Monday, February 17, 2014

the diagnosis

friday morning came and i was a wee bit nervous. i had the first appointment of the day with the foot/ankle doctor, and looking back, that was a great strategy because i was in and out in a jiffy (makes a 7:45am appt totally worth it). i got x-rays first and then settled in to meet with the doctor.

while i normally go to all my doctor appointments solo, brandon graciously agreed to go with me. i needed him there for a couple reasons; #1 he'd force me to be honest about my pain (not under explaining how much it hurt, etc), #2 he'd ask the right questions (because i never know what to ask doctors) and #3 he'd keep me honest about treatment (having someone else hear what the doctor tells me to do is clutch). i recommend having a doctor buddy - if you're anything like me - to keep you on track and honest to make sure you get the proper treatment for whatever ails you.

anyway, after x-rays, me explaining my history of aches, breaks and running related injuries, i had some answers that seemed to align with the pain and symptoms i've been having.

1) i don't have a bunion! - this is a shocking revelation, because i've gone since september thinking i had a bunion that was causing me pain. let this be a lesson learned: always get a second opinion and always get x-rays - they're the only way to tell for sure whats going on under the skin! what my original consultation in september thought was a bunion is actually bursitis, which is basically a lot of painful inflammation and swelling of the bursae in my big toe. on the xray, you could clearly tell the large lump on my big toe was tissue type stuff, rather than the bone of a bunion. you could also clearly tell that my toe is not severely slanting to the right, like it would with a bunion in the picture. bunion de-bunked! 

2) i have metatarsalgia ... - after taking a look at my foot, the doctor pointed out two things i had never ever noticed: #1 a large callus that has been developing on the ball of my foot, between big toe and second toe and #2  thinning fat pads. i was shocked that i wouldn't notice something like a callus, but it was quite obvious when she showed me. i also had no idea that fat pads could thin out. the thinning fat pad and the callus were all indications to her of extraneous stress/impact on my metatarsal heads and thus, metatarsalgia (inflammation in the ball of my foot). aside from my thinning fat pads, which provide cushion to the metatarsals, ill fitting shoes can lead to this type of inflammation, and my guess is that this certainly is part of why i'm experiencing this type of injury. i've blogged too many times about how hard its been for me to find a good fitting running shoe (here, here, here, here). anyway, the doctor fitted me with a temporary insert and metatarsal bar to help take the pressure off my metatarsals. the more long term solution is a custom orthotic that will do the same, but in the meantime, this will give me an idea of whether or not this type of solution will relieve the pain i'm having. my next immediate step is to also find a shoe with a lot of cushioning in the forefoot. thank gosh for demo shoe day coming up in march!!!

3) ... and acute plantar fasciitis - i feel like i hear about this injury in the running community a lot. after describing some of the more recent heel pain i've been having, the doctor also told me i have acute plantar fasciitis. she gave me a list of stretches to do 5-6x a day (and she also told me not to expect any results if i only did them 2x a day). of course, i haven't done any of them yet, but i will start. i promise!

the good news out of all of this is that i don't have a stress fracture. i was honestly preparing myself for one, because i always prepare for the worst. but knowing that i don't have one means i can go into my races this weekend and not worry too much about making any injuries i have exponentially worse. its going to take a bit to get used to the inserts, find the exact right placing of the metatarsal bar, but it should all be worth it if it relieves the pain and keeps me running! i do wish i had gotten an x-ray at the beginning of the injuries, back in september, but am glad i finally took the right course of action to see a doctor now.

anyone out there dealing with metatarsalgia or plantar fasciitis? i'm curious about what shoes have been great for either of these injury types!


*also, i am not a doctor. please do not take anything i say here as medical advice. i'm just sharing my experiences and personal reflections *

21 comments:

  1. Ugh - so sorry you are dealing with multiple injuries at once, but it sounds like you are at least able to still run as long as you've got them all under control. I've had my fair share of foot injuries over the past year, including plantar fasciitis and a metatarsal stress reaction. I got custom orthotics last June and I really do think they have helped me! I also think that shoes with a wider toe box can help the PF because it allows your toes to spread out and the muscles aren't constricted. I run in Altras and have had a lot of success. Their new Intuition 2 has a lot of cushining, as do the Torins. Finding the right shoe can be a long, hard process - good luck!!

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    1. You run in Altras? See, I've been looking at them for a LONG time, but now I was worried with them not having enough cushion because they are zero drop. Maybe I shouldn't over look them?

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    2. I have never found a shoe that I love so much! A lot of people hear "zero drop" and they assume it's a minimalist shoe. It's definitely not - they have as much cushioning as a traditional shoe. And the Intuition 2 is like a dream - with tons of cushioning! I would definitely recommend them to anyone. Worth a try on at least...

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    3. Alright, you sold me! There's a shoe demo day coming up in March, I will make sure I try them!!

