Thursday, June 5, 2014

Good news


You know what they say about opinions--everyone has one. I've certainly been the recipient of multiple opinions regarding my foot since my injury 7 weeks ago. To recap, I was running my usual 6 mile neighborhood loop and came down funny on my left big toe, causing me to have excruciating pain. By the next morning, the pain had calmed down, and several days later, I ran my 10 mile race and PR'd.

I received the following opinions about my injury:

Dr Sport: arthritis flare up. Gave steroid injection in the joint.

Dr Foot, sports podiatrist, seen previously: arthritis. Built up my orthotics.

Becky, corrective exercise specialist: hip imbalance/glute weakness. Exercises and strengthening. Boo to the orthotics.

Dr Rad, radiologist #1: avulsion fracture L MPJ

Dr Sunshine, radiologist #2: non-healing avulsion fracture, old fracture, cortical avulsion fracture L medial sesamoid

Dr Peds, medical director of my practice: whatever it is, you need to take time off work. And definitely no cycling.

It just keeps getting better. What's a runner to do with all these opinions?

And if that weren't enough, I saw Dr Ortho today.

An orthopedic surgeon, Dr Ortho's specialty is foot and ankle. His wife roomed with one of my partners during medical school. Dr Sport talked with him prior to my appointment. I felt like I was in good hands.

When I apologized for not seeking help sooner, he laughed. "Runners are like that," he said. "You are so used to running with pain that you try to fix it yourself. And you only come when you can't run."


Hello? This guy gets me! What a breath of fresh air.

He looked at my xrays and told me he didn't think the fracture was recent. He told me that if I had fractured that joint, I wouldn't have been able to run at all. He also thought that I would have had some significant swelling. I nodded in agreement.

The proof! A 10 mile PR 3 days after the initial injury.
He examined my foot. Made me stand on my tippy toes. No pain. Pressed on the joint. No pain. Took a few more xrays, while I was standing. Those views did not show a fracture. He told me that maybe there was an old fracture, but what he was seeing was....arthritis. His opinion? Something I did aggravated the joint. The treatment? Rest, immobilization aka the boot, ice, antiinflammatory medications--steroids. Everything I had done. Oh and by the way, cycling was fine.

He wants me to- gasp!-try running on it and see what happens. Nothing crazy, but start out slow. He told me to take the boot to work, but to try wearing my shoes and see how it feels. No need to come back, unless the pain returned. Oh and by the way, trash the orthotics. He looked at them and showed me how stiff they were in the midfoot, causing me to land harder on my toe. Probably leading to some of this pain.

Shocked? Yes. Surprised? Yes. Happy? Yes! And a little confused. I did call Dr Sport after the appointment and he had the same reaction as I did. So we're back to our original opinion. Why such differing opinions? Here's the thing. The radiologists read the xrays. But the orthopedic surgeons are the experts. My only regret? Not going to see this guy sooner. Although it sounds like it wouldn't have changed anything. Maybe that radiologist did me a favor by giving me the doom and gloom report. I might not have sought out the ortho. But I'm glad I did. I'll keep you posted on my progress.

Tomorrow, work all day. Saturday, I plan to test out the foot. 2 miles. I have to also wean myself from those orthotics. Running without them is going to change my body mechanics. It was hard getting used to them. I wonder how long it will take me to get used to running without them. Prior to all this, I had a plan to take it easy for the next 6 weeks and let Becky push me on the weights. That plan is still in place--the only difference is that I'll be easing back into running instead of cutting my miles.

My opinion about all this? I'm cautiously optimistic. For now, the boot isn't going back into the closet.




13 comments :

  1. Absolutely crazy how so many doctors can have such differing opinions. Wow! But happy for you and easing back in! Sounds like a good plan!

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    1. More than crazy, I find it a little bit troubling. I mean who do you trust? Definitely the ortho and sports med. When we get readings back from the radiologists, we always say to correlate the xray with the clinical picture. I guess the lesson here is not to base your diagnosis on the opinion of one person.

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  2. I think... go with the opinion that has you running soonest! LOL, that is good news and I hope he is on the right track! And since you shared this we all know to see the ortho as soon as possible :)

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    1. Of course! I think there is a lesson to be learned somewhere here! Keep going to different doctors until they tell you what you want to hear! LOL! In all seriousness, I do think I found the right ortho for a runner. So many doctors (and I see this in my own practice) sideline athletes needlessly, because of course rest will help you feel better. But what about addressing the issue causing the problem?I love our sports medicine guy. He's great with that. As well as my trainer.

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    1. Oh you know me...haha...but yes, I plan on it!

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  4. OMG! How confusing! I wouldn't know who to believe?!! I have never heard of so many different opinions! Hope it is feeling better!!

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  5. "The treatment? Rest, immobilization aka the boot, ice, antiinflammatory medications--steroids. Everything I had done. Oh and by the way, cycling was fine." - I basically spent a lot of money on doctors to get the same story. And I'm also cautiously optimistic. Very afraid to make it worse, but looking forward to it healing completely!!!

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    1. I don't know if mine will heal completely, since I have reduced range of motion/hallux rigidus already. Sucks. I'm just figuring out how to run with it...

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  6. Wow that does sound crazy, but glad you got a reasonable diagnosis. Hope your foot feels better soon! Thanks for linking up with us!

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    1. Any diagnosis that tells me I can run is reasonable to me! So far so good. Thanks for checking out the blog!

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