Anyone have advice on learning to run?

[ArtFossil]

26 minutes ago, ThyPeace said:

It's Monday, still no running.  My ankle still aches.  I've been doing more reading on the Internet and none of it is encouraging.  I think I have injured my tibialis posterior tendon.  And if so, the Interwebs say I need to consult a doctor or risk permanent damage.  Yay.  So now I guess I need to call my doctor's office and find an orthopedic guy who specializes in ankles.  Because in my area, they specialize that far.  

ThyPeace, pretty sure I know what practice I'll end up at.  They're a few blocks from my office.  I would usually walk it, in fact.  Sigh.

Sorry about your injury, ThyPeace. I've followed your thread with interest. Back in my late 20's, 30's and early 40's I ran. But I was in Alaska (before global warming) and running outdoors was confined to May to Labor Day. I would just do a short run (about 30 minutes) or a long run (about an hour) and never tracked my mileage. (Also before FitBits and pedometers became common.) My then-husband is 15 years older than I and our running speeds matched well so we often ran together. No injuries, no problems but--for me at least, it was also not a sustainable method of fitness and not just because of being limited to four months a year.

Fast forward 25 years and I'm now almost 70. I walk or exercise/swim in a pool and do Pilates and I'm a year out from a hip replacement. While there are many people who LOVE running I wasn't one of them. If I were to do it over again, I'd just walk.  (More relaxing, still weight-bearing and little chance of injury). 

You're a lot younger, though, and eager to run so I do hope you get your ankle issues resolved quickly and get back to your running program.

[ThyPeace]

 

I've been a way for ten whole days, I see.  Last Friday was the final exam for the last class in a certification I've been working on (now I can claim to know something about facilities management), so I spent much of last week studying rather than spending any time on forums like this one.  And just as I was finishing studying last Thursday night, we got the news that a close friend's husband would be taken off of life support the following day.  Obviously we'd known for several days that things looked bad, but it was still not a good evening.  So Friday I got up and went for a walk at 5:50am, finished studying, started packing, took the test at 8am, went to work, finished up everything I needed to do there, left work around 2pm, came home and finished packing, drove through Memorial Day traffic to the airport, was on a flight at 5:15pm, and by 8pm was sitting vigil (pretty much just like a wake or, if you've never been to one of those, imagine a potluck with lots of food, beer, wine, singing, drumming, and a dead guy at the far end of the garage) with our friend.  I'm glad we went -- her close-by friends and family were completely exhausted and all needed time to be with their own families.  Though we could do very little, giving everyone else the next evening to take care of themselves while we took our friend out for dinner, drove her back to her place, and then did an hour of straightening up and laundry, was probably quite well timed.

Somewhere along the way, there was a post that got lost.  Sorry, @ArtFossil, I intended to respond to you much sooner.  In any case, thanks for sharing your running history.  I completely understand about choosing not to run -- I've done that most of my life, in fact!  I just have found that there are times and places when the running seems to work better.  I was a swimmer when I was a kid and have plenty of joint damage to go with that (shoulders and knees), and biking tends to cause my back to spasm around the instability point that was once a major herniation.  So walking and running usually work best. 

Anyway, over that few days when there was no time for working out, there was also far too much pain in my ankle.  It got bad standing in line for the plane on Friday evening and progressed to misery during all the standing during the memorial rituals and things on Saturday.  I ended up icing it in the car and then again at our friend's house in the evening.  By the end of all that, it just felt -wrong- somehow, and I started to worry more about a stress fracture than I had before.  But there wasn't much to do about it, so I hobbled on through the return flight and travel with ice and a limp. 

Yesterday (Memorial Day), I wore different shoes and was out and about doing yard work for various parts of the day.  Somewhere in the process there was a little grinding pop in my ankle and it went back to just hurting instead of feeling -wrong-.  I'm guessing maybe one of the bones in my ankle or foot had gotten misaligned -- it felt very similar to when my back gets out of alignment.  Not nearly as bad as when it happens in my back (in my back it causes all the muscles around it to spasm) but similar.

This morning it was sore but not impossibly so, and I took myself out on a hopeful walk.  Definitely no running, but walking was possible and no worse than standing or sitting.  Well, maybe a little worse than sitting.  In any case, it was in that condition that I finally got to see the ankle doctor.  The encounter went exactly as I expected it to -- an xray to rule out a stress fracture (nothing showed up with a careful manual examination of my ankle either), and a diagnosis of posterior tibialis tendon tendonitis. 

