Tuesday, July 28, 2009

Second Opinion

After feeling so frustrated and angry at the way the "sports medicine" orthopedist dismissed my desire to keep running (and after a record thirty comments in response to a post about it on Facebook, roughly half in favor of giving it up and half in favor of sticking it to the obnoxious doc) I went to a podiatrist yesterday.

He was almost as obnoxious and abrupt as the other guy, but with a dx I liked better. I do have plantar fasciitis and a heel spur, and I do have some arthritis developing in my big toe, but neither should stop me from running in the future if I so desire. He said, contrary to Dr. #1, that yes I do pronate and yes I do need orthotics. (2 sets, one for walking, one for running. Total cost, about $700, no insurance coverage. And no I can't afford that. But I'll deal with that later.)

He didn't think physical therapy would solve the problem but might make me feel better in the short term - but he prefers drugs for that and prescribed a very strong NSAID. We made an appointment to come back and get cast for the orthoses (I think that's the plural of orthotic?) and that was that.

So I've decided to do all of the above. I started taking the NSAID, and it made me feel sorta queasy and weird today. (Maybe compounded by painting the kids' room, and breathing the fumes, in the hot humid afternoon, after very little sleep for two nights running.)

And I went to PT this afternoon, at a place I've not tried before. And Loved it: this woman spent 10 times as much time really trying to understand me, my feet, my legs, my bones, muscles, tendons, fascia, as both those guys put together. She did all kinds of manipulations and put me through a lot of different excercises and test to find out my precise strengths and weaknesses.

I so don't have time to go through this, but think if anything is going to get me back on the road again it's my new best friend, Kim the physical therapist. She asked so many questions about ankle injuries I had when I was 12, the dance training I had as a teenager - it was all important to the big picture.

The doctors made quick decisions based on their preconcieved ideas: the podiatrist knew before he started that people who pronate need orthotics. The orthopedist had already made up his mind that orthotics don't do anyone any good. The physical therapist based her judgements on what she actually observed as she got to know me. Why does she get paid so much less, when the care she gives is so much greater?

Thursday, July 23, 2009

Need Second Opinion

I went to the world's meanest doctor today!

Or maybe just realistic. But I definitely want a second opinion. With pain in my heel and in my big toe joint, I went to the only "sports medicine" doctor in our area, with the local orthopedic practice. He gave me about 30 seconds to explain my background, and examined my foot for another 30 seconds. He said he actually didn't need to examine me at all - just looking at me - overweight and past 40 - told him everything he needed to know. He asked, "do you actually like to run?" as if the very idea that a middle-aged woman could want to challenge herself at something that doesn't come naturally was bizarre and unnatural.

His diagnosis (based on the x-ray and the 30 second exam) was: flexible flat feet (not pronation), posterior tibial tendonitis, arthritis in the big toe joint, heel spur, and of course what I already knew, plantar fasciitis. He literally laughed at the shoes I was wearing (reasonably supportive naot's with drugstore arch support inserts), and said I should wear only running shoes or very supportive cushioned shoes, go to physical therapy, bike and swim and come back in a month. No running, ever again.

He's anti-orthotic or arch support (says that a 50-year longitudinal study proves they do nothing) and that the difference between motion control and other shoes is non-existent, just marketing hocus pocus. (Did I mention he's anti-running? He told me he ran the NYC marathon in 1976 but his "wife put 50 pounds on him.") He said that if I weighed 140 pounds I could run, but otherwise I should just forget about it. (I haven't weighed that since I was 14 years old - if I could get to 180 I'd be thrilled.)

Various friends have given me advice from 'stick with swimming and elliptical' to a macrobiotic diet. I am dismayed but not discouraged - I have an appointment with a podiatrist on Monday and will explore all the options. Plus try the PT - why not? I think I'll also go to a serious running store - the kind where they watch you run on a treadmill and choose shoes based on your stride. And try to stay fit and not pack on more pounds while I heal.

Other athletes I know have come back from much worse than this - I may not run a half-marathon this year, but I will be back!

Sunday, July 19, 2009


I think it's plantar fasciitis, but it's constant, all day - and I dn't even have to be on my feet to feel the pain - like being stabbed in the heel. Plus the big toe joint is extremely sore. I have taken most of this week off from running and am trying t wear shoes with good cushioning and arch support. I think the cause was a combination of: running while fat, and wearing cute shoes. (I'd bought some great sandals at Macy's. They're a cork footbed, contoured, but probably not supportive enough.) So now what? I can't fit pool swims in, most days, because of the kids' summer schedules - by the time I get them to day camp the pool hours are over. (This week might be the one exception.)

I was feeling a bit better so played tennis today, for only abut 20 minutes. Now: agony.

I have two dr. appointments - my sports medicine guy on Tuesday, and a backup appt with a podiatrist next week, in case this appointment isn't helpful. My friend Janet, a dancer who lived through terrible PF, said it can take a year t recover and is always vulnerable to reinjury. (She gave me lots of rehab exercises, though.)

This really sucks.

Thursday, July 09, 2009

Boot Camp

My dream come true: I have organized a runner's boot camp for our little Marathon training group. (I arranged time, place and leader.) It's lovely to work out with a small group of people, outdoors in the evening. It's hard - very hard - and lots of fun. I can see that my confidence will come back, and my performance will improve, by sticking with this. There are only 8 sessions - the month of July - and then fearless leader Tina will go on vacation. But I think I'll make a lot of progress. 2 of these, one long run, some bike rides with the kids, and a swim or two if I can possibly fit it in.

I've lost a couple of pounds in the last week or two (not close to what I've gained - down 3 or 4 of the 15 or so I've gained) - not by following a specific program or plan, but by exercising every day and by not snacking between meals. I think the hardest thing is to feel like it's OK to be a little bit hungry - you don't have to feel overstuffed every minute. I have to learn that lesson over and over again in my life. That, and the self-awareness to say: I've had ice cream today, so no wine. Or I want a glass of wine later, so no ice cream now. This week, it's working.

I have two goals: to get under 190 pounds and stay there, and to run a half-marathon in 12 minute miles (about 2:37). Right now I weigh about 205, and I did the half-marathon in 14:15 miles last year. I have four months to get there. I think the weight could happen. Could the speed?