April 2024 Update

Just going to keep this short and sweet since not a lot has happened since last time.

I had another follow up for my knee injury. It’s been trying to get better, so I opted not to talk with a surgeon at that appointment. It’s still limiting me enough that I’m still considering surgery, but I figured if it seems like it’s trying to improve, it would be best to hold off for now. The lateral knee pain has gotten better in that it’s not every day anymore, but it does still bother me if I stand with too much weight through my left leg, or it I have my knee bent a while and then straighten it. I haven’t noticed major issues with the lateral pain after I workout. The posterior pain is an ongoing issue, as is the joint as a whole feeling swollen after I run, and sometimes if I bike more than an hour. I’m usually good to run for a mile to a mile and a half without having pain later, but more than that and it isn’t pretty. I’ve pushed my running to three miles a few times, and while I usually feel okay during the run itself, I have pain soon after stopping and I hurt for the whole rest of the day, sometimes into the next day.

My doctor still thinks a lot of my issue is my IT band, but I’m just not so sure. When I get the lateral pain, it’s different than when I’ve had IT band pain. The pain I get now is lower. Back near the beginning of everything, I did have that very classic IT pain, but now I just don’t know. He explained that the IT band can cause pain where it attaches lower down the leg from that “textbook” area, but I’m hesitant to cut it until I feel sure. Still no clear idea of the cause of the posterior pain. May be my torn meniscus, may not be, especially since the area of pain doesn’t overlap the tear most of the time. If I have surgery, they’d look at everything first and then the plan would be to release some tension on my IT band and fix/cut out the tear in my meniscus, along with fixing whatever else they find while looking inside. It just scares me to mess with my IT band because what if it isn’t the problem after all and then it’s too lax? I don’t want to set myself up for future injuries.

I follow up with the doctor again at the end of May, and honestly if there isn’t ongoing improvement, I’ll likely just go the surgery route. The surgeon he wants me to see is very busy, so I assume surgery would be pushed out a couple months anyway. If in the lead up to it I feel things have improved, I could just cancel. It sucks to be at this point where I don’t have conservative options left and I’m just playing a waiting game. I’m having a hard time knowing what the right decision is here for myself.

One Final Push

Had another follow up with the ortho clinic two days ago. I’ve had very minor improvement in my knee since the last injection, but I’m still getting pain with even walking still sometimes. I can walk farther most of the time before it starts bothering me, but I still have days where it just doesn’t like me to walk on it at all. After every activity that involves weight bearing, I have pain. I get pain after walking, after running, and even after standing twenty minutes to cook or greet people at the doors at church. Biking is almost normal, but I’ll still get pain after that if I ride longer than about 45 minutes, but shorter rides are okay 85% of the time.

All that said, I feel like I’m back to where I was before I injured myself further at the 5K race in November, but even before that I was still struggling with these same issues for 3 months. Now we’re at 7 months, and it’s not looking great that they will resolve without help. The doctor told me there’s still a chance that they can improve, but told me to look at it from the perspective of how much it’s limiting me from the activities I want to do. The truth is that it’s holding me back.

At my appointment, I had fully planned to discuss my surgical options, but I was so undecided about it. The doctor was really understanding about it and told me to take the next month and see if things improve, and during this next month, he told me (directly quoting him) to “beat the shit out of it as a field test”. He told me to increase my activities and see how it responds. Just based on how the weekend went, I think it was stupid of me to push surgery off another month, but I want to be sure I need it. I really don’t see things improving in the next month, but I’ll make suer I run consistently and keep doing my rehab exercises and see what happens.

Steroid Shot Round Two

I had my ortho follow up yesterday. I did get some relief from the steroid injection into my knee joint last time. It gave me some off my range of motion back and helped with some of the pain, but it didn’t help with everything. I remain unable to bend my knee all the way, or straighten it all the way, so trying to do some of the stretches the doctor gave me hasn’t been going well. It’s still too painful to attempt a quad or hamstring stretch, but I’ve been able to do most of the strengthening ones pretty decently.

Given continuing symptoms at my appointment today, the doctor injected my distal IT band to see what that does for me. I’m still getting lateral and posterior pain, and walking still isn’t comfortable, but biking has been feeling a little better. I’m having less pain and stiffness after a ride as long as I keep it slow. Although any amount of pain is still too much, it’s at least a step in the right direction.