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  2. I'm glad you don't have a stress fracture either! Have you thought about making an appointment with a physical therapist that is also a runner (I was able to find one easily) to get shoe recommendations? Good luck!!

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    1. I was in PT all last fall, and it was minimally helpful. But, trying to find another that would have a shoe recommendation is certainly possible. Every place/person is different!

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  3. Thinning fat pads?! I had no idea that could happen! I guess that is another reason why good shoes that fit your feet well are so important! I've definitely learned that the hard way.

    I am so glad to hear it was not a fracture and that you can keep running! It sounds like you are keeping your head up, which is great. At least you know the problem now and are headed in the right direction to relieve some pain. So happy to hear it!

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    1. RIGHT? I didn't know that could happen either. I guess it makes sense, but still. Weird.

      I am surprisingly happy to have the injuries I do! Nothing to do but be positive - anything else would make it all worse, ya know?

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  4. So sorry you are having all these problems. I hope you will be able to Make it through PHM weekend pain free! I also wear Altra Drop zero and love the wide toe box. Glad to hear Ashley loves the Intuition 2 cus I just ordered those. If you are looking for a drop zero with Maximum cushioning choose the Torins or the new Olympus. The thing with the drop zero is that you have to work into them gradually or you will experience calf pain! I actually did a review of these shoes explaining all this. I hope to see you at PHM. Good luck girl!

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    1. You and Ashley have me convinced to try the Altras now. I've been wanting to try them because of their toe box, but now that I hear theres plush cushioning, I'm all over the idea! :)

      Hope to bump into you at PHM, too!

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  5. So glad to hear it's not a stress fracture! I had PF for 10 months, bad. I couldn't run at the time, or barely walk. The stretches help!! Do them religiously! I assume one of them is a calf stretch? That's the one I do daily (still). So the shoes that helped were minimal shoes, low drop. I ended up with 4mm drop Brooks PureFlow and loved them!...but...and it's a big one...after about 5 months, I started getting heel bursitis where my achilles meets the heel and everything pointed to the low drop shoes. So...I am still on the hunt and not sure I will ever find a shoe that doesn't cause an imbalance somewhere! Let me know if you find one! 5 days!!!!!!!!!!

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    1. Okay, good to know about the calf stretch. Honestly, I still haven't looked at the stretches, is that terrible or what? But knowing they helped you, I will do them. I swear! Haha

      You're the third person thats mentioned zero/low drop. I hear the Altras have some serious cushioning, maybe that would help you too? No idea. This is why I'm still struggling to find the right shoe :)

      Only 4 days now!!

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  6. Yay for no stress fracture and no bunion! Bunions are annoying. :) Sad to hear you have the other injuries, but it's good you'll be able to do the Princess races this weekend. Good luck with the healing and the races!

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    1. Knowing my dad's side of the family, I wouldn't be surprised if a bunion was still in my future, but I'm happy to know its not something I have to worry about now!

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  7. SO glad you don't have a stress fracture! I hope you are able to enjoy the races with minimal pain! Hope to see you soon, Alicia!

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    1. I hope so too! My only goal is to run this weekend without a ton of pain, and finish happy!! Hope we bump into each other during PHM!

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  8. Have you heard of SOLE inserts? They naturally conform to your feet though use or you actually stick them in the oven (so it conforms quicker), but they've really helped me with my PF. I have issues pop up every now and then, but that's just if I'm barefoot a ton. My plantar faciitis was so bad to the point that I couldn't even walk in college and the athletic trainer gave me a pair to try and they helped within a couple of days. I hope your foot feels better! :)

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    1. I haven't heard of SOLE inserts, but now I'm coming to have to check them out! I'm sorry to hear about your PF, but glad to hear you've found things that have helped. I'm due to go to the running store today, I will certainly look for those! Thanks for the heads up!

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  10. Foot/ankle problems suck! and are bountiful when it comes to long distance runners :(

    But, like everyone else has already said, at least it's not a stress fracture! or a bunion! My boyfriend had/has chronic plantar fasciitis and what he would do is freeze a water bottle (he used Smart Water, since they have a smooth edge) and then roll his foot out on it after doing his stretches. His physical therapist recommended it to him, and I think it has really helped! But yes, constantly stretching is key...unfortunately.

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  11. No suggestions on shoewear, but a definite suggestion to listen to the doc when she tells you to do your exercises 5-6x a day. I have majorly slacked on my ITB exercises (the burn got in the way, now I'm crazy busy traveling) and while I am doing better and was able to run a little bit, I know that the problem will persist if I don't do as I'm told!

    I am so glad that you've gotten some answers, and GOOD LUCK on the shoe hunt!

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Getting comments feels as good as a freezing cold glass of Gatorade on a hot summer day. So don't be shy - share your thoughts & opinions! - Alicia