Tag Archives: arthritis

Grin and ice it

Running in Dublin, 2011.

The 50k days – 2011.

‘Hallux limitus’. It doesn’t sound too sore. In fact, it hardly sounds like an ailment of any sort.

But it is, and those who’ve experienced it know exactly what those words mean – and what they feel like.

The condition is a stiffening of the big toe joint, caused by osteoarthritis. Not only does the joint stiffen and flare up in pain, but a bone spur begins to emerge on top of it.

If you’re a runner this spells trouble (likewise if you want to wear those Italian dress shoes). You can hold it off for a while, by way of inserts and cutting your distances, but once it’s underway it’s unstoppable – without intervention at least.

In my case, I’ve been managing a worsening case of the problem for the past four years. Almost two years ago I wrote that it would, untreated, surely stop me running.

To date, it has not. But I run less. My onetime 50k a week is now a distant memory – anything above 20k causes problems for me at this point. This has meant more time than I ever envisaged, or desired, on an exercise bike in my local gym, and long, long, walks on the weekend.

My hallux (big toe).

My hallux (big toe).

Despite such workarounds, and the availability of cortisone shots, I’m edging closer to the day when I make an appointment with my physician to be referred for surgery.

For now, I’m running in denial – or a form of denial, at least. This is why I occasionally attempt something I used to do regularly – a handy 10k on a Saturday morning, for instance – knowing, but refusing to recognize, that I’ll likely spend the rest of the weekend dealing with the effects.

This mentality, common among pavement pounders I imagine, fascinates me. If any other activity was causing me pain and damaging my body, I’d stop. Who willingly courts pain? And if you do, what does that say about you?

For now, I tell myself that the fitness and endorphin rush payoff trumps the discomfort. But only just. And the scales will, shortly I’m sure, start to tip in the opposite direction.

Until the, and the day I make that physician call, it’s grin and bear it – and ice it immediately.
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The five stages of runner’s grief

The foot

The foot

“The waiting is the hardest part,” sang Tom Petty in his 1981 hit, a song written as he recovered from a hand injury which limited his guitar playing. Or so I once heard.

At least Petty got back to the fretboard. My own experience with injury of late has been more along the lines of The Long and Winding Road, most of which has been pedalled.

For the past three years I’ve suffered with a running injury that worsened from an annoying niggle to a painful case of plantar fasciitis to a diagnosis of osteoarthritis in my big toe.

The result has witnessed a collapse in my mileage, from around 50k a week in 2013 to a pitiful five (10 if I push it) at present.

A programme of physiotherapy, along with exercises, x-rays and shoe inserts, was followed by a medical consultation and, finally, an appointment to an orthopaedic surgeon next month. While I wait on the latter my exercise regime has been confined to static, dull hours on a stationary bike, broken up by long walks (tantilisingly along my old running route).

The ongoing big toe saga also led me to google ‘how to cope with running injuries’, which brought me in turn to a Runner’s World article documenting five stages of ‘runner’s grief’.

First off, I’m aware that there are bigger problems in the world that a painful toe. But anyone who’s been injured will have encountered one or more of the five stages – denial, anger, bargaining, depression and – the fabled holy grail – acceptance.

Run or walk? Jogging in Porto, 2015

Run or walk? Jogging in Porto, 2015

In my case the first two, denial and anger, were one and the same, signifiers of a period when I’d run 40 and 50 kilometres and then lose my temper when I could barely walk for three days afterwards. Being as stubborn as most runners, this pattern of jog-wobble-hobble repeated itself for a year.

Then, with the onset of physiotherapy, I shifted to the third stage. I’d trade a dull, 45 minutes on the exercise bike for a 5k run. Then it became an hour for 2.5k and a handful of Vitamin I.

Was I depressed at this point? If I was I buried it in sweat and episodes of Deadliest Catch – still my stationary bike show of choice, mainly because the Bering Sea looks like the only place less enjoyable thank the tedious pedalzone I set up in our living room.

Then, one afternoon last December I walked into a radiology department at a Dublin hospital and, at long last and by way of my doctor, received a diagnosis. And now I’m awaiting the surgeon’s appointment.

Cue acceptance.

But not so fast (a bit like my 5k times). While I convince myself that I’m at ease with my injury and assure myself that I’ve learned lessons of limitation, ageing and common sense, the first question I’ll pleadingly ask the surgeon will be “can you help me run 50k a week again?”

To which he’ll likely laugh – and then recommend a stationary bike. Petty was wrong. The waiting’s been easy – the accepting’s the hard part.
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The two words that will stop me running

http://www.parkrun.com/

Running in Tokyo, 2014

In the beginning was the burn – and the burn was sore.

A sharp, annoying type of sore, which radiated through the joint of my left big toe. First I felt it while running, then while walking. Eventually I couldn’t shake it off, it stabbed at me as I lay in bed at night.

So what did I do?

I ignored it, at first. Until it got so bad that – in a chain reaction of injury that doctors warn about but those who know better, like me, disregard – it kicked off a bout of plantar fasciitis.

That was over two years ago. At the time I reckoned – as did my then physio – that I’d sprained my toe and that rest, stretching and incorporating some cycling, would be fix me.

It didn’t. After two years of stretching, bathing, ibuprofen, heat rubs and an increasing sense of annoyance, all the while running less and less, I found myself with a new physio and the same old pain.

This time the news wasn’t good. She didn’t need an X-ray to diagnose hallux limitus, a form of early onset arthritis which leads to (the far more debilitating) hallux rigidus (two words that may eventually stop me running). Fun fact: ‘hallux’ is Latin for big toe. Less fun fact: ‘limitus’ translates as ‘oh dear’. (‘Rigidus’ is unprintable.)

Now that we had a diagnosis for the sharp needle jolt through my joint we could go about trying to stop it. But hallux limitus goes beyond just physical discomfort.

Big toe, big joint, big niggle.

Big toe, big joint, big niggle

As I started treatment I found (correction: I still find) myself looking at 40 and 50-something runners in the park now and thinking – jealously – how can you still do that?

Of course, they may ache too. They may, while lacing up, wince and curse God, or their antecedents, for handing them shaky knee joints, tight hamstrings or a weak left ankle. But still I look at their feet, particularly their big toes, enviously.

And so began the last six months – a period of painful massage, podiatrist appointments, endless fiddling with inserts and, finally, the arrival of spanking new orthotics.

This culminated in a command from my physio – no running for 10 days.

Did I feel better? Am I limiting the limitus? It’s too early to say. My mandated 10 day break ended this week with a meekly-jogged 5k.

Of course this is the point at which I feel duty bound to warn of the dangers of not seeking treatment quickly for running injuries, the benefits of rest and the advantages of gentle walks.

But I can’t. In the past 18 months I’ve been lucky enough to experience solitary, mind-clearing dawns break over some wonderful places – Tokyo, Bordeaux, London, New York City, even Galway – something I could never have experienced without running – or without feeling that old familiar burn.

Lesson learned? Not yet, I’m afraid.

Dawn run, Galway, 2015

Dawn run, Galway, 2015

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