If this steroid injection doesn’t fix the problem and get me starting to run, I’ll be discussing surgery when I go back in 6 weeks. Hopefully it won’t come to that, but that’s the very last option. I’m not crazy about the idea of surgery when we don’t even know for sure what’s going on, but I’m pretty sure arthroscopy can aid in diagnosis, and they can fix the problem if they find something right at the same time, so I’m trying to be as positive as I can. The doctor mentioned possibly releasing tension on the IT band, but that’s assuming that’s the cause. The area where it hurts isn’t the same as where I had IT pain before; that was a little higher up on the knee and this is lower. He still doesn’t think it’s likely to be my meniscus even though it is torn since it’s on the medial side, which is the opposite side of my knee. I also have a Baker’s cyst that could be the cause. Basically, we’re both just crossing our fingers and hoping we can at least narrow down what’s going on. Unfortunately, it could be one or all of those things.

I felt pretty good when I woke up this morning (waaaay too early at 2:45 am thanks to insomnia being a side effect of the injection), so I took myself out for a walk at 6 am and managed to hit two miles. I was really slow, but only mildly sore while I walked without a noticeable difference in pain later on, so that’s a good sign. If I can get the pain while walking to disappear over the next two weeks, I’ll try slipping in a couple tenth mile intervals into a walk. I don’t want to rush back into trying to run and make it worse again, but I also need the information for when I go back for my follow up. If I still can’t run, I’ll let them cut me open and see if they can find the problem. I’m far too young for this to be the end of my running, so I’ll give it a try if I have to.

I’ll let you guys know how things continue to go as always!

November Update

I’m having a day where I’m feeling pretty low. I had a follow-up appointment with my surgeon today to see how taking the meloxicam every day was helping me. This past month was the least amount of pain I’ve had in a very long time, which has been nice, but I was out of medication three days ago and I can already feel the difference in my pain level. My doctor offered to let me keep taking it if I was getting blood work done occasionally by my primary care doctor, but I declined for the time being. Apparently it can cause kidney damage with chronic usage, and that’s not something I really want to deal with. I’m young and healthy, so the chances of that would be low, but I don’t want to risk it. I would rather get to the root cause of the issue my foot is having than just masking it by taking medication all the time. He said to call if I changed my mind, so at least he’s leaving the option open.

In other news, I still don’t know what’s going on with my foot. I just can’t believe that all of this pain is from the tiny bit of arthritis in my subtalar joint. It just doesn’t feel like joint pain. I feel like something is being pinched, and there seems to be some soft tissue swelling in my right foot over an area where there’s an indent in my left foot. I’m not saying the arthritis isn’t causing some mild pain, but I still don’t think that’s the whole story. Now I don’t know what to do. My doctor just told me to come back as needed, but if he isn’t going to explore any other options, then I don’t see the point. I obviously don’t have the level of expertise that he does, but the fact that the joint injection I had a while back didn’t help more than a couple of days tells me that there’s something else happening, especially since even the doctor was surprised by it. I have the option of trying another injection if I feel like I need it, and I might try it again shortly before my 5k.

An unintended consequence of the meloxicam was how much it was masking my true level of hip pain from my gluteus medius tendinitis. I’m feeling more pain in the last couple of days than I was while I was still taking the medication. I’m diligently working on the stretches and exercises my physical therapist gave me and icing my hip a couple of times each day, but if this hasn’t started to improve by this time next week, I’m going to have to call and ask what to do. I’m still hoping I can avoid formal sessions because I want to get back to training, but if I do have to do them, it’s better to start as early as possible. It’s already been three weeks since I hurt myself, and I really miss running. I’ll do whatever I have to in order to get back to it.

Well, I suppose that’s all I have for now. Hopefully the next time I write, I’ll have some good news to share with all of you.

Another Update

I had another appointment with my surgeon yesterday. My Achilles tendon is holding up pretty well, but the unknown issue on the outside of my ankle is still troublesome. The steroid injection only lasted a few days, which seemed to perplex my doctor. He said it should have lasted longer than that. Of course, my problem is apparently really unusual because he still doesn’t know in full what it is. Some of the pain is probably due to the arthritis I have in my subtalar joint (that’s right— I’m old at only 32 years of age), but there’s still something else not right around the area where all the ligaments are. He presented me with a list of options to try, which all focus more on the joint, and I’m just not convinced that’s all that’s wrong.