The prescription is as follows:

• Wear a brace at all times except sleeping and bathing
• Ice twice a day
• Ibuprofen at morning and evening meals
• Physical therapy
• Absolutely no running.  And no long walks.  I negotiated for short walks and was allowed 1.5 miles.
• Stationary bike and swimming are allowed.  Which is nice but I don't have access to either one at the moment... oh wait.  There's a bike at my office that I could maybe use.  Hmmm.  I'll have to figure out how I can do that.
• Absolutely no running.  None.   We'll talk again when I see you in two weeks.

And yes, he really did repeat the injunction against running.  Apparently he's worked with people like me before.  Unfortunately, the first available PT evaluations were at a time I can't go, and the next ones that are available are a week from Thursday.  So that's when I'm going in, and they'll call me if anything opens up since my office is very close to them.

In the meantime, I guess maybe I'll see what I can do to build strength.  Nike Training Club workouts, maybe, if I skip everything that has footwork.  Sigh.  Frustrating.

ThyPeace, the doc sounded really surprised when I told him my goal was a 5k when I'm 100 years old.  Guess he doesn't hear that one very often.

[ArtFossil]

@ThyPeace--respectfully (but emphatically): forget building strength! Your JOB is to heal and you can't rush healing but you sure as hxxx can prevent it. 

Rest, ice, take your ibuprofen and wear your brace. Your mile or so of walking means you can get through your daily activities. Forget the bike--biking tweaks your back, remember? Be grateful you can be weight bearing and don't have to be on crutches!

[ThyPeace]

@ArtFossil, you are reminding me of my mom.  This is not a bad thing!  It just is frustrating to be inactive when I have worked so hard to rise up out of sloth.  I'll go for my 1.5 mile walk this evening and be happy.  (And do some pushups...)

ThyPeace, incorrigible.  And yes, grateful that I'm allowed to walk around.

[ArtFossil]

6 hours ago, ThyPeace said:

@ArtFossil, you are reminding me of my mom.  This is not a bad thing!  It just is frustrating to be inactive when I have worked so hard to rise up out of sloth.  I'll go for my 1.5 mile walk this evening and be happy.  (And do some pushups...)

ThyPeace, incorrigible.  And yes, grateful that I'm allowed to walk around.

LOL! From what I've observed I'd say you're incapable of sloth. And you won't lose all your strength in one month. Or two. Or three. It will come back quickly when--IF--you are healed. 

And don't even think about that stationary bike as you were careful to note that biking bothers your back. But, if you want to try water WALKING, know that some of my city's most accomplished runners cross train with this at my Y pool, with and without a flotation belt. Being supported by the water it is, as far as I can prove, impossible to injure yourself (but of course check with your doctor).

You're in this for the long haul, right? Time to be smart about your exercise.  You've got a lot of decades until your 100's. 

[Jomomo]

Hi ThyPeace.  I sped read your posts.  Good for you on your progress.  I concur with the above advice to take it easy.  You need to heal and then you will be ready to run again.  I agree it is hard to be inactive.  I have been running since 1977.  Yep I am an old mother runner, ha ha ha!  Follow Dr's orders.  I have been relatively injury free.  However since this winter was particularly mild, I overtrained for a half and had a sore foot for awhile.  Kept trying to speed up the healing process.  Doesn't work that way, especially at my age.

I use an elliptical trainer and have been taking walks.  But I too can't wait to run.

 

Hang in there.

Joanne, day 12 of Whole 30

[ThyPeace]

I'm very very capable of sloth.  It looks like 40 pounds more weight, pre-diabetes, metabolic syndrome, and inability to do basic things like climb stairs without wheezing.  I've been there and done that and would rather not go back.

And @jomomo, yes, exactly.  Speeding up the healing process just isn't working.

