Injury Update: Some (Vague) Answers from the Podiatrist

Yesterday, I saw the Doc:

Armed with 3 months of my training calendar (scribbled on
with pain notes), and notes/questions on the chair.

For a quick refresher: I’ve been off running (and biking) for 7 weeks as some pain crept up on the inside of my heel. (See this post for more on that.) I’m still in daily pain by not running, not biking, easing back on time on my feet, doing lots of foam rolling, wearing softer inserts, etc. Just standing around cooking supper makes it hurt. I felt like it was getting better day-by-day for the first 2 weeks of not running, but then it totally plateaued. It’s not getting better, and it hurts every day.

It wasn’t a great appointment as I felt really rushed: when I was given my paperwork at the end, I had to ask about being fit for an orthotic (as the Doc told me to do) and the nurse had to go and talk to the Doc again and come back; and then when I was back out at the desk making a follow up, they told me I wasn’t given the paperwork I needed to make a PT appointment. So someone had to create that paperwork back in podiatry and run it up to the desk where I was waiting. (And I’ve since “MyChart-ed” my doc [like an internal email message] 6 more questions that we were never able to get to - one being how to receive 2 different therapies that she told me to get, but then didn’t address who to see or how to get them.) So all of that was annoying.

I was rushed through so much that I never was given a name for what’s going on with my foot/heel. Maybe they still don’t fully know? Or maybe it's a basic tendon issue. But here’s what I’ve come away with so far:

- Sleeping in the “boot” (the night split) is good and necessary.
- Keep the inserts that Dr. Backus told me to wear, but add heel lifts under them.
- Ultrasound therapy that Dr. Backus was doing should be kept up.
- Wear my shoes all the time. My Haflinger slippers are great to wear in the house too.
- Orthotics with a high arch and softer heel will help (will be fitted for those in a few weeks).
- STRETCHING IS BACK. I wasn’t sure if stretching would be too aggressive, so I’ve just been foam rolling. She’s having me stretch my calf specifically with my leg straight to get at a spot (the gastroc, I think?) that needs to be stretched. Straight leg on the ground, straight leg “pushing off” a wall, and straight leg dropping from a step. Sort of “old school”-looking calf stretches.

Here are the 6 questions I’m still waiting to hear back about (these are the slightly abbreviated versions). Some of these are obviously more important than others, but still they are all things that got glanced over:

- How much ultrasound? How often? And still through Dr. Backus?
- Stretching AND foam rolling? Do them at the same time? Does it matter which one is first?
- Still swim? Or total rest right now?
- Still lay off leg presses and standing PT exercises? Or reincorporate? And still lay off biking?
- How much do I make it a point to stay off my feet? (Just STANDING around makes it hurt.)
- Are we acting on the steroid idea right now?

My blood pressure was a bit higher than normal, but I was
obviously stressed a little. But 48 bpm while at the docs is nice!

I don’t have high hopes that much of that will help, but stretching was a new/good sensation last night. I stopped wearing the boot about 10 days ago when I felt like nothing was working, so that will be re-incorporated again as well. We’ll see what the Doc says in her follow up message via MyChart.