First up, I am trying a daily prescription anti-inflammatory until my follow up appointment in a month. I’m hoping that ends up helping. If that doesn’t work, I have four other options he presented me with. The next step would probably be another injection, this time with ultrasound guidance, which would take place two months from now. I also could get a brace custom made, but it would be restrictive and not allow me to run. I brought up that concern with him and he said we could wait a little while to try it since I’m training for my 5k. I wouldn’t mind wearing something like that for work, though, since I’m on my feet all day. The only other options he brought up besides the ones above were both surgical. He could either do a surgery to clean the joint up a little bit, or he could do a subtalar fusion. I really don’t want another surgery any time soon, especially a fusion because that would limit the activities I finally have hope of performing in the near future. The only way I would consider surgery again is if that’s the last option and the pain gets so severe every day that I can’t take it anymore.

For now, I’ll just keep doing conservative treatments. Even though some days the pain will get to a 5 or 6 out of 10, it’s not every day and usually not even all day. It’s definitely worse on days I’m working. I’m trying to find a less physical job so I can get some relief, but that’s been a challenge so far. In the meantime, I’ve still been running three days a week. I feel like I should be doing more, but I will not cause myself anymore injury by overdoing it. I have four months until my race, so that’s plenty of time to be conditioning my body once my endurance improves.

It’s a Marathon, Not a Sprint

Ironically, I highly doubt a marathon will ever be in my future 😀 It’s been a week full of news, some good, some not so good. I’ve been off work all week, which has been nice. I really needed the break to help my foot feel better. It’s never happy when I spend all day on it nearly every day. It’s been feeling pretty good this week, but I’m trying not to get too spoiled.

I had my follow-up with my surgeon on Wednesday. My Achilles tendon is getting there, slowly, but it’s still making forward progress. However, the issue with the outside of my ankle on that same foot has been feeling worse. It’s been holding me back more than my Achilles tendon some days. The doctor looked at it and said he wasn’t 100% sure what it was, but that it could possibly be an impingement of some sort. He asked if it hurt bad enough to try a steroid injection, and I immediately said yes, so that’s what he did. It didn’t hurt as much as I thought it would, but it was still not a great feeling. It felt like a strong ache deep inside my ankle. Some of the swelling is down now, but I’m not sure if it’s because of the shot or because I’ve been off work so many days now. I guess I’ll find out next week. The doctor said that he’s going to check my foot again in a month and decide from there whether he wants me to have some tests done. He wants to know how the steroids worked first. He told me he was fine with me running on it in the meantime, so I’m glad I can keep trying to work on that as long as it will let me.

Thursday I had another physical therapy appointment. I hadn’t been in close to three weeks, so it was nice to be able to get a little extra relief. My therapist wanted to wait until after I had my next doctor’s appointment to find out what was going on with the side of my ankle. He spent a lot of time with me discussing realistic goals and making sure I didn’t try to push myself too much. I was told it would be better to wait until spring to attempt a 5k run because he wanted me to increase my training very slowly so I don’t end up making anything worse. So naturally, tennis and martial arts will be pushed back as well, but he did tell me that I can hit the ball against a board if I was careful not to do jarring movements. Not quite the same, but at least it’s something. He told me that once I can run a mile without pain, then I can look at getting back to some activities slowly. That still seems like a long way off. My therapist taught me some new exercises to help build strength and balance in my right leg, which is what it needs. After doing them yesterday, I have sore quads today, but at least I know that my muscles will get stronger doing them. It’s a good kind of pain because it will have benefits in the future. He told me that he was going to leave it up to me when I come back for another appointment, and if I wanted to check back in every couple of weeks, I could, or if I wanted to try doing things on my own, he was fine with that, too. I told him I honestly was afraid to be on my own right now because it’s never gone well when I’ve tried it in the past, so I’m going back in two weeks. I think it’s wiser to do that to make sure I’m not hurting myself with the new increases in activity I’m trying.

Given all the new information, I thought I’d try working on an interval plan to get me running. Since I’ve been told not to do too much too fast, I’ve been using the None to Run plan, which is online for free. It’s a twelve week program that’s supposed to get you running 25 minutes straight, which will eventually get me to a 5k. I’m not going to be at the front of the pack of any race, but I just want to be able to do it. This program is slower than other interval running plans, which should make my PT happy enough, and I can repeat any weeks I need to until I don’t have pain when doing them. I did the first day of week 2 yesterday, which is a 5 minute warm-up, and then intervals of 1 minute of slow running and 2 minutes of walking until you get a total of 25 minutes. It was hard for me. I’m used to biking, which gets my heart rate up, but running is so much harder. Maybe once I build some muscle back up in my right leg, it will feel easier. I got sore part way through, but not enough to stop. I finished the intervals as laid out, and plan to try again tomorrow morning. I’m trying to give myself a day between runs and plan it for days I start later at work to maximize the chances of success.

