Ankle pain (OMG not again)

[Crankin]

Ha, ha, I had the same issue a few years ago when I was commuting to the train station in street clothes, to go to class. And, it wasn't even an uphill start (which cause me issues even with my Speedplays). My foot just flew off of the pedals when taking off at a crowded intersection, on my old Jamis with campus pedals. There were cars everywhere around me and I got really freaked, in a way I never do with my road bike. However, there have been a few times since then we have rented bikes for city tours while on vacation, and I just have to make myself think and focus while riding with flat pedals and it's fine.
I empathize with you. I had to force myself to cool it while my probable stress fracture healed last fall. Riding did not bother it, while riding, but afterwards, it ached. Since I had to stop hiking and walking and modify my tabata class, I did not want to give up riding. I should have.

[emily_in_nc]

You are not alone, NY! I had to relearn how to ride with flat pedals when we were riding cruiser bikes in Belize and again in Mexico. It is a transition like any other change. And hills definitely make it harder. We were lucky to be riding in flat places; I'm not really sure how to manage an uphill start without clipless. I am sure my 10-year old self knew how!

Anyway, glad you were able to get the changes made and get out for a short ride. I know it must have been good to be on a bike again, even if the situation was not ideal. I am sure the pedals will become easier in time, just like all other things bike-related seem to be.

[ny biker]

Another update. A week ago things felt really good, then it started to hurt again. Oddly, it hurt when I woke up, as if I'd done something to it in my sleep. Maybe I was turning my foot the the wrong way in my sleep or something. After a couple of days of that, it's been better again. But it seemed like it was time to check in with a doctor, so I went to see an orthopedic surgeon today.

Finding a doctor took a while. I asked around for recommendations and then looked to see who accepts my insurance. Called one place for an appointment but they only do knees and shoulders. They referred me to a foot and ankle practice, and I got an appointment with one of the two doctors there, the junior one in the practice. Then I found out that one of my co-workers was a patient of the other doctor there, and she hated him and everyone else who worked there, the PA, front-desk people, etc. Great. Asked around some more, found that a neighbor went to the guy that my co-worker hated but she described him as "a genius." What? Poked around online and read some reviews, and found that every doctor who is highly recommended has some haters, too. So I decided to keep the appointment I had but had names of other doctors to see if I didn't like the first one.

One thing that I thought was potentially good about the doctor I had the appointment with -- according to his bio on their website, he played rugby until an injury ended his career. My hope was that someone with a serious athletic background would be a good fit.

So, this morning I had the appointment. Overall things were fine. An assistant took x-rays and I gave her copies of the operative report from the original surgery. The doctor read the report, recognized the name of my old surgeon, who publishes a lot of research. I thought this was a good sign.

He said everything looked good on the x-rays -- the arch of the foot has held up well, he could see where things were done during the surgery and those areas looked okay. Then he examined the foot and ankle. Based on the the site of the pain, he thinks I just strained the tendon. He recommended that I rest it by wearing a boot for 4 weeks. I asked if I could do other activities, e.g., upper body weight training, stretching upper legs and hips, and he said that would be okay. But no cycling, and wear the boot all the time except when I'm in bed or driving.

So I'm not loving the boot. My toes are cold despite wearing two wool socks on my foot. It will be a huge pain trying to run errands, like getting the maintenance done on my car which I've been putting off for several weeks already. I expect my other leg or my back will start to complain from the weird way I have to walk in the boot. But all in all this could be much worse!

After the four weeks, he recommends custom orthotics to wear going forward. If it continues to hurt, he'll probably order an MRI. Needless to say I'm hoping that won't be necessary.

p.s. re: the cold toes. I do have neoprene toe covers for my bike shoes. I wonder if I could wear one on my foot with this boot... will have to try that out when I get home...

[Crankin]

I bet the toe cover would work.
Re: the foot hurting when you woke up today. I found that this was occurring when my stress fracture/toe was healing and near the completion of the process. Not sure why this happens, though. My foot (the one I hurt) was aching when I got out of bed today, too and the only reason I can think of is I have new shoes for the gym and I did a lot of jumping in tabata yesterday. I had the shoes last week, too, but there was a sub and the class was different.
Good luck with the boot. It would drive me nuts.

[emily_in_nc]

Ugh, NY, that does not sound fun or comfortable.

I'm glad to hear that the doc sounds like he's suggesting lots of conservative treatment. Many Ortho surgeons jump to recommending surgery pretty fast since that's what they do, and it's obviously their bread and butter.

[Pax]

Ugh, NY, that does not sound fun or comfortable.

I'm glad to hear that the doc sounds like he's suggesting lots of conservative treatment. Many Ortho surgeons jump to recommending surgery pretty fast since that's what they do, and it's obviously their bread and butter.

Definitely, I was never so happy as when I reached the age and maturity where I understood I controlled the treatment. I've had orthopedic surgeons want to cut on my foot, both shoulders, hip and my good knee. I declined and sought out more conservative treatment and I'm FINE.

[ny biker]

If this turns into a more prolonged problem, whether surgery is recommended or not, I already have a plan to get multiple opinions from different doctors. There are one or two in this area that were recommended and participate in my insurance plus a third practice that several people recommended but doesn't accept my insurance. And there is the option of going back for a consult with the doctor in NY who did the original surgery back in the day. And my cousin is a nurse at in an orthopedic surgery practice so she might be able to recommend someone, either in NY or a couple of hours away in Virginia where her in-laws live. So I really hope that it never becomes an issue, but if surgery is recommended I will make sure as much as I can that it is really the best course of action.

One thing that I am thinking about now is that, back when this problem first started around 1990 or '91, no one prescribed the kind of rest that has been prescribed for me now. A doctor in Chicago gave me a cortisone shot, the one in NY had me wear orthotics and I don't remember what else we may have tried before finally going ahead with surgery. But I did so much walking back then and no one ever told me to wear a boot or use crutches or do anything to rest the tendon and let it heal. I suppose I cut back somewhat, I remember wearing sneakers all the time (with business suits), but I was still walking to and from the subway to get to work and walking to the grocery store and the bank and the drug store and the dry cleaners and all my other errands. It seems kind of obvious now, but apparently I wasn't smart of enough to do it on my own and no doctor recommended it.