If you're lucky enough to be in the mountains, you are lucky enough.

When something bad happens, you have three choices: let it define you, let it destroy you, or let it strengthen you.

The purpose of life is to discover and develop your gift. The meaning of life comes from sharing your gift with others. - David Viscott

Wednesday, January 11, 2012

Running is cancelled.

Saw a doctor. Dirty laundry list below (left foot):
 - compressive neuropathy 1st branch Lateral Plantar Nerve (Baxter nerve) with adverse neural tension
 - FHL/FDL stenosing tenosynovitis
 - distal plantar fasciapathy
 - partial tear of medial plantar fascia at calconeus
 - mild metatarsalgia/capsulitis 2nd metatarsal
 - Cuboid syndrome
 - mild herniation L3/L4

The whole list is either caused by #1 or causes #1 to develop/worsen. The diagnosis of entrapment was correct...only a different nerve is the issue. Or, may be it was in conjunction, but not the main cause of this incredibly increasingly bad pain. I am pretty pissed off at over a month of time wasted on wrong therapy. For the future, if you need to know the real problem - see a doctor-specialist, not a chiropractor (as great as they can be). If your foot hurts, it's time to see a foot doctor, not a sport medicine doctor, not a chiro, not LMT...Apparently, Dr. Baxter is from Houston, TX, and Dr. Spears I saw had orthopedic surgery specialization under Dr. Baxter. What are the odds...

A bunch of medical mumble-jumble:
Baxter nerve entrapment information, diagnosis and treatment.
The first branch of the lateral plantar nerve travels between the deep fascia of the abductor hallucis and the medial fascia of the quadratus plantae and then continues deep to the flexor digitorum brevis muscle. Although somewhat variable, it has several branches. It typically provides a sensory branch to the medial calcaneal tuberosity, motor branches to the flexor digitorum brevis muscle, and sometimes a motor branch to the quadratus plantae. It then provides a sensory branch to the lateral heel and a motor branch to the abductor digiti quinti muscle.  
Entrapment of the first branch of the lateral plantar nerve beneath the deep fascia of the abductor hallucis muscle and/or beneath the medial edge of the quadratus plantae fascia are the most commonly seen causes of tarsal tunnel syndrome. 
Symptoms usually worsen with increased activity, as well as toward the end of the day and after long periods of standing, walking, or running. Prolonged standing in one place may be an aggravating factor (here is the reason I am having hard time standing in the kitchen!). Most patients continue to have pain or burning ("after pain" or "after burn") for 30 minutes to several hours after they are off their feet (tell me about it, I sit at work and feel the burn). 

Prognosis - PT for 3 months, no running, cross-training with what does not cause pain. In general a pour outcome and surgery eventually required in most cases. I will have to really think in the next couple of weeks as I go through PT if may be I want surgery right away (recovery of 2-3 weeks non-bearing exercises and then introducing weight-bearing), this way there is still hope to make it through at least my mid-season, which is the most important anyway. I am giving up 3M half-marathon and Austin marathon (so much for plans to PR, train for speed, enter ultra season in fast shape...). I am not giving up anything beginning April. I am resolved (after spending some time crying) that I will get in shape on all those machines I hate so much (and had been using for 6 months sans December, in which I got overzealous with running miles and meeting arbitrary goals and had put my already not-directly-pointed recovery further back than where it was to begin with), I will adjust my food intake (what and how much) to the fact I don't do cardio my body may demand for a proper burning, I will focus on yoga for those herniated disks rearing their heads back to their 12-year old history, and I will not give up my dreams and passion. And I will buy those soft sleepers so I can stand in my kitchen and keep cooking meals every night:)

No pity, but encouragements are appreciated. I am pretty seriously tired, discouraged and in need of a good ass-kicking. Oh, man, back to spin classes...


Dave said...

oh no...stay strong...and maybe get a bike....peace and prayers to you Olga

Jill Homer said...

More frustrating news. I admire your attitude about it, and determination to not let injuries get in the way of pursuing your passions.