I may not have an update for a couple of weeks, so as always, take care! If you have experience getting back to activity after an injury, let me know what kind of tips you have that worked well for you!

Learning to Run

Today was a milestone day for me: I got to run! My physical therapist only cleared me to start with 100 yards a couple of times per week, and at a pace barely faster than a walk, but it’s better than nothing! He said once I know how my Achilles tendon responds, he’ll let me do more. I’ve been doing ASTYM for the last 6 weeks or so, and it’s really been working well. I have more movement in my tendon now, still not 100% but definitely better than where it was, and I can feel my calf muscles contracting sometimes instead of me just kind of dragging my leg along with me. I’m off from physical therapy until September 5th to see how things go and to check in with my surgeon about how everything is progressing and to address the weird swelling on the outside of my ankle that has my PT baffled. He said it’s got the characteristics of an ankle sprain but I didn’t do anything to it and it’s been like that all year. I’m hoping I don’t have some other issue; that’s the last thing I need. I really couldn’t have asked to be working with a better clinic. I’m so glad they didn’t give up on me and were willing to keep trying new things until something worked. I made them a gift for the clinic with the only skill I have: Japanese. I wrote my favorite proverb that motivates me through the hard days, and my hope is that it inspires other patients there, too. Here’s what it looked like:

Other than trying my hardest at therapy, I’ve been trying to get out biking. I’ve found that about once a week I can do an hour long ride, but the other days are shorter. When my physical therapist asks me every week how much I’ve been out, I usually tell him, “Not as much as I want”. He laughs at me for always saying that, but it’s true. Compared to last year, I’m doing about half so far. A couple of weeks I’ve gotten as high as 70 miles, but most weeks hover at 45-50 miles. I know one day I’ll get there again. I did make a new friend while riding: a cute little frog that didn’t want to leave my bike.

It’s been a long process, and I seem to be taking longer to recover than most people with the type of surgery I’ve had, but I’m at least moving forward, and slow progress is better than no progress. Now I’m off to bed, but I’ll leave you with a parting gift: How I’m sure I looked when I ran for the first time in a year. Bonus points if you know what this is from!

A Spark of Hope

It’s been a couple of weeks since I started ASTYM, and it really seems to be helping. My pain at work is unchanged, but at least it doesn’t hurt as much to bike as it did before. I think work is the single biggest thing holding back my recovery, to the point where I’m going to have to start looking for a less strenuous job. Every time I start to feel better on my days off, the pain always comes back the next time I work. I can’t handle that many hours on my feet without breaks anymore. I’m so tired of living in pain every day and limping around the house when I get home.

For the first time in a long time, I feel like things are looking up. I started working on some new exercises at physical therapy which should help me to run and jump again someday. It’s amazing how hard it is to jump! My left leg does all the work, but I’m hoping the right one will step in eventually and remember how to do it. I think it probably needs a little more strength first, but I’ve been diligently doing everything at home. I’m probably one of the few people who actually likes to do the home program based on what I’ve heard other people say. I like putting on some music really loud (usually country or jpop) and working on fixing my body. It’s a half hour of my time well spent every day. On my days off work, I’ll do the program a second time before bed. If it will get me walking normally again, then running, then playing tennis, how could I not enjoy doing my homework? I’ve dealt with this injury for over two years, and while I had hoped recovering from surgery would be a little faster than it’s been, at least I’m feeling like I’m making some progress again.

My other concern as of late is that I think I found out what’s been wrong with the outside of my right ankle: sinus tarsi syndrome. I have to discuss it with a doctor, but all the symptoms match: pain on the outside of the ankle, swelling, trouble walking on uneven surfaces, degenerative changes at the subtalar joint and fluid collection (evidenced on my MRI from last summer), pain turning my foot inward… I’m not dumb enough to diagnose myself on the internet, but reputable sources say it’s often misdiagnosed, so it’s worth asking about so I can get started treating it if I do have it.. It also can weaken the Achilles tendon, which might account for some of my trouble healing. Here’s a link to the site I found with extensive information about it: Physiopedia: Sinus Tarsi Syndrome. It’d be nice to know for sure what the problem is because it’s holding me back as much as my Achilles tendon is, if not more.

