Flat Foot, Acquired

The six miles in Rock Creek Park on Saturday went well enough, although the aftermath didn't. Sunday I had to go up the stairs one at a time like an arthritic old man. After 12 weeks of "recovery" to no avail, it was time to get serious about my sore ankle.

Only it's not my ankle, it's my foot. According to the podiatrist, it's Posterior tibial tendon dysfunction (Posterior Tibial Tendonitis), caused by tibialis tendonitis flat foot, acquired.

Actually, I was born with flat feet, I'm pretty sure.

I had a nice visit with the specialist. After two visits to GPs who poked around on my foot and kept asking, "Does that hurt?" to which I'd say, "Sort of," I got referred to a specialist (another, higher, co-pay).

The podiatrist listened to my tale of woe while I stood barefoot, looked down at my flat feet and had me rise up on my left five toes while standing only on my injured foot. Then he announced what I had.

That was it.

While I sat, he traced on my lower leg the calf muscle to where it attached to my foot via the tibialis tendon, below the ankle, and said, "That's inflamed due to chronic overuse. Fortunately it's not ruptured, or else you couldn't have stood on your toes." Around my ankle bone, the light yet pointed passage of his index finger traced the center of my pain exactly.

Prognosis: Ankle brace, contrast therapy, custom orthotics and ibuprofen for ten days for the swelling. The doctor parroted back to me sua sponte the "ten percent rule" which I often cite to trainees (never increase your weekly distance by more than 10% any week).

He said, "That six miles on Saturday, after hardly running for three months, way overdid it."

I hung my head in shame, secretly smiling inside.

Hey, I have a diagnosis, a treatment plan (I'll be transitioning to start-up running in two weeks, hopefully) and I'm back!

Little toe, big problem

It's just a little toe on my left foot. Not the little toe, a big toe. Not the big toe, the long toe next to it. For some people, the big toe is the long toe so the long toe is not next to the big toe, it is the big toe. But my pain isn't in the big toe, it's in a big toe which is the long toe, which is just a little toe but not the little toe. Clear?

Anyway, I hurt it a week ago Saturday during a 13 mile training run with my group. It just started hurting a couple of miles in. And kept hurting, although not unbearably so. Yet. Other than the pain, it was a wonderful run. Thirteen plus miles around the storied monuments of the nation's capital on a wonderful winter morning, about 40 degrees with a very slight breeze and a sunny sky. Perfect conditions for running.

Shortly after I started running nine years ago, I had pain in that very same long toe that eventually forced me to suspend running completely for eight weeks, twice. My doctor diagnosed it as tendinitis in that toe each time and prescribed two months of rest, period. Each time it had gotten to the point where the pain in my foot would cause me to just pull up. It would just come on, walking or running, and force me to sit down and tear off my shoe and massage my toe until I could go on.

These bouts came on about a year apart, and the rest period was the only thing that helped. For about seven years though, I haven't had a whisper of the problem. Until Saturday.

Sunday was 60 degrees and I tried running. I just had to run in such gorgeous weather after the long cold snap. I made it to the end of my sidewalk and stopped. My toe didn't hurt worse, it just still hurt.

I felt guilty and lazy, but I took the whole week off from running. In my yoga class, I did plank position from my knees like a decrepit old man so as to keep off my toes. I rubbed Tiger Balm arthritic lotion on my toe each night. I had a big relay race coming up on Sunday which I had to do so as to not let my teammates down. By this morning my toe felt much better although I could still feel a slight ache in it occasionally.

This is the only injury that has ever caused me to miss more than a few days running at any time. It put me down for two months, twice. It has my complete attention. I have to be able to run to conduct the training classes that I direct for my club and am responsible for. Such a little toe. Such a big problem.

Starting Over Again

You gotta read Not Born To Run's latest post, although you won't find it on her blog. It's called Starting Over, that's what it's about, and you'll find it here. She's a brilliant writer so she describes it much better than I can. But here's what I think about starting over in running as synonymous with life.

Jeanne speaks words of wisdom. I wish her a rapid return to running.

When I started running seven years ago, I was brought to a screeching halt twice by, of all things, tendonitis in a single toe. The layoffs were a year apart. The only remedy each time was six weeks rest. Nothing else helped. (Thank you Dr. Lee.)

I chafed at the inactivity. Since I didn't practice yoga at the time, I did nothing. But when the six weeks was up, I had a hard time getting back to running.

I dreaded going out to start a run. I had gotten away from carving time for a run out of my busy day. I'd lost all my prior fitness. I had to go through that unpleasant feeling of oxygen-deprivation during my first few runs back. I didn't like it anymore. I had to start over.

But you know what those enticements to lethargy were? Excuses. A lack of will and a diminution of self-esteem. I felt like giving up because it was too hard. So what if I returned to being overweight and just sinking down on the couch, shut up in my house alone, to watch TV. Hey, it's March Madness time. A game is on somewhere.

But I got through my doubts and lassitude. I found discipline and exerted patience. I didn't ruin running for myself by being stupid about starting over. I refrained from running impulsively or compulsively at the beginning and re-injuring myself.

I ran once in week seven. I ran twice in week eight. I ran three times in my third week back. By the end of the month I was back to running regularly five times a week and feeling good about myself. I honored my body with a little fitness.

I did this twice, coming back from a forced lay-off. But I only had to come back from a little pain in a solitary toe. Jeanne has to come back from surgery. I know Jeanne and she'll be back better than ever.