The last month has been just flat annoying.  I've started physical therapy and really started to feel better for a few days.  They gave me some exercises to do at home -- four-way ankle work and standing on one foot.  It's amazing how hard that can be when you're injured, but after a few days, it started to feel pretty easy.  And then I went to the second physical therapy appointment.  I was feeling good and they worked me pretty hard.  By far the hardest thing was doing twenty squats on a Bosu Ball:

https://corestrengthblog.com/2013/04/30/bosu-ball-squats/

My ankle was in enough pain after that that I told the physical therapist about it.  She worked on massaging it some and then we did some more exercises.  I declined the offer of ice afterward because I was late picking up DD and I felt okay by then.  The next morning, and since then, I've been pretty sore.  Frustrating.

I did learn something that @artfossil may yell at me for -- I carefully tried out my bike and was delighted to learn that my strength work in the last year has me to the point where I can ride without tweaking my back.  Yay!  My first ride was all of 20 minutes and I waited 48 hours before I decided I hadn't hurt myself.  Then I did a 25 minute ride, again without pain, and then 45 minutes, and then an hour.  Interestingly, the very light repetitive motion also seems to help my ankle.  My theory is that it increases blood flow to the injured area, thereby improving healing.  

So, some good, some bad, some ugly.  I'll be walking the 5k that I was planning to do with my daughter this weekend.  The doc says that I can run when I am completely pain free.  

And we had a very interesting conversation about my goal race -- the 5k when I'm 100.  I asked if he wanted to be on my team, and he glanced at my chart and said, "I'm going to be 103 when you run that race.  I think you need a team forty years younger than you are."  It made me really stop and think about how much planning and work and foresight it's going to take to get that goal race done.  

ThyPeace, I think I really do need a team.

[ThyPeace]

It's a week later and I'm still fighting the good fight.  And I will admit feeling really sorry for myself for a little while this morning.  The "this is never going to heal, it's going to hurt forever, I am never going to run again" sort of sorry for myself.  Sigh.

I've learned that the only thing that really mitigates the pain is very supportive shoes and the brace.  Even then it hurts some.  If I omit one or the other, though, it hurts a lot.  Like when I had plantar fascia, I've started wearing my shoes All. The. Time. 

What I don't know is whether I am improving or not.  There are immense daily variations.  Last night I would have told you for certain that it was NOT getting better and in fact was much worse.  ... And then I realized that I had made a terrible shoe choice that morning, had not had any ibuprofen all day, and had not used ice in 24 hours.  If I had done that three weeks ago, I wouldn't have survived the day.

The exercises are not necessarily getting easier very quickly.  But maybe they are very slowly.

Still, it's immensely frustrating.

Next week I have an appointment to start the process to make orthotics for my running shoes.  I don't know a darned thing about orthotics, so will have to do some research.  Anyone here have any advice?

And on a good news note, DH has finally recovered enough from his plantar fascia that he was able to go on a three mile run-walk yesterday.  For him, that's not much.  But it's been two months since the last time he ran more than a few steps at all, so this is a really big deal.  I may be cheering him on at the half-marathon rather than running it myself.  We'll see!

ThyPeace, not giving up hope, but it's less than three months away now.  Seems like running it may be hard.

 

[ThyPeace]

Physical therapy is still progressing slowly.  Last Friday I got to work almost the whole time with my physical therapist instead of starting with the assistant.  That was really helpful because she actually corrects me and modified the exercises that I just can't do yet, rather than just watching me fall over the way the PTAs do.  I kept telling her how much how much it my ankle still hurts, but she didn't start to believe me until I yelped when she happened to squeeze my ankle in just the right spot.  Her whole demeanor changed at that point -- apparently I should NOT have that much swelling this far into the game.  Her comment was, "Wow, you must really have done some ligament damage, too."  I was in too much pain to say anything snarky.

So I got to meet my new best friend, the Game Ready machine.  It gets cold and compresses.  And then relaxes, and compresses again, the goal being to reduce inflammation.

 

 

And she told me to go get an ankle sleeve to reduce the swelling even more, and to ice every day (already am), continue with the ibuprofen (I was), and just keep trying (yeah, I know).  I decided that over the weekend I was going to do Absolutely Nothing, and see how that felt and whether it helped.  I slept 9 hours one night, 10 hours the next, and then took a 2 hour nap.  Poor DH had to do far more work than usual to let me do it, but sure enough, by Monday morning, I was in a lot less pain and there was a lot less swelling.  I was still a little tender, but not as bad.  