Well, that’s all I have for tonight. I don’t have physical therapy this coming week because my therapist is out of the office and the other one doesn’t do ASTYM, but I’ll be picking back up again on the 29 of this month. Until next time, stay well!

Discouraged

Maybe one day I’ll have something positive to post on here, but that day is not today. As you all know, I was anxiously awaiting my return to physical therapy. It did not go well, however. I had high hopes at the beginning when my therapist was discussing things with me and then he tried something new called ASTYM on the scar over my Achilles tendon. It was painful, but now that it’s calmed down, I think it really helped. The bad thing is, though, that I’m apparently not doing any more sessions. He told me that he didn’t know what else to do for me because I should be farther along in my recovery by now. He wants me to talk to him after I see my doctor next week and tell him what the doctor says, and that if the doctor had any suggestions then he would try them.

I feel like my therapist is giving up on me. Whether that’s true or not, I have no way of knowing, of course, but that’s what it feels like. I don’t know why he did the ASTYM for the first time today if he wasn’t planning for me to come back. If I’m not where I should be, then I want him to help me get there. I just don’t see things getting better working at home after how the past month of that went. It’s not enough. At least when I was regularly attending physical therapy sessions, I felt like I was making progress. I don’t feel like I got anywhere working alone. Just because I can do some stretches, squats, and lunges at home, doesn’t mean everything is going fine. I wanted to go back to that clinic because things went well when I had therapy there before, but now I just don’t understand what’s happening. I just want help getting back to normal function. Even just one guided session every week would be fine with me where my therapist could keep working on my scar tissue and give me more challenging things to do. Most importantly, I need help preventing some of the new issues I’ve had from getting worse. I’m tired of the hip pain, and afraid of what’s going to happen to my left Achilles tendon if I can’t get the right side in shape.

One day I might look back at this difficulty as just a small bump in the road, but right now it might as well be a huge wall. I was crying as soon as I got in the car after my appointment today, and spent most of the morning tearing up every time I thought of it. All of the goals I set for my recovery are slipping farther and farther away and seem so out of reach right now. I’m not signing up for any bike events when I can only ride a third of the distance I would need to (and that’s on a good day). I wanted to run a 5k by the end of summer, but honestly I’d be happy with a mile, or even 100 feet at this point. And tennis… I miss tennis so much, but how can I play tennis if I can’t run? I also planned to sign up for martial arts (probably aikido) this fall/winter, but I can’t do that if I can’t get my foot moving right or I’d just injure it more. I need to get back to what I enjoy, and I need the ability to do whatever activities I want to do.

All I can do right now is just wait for my appointment with my surgeon on Monday and report back to my physical therapist and cross my fingers that he’ll try something new. I really don’t want to go to a different clinic, but it might come down to that. I’m not living the next 50 years of my life feeling the way I feel now. I refuse to accept that this is the best I can hope for. Just because I seem to have hit a plateau doesn’t mean it won’t get better. I need someone fighting in my corner.

In Need of Assistance

It’s been a little over two weeks since my last physical therapy appointment. I wish I could say things were going well, but they aren’t. I’ve been having more pain and swelling than I had been before, and I’m feeling very frustrated and discouraged. I’ve been following my physical therapists advice, and I’ve even switched to shorter bike rides more frequently as opposed to longer ones less frequently. I just don’t know what to do anymore. I’m really hoping my therapist will have me attending appointments again. Something I was doing there definitely made me feel better, but I don’t know what. I think I still need help. I need to be able to actually get my calf muscles to stretch, because right now the pain at the base of my heel won’t let me get a good stretch to the muscles. I also can’t get the muscle to engage when I’m walking. If I can get that going, I think that will be the turning point. I’m just so worried that I’m going to be discharged from formal therapy sessions, and if that happens, I don’t know if I’ll ever get better. My body is getting tired of compensating for my continued issues. My left Achilles tendon is starting to get that familiar ache at the base off and on for the last three weeks, and my left hip has been bothering me since I was still wearing the boot full time. It’s going to be a long 9 days until I go back to see my therapist, and I’m praying that he can help me. I want to get back to normal!