Ye Olde Updayte Tyme Again!

Just a quick check-in to update the proceedings at Resurrected Runner Headquarters.

Fall has settled upon the Inland Northwest, and we've taken it upon ourselves to hire an entirely new staff. By "staff," I of course am referring to a brand new pen, a new page in my old school running log, and a new and improved mess of running shoes scattered across my closet floor.

Aside from that, here are a few updates:

1. My broken arm is still broken, but I've finally moved out of the splint and am doing a series of exercises to regain both strength and mobility. It's going surprisingly well. If that continues, I won't need official occupational therapy. The scar is also healing nicely, too. It'll still be a while before I can lift anything heavy.

 

2. I've been running twice per week for going on 6 weeks now, gradually increasing both my pace and distance. Last Thursday, I ran a not-so-easy 7-miler (longest run in 2 years). This morning, I cranked out a nice 4 mile tempo run, followed by 4 x .08 mile strides, for a cumulative average pace of 7:46 per mile. Probably didn't need to do the strides, given my knee issue. But man, they felt good! It seems like this twice per week frequency is at least somewhat agreeable to my knee, given that it has felt about the same for every run this past 5 weeks.

3. Which leads me to the knee MRI update. Since we're still fighting my insurance company on my broken arm costs, and they've been GLACIALLY slow at processing claims, it now looks like I won't be able to get my MRI by my October 16th deadline, unless I want to pay for it out of pocket. Given how much we've already paid out of pocket for my arm, I don't think this will be doable for us right now, sadly.

4. However, I have been doing some knee-related exercises and stretches in an attempt to remedy the situation myself. I've done plenty of reading and video watching and am doing what I need to do for "runner's knee," which is a rather ambiguous term for the pain I'm experiencing. Not sure if it's helping yet, but as I mentioned earlier, it doesn't seem to be getting any worse, given my two runs per week currently. One probable side effect of my left knee pain is a right hip that's been pretty sore. I would guess that I'm compensating for the knee while I'm running. Dang, this old body...

5. To continue on the running theme (hey, I should do a blog about running!), I am now 15 miles shy of 10,000 lifetime running miles. Unless something interesting happens the next couple of weeks, I'll probably refrain from posting here until I hit that milestone.

...and you never know what kind of interesting injury I can fit in between now and then, so stay tuned!

X-ray Done, MRI Coming Soon...Hopefully

A week ago today, I visited my arm surgery doc to start discussing my left knee issues. In case you haven't followed along at home (if not, I don't blame you!), my left knee has been hurting for about two years now, and has gotten progressively worse. It's usually a sharp pain underneath my kneecap (lower, inner part) that most often shows up when my foot hits the ground when I'm running. Usually, it hurts badly for the first mile or two, then settles down the rest of the way. But if I try to run too often, it seems to last longer and, eventually, I'm forced to take a break from running altogether. Currently, I've been running twice per week, 3-5 miles at a time. Yesterday, during a 5 mile run, the knee hurt for about 3 miles. Getting close to that "take a break" time again, it seems.

Anyway, I had an X-ray last Friday, which showed nothing out of the ordinary. In fact, the doc said there was nice spacing around the joint (meaning I haven't totally destroyed my cartilage yet). He also wiggled my kneecap around and didn't feel much grinding or clicking. At that point, he gave me two choices: start physical therapy or get an MRI. I chose the latter, just because I want to know for sure what's going on in there...assuming an MRI will disclose that information. So now I have to wait for approval from my insurance company. I've met my deductible, but due to slow processing by said insurance company, that's not "official" just yet. So, I may not get approved anytime soon. And I'd rather not pay out-of-pocket for this MRI, especially after all of my recent medical expenses.

As for my broken arm, it's coming along fairly well. I'm still wearing the splint, and when it's off (when I'm showering or changing the sleeve under it), my arm feels very fragile and vulnerable. It hurts to bend my wrist in any direction. The incision is healing quite well, though, so I'm hoping that the scar won't be too ugly in the future. I go in for a checkup at the end of this month (Sept.) to possibly schedule my first session of occupational therapy, to try to get some strength and mobility back. I'm looking forward to having two functional arms once again.

Even though I could probably set up my trainer and do some indoor riding, I haven't done it yet. I'm pretty sure my bike needs some attention. Actually, I could probably get it into rideable condition for the trainer, but I'm sure it's not ready to ride outdoors. It'll need a pretty serious tune-up at the shop first.

So, things certainly haven't been boring here in Resurrected Runnerland.

But, honestly, boring sounds pretty good about now...

Post-Surgery Update, and Potential Plans for More Surgery

It's been 9 days since I had surgery on my broken left arm, and things seem to be progressing as expected. The surgery to insert a metal plate and screws (not sure how many) went well (only took an hour), and I'm back in a hard splint, held up by a sling. I have full use of my fingers, which is a good sign, although there's a very small, persistently numb spot on my index finger. Even if it's permanent, it's not a big deal.