I personally love spinning. I haven't attended a class in years; it's been that long since I belonged to a proper gym. But spinning is what I blame for getting me hooked on fitness. I've always been into the outdoors and adventuring, but I specifically remember the days when I resented physical efforts that were "harder" than I thought they needed to be when I was simply trying to get somewhere I wanted to go. Spin class at the Apple Fitness in Idaho Falls introduced me to my first regular hits of endorphin rush and changed my life. Hope you can find similar sanctuary in non-weight-bearing activities.

Sarah said...

Okay that does sounds really terrible. No pity but I'm still sending a hug!

Acupuncture has helped me with nerve stuff so maybe try that too. Pool running can be mind-numbing but I like it in short spurts. Doing the cross country ski motion while holding the foam "dumbells" will raise your heartbeat fast. Or if you can find a really good aqua aerobics class I'd recommend that too. Not one with the little old ladies flapping their arms in the shallow end, but a serious deep water class. And go full tilt, double intensity. I hate the machines too but have never tried true spinning.

Keep us updated! Before you know it this time will be a distant memory. Hang in there!

ultrastevep said...

Sorry to hear, Olga...rest up, let things heal and you will be back stronger than ever (maybe take the surgery route).

I'm wondering if you think running in the Crosslites had something to do with this. AJW has been cured from his ailments after starting to run in Hokas!

mtnrunner2 said...

Also wondering about footwear, and if something less constricting might help long-term.

I can't wear La Sportivas due to the narrow platform (too bad, because I love the traction...), and I'm branching out into "barefoot" brands right now to give my feet more room. As I look back I can clearly see many of my issues have to do with cramming feet into little laced tubes. No more.

Yeah, swimming is good. I'm about to start up at the local rec center. Last time I couldn't run at all, I worked up to swimming a mile, and that's definitely a worthy workout.

kelly said...

Oh, Olga. I am so sorry my friend. You sure have had your battle with injuries! Hang tough and cross train like a mad woman. You will keep fit and be on the road to recovery. Good luck!

amy said...

So sorry, dear. I have no doubt you'll stay fitter than the rest of us even while recovering and staying off of your foot. Let me know if you're making any Oregon visits in the coming months. We can focus on getting together for something social outside of running, like beer drinking.

Thomas Bussiere said...

I know you, and you will kick this in the butt also. You already know, keep up with the cross training, run in the pool / ride a bike, get the surgery, recover, train like a mad woman, and kick some ass when it is all behind you. Life often throws stuff at us to test the inner drive and teach us something about ourselves.

My son Josh has a saying when it gets tough in wrestling - "Embrace the suck"
Last weekend we ran the Disney Marathon which Josh almost couldn't because he popped his knee out during wrestling practice 3 days before the run, and could only walk with a painful bad limp. At the last minute, he decided to see how far he could get before he could no longer make forward progress. During the race, we came up on a young military man who was struggling hard, and in a lot of pain because of his artificial left leg, but was getting it done. Josh looked at me and said "Dad, I have no excuse and should be thankful for what I have". We finished the race with a new perspective.

Go finish your race!

c said...

Dang! But the thing about you, Olga, and I remember it from your first article in Marathon and Beyond, is that you are an athlete. While you are recovering, you will cross-train, do yoga, become better than most of us will ever hope to become at all of it. I love how you always go for it in everything you do.

J Scott Chapman said...

Oh, let me see. After working with you at Bandera at the Last Chance aid station, I think you would say something to yourself like "What, are you just going to sit there and feel sorry for yourself? Come on! It's not that bad! You still have BOTH of your legs!" Just kidding!
Seriously, though, suck it up, crybaby.

javapuntnl said...

Sorry, this is quite after the fact, but I'm wondering how you made out? After too many sleepless night, being awoken by a burning pain in my heel, I feel like I earned a medical degree from Dr Google and self diagnosed my injury as Baxter's Nerve Entrapment. Unfortunately before that I was the victim of a doc who qualified all heel pain as plantar fasciitis and immediately jumped to the cortisone shot remedy.
Just wondering if you had the surgery or an alternative treatment and how things developed from there.

Jacob V.

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