At PT that afternoon, I got to go on the elliptical for 10 whole minutes!!  That's the most aerobic work I've done in weeks, and it felt fantastic.  I was really careful with my ankle and was able to use the time to warm up the area really well, which led to less pain rather than more.  That's a good thing.  PT itself was just about as miserable as always, but I can still tell that there is some progress.  I can do the Bosu ball squats without it hurting, for example.  And I'm up to 200 pounds on the leg press (they started me at 120 pounds, but that's just silly; I weight 170, after all!).  120 pounds on the single leg press was hard.  I could only do 17 reps instead of the 20 they asked for.  Ah, well.  I'll work at that no problem.

The single leg touches (below) are particularly hard.  I did ONE on the bad side.  Nine on the good side.  Sigh.  The other exercises are all either easy (stand on something and rock my leg back and forth) or hard-but-not-painful (planks).  

More to come on the orthotics fitting, but for now must go back to other things.  Have a good day and don't get hurt, y'all!

 

 

ThyPeace, "be careful out there" is one of my favorite lines from Hill Street Blues.

[ThyPeace]

Okay, so on to the orthotics fitting.  That was Tuesday.  It was a really interesting process.  The pedorthist ("a professional who has specialized training to modify footwear and employ supportive devices to address conditions which affect the feet and lower limbs," thank you Wikipedia) had me describe what had happened and what shoes I was wearing in more detail in far more detail than anyone so far.  Of interest was that he said that he was seeing quite a few people come in with injuries after wearing the Brooks Adrenaline shoe.  He attributed the problem to walking in them, rather than running in them.  The design that prevents over pronating in a runner seems to roll the ankle outward too much when walking.  That then leads to the muscles tightening up to try to compensate, which then leads to everything on the inside of the ankle also tightening up.  Over time, that leads to the type of injury I have.  It got exacerbated when I tried to run on it, not realizing the problem.  The lack of stability, combined with the force, damaged the ligaments between the ankle bones as well as the tendon.  

And because I continued to wear those shoes after I was injured (thinking hey, new shoes, probably better for my feet, and they're larger so the brace fits better!) means it just continued getting worse.  Maybe that's why the first PT session, when I was still wearing those shoes, was such a horrible experience.  Sigh.  Live and learn.

So anyway, he went on to check my feet and ankles carefully.  Apparently my feet are slightly inverted, meaning they point inward somewhat when in a neutral position.  In addition, I am asymmetric.  On the left side, my big toe doesn't fully hit the ground.  On my right side, it's my little toe that doesn't quite get there.  Which is why the left ankle got hurt more.  And my toes are straight.  This is apparently a good thing.

After he looked at my feet, it was time to do the imaging of my feet.  They do a 3D image instead of a plaster cast, and the way they do it meant that I had to stand on one foot with my other knee on a chair for a couple of minutes each side.  I really, really should have asked to put my brace for that part.  Standing in that awkward way put a huge amount of pressure on my ankle, and I was really tired and sore by the end.  

We also talked about my PT.  His assessment was that I have been given an extremely aggressive PT regimen.  He wasn't convinced it was a good idea (he is also a physical therapist in addition to being a pedorthist), but said only that he'd talk to my PT about it.  

And then .... I wait five weeks (!!!) for the orthotics to come in and "then you can start healing!" or so the pedorthist said.  I wanted to hit him over the head for that.  I darn well better be a lot more healed 5 weeks from now than I am today.   That said, knowing that orthotics are helpful for this is a good thing.  I may go find a running store while I'm on vacation next week and buy some more supportive shoe inserts than the ones I have now.  And since I'll be on vacation, I can spend all my time in my supportive sneakers rather than in my somewhat less supportive dress shoes. 

 

The next day I had physical therapy again.  I was tired and sore from Monday's PT and Tuesday's excitement with standing up barefoot for a long time.  The PT itself went about like Monday -- elliptical (yay!), exercises (boo!), and Game Day were all the same.  This therapist spent a long time doing a very gentle massage of the posterior tibialis tendon itself.  It was knotted at one point, and her goal was to unknot it.  Now, I know she was using the level of pressure that you might use when rubbing a baby's back to get her to fall asleep.  I -know- that.  However, it hurt like she was sticking a needle into me.  Sheesh.  Talk about a tough session.

