Yesterday I went for a medium length (well, medium length for me at least) ride. I did 37 miles and averaged out a very good pace for me on my ancient bike. My leg muscles have noticeably adapted to biking. I was able to ride hard for a relatively long time and it wasn’t my legs didn’t give up on me. It’s amazing how quickly the body adapts.
I also put the aircast back on. After one day of not wearing it my ankle felt strange, possibly painful just walking on it. I don’t know what to think about that.
Last night I took the stupid aircast off. I tried to keep an open mind about the whole thing but more and more I’m convinced that the aircast is snake oil…or at least not applicable for tibial stress fractures. OK, OK, at the very least the aircast didn’t work for me. Maybe it works for other people but I’m doubting it.
I’ve been looking into the possibility of using an Exogen ultrasound bone stimulator. I don’t have enough information at this point and I’m afraid this might be snake oil too. The last thing I want to do is have insurance pay for another useless treatment. As I type this I think I might not bother with the bone stimulator. For one thing you need a prescription. For another plenty of people heal just fine without one. I’m not a pro athlete. My livelihood doesn’t depend on running. My sanity might but my family won’t starve because I can’t run. I need more information.
I just did a quick search on pubmed.com (one seriously awesome site for searching medical research texts) and found some interesting hits (with full text!). One study, which doesn’t seem to be a study since I don’t see a control group mentioned, has a positive outlook on LIPUS (low intensity pulsed ultra sound) in accelerating the healing of bone fractures. Another study, which appears at first glance to be well executed (double-blind, randomized, used a placebo device in the control group) found no statistical difference out of a group of around 100 patients. This sounds like the aircast all over again.
If it sounds too good to be true it probably is… but not always. I think in this case it’s too good to be true. I’ll stick with the tried and true method to return to running.
Monday morning I marched back to the doctor’s office for my appointment to go over the results of the MRI. They informed me at the desk that I didn’t have an appointment. I knew I did and luckily they were able to fit me in anyhow. Later that day I confirmed that I did have the correct appointment day and time as it is clearly written on the appointment card I was given. That’s really beside the point. Mistakes happen. What’s important are the MRI results.
“Very atypical distal tibial stress fracture” That’s what the doctor wrote on the script for the MRI. I don’t like being atypical. If I had a typical tibial stress fracture I would have been running by now. But the truth is that I don’t know if I have a stress fracture. As I said from the beginning half of my symptoms indicate a SF and half do not. I have localized pain on the bone where most tibial SFs occur (and most SFs are tibial). The pain came on rather abruptly. I was running on a new surface and my intensity had increased. The pain increases in the evening and a bit in the morning. On the other hand I can hop without pain and that should cause serious pain (the vibration through the bone makes a SF hurt). Also the pain disappears rather quickly.
For the last two weeks I’ve been treating this as a tibial stress fracture and have diligently worn the aircast leg brace. With that brace I should have been running unrestricted in 3 weeks. Unfortunately I feel like I haven’t made any progress. I am pretty confident that I would be in extreme pain if I ran for just 1 mile.
Both the doctor and I are confused. He took x-rays yesterday and they showed nothing out of the ordinary. X-rays rarely show anything for a stress fracture until they have started to heal. Even then many x-rays don’t show the fracture. So the doctor ordered an MRI. I was lucky enough to get the MRI done last night. I won’t know the results until Monday afternoon. The technician wasn’t allowed to show me the images. He claimed it was illegal.
I repeated the “Day 2” of the recovery plan again last night. It went pretty much like every other time I’ve tried to run in the last 4 weeks. It felt OK but started to be noticeable. By the end of 1600m (and that’s only running 200m at a time for a total of 800m running and 800m walking) it was achy. It ached for at least 30 minutes after the workout. It aches this morning as I type this. It is tender to the touch again.
My hope in a quick recovery is almost gone. I am 99% certain I won’t participate in a Fall marathon this year.
I went to the pool again last night where a friend patiently attempted to teach me to swim. Swimming isn’t much fun right now but that’s because I don’t know how to do it right. Once I learn I can imagine that it might be fun. Until then I’ll try to be patient.
I will attempt Day 2 (200m walk, 200 jog, for 1600m) again tonight. I am seeing the doctor again tomorrow so I think another attempt at running is in order. At least that way all of the pain/discomfort (if any) will be fresh in my mind.
I’m trying to be patient and positive and I don’t think I’m doing very well.
I didn’t run yesterday and I don’t plan to run at all today. Yesterday I did a couple of upper body weight workouts (one at lunch, one in the evening). I’m leaning towards not running at all until speaking with my doctor again on Thursday morning. At this point a few days really doesn’t matter to me. I’ve been “not running” for so long that it really just doesn’t matter. I don’t care about running a fall marathon much less attempting to break 3 hours. At this point I long for the feeling I get when I’m mid way through a long run and that feeling takes over. It’s a feeling where everything is right. I can run incredibly fast and feel absolutely on top of the world. I long for the feeling of exhaustion (which is actually a wonderful feeling) after a good workout. Cycling for 4.5 hours this Sunday made me tired but I never felt even remotely close to how I feel when I run. The most significant feeling I had while cycling was boredom.
There is good and bad with everything. I’ve been trying, and failing, to be positive. These are some things that are positive about this experience:
- It could be worse. This isn’t ending my running career. It’s a temporary break.
- I don’t really think I’ll lose that much fitness. I’ll lose some but I bet I can get it back pretty quickly.
- My expectations have been reset. I was expecting too much out of myself and with that comes disappointment.
- I’ve been brutally reminded of how much I really love running. Running is a huge part of me that I think only other runners can understand.
- It’s dangerous to put all of your eggs in one basket. (see the preceding bullet point). There are other things that can be enjoyable. I’m hoping to learn to swim and I think I’ll like that.
- This time off has given the rest of my body complete time to heal.
- I don’t have any mileage goals for this year anymore. Once I can run again all I want to do is run without pain. That’s a liberating feeling.