Let's Get Technical: My Diagnosis & PT [Running & Injury]

SOOOOO with next week being the official start of the November 2014 marathon training, I plan on speeding along this part of my journey so we can get to the more interesting and PRESENT facts. It's important to me to remember all the dramatics and steps I've taken through my first running injury and recovery BUT boy, do I not want to keep rehashing the past. As of late, the (metaphorical and oh-so-real) sun has been shining and I'm trying to soak every little bit of it up!

[Not much to see on the x-ray...except for my poor crooked toe. #bornwithit]

As mentioned in my last running & injury post, I initially went to an orthopedic urgent care office and walked away (hobbled) with a general diagnosis of inflamed tendons. During the consultation, however, I expressed my concern that I thought it was more. I was in pain, upset and confused so unfortunately most of the conversation was me on the verge of tears! Right before leaving, a last minute decision, the doctor asked me to do the one-leg "hop test" on my injured foot. Do you or have you had a stress fracture? An easy way to tell if you have one is by standing on the one leg causing issues and hopping on it up to 15 times. If the hop results in pain, it's likely a stress fracture.

I could barely do it, mainly out of fear, so the doctor ordered a bone scan for confirmation...which I later declined due to cost and at the recommendation of my dad. So I went on for another four/five weeks walking on the outside of my foot. I even went sailing in the British Virgin Islands with the stress fracture. Walking barefoot on the boat, sand and up swim ladders was miserable---luckily the views and Pain Killers were supremely distracting! I only wish I could have gone on more hikes and snorkeled with more confidence.

I attended some cycling classes during these weeks, determined to keep my fitness and fight the burning, eye-stinging anger. The standing positions, however, put too much pressure on my foot so I stopped. I also joined the YMCA so that I could try my hand at water running. It seemed fun for the first 5 minutes, but then: What a boring way to exercise!

Not long after our return home from Christmas vacation with virtually no improvement (my foot actually began swelling more), I made an appointment with a recommended sports medicine doctor. An ultrasound revealed some calluses on my second and third metatarsals---evidence of healing stress fractures. She also suspected a Lisfranc injury due to the location of my pain. An MRI revealed a healing stress fracture in my second metatarsal, excess fluid in my toes but no Lisfranc issues. I was put in a boot with an arch support insert for 3-4 weeks. Funnily, these weeks were filled with an entire winter season's worth of snow and ice. But I finally found comfort and hope in that I was helping my foot heal and was inching closer to running again.

Moral of this part of the story? Trust your gut. Only you know your body and know the impact of an injury on your well-being. I knew my foot needed help and that running was so, so important to me. If I could do it over, I would have gone to a sports medicine doctor as soon as the urgent care doctor suspected a stress fracture.

The best part of being booted was being able to workout again---with my boot, I could (albeit awkwardly) use the elliptical. My doctor confirmed that cycling was still off my plate for the time being, as was swimming. She wanted my foot and arch as stabilized as possible.

After the fourth week, the pain was all but gone so off went the boot and on I was sent to physical therapy. This was my first time it PT, so I had no idea what to expect...it's actually still a bit of a confusion still. Overall, I received a mixture of hip and ankle strengthening exercises, some foot muscle manipulations/massages and guidance on how to work back into running. I went consistently once every week for a month and slowly started decreasing my visits to one every other week. The solution was strong hips and knees = less impact and strain on my feet so my initial exercises consisted of:

• Resistant band side-stepping
• One-leg bridges (1 second and 30 second)
• One-leg balancing activities with resistant bands and a kettle bell
• Side planks
• Toe yoga to strengthen my arches (ugh!)

Then one day I came in and it was time to run. I was looking forward to it the entire week prior, the glorious feeling of my lungs expanding, the gentle bounce of my ponytail on my shoulders...you know, the glamourous side of running I'd been missing and yearning for for MONTHS. Well, it wasn't pretty and it wasn't painless but I kept a smile plastered on my face until I made it back to the car. Would my foot ever be the same again?

I put way too much pressure on myself and that first 5 minute run. The next run felt better but still weird to my foot. My lungs were heavy and weak. As if things weren't foreign enough, I was told to begin attempting to shorten my stride to help ensure I was landing mid-foot and cutting out some of the impact to the front of my foot. I downloaded a metronome app to help! Like the boot, the rhythm gave me some comfort in knowing that I was trying to get better.

The next few weeks, I gradually went back to SEAL Team workouts and ran no more than twice a week. I was/am anxious to be back 100% but knew I should hold back as much as possible. Some days, even now, I notice a light throbbing in my foot and wonder if I'm completely healed. The best thing I can do is give myself a few (frustrating) days break---or as I like to refer to it: A long "workout weekend".

My lesson all along has been one of patience. There have been many tears and a few setbacks in pursuit of it. Even now, I'm not sure if I could work through an injury with less frustration and heartbreak...but maybe I'd surprise myself. Maybe I'd surprise myself much like I did on November 16, 2013, when I crossed the finish line of my first marathon, 26.2 miles full of sweat and smiles.

(And on days we need more perspective: A news story about the positive attitude of a guy from my hometown who chose to amputate his foot due to a rare disease. Seriously.)