Coming down from Ironman has been a humbling experience. I feel eager and excited and full of energy…until I’m 3 miles into a 6 mile run and want to just take a nap. My muscles aren’t burning, my joints aren’t creaky, but I’ve been insanely sleepy. In fact, I could pretty much – 3+ weeks later – fall asleep at any moment. The sleepiness is starting to lift though and with each workout my body is waking up more quickly and engaging more efficiently. I finally feel like the fog is lifting.
Which is why it was especially infuriating after Track Tuesday one week ago that my right foot started hurting. My right foot being the one that’s been fine since Portland Marathon 2009. During the 2 mile time trial my foot felt fine – the rest of my body including my lungs is a whole other story – but when I got in the car and started driving home my big toe felt cramped in a claw-like position, and the cramp extended into my arch. Having battled PF before I knew what to do and iced, rolled it out, and stretched my toes.
So when it hurt 100x more the next day I was really angry. And concerned. Wednesday morning my big toe joint was immensely swollen, and the pain was radiating from the center of the joint upward. I could hardly walk on the poor toe, because I really couldn’t move it. As the day progressed it hurt more and more, and then I got worried. I called my doctor in a panic and though he was leaving on vacation the next day he let me come in after hours to take a look.
When I arrived and described the pain he looked grim. And when he came back with x-rays I knew that he had not good news to share. He showed me a few x-rays that looked fine, and then we got to looking as my sesamoids. The words ” stress fracture” and “boot” were said. According to the x-ray my 2 sesamoid bones were in 3 pieces.
I left the office feeling like my heart had been ripped out and thrown on the floor. 4-6 weeks in a boot. No NWM Half. No NYC Marathon. But it wasn’t even the boot-time and missed races that got to me the most. What got to me is that this time, this training cycle, I listened to my body. Since my last bout with stress fractures at the slightest sign of something amiss I’ve taken action, be it rest or physical therapy this time around. On the list of top 200 body parts that hurt during training or racing IMC this spot on my body wasn’t ever on the radar, truly. I drove home wondering how I’d ever be able to trust my own instinct again, and arrived on the assumption that I wouldn’t.
In the following hours I became more and more doubtful – 50% in myself and ability to read pain, but 50% in my doctor. Sure I’d wear a boot, but only until I could get a 2nd opinion on the injury. Generally stress fractures can’t be seen in x-rays, and if I was going to be in a boot for 6 weeks I wanted concrete proof that I needed to be there. My doctor was gone so I couldn’t show up on his office doorstep anymore, so I pulled together a list of new doctors to call first thing in the morning. At 8am I called and pled my case with each office. Thank you sports medicine community for listening to my woes – I was granted appointments with every doctor that I called and had my pick. I picked Dr. Blahous at The Sports Medicine Clinic.
I arrived, explained the onset and pain, and the doctor was great. He didn’t discount my previous diagnosis too much, but at the same time said that it didn’t sound like a fracture of any kind to him. Music to my ears!! He poked and prodded and asked thoughtful questions, then more x-rays. This time around they took images of both feet and I thought nothing of it.
Dr. Blahaus came back and shared new images with me. This time the image was more clear; the blurry line that had looked like a fracture the day before was much more pronounced, and my sesamoid bones were much more separated.
Then my new favorite person in the world then shared the news that earned them that title: No fracture, I’m just a freak!
“Sesamoid fractures need to be differentiated from bipartite, or two part sesamoids. Bipartite sesamoids are found in less than 10% of the general population. Bipartite sesamoids are usually found bilaterally. Therefore, one way to differentiate a bipartite sesamoid from a fractured sesamoid is to take a comparison x-ray of the non-symptomatic foot. Bipartite sesamoids usually have a rounded appearance at the separation of the two fragments while fractures are typically sharp edged, without rounded edges.”
Though the physical pain and swelling didn’t immediately disappear with this news, I felt like a boulder had been lifted off my emotional and psychological state. The doctor guessed that the pain was some sort of soft tissue issue, prescribed lots of ice and Advil, and guessed I’d be good as new in a couple of days. His thought that track work on a tired body was the culprit.
The moral of this story: Trust yourself. 4 days later I’m back to running with no swelling, minimal tenderness, and no real pain. I can’t stop thinking about if I had agreed to hang in a boot for 6 weeks…for no reason!