The Game Ready only helped some afterward, and I was icing my ankle all through supper time.  The next morning (yesterday), I was in so much pain that I didn't do my exercises and could barely walk.  Things steadily improved as the day went on, thank goodness, and this morning I was back to where I was on Tuesday morning.  I don't quite understand everything that contributes to high pain levels, but I can tell you for sure that PT brings it on!  I do think that if I could just get in more healing time between PT appointments, I might heal faster.  However, the constant reminders that this is a long process are... good.  I guess.  Sigh.

 

Tomorrow, we go on vacation for a week.  It was supposed to be a fun active vacation with beach time, water park time, running, and other good stuff.  As it is, well, I'll play mini golf and spend time in the lazy river.  At least I get to see fireworks, my nephew, and drink bourbon with my brothers!

 

ThyPeace, looking on the bright side as much as possible.

 

[ThyPeace]

Just a brief stop-in.   My vacation was nice but frustrating.  Going to a water park when you can't run around is hard.  I did play mini golf once and spent time in the lazy river.  I had bourbon with my brothers and stopped at a biergarten one of them started a few weeks ago.  And the one slide I went down was because my 2 year old nephew wanted to go with me for his very first water slide ride. Hard to turn that down!  

And I tripped while walking (apparently that wasn't a place someone with a bum ankle should walk) on the second night there.  It hurt badly enough that I ended up crying on my husband's shoulder after we went to bed.  The next day, I realized that the pain of that encounter was not all that much worse than PT had been.  It really made me think hard about PT.  I rested as much as I possibly could after that.  Spending a lot of time in the water, where I was putting no pressure on my ankle and foot at all was really nice the last part of the trip.  I came back with the swelling and pain significantly reduced.

This week has been a slow increase in aches and pains as I have gone through physical therapy and just getting back into my routine.  I backed off on the thing that was really hurting my ankle the first time back to PT, and the next day, amazingly, wasn't crying in the shower.  I think the several days off from PT was also helpful.  And so today, of course, I got a whole new set of exercises.  

Here are a couple of pictures -- note the emphasis on balance -- that demonstrate one of my new exercises:

https://www.meyerpt.com/airex-balance-beam

Fiendishly hard.  I didn't start with that, I started just standing on one foot on the stuff.  Ugh.

Then there was this exercise, the sliding side (and also back) lunges:

See how he keeps his foot in the same position the whole time?  I can't do that.  But I did 20 of the best I could.

And last but not least, we now have planks with my feet tapping down from a bosu ball.  That was hard.

I did two sets of ten of these (one rep requires tapping down with both feet).

With the leg press, calf raises, one-legged leg press, and Bosu ball squats, I'm getting a pretty good lower body and core workout twice a week.  No cardio or much upper body, though.  Sigh.

ThyPeace, who really just wants to go out for a nice long run-walk.

[ThyPeace]

 

Still doing the same workouts as described above.  The physical therapy assistants who follow me around while I'm doing it tend to get really big eyes somewhere along the way in the workout.  Apparently they are more accustomed to the older people who are recovering from hip replacements and things like that, rather than someone who wants to go back to being really active afterward.  Speaking of afterward, I'm in far less pain than I was two weeks ago.  I still can't imagine running or jumping.  Instead, I -can- imagine walking without a brace.  That's a good step.  I skipped the brace yesterday to allow my foot to recover from the injuries it does (bruises and pressure spots, mostly), and today I'm not too sore.  I had to go back to wearing it, though, so you know I'm still not healed.

 

This week I have a regular PT appointment, a PT evaluation, and an orthotics fitting.  I have a feeling I'm going to be really tired after all three -- and two of them are on the same day.  I'm wearing my new shoes today to get them broken in a little bit before the orthotics appointment -- the pedorthist asked me to buy a larger and wider shoe size so that the orthotics would fit well.  And he told me I really would be better off in the larger size anyway.

 

I haven't don't any real exercise other than the PT in weeks.  I did go for bike rides both days this weekend.  It felt good to get a little exercise in -- just light 40-45 minute rides both days, tooling along at maybe 7-8 miles per hour, so nothing intense.  Once I'm finally cleared to get a little more exercise, I'm going to have a lot of catching up to do in terms of cardiovascular fitness.  I'm building muscle nicely at the moment, though.  Even my biceps, though the only things I'm doing to strengthen them is planks and holding the stretch bands when I do my ankle exercises.

