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.

[ny biker]

Two subplots running concurrently in my life...

1. When you put the ankle boot on, you inflate a couple of small bladders in the back so the boot won't be too loose. After a while these bladders dig into the sides of my ankle and it hurts. I've tried wrapping a soft microfiber cloth around the ankle inside the boot, but it still hurts. If only I could find a thicker soft cloth...

2. I'm working on learning to crochet. So far my initial row of chain stitches is a mess but once I get going the rows of single crochet, double crochet and half double crochet stitches look pretty good. For practice, I crochet a section about 6 inches high and 8-10 inches wide. I've got several of these practice crochet pieces now, what am I going to do with them?

1+ 2
I put two pieces of practice crochet into the boot behind my ankle. It feels much more comfortable now.

[emily_in_nc]

LOL, NY, your post made me laugh, and that's a good thing.

Good luck with the crocheting. It is really not that hard to learn (easier than knitting) and immensely satisfying! I used to knit and crochet quite a bit though haven't done either for years. I didn't have the stick-to-it-iveness for really large projects, but a couple of of my favorites were crocheted white snowflakes (made with white twine and stiffened up in a cornstarch/water bath) for Christmas tree ornaments, and a lovely cotton cardigan I crocheted for one of my nieces. Oh, and a few cute dog sweaters!

[ny biker]

I'm thinking of crocheting something like a footless sock to wear over my heel and ankle inside the boot. Right now I'm wrapping pieces of crocheted fabric around it, but it's hard to hold it in place while putting my foot inside the boot. But first, since it's about to get very cold here, I'm going to see if I can wear one of my winter cycling booties inside the boot. The thicker Gore booty may not work because there's a zipper down the back, but the Louis Garneau neoprene booty might be okay. I've also got wool Kneekers (knee warmers from DeFeet) that might do the job. Or maybe I'll try a fleecy arm warmer, folded to double thickness.

Oh, I just remembered the fleecy Terry ear band that I bought about a year ago. It has a velcro closure. Maybe I could wrap that around the crochet pieces to hold them in place. Hmmmmm. I'll have to go through the Big Orange Tote Bag of Winter Cycling Gear tonight and do some experimenting...

BTW, it is SUCH a pain in the a$$ having to take the boot off every time I get in the car and put it back on when I get out. It's very hard to do it in the car with the steering wheel in the way, so I have to open the door and swing my legs out. Today when I got to work it was windy and the car parked next to me was too close to get the door open all the way so I could barely reach down to my foot. I was swearing like the father in A Christmas Story when the furnace breaks down. Then I realized I had forgotten to pick up lunch on the way in, so I had to take the boot off again and put my sneaker back on to drive to the deli. &^%$#&&*@!#! When I got back to the office I parked in one of the visitor spaces right near the door, where there was plenty of room to maneuver with the boot.

For short walks into sandwich places to pick up lunch or to put gas in the car I make an exception and don't put the boot on, but for everything else I remind myself what the doctor said: it won't work if you don't wear it. Last night after work I had three errands to run in stores that were next to each other. One store was Whole Foods, so I made that my last stop, bought a salad at the salad bar for dinner and ate it there. It generally is less annoying if I can park the car once, put the boot on, then run multiple errands.

The other night I managed to go to the gym for weight training. I had to skip a few exercises but was able to do most of them. No cardio, of course -- walking around the office or in grocery stores is the closest I get to that. At least I'm weight bearing and not forced to use crutches. And I have a few pairs of shoes that are close enough to the boot in terms of heel height, so I'm not having problems with hip or back pain.

p.s. I do like the crocheting. So far my single crochet, half-double crochet and double crochet stitches are pretty good. My first row of chain stitches is still a mess, very uneven in size. But I think I am ready to move on from practice swatches to an actual pattern. I'm thinking of starting with one of the pink hat patterns from the pussyhatproject.com. I'm also starting to think about possible Christmas gifts that I might be able to make for people next year -- I like the snowflake decoration idea.

[ny biker]

I remain in forced sedentary status due to the ankle tendon issue. Two weeks down, two more to go wearing the boot. Will be a total of 8 weeks of almost complete inactivity by the time I take it off and hope the pain is gone for good. My mood is now a constant state of blah and I've gained two pounds.

