donate button on this page, or access my GoFundMe directly at this link: https://gofund.me/cd916b22 Gotta go for now, it’s almost time for me to start running!