 

ThyPeace, likes having muscle, but not as much as I like running.  I think.

[ThyPeace]

Another week, another week of the same workouts.  Nothing too interesting and definitely no running.  I am noticing that I am craving carbs quite a bit at the moment, which is not helping me with my continued quest for a healthier lifestyle.  I keep thinking about what I'm going to do to improve my diet and life overall, and keep coming back to "Meh.  Things are fine.  I'll improve later."  This is probably not a good answer.  

I note two things about my body composition.  When I look at myself from the front, I see a belly that is rounder than it was two months ago.  I attribute that to not running, though my weight has not changed much in that time.  And when I turn around and look at myself (thank you, mirrors) from the back, I see that my back seems much more muscular than the last time I looked at my back closely, probably six or eight months ago.

I'm noticing that my upper arms and shoulders are more muscular, too.  Can't quite figure that out, since I'm not actually working those parts of my body (unless you count two sets of planks twice a week, which I don't).

ThyPeace, looking forward to a bike ride this weekend.  I need the peace and quiet.

[ThyPeace]

So the weekend actually held two bike rides.  One was a flying craziness with my husband, trying to do seven miles before it got dark.  (I'm slow.  He's not.  I was in front and still struggling to keep up.  He even coasts faster than me!)  Probably pushed it too hard because my knees were sore afterward.  Sunday we did a calmer ride up to the track so DH could run. I stopped at Starbucks and got coffee on the way, so you know it wasn't hardcore!  Once I got to the track, I decided to walk a little and found that it didn't hurt nearly as much as I expected it to.  So I walked a half mile, then sat and drank some coffee, then walked another half mile.  While carrying coffee to force myself to go as easy as possible.  

I had physical therapy on Monday.  The physical therapist was all "You're awesome!" and "There's nothing wrong with you anymore!" and "You're 100%!" And I was all like, "I can't do a single step of running yet, what planet are you on?"  Now, I will admit that I can do squats on a Bosu ball, planks with my feet on the Bosu ball and tapping down on each side, single leg squats with a slider thingy, and more weight on the leg press machine than any other current patient can do.  Great.  I'm strong.  But I fall over when I try to do the single leg touches.  I shake and get exhausted standing on one leg on squishy foam.  I take an eternity to walk a squish balance beam.

I am not 100%.  And I can't run.

Tuesday, I told the doctor all of this as he was testing me and said, "Yeah, still some weakness there" while I tried to hold my ankle inward against his push and couldn't.  He suggested that I seek another physical therapist, even though the one I've been seeing is with his practice.  I decided to take him up on it and called the physical therapy practice that advertises at the races I've been to, and where I went to the stride clinic back in February.  They had had a cancellation and fit me in the next morning.

So I got a fresh new evaluation from a new physical therapist yesterday morning.  He seemed pleased with my overall strength, and instantly identified weakness in my left outer glutes.  He said that is tied to the arch and we need to activate it to get the arch muscles activated.  he also noted the different in the arch in my two feet (yes I know...) and asked about a dozen times "So... no one did an MRI?"  It was pretty clear that he would not have done things the same way as they went in the last three months.  But oh well, we all knew THAT by now, eh?  He said that there's pretty clear evidence of a stretch injury, which is likely not the original injury but from one of the major tweaks I had after that.  And the day when I felt my whole foot shift, he said was probably the tendon popping part-way out of the groove it's supposed to live in.  When I later felt my foot shift back into place, that was probably when it had calmed down enough to go back into the groove.  Interesting interpretation and different than the one I'd previously, which was that it was the ligaments being damaged.  I have no way to judge which one's right, of course.

The assessment involved checking the strength of various muscles in various directions.  The key was using the glutes to hold the leg up (rather than the hip muscles) when I'm on my side but my leg is slightly behind me, where the larger muscles can't work.  Turns out I can't do that on one side.  He also had me do a mini squat on each leg to see if my arch engaged when I was doing it.  Yes on the right, no (and falling over because of lack of balance) on the left.  Ah ha!  I think we have a new view of the problem.