I'm working on crocheting a scarf for myself using a mushroom-brown worsted wool. The pattern I started with (alternating two types of stitches) didn't seem to look right so I'm improvising one of my own, mostly single crochet stitches with some double crochet rows every four inches or so.

The boot is causing some discomfort (sometimes outright pain) in other parts of my ankle and leg. I've tried to add padding inside it but that seems to alleviate discomfort in one spot while causing pain in another. Frustrating. Had to put a plastic bag on it a few days ago so I could go outside and clear the snow/sleet/ice from my car and shovel the area around it. My foot was very cold.

I can't stand being stuck in my house all weekend with the stomping neighbors upstairs so I've been looking for excuses to get out. So far I've seen Logan and La La Land. Trying to decide what movie to see this weekend and which theater to go to. Also I'd like to finish up the bedroom furniture painting, which will necessitate wrapping the boot in plastic again to keep from getting paint on it.

I so hope the tendon is healing!!

[Pax]

There are many downsides to living in FL, but one big upside is the kayaking. I get so tired of being held hostage by my bum leg "is it okay enough to ride or walk today... how about tomorrow". My upper body still works fairly well, so I can almost always paddle!

[emily_in_nc]

Sorry NY and Pax! Having a bum leg, ankle, knee, whatever, is really a pain in the ...!

[Crankin]

I empathize with both of you. Since I am hopeless at any handwork, finding that kind of replacement for sports would not work for me! Having a stress fracture (twice) and flantar fascitis pushed me to the limit, because usually if I am tired or hurt, walking is my go to thing. I couldn't do that with foot problems. The first stress fracture and plantar fasciitis, I had a pool, so I swam. Since I can barely swim, it was a good thing the pool was in my backyard. It was 5 AM and I was blasting aerobics music. Thankfully, it was still September in Phoenix, so the AC units were droning away, drowning out the music.

[ny biker]

I am definitely lucky that cycling is generally considered an okay activity when you have ankle problems. I will try to ramp things up slowly once I can stop wearing the boot, because I don't want to end up hurting something else due to trying to do too much too soon. So I'll probably start with easy rail-trail rides on the mountain bike with flat pedals, then if all goes well will progress to relatively short flat road rides.

If I couldn't ride my bike, I think I might look into swimming, even though I suck at it and look hideous in a swim suit. And I actually do want to try flat water kayaking one of these days. I'm glad it's something you're able to do, Pax. I know some people who have had leg injuries that prevented them from kayaking because they were not able to get in or out of the boat. Also I've thought about your reluctance to get a handicapped placard for your car -- more than once I have wished I could park in a handicapped spot over the past few weeks. Most of the time I'm fine when I'm out shopping, but sometimes I am just tired and the boot is just not comfortable. And we don't have reserved parking spaces at my condo, but if you have a handicapped placard the management office will designate a space near your door for you to use. Since I typically get home late, I usually have to park several doors down from my building and I'm always carrying stuff and there's just enough of an incline in the parking lot to make it hard to walk with the boot. So I completely understand reasons for not wanting to get that handicapped tag, but at the same time if this was not a short-term thing I would already have asked the doctor to fill out the form for me.

Meanwhile, one thing I am still able to do is upper body weight training at the gym. I'm going tonight. Still have to do a modified version of the workout I was doing before, but that's certainly better than nothing. Another thing that I've thought about recently -- I never went to the gym before I had the ankle surgery back in the day. But I struggled so much with the crutches after surgery, once the physical therapy was over I decided to join a gym. At the time I just wanted to make sure to have enough upper body strength if I ever needed crutches again. But it turned out that I liked weight training enough to stick with it for all these years. And the personal trainer that I met when I first moved to DC and joined a gym here was very helpful and supportive when I bought a bike and then bought another one and started to do longer rides. And he's been helpful and supportive in other ways, up to and including this here current ankle problem. The ankle surgery was painful and disruptive, but it did start me on a path with all sorts of unexpected consequences -- friendships and empowering accomplishments.