Saturday, April 12, 2014

Agony of da feet (groan)

I love puns! I seem to have a very juvenile sense of humor, which works out well for me in my job as a pediatric nurse practitioner. As an adult, not so much...



Moving on to the subject at hand...I mean feet...



Most runners complain about their knees, their hips, their IT bands. Yes, I've been bothered by issues with those areas, but my biggest issues affecting my running have been with my feet. Today, as I sit on the couch with a ice pack on my foot, I feel defeeted (-sorry couldn't help myself, there I go again).

Over the past year or so, I've developed pain in the joint below my big toe (aka first metatarsal joint) of my left foot. My podiatrist, who I saw more than my husband a few years back, did an xray but couldn't figure out what was going on with that toe. He chalked it up to osteoarthritis and built up my orthotics to take some of the load off of that joint. My trainer Becky also has been working on strengthening my hips and glutes to give me more power and balance so that I don't come down so hard on that toe. And it all has been working. Until the past couple of months. The pain has gradually increased in that joint and today, after a fabulous 8.3 mile run, was pretty bad.



The good news is that once I get moving, the toe doesn't bother me much when I run. Walking is a different story. Which is a problem since I spend all day at my job on my feet.

I'm trying to decide which way to go. Do I go back to my podiatrist? Or do I take up the offer of our sports med doc to try a steroid injection in the joint?

Now, as I mentioned, my podiatrist and I have spent a lot of time together. Three years ago, while training for the Chicago marathon, I developed pretty severe plantar fasciitis in my right foot, which led to heel pain. At that time, my podiatrist, as all podiatrists are wont to do, put me in custom orthotics. I knew that there was going to be an adjustment period, but those orthotics rocked my world. I almost gave up on them, because really, I have a pretty neutral gait, and they were making me miserable. Anyways, after about 6 weeks, I got used to the orthotics. In the meantime, I was seeing him weekly for evaluations. One nice benefit of seeing a sports podiatrist was getting my legs and feet massaged every time I was there. The massage therapist was this 60 year old woman who had a hard body like a 25 year old. The first deep tissue massage almost brought me to tears, but after I knew what to expect, I could handle it. And the relief I felt after the treatment was amazing. My heel pain did not go away though it did improve.



After I ran Chicago, I waited for my family near the finish line. I could not stand on my feet. I was in so much pain, and not just in my heel. My feet were angry at me for all the abuse I had heaped on them throughout the past 16 weeks of training. As I recovered from the marathon, my feet were slow to forgive me. I continued my visits to the podiatrist, and as things got better, he eventually discharged me. It felt weird, after going to his office so much!



Several months later, my family and I were at the beach for a spring break trip. The Gulf of Mexico was particularly wavy that year, and we had fun body surfing and jumping the waves. One wave was so strong and I hit the floor of the Gulf with my right foot. I felt a pop and knew immediately that something broke. Being the compliant medical professional that I am, I refused to seek treatment in Florida, and hobbled around for the rest of our trip. When I got home, I resumed my relationship with my podiatrist. Yes, I had a stress fracture in my 3rd metatarsal on my right foot. He put me in a boot for 6 weeks. I was able to keep working, wearing the boot. My patients were really concerned for me, which was kind of endearing. After 2 weeks of healing, I was allowed to begin cycling. I actually tested road bikes wearing my boot. Clearly, I needed an intervention!



Once I healed and began running again, my old nemesises (nemisi?) PF and heel spur flared up. This time, my podiatrist got serious with me. We talked about options: steroid injections, PRP (platelet rich plasma injections), shockwave therapy, and surgery. I immediately ruled out surgery, and went home to do my research on the other treatments. For that heel spur, shockwave treatment made the most sense to me. The shockwaves are pulsed vibrations on the affected area, which can break up the scar tissue. The best analogy I can think of is when my father, who is very practical, took a mallet to his heel when he was suffering from the same pain. Although I can't recommend his method for breaking up the scar tissue, it was very effective.