I took the day after surgery very easy. I took pain meds every few hours. I've since resumed full-time work and am only taking pain meds when needed, which is right before bed and occasionally one during the day, if I've been a little too eager to use my left hand (like today, for example).

My first return visit to the doc who cut me will be on Monday, Aug. 31st. He'll most likely remove the splint to take a look at how the incision is healing. Hopefully, he'll put me in a shorter splint so I can bend my elbow. We'll see. He won't be putting me in a traditional hard cast, though, which is nice.

The itching under the splint has been more annoying than the pain, but even that seems to be subsiding. My other cuts and scrapes are healing nicely and have formed some of the biggest, thickest scabs ever seen in the free world. The looks and reprimands I've been subjected to for picking at those scabs is terribly unfair. I mean...it's so satisfying!

I still need help doing many things, although I've taught myself some tricks and shortcuts, and have become more dexterous with my right hand. I can button and zip my pants all by myself, like a big boy, but I still need help making my meals and washing myself. I hope my wife doesn't get suspicious when I still ask her to bathe me a year from now. "But honey, the doctor says that this is the last skill to be redeveloped after such a violent break. It could be five, ten years before I can bathe myself...and even then, it's dangerous."

Yeah, I doubt it, too. A guy can dream, though...

As for my activity level, I can do a few exercises, some 1-arm dumbbell work, and walking, as long as I don't get too sweaty under my splint. Going from 150+ miles of cycling per week to zero has confused my body, both from an exercise perspective and a dietary one. I still want to eat as much as I was pre-accident, but I'm trying to keep the intake in check. It took too long to drop last year's excess weight. Don't want to go through that again.

Now, the even more interesting news. Since my insanely high insurance deductible of [insert Luxembourg's GDP here] has finally been met, I now have full coverage. Imaging is included, so it might be time to get my left knee checked out. I at least want an MRI to determine what's going on in there. Then, if there's a chance it could be fixed, perhaps surgery would be worth it. If so, here's what the next few months potentially looks like for me:

AUG - arm surgery
SEPT - root canal (9/3)
OCT-DEC - knee surgery?
JAN 2016 - beg wife not to leave me

It would be a royal pain to go through all that in just a few months' time, but if I can get an MRI and knee surgery for essentially no cost out-of-pocket, it would be a shame not to do it — especially if it would allow me to run again. I'm not getting my hopes too high just yet, but who knows?

MRI Results

Well, the culmination of my foot frustrations came to a head today, with a meeting between my sports medicine doctor and me. The MRI results are in, and the diagnosis isn't a big surprise to me.

As I mentioned previously, there is a bone deformity on (or as a part of) my right heel. The MRI not only confirmed that, but it also showed the resulting damage to my Achilles tendon. The “Tendinosis” was caused by the tendon rubbing up and down over the protruding bone growth on the back and top of my heel. He also pointed to an “Equinus” (tight calf muscle & Achilles tendon) as a factor which increases the tension of the tendon, thereby exacerbating the damage. He told me to envision a rope being grabbed from both ends, pulled taught, and rubbed back and forth over a sharp corner of a counter.

WHAT NEXT?
There are two paths of treatment. One involves surgery (I'll explain that later). The other is a conservative approach, and the one I'll be taking, based on my doctor's recommendation. It's a 3-phased plan. Phase 1 is Rest & Protection. I'll be in a walking boot for 3 weeks, after which the condition will be reevaluated. If things have improved, we move to Phase 2 — Strengthening. After this is, of course, Phase 3, which is Return to Activity. The lengths and activities of phases 2 & 3 will be determined after phase 1 is complete.

RUNNING FUTURE?
I'll do my best to maintain optimism during this entire process, but there's a chance this will permanently affect my future running goals. Most doctors like to hint at worst-case scenarios, and this guy is no different (except for the fact that he's a Sports Doctor with a lot of knowledge and experience with endurance racing — running and triathlon). He said that, due to this deformity (man, that word makes me sound like Quasimodo or something), maybe I won't be a “marathon runner”. Perhaps I'll only be able to run limited mileage, possibly combined with cross-training (the latter not being a bad thing, necessarily). Swallowing the possibility of not being able to run as much and as far as I'd like to is difficult. I'm choosing to focus on the word “possibility”, and not the phrase “not able to.” The wild card in this whole scenario is the protruding heel bone. As long as that's there, the condition could return (and possibly worsen) in the future.

Which leads us to...

SURGERY (YIKES)
This condition has proven itself to be chronic before, so there's no guarantee that the above-mentioned “conservative” approach will take care of the problem. If it doesn't, surgery will be the option. This will involve cutting around the heel and slightly up, detaching the Achilles tendon, shaving the heel bone, removing scar tissue from the tendon, then reattaching the Achilles tendon to the heel bone...after which I'd be completely out of commission for a half a year, minimum. Even after healing from this procedure, there's no guarantee I could run the way (or as far as, or as much as) I'd prefer to.