So after the assessment, he took an ultrasound machine to my ankle (after again appearing surprised that no one had tried it before).  He said it was to improve blood flow in the tendon by warming it up, which seems to have been generally true; an hour later, the area was warm and a little puffy, and then it receded later in the day.  Interesting effect, that.  Then we looked at my shoes (Mizuno Wave Inspire) and inserts (SuperFeet Green) and he pronounced them an excellent choice for my current status.  He also looked at my brace and said it's a good one.

And he said we'd try some tape.  I looked perplexed, so he got the tape and proceeded to tape my foot in a way that supports the arch.  He asked me to leave it on until I had a chance to go back to the track and walk, to see if the tape would allow me to go a little further without pain.  I said sure, I'll give it a go.  He also recommended finding a combination of walking, stationary bike, and elliptical to get me back into cardiovascular movement "so I won't feel so much like a slug."  Hey!  He must be a runner -- he knows how I feel.  

Then it was on to the exercises.  He gave me deceptively simple ones that are designed to engage the glutes and the arch at the same time.  Stand on one leg, bend it slightly, engage the glutes and the abdominal muscles.  From there, just pull a very light stretch band that's around the ankle (of the foot that's not on the floor) in and out.  Easy!  Except for the mental connection that I'm required to make between the glutes and the arch -- they have to engage at the same time.  And that part?  Hard.  I'll keep working at it, but I will definitely need his advice on when I'm doing it right and when not.  That exercise is to be done 2x20 times on both legs and in two directions, twice a day.  And I'm to continue doing any of the other exercises that I found helpful.  

So, that's the doctor and physical therapy report.  Next time, I'll report on .... (dramatic music here!) Going For A Walk.

 

ThyPeace, how's that for a cliffhanger?

 

 

[ThyPeace]

Okay, so I think 18 days later is long enough to leave everyone in suspense.  Let's see.  I went for a walk.  The first walk was an evening one, and it took me 30 minutes to cover 1.5 miles.  Golly, I was ginger and feeling weird!  It didn't exactly hurt, but I noticed my ankle with every step.  And golly, I wanted to run so badly I could taste it!!  I contained myself, though.  Since that had gone well, I did it again a couple of days later, this time a little faster but still carefully. 

That got me to my next PT appointment, where he was pleased with all my progress and encouraged trying out some very short intervals of running mixed in with the walks.  

ThyPeace, and now another pause; I'm a bit short on time right now.  More to come!

[ThyPeace]

So the next week, I did what the PT said.  Did my exercises, including the new ones he gave me.  And I did my 1.5 mile walks.  The first day I did some very ginger running.  I learned that my ankle can't take a corner well, but straight and flat I can do 30 seconds at a time.  So I did four of those.  I kept that up until my next PT session.  The physical therapist was, I think, trying not to laugh at me as he suggested that I could increase it to a minute per run and didn't need to be so cautious.  He was again pleased with my progress.  I guess all that strength work with the first PT did me some good.

Anyway, so that day I'd planned to go running, but also had a dentist appointment to get a cracked tooth repaired.  After an hour of that, some of it before I was numb (OW!)  and some of it when my face was so numb that I couldn't quite feel my nose, I was not up to going out to run.  So it ended up being two days later, and I got a lot of rest in between.  It was GREAT!  I felt so freaking fantastic -- I went for a minute and felt okay.  I walked for a while.  I went for another minute.  I did it again.  EIGHT TIMES.  And extended the distance to 1.75 miles, though I briefly considered that maybe I'd done enough before I did that.

Turns out I should have considered that more carefully.  By that afternoon, I was aching like crazy.  Took a day off from the PT exercises, slept a lot, iced, and went back to just easy walking.  The next PT session was not so good, as the PT spent a lot of time wondering why my ankle had reacted like that.  I had no answers for him (and did not say "I told you so" because after all, it's my body, not his).  It took four days until I felt better, which is when I saw him.  He wanted me to try running again the next day, so I did.  I could go for a minute without much in the way of pain, and did four sessions of it.  I was feeling pretty good when we were almost home, and decided on the spur of the moment to try some side stepping that the PT had had me try on a treadmill.

Guess what?  ThyPeace the genius has learned that bounding side steps are -really- not a good idea for an ankle sprain!  Yeah, I know.  I'm a genius.  Sigh.  So I suffered with soreness the rest of that day and the next.  I did everything I could to stay off of it and rest, and by Sunday, I felt a lot better.