I received 3 rounds of shockwave treatments to my heel. Each treatment was preceded by a nerve block, which was extraordinarily painful. According to my podiatrist, the shockwave treatments would be very painful without the nerve block. Plus, he could bill for the nerve block and not charge me for the treatments. I was all over that. I sucked it up and got through the treatment.



Since receiving those treatments, my heel pain has not returned. I do still have PF after I run, and wear my Feetures PF compression sleeves on a daily basis. This has replaced rolling on an ice bottle or a golf ball.

And so here I sit. I have a race next week, a 10 miler, and a half marathon in May. I was going to take some time off after that--well, ok, cut back a little on my miles and cross train--to let my feet recover. I'd love to wait and see what happens. After today, I just don't know if I can do that. I don't want to risk injuring that big toe joint, but if it is just arthritis, I can learn to live with it. Guess I'll have to wait and see what happens this week.

And to add insult to injury...looks like I'm going to lose a toenail...


Feet don't fail me now!

What injuries have plagued you? Do you have feet issues? What do you do to keep your feet happy?

I'm linking back #bestfootforward! Share the love! 

16 comments :

  1. Oh wow! So sorry about the feet saga. Way more than your share with that shizz. Knock wood no foot probs for me other than a post-marathon toenail that decided to defect from the mother ship in the middle of a Pilates class and shoot across the studio.
    I have had posterior tibial strain, ITBS, and a ruptured hammy though. Nice.

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    1. Yeah my left foot is really hurting tonight. I hope it passes!

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  2. I have been plagued on and off by running injuries. Right knee, left knee, achilles tendon...Orthotics helped the most, as has rest. Swimming allowed me to stay active without the stress on knees / feet. I took 6 weeks off and it was the hardest 6 weeks of my running life... so now I don't push it. I know that 10K is my limit. I prefer to be able to run shorter distances, an keep on running, than pushing myself and not being able to run at all. Buts its a fine line. Good luck & hang in there...

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    1. My feet are what holds me back from another marathon. I'm hoping they calm down for my race this weekend!

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  3. oh yeah...had achille tendinitis, had a metarsal stress fracture..now on and off have bunion/metatarsal joint pain - good luck with your problems. Hope they heal quickly.

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    1. I'm pulling out new shoes this morning..hoping for some healing!

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  4. I feel your pain! I have feet issues too and it's not fun!! :(

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    1. What issues do you have? And what do you do for them? Misery loves company!

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  5. Injuries...it's a never ending saga, huh? It's so hard when you work on your feet all day. I live in compression socks just because they are the only things that make my feet feel normal at the end of a work day. Hope you find a solution!

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    1. It really never ends! I've been having such a strong spring too.

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  6. Wow, I totally feel your pain. Sorry but I couldn't help but chuckle at Mr. Peanut! I had a stress fracture in the 3rd metarsal of my right foot last year...and I wore a boot from February til mid-May...it was awful. Then when I started running again in new shoes I got plantar fasciitis! I never worked with a a sports podiatrist though, just a sports medicine doc. It's such a crazy experience. Thankfully I'm on the mend now, and I love using my foot roller after each run. Hope you feel better!

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    1. We are simpatico! With this new round of pain, I've talked with the one of the sports med docs at work, and he's going to evaluate my foot. I'm going to run in new shoes this morning, so we'll see how that goes. Ay!

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  7. hmmm ever tried acupuncture?? I've seen that help a lot of folks, myself included. Fingers crossed you are ok to race, I know how frustrating a nagging injury can be!

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  8. Your poor feet! Figure skating can involve a lot of the same injuries: metatarsal stress fractures are really common (I've been lucky enough to avoid those). I'm picking up a new pair of figure skates tomorrow, I hope it's not too hard on my feet to break them in. I haven't been through the pain of breaking in a new pair for 4 1/2 years. My old pair was starting to give me Achilles and posterior tibial tendonitis so it was time. Breaking in my current skates did involve several trips to the skate fitter for adjustments, a couple of trips to the podiatrist, and a steroid injection to the little toe.

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    1. At least you don't have to break in running shoes! I hope your feet recover quickly as well. What we do to our poor feet....!

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