In the meantime, I'll be preparing to sell tickets to the Gun Show doing upper body weight work until I'm cleared to start working my legs and feet again. I'll also be doing my best to NOT have to break out the 'fat jeans' (the few I've saved, anyway). Oh holidays, how I resent your culinary temptations.

To be honest, I'm feeling pretty melancholy about the whole predicament. Part of me wants to stay plugged into the running community (both online and local) because it's a great bunch of people, and part of me wants to completely disconnect because it reminds me that I can't physically be a part of it (if you're reading this and you're NOT a runner, this probably sounds pretty extreme). Odds are that I'll pull back a little... but running is in my blood, so I'm sure I'll still be part of the “gang”.

And of course I'll keep you posted on my progress (and still post some crazy videos from time to time).

I have a two-mile “race” (fun run) scheduled with my oldest daughter next Saturday. There's no way on Earth I'd miss this. I can't think of a better way to end my running for the time being.

Here's to hoping my blog title has even more relevance in a few months, and that I don't have to change it to The Retired Runner.

Sleeping Glute*

*My new Native-American name

I just returned from my MRI appointment. I had forgotten how long it takes to get 'er done. I sat completely still for 40 minutes (until my right glute was sound asleep) while the funky little machine hummed and growled away.

I'll return to the doctor on Tuesday to view and discuss the results.

Running a marathon soon? Check in tomorrow to see a new and enlightening video.

MRI, and Insurance News

I'm getting an MRI on my foot tomorrow. I'll visit my doc again next Tuesday to go over the results.

My wonderful wife called our insurance company today and was told that they will cover orthotics (100%!) as long as they're billed as "preventative". I don't see why they wouldn't be considered preventative, as they will hopefully help me avoid further injuries once I start running again.

So, good news, as custom orthotics aren't exactly cheap.

Tune in Friday for a new, timely (regarding fall marathon season) and VERY helpful video!

First Visit to the Sports Medicine Clinic

I just returned from my first visit to the Sports Medicine Clinic in Seattle. While more info will be forthcoming, I do have some preliminary info to share.

We discussed my recent running history. I told him how I trained for and ran my marathon back in May, then had my first run-in with the heel pain a couple of weeks later. Then came the 3 week layoff, then back into training (for Ragnar, primarily), then a six week layoff, then very minimal running the last 4-5 weeks.

He then observed my feet as I was standing (barefoot) and noticed that my offending foot pronates quite a bit. He then remarked at how tight my right calf and achilles are, and how that is likely affecting my foot movement during foot strike.

He then took xrays of my foot (unlike the PT I saw earlier this year). I don't have them to post here, unfortunately, but upon his diagnosis, he explained—and showed me— that I have a condition called Haglund's Deformity. There's a prominent growth on the top of my right heel that's causing irritation of my achilles tendon and, possibly, the bursa. While this may not be directly related to the pain I'm also feeling in other areas of my foot, it's certainly the genesis of this injury. The excessive pronation is likely the cause of at least the other pain, if not also this deformity issue. He also said something about a possible cyst there, although I wasn't totally clear about that. He said that surgery probably won't be needed. Oh — he also said that my six week layoff would have been enough time off if it was just tendonitis (not totally sure I agree), and that the recurring nature of the injury points to a structural problem (as the x-ray showed, and to which I do agree).

I asked him if he thought tinkering with my running form could have contributed to this and he confirmed that he has seen many runners who have been injured during that process. While agreeing that working to improving one's form isn't a bad thing, he said that our bodies do settle on a natural running form based on our biomechanics and structural issues (but again, no, he doesn't think over-striding and heel-striking are good). He did comment that I'm probably not a good candidate for Vibram Five Fingers, though.

He agreed that other contributing factors could be overuse and increased hill training (which really pushed it over the top back in August).

As you might suspect, he does recommend custom orthotics. While I've been averse to this idea before, now I say bring 'em on. Fortunately, he's not a fan of what he calls "bricks" (i.e. heavy, motion-control shoes, which I used to wear) and that I should be fine continuing to wear my neutral running shoes. I'll just have a bit more support to correct my overpronation in that foot.

The next step in the process will be an MRI to take a look at the soft tissues & tendons surrounding the heel (and ankle area) to see how inflamed they are. I'm awaiting a call from their office to schedule an appointment.

Thankfully (and as I suspected) there's no sign of any stress fractures. I just have a freakish heel bone and a wonky foot movement.

So that's all I know at this point. As you'd guess, I'm done running for the time being. After the MRI, we'll discuss cross-training options, and how long it might be until I start running again.

Not running is a major bummer, but I'm happy to be working with someone who (so far) I trust.