MRI Results: a Big Injury Update

Here's a quick (well, "quickest possible") review of my injury situation:

• I had some lower calf/foot pain creeping in around the start of August. I stopped running shortly after with some pain inside my left heel. It was my biggest 365 days of running, and they were nice and consistent with nothing "stupid" bringing on this injury.

• I went to my normal chiro (Dr. Backus) and A.R.T. Doc (Dr. Folske) a few times. They loosened stuff up, but it didn't seem to do much for my pain. So what was causing the pain?

• I'd get sore just being on my feet. The State Fair killed me. Standing and cooking for an hour was (is) horrible. I got an x-ray on Sept 23rd. It showed nothing.

• I saw a podiatrist on Oct 1st, and she kinda blew me off. She told me to stretch more (I stretch a LOT, but stopped doing calf stretches when this issue flared up in case it was a tendon issue and I'd actually be hurting it). I knew I'd be just waiting in pain for a month until our follow up. (Spoiler alert: I was right.)

• All the non-running meant more time to swim (and PT and my podiatrist said that swimming was OK), so I set a monthly distance PR in Sept, and a yearly distance PR by early Nov.

• In addition to all the swimming, I've gained a lot of strength in the gym as I've been doing a lot of that. Probably more pull-ups in the last 2 months than in the last 5 years. (Really.)

• I've seen 3 physical therapists in the last few months, and I've confused all of them. I posted about the first guy I saw, saying this:

I told him I'm flexible, have good mobility, and am strong, and he was like "Yeah, yeah... we'll see..." (And that's an appropriate response having just met a patient.) Well, after 40 minutes of poking, testing, prodding, and having me do exercises, he was smiling while saying things like "jeez, most runners don't have that ankle flexibility", and "I wish all my patients were as flexible as you - some have to stop HERE, but you can go to HERE" (motioning 4 inches farther), and "I totally believe that you do all the proper strength exercises to compliment your training!"

• I started iontophoresis (like forcing a liquid steroid through your skin) on the sore spot with my next PT (who was Natalie - someone I worked with years ago for a different issue). She was equally confused with my body. After 3 ionto treatments and lots of new exercises from her, I posted her final thoughts here, which were basically to keep swimming, stretching, and icing (1x/day). She chalked it up to "inflammation," but knew that was a generic answer. (Quite possibly the RIGHT answer, but with no definitive cause or solution.)

• In late October, Natalie said something I had suspected for a while: "it doesn't seem to be anything tendon-related, so you can stop sleeping in the night splint." THANK GOD.

• On Oct 29th, it was back to the podiatrist to say there was no change. "OK, MRI time" was her response.

• My podiatrist-recommended orthotics came in early November, and I've been in them since then. They didn't magically help anything. (In fact, my new PT says to just wear them until everything gets "back to normal," but then to scrap them because they're like a crutch. Interesting.)

• After seeing my new PT (not because I didn't like Natalie, but because Natalie's not "in network" and she said a new set of eyes could be helpful), she had me try running on our first day on the treadmill. And then I did 1.25 miles of running last week. My foot hurt, but no more than usual. A positive sign??

So I had an MRI last week:

Sexy, form-fitting, one-size-fits-most MRI pants.
And... um... yes, those ARE X-Men undies...

Right after that MRI, I had my first visit with my "new" PT, Jessie. The MRI results weren't posted at the start of our appointment, but they were up before our appointment was done. The images weren't up, but the notes from the person who read them were there........

No tendon or ligament issues. A little build-up of fluid at one spot. And a slightly inflamed fatty pocket in my foot.

Sooooo.... what's that mean. Well, I stopped wearing shoes all the time (which were loaded with my new orthotics because EVERY podiatrist says you need orthoitics - just like EVERY physical therapist says you need more exercises) because maybe it's some rubbing that's pissing off my foot. And sure enough, I could do more around the house before things really started to hurt if I was barefoot or in my Haflinger slippers (which don't have a heel so nothing is rubbing on that spot). Prior to seeing the MRI results, the thought was to STAY in shoes all the time to get that extra support for the foot.

I was back for PT with "new" Jessie last week Wednesday (Nov 13th)...

Waiting for her to grab some things to work on my ankle/foot a bit.

... and then I had my follow up with my podiatrist to go over the MRI results just after that:

The podiatrist said that ONE SLICE of the MRI (which "slices" every 1 mm) showed something a little off in a fatty area of my foot. Just one of the many many scans showed this issue. She pointed right to a certain spot, and I don't know exactly what it was (my untrained eye saw nothing), but it was in this area:

I made that circle. I don't remember if the issue was
right in the middle or off to one side. I recall it being just
that SLIGHTLY darker area left-of-center inside that circle.

She also said that being they saw an issue and that it's not right next to where my Achilles joins my foot that they could give me a steroid shot right in that spot. They wanted to try to kill the inflammation that's going on in there. So the Doc working with her sprayed some freezing stuff on my skin, and S.L.O.W.L.Y injected a cc of steroid. When I asked about taking a pic while he was doing it, he remarked something like "Uhh, yeah sure! Most people are howling from the painful pressure being placed inside their foot, so if you feel good enough to take a pic, that's great!" (I'm not saying I'm tough - I feel like I got lucky.)

A slow 30-40 second injection.

I had some sharp pain in my foot 30 minutes through 2-3 hours after the injection, but then it felt great. I didn't do any workout later that day because I was warned not too - I could get hurt because things would feel SOOO good.

The saddest part of these last 3+ months was realized the day after the injection. That night, I thought "I should take the boys to run around the mall and go to SeaQuest." I haven't had a thought like that for months. Because I've been in pain and literally couldn't do something as basic as that with my kids. And in going to SeaQuest, I had to keep reminding myself that I didn't need to wonder where I'd sit and rest, or how often I could get off my feet, or if we'd be there too long. Because that's what the last 3 months have been like. I haven't taken the boys on a hike, on a bike ride, or on an "adventure" by the river when usually autumn has most of our trips like that. I got a taste of what "the usual" was, and it bummed me out that I've had to stay off my feet so much and miss out on "adventures" with them. I feel like a shitty Dad because I've BEEN a shitty Dad.

A selfie in the little underwater part of SeaQuest Roseville last week.

So the injection felt great later in the day on the 13th, all day on the 14th, and then started feeling a bit "normal sore" after that. I got in another short run 3 days after the injection (3 x [3 mins running / 3 mins walking]), and then I iced that spot for 10 minutes with an ice cube post-run:

Red from the ice, and a small bruise from the needle 3 days before.

New PT Jessie says to keep swimming, and she's having me add in a lot of my "normal" training. I've ran 3 times in the last 10 days, and I've been on the trainer for 2 easy rides as well. (First runs and time in the saddle since August!) I don't know if that's the right thing to be doing yet, but it's also not hurting anything any MORE, so it's not setting me back right now. (I've been wondering for 2 months if I just need COMPLETE rest for some time - like non-weight bearing and/or in a boot.) She's also not having me do any "extra" stretching - she says I'm flexible enough and she doesn't want me to overdo it there.

We'll see what new PT Jessie says when I meet with her this week - I wonder what she'll think about the steroid injection. So I'm still in daily pain and I'm still trying to figure out what to do to relieve that. But the outlook feels more hopeful now that we know what it is. Now just to figure out how to kill it...