And I had plenty of free time.  And have I mentioned that DH has been trying to get ready for the half marathon that I had planned to run, though his own sea of pain associated with his Achilles?  No?  Sorry about that.  The poor guy has really been suffering.  He'd much rather just ride his bike, and I keep telling him he can have a pass and it's fine, but he's stubborn.  He's decided he wants to do it and he's going to.  He did finally get an appointment with a PT last Friday and she gave him a ton of useful advice.  I think he's going to be better, but still in a lot of pain after the half, which is only ten days away now.  

Anyway, Sunday he needed to get in a long run, which he's been doing at the local track because it's easier on his Achilles.  So we biked to the track together and I walked while he did his run.  I tried a few steps of running and decided my ankle wasn't quite ready for it, so it was 50 minutes of steady walking for me  -- way more than I have done in the last three months.  I eventually had to stop because my calf was starting to complain, but still, it felt fantastic.  The bike ride home was a lot slower, but we were both functional the rest of the day.  That's progress; the previous weekend, DH was a wreck afterward.  I think the longer walk breaks, more water, cooler temperatures, and advice from the PT all helped.  And the peanut butter sandwich I made him try.  He hadn't been fueling at all, and with a half, he really needs to have something along the way.  Next week I think we may try half-strength Gatorade.  He's not doing a Whole30 at the moment, and it's pretty tried and true.

This week I've been pretty cautious about running, and only doing what I think I can do without hurting myself.  I'm getting better at gauging it.  This morning was fine -- five runs of a little over a minute each -- and I think I'll be able to go out again by the end of the week.

My next focus is finding better dress shoes.  I've been wearing my brace with my dress shoes, and though it allows me to function, it's uncomfortable and I think my gait is messed up from the way it has limited me the last few months.  I hope the low boots that I ordered will work.  They have a removable sole that I can put some Super Feet into, I hope.  That ought to work out okay.

ThyPeace, slooooow progress.

 

 

[ThyPeace]

Well... crap.

 

After a lot of slow progress and continuing pain, the doc finally did an MRI.  I have something called a full-length split tear of the tendon.  Basically, that means that my sense that the tendon had been shredded was entirely accurate -- think of a string that has split lengthwise.  There are apparently very few options other than a major surgery where they take the tendon out and replace it with one that currently controls the scrunch motion of the foot.

 

Crap.

ThyPeace, adjusting to a new reality ... badly.

[ThyPeace]

 

Hi Folks --

Got a second opinion from another orthopedist with a similar result.  The only way to repair the tendon is to replace it; it's shot.  

However, as I read more and ask more questions about the condition I apparently have, which is called alternately "adult acquired flat foot" or "posterior tibialis tendon dysfunction," the more I realize that I have probably been seeing the wrong kind of doctor.  Besides which, the doc I have been seeing has never even mentioned those terms, and now that I know how badly my tendon is messed up, I think he could have figured it out at least a month before he did.  

So... 

I think it's likely that what I need right now is a podiatrist to help with orthotic support to the foot, rather than a surgeon.  When I have a brace or orthotic on, I am basically never in pain.  It's not clear, from what I've read, whether orthotics are enough to arrest the progression of the condition or not.  But it's worth trying.  I've decided to give myself a year of really hardcore work at that before I consider surgery. 

Today I'm wearing my sneakers at work, and under one of those sneakers is an AirCast.  It's not a great thing to stand on, so I'll have to think that through.  I will say that it essentially eliminates any pain I was feeling while walking.  

The bad news is that most people with this kind of injury never run again.  There are only a very few instances where people do, and I have a feeling their tendons are in better shape than mine.  But I'm starting to see that it's not the end of the world and that I can still lead an active if I'm careful and really cautious about dealing with the injury from here on out.

ThyPeace, really need some aerobic exercise, though.  May have to invest in an exercise bike or rowing machine or something.

[NoneOtherThanAmy]

Oh @ThyPeace, I'm so sorry to hear about the extent of your injury. I discovered your thread back in May when I was doing my first Whole30 while also learning to run and I learned a lot from it. I was hoping I'd check in and see you back at running. I hope you can avoid surgery and that you find some other options for exercise.