Friday, 20 September 2013

Miserable Morton

This post was started around 2 weeks ago. Due to moving house and various other amusingly-timed crises, I'm getting around to finishing and posting it now.

It was actually a chiropodist named Durlacher who first described the agonisingly painful condition, known as "Morton's Neuroma", that my left foot has been experiencing for the last month. So perhaps this post should be named "Dour Durlacher"rather than blaming the mysterious Morton. It's not even a true neuroma either though, so as far as nomenclature goes this is a pretty useless moniker. Let's start again.

The description of the condition is at least accurate: the problem is characterised by pain and numbness, due to irritation of an intermetatarsal plantar nerve. Of course, what it doesn't detail is that the pain is of the type that makes you feel your foot is on fire from the inside, and that the tingling and numbness goes all over your foot, not just around the inflamed area. It also doesn't explain how such a little thing (literally) can totally incapacitate a young and relatively healthy woman.

I am, as you might guess, pissed off. It's been almost a full month six weeks since my last run. It's been a prolonged period of pain in general. After just over a week of said pain not improving, I went to see a doctor. This is the first time I've actually been in need of anything other than a regular check-up appointment, and getting examined and treated for something unknown is like financial Russian Roulette here: my insurance does cover a good deal, but it's always fun to find out just what they won't cover, and that doesn't become apparent until after the appointment - it really adds to the stress of already feeling worried and painful. He diagnosed me via X-ray, to eliminate the possibility of a stress fracture, and squeezing my foot in various ways to see where the pain was. From there, he knew that it was the nerve that was the problem, and prescribed me rest, 800mg of Ibuprofen three times a day, and metatarsal pads for my shoes (no heels allowed).

That's a lot of ibuprofen.

Mmm, anti-inflammatory.

For out-of-shoe metatarsal support.

In-shoe metatarsal pads.

The lack of running was the main focus of my frustration during my first two weeks of rest and a "no exercise" mandate. It made me sad, frustrated, anxious, and angry. I went from running five times a week to no running. I couldn't help my lovely Bertie relieve some of her anxiety by running with her. I'm perfectly aware that I'm slightly addicted to the feeling of achievement, freedom, and strength that running has brought me. Anyone who's read this post, or seen this board, or has heard me ramble endlessly on about how much I bloody love it (!) will know that, too.

However, I also found that I couldn't do much of anything: walking was a strain and the pain was immediately returning as soon as I did even the most minimal of tasks (walking to and from the car, for example). I actually started this post pre-house move, so during the move saw me not being able to lift much and having to take frequent breaks made me feel pretty pathetic, not to mention ungrateful to all the people helping (I know they'll tell me to shut up, but still, the feeling is there).

Resting did not do the trick. Even two weeks of pretty much no exercise at all (ugh), and the same pain would return as soon as I did pretty much any kind of activity involving my feet. Walking from the car park to work required an ice pack at the end of it. It was just silly. So, I decided to see a specialist. I went to an amazing sports doctor near the new house, who did further diagnoses and ended up prescribing a steroid injection to help reduce the inflammation, cold therapy, and more rest. He also told me only to wear supportive flip flops (specifically Teva brand, the Mush II model - he went to the extent of looking them up online, finding a good price, and telling me where to buy them!) to ensure my foot was not restricted and the base of my foot had support. The follow-up would determine whether I needed another shot or physiotherapy.

Post-steroid shot. My foot bled a lot.
Cold therapy is essential.

Now, I'm generally pretty good with pain. My mindset is that it will pass, and the pain you choose to put yourself through is usually preferable to pain you might experience if you don't take action. The shot itself was not painful, but the anaesthetic injection prior to the shot was very disconcerting. It felt so strange; not a simple painful experience but a horrible, internal pressure inside my foot. I shudder thinking about it. However, the doctor warned me that it would feel great for about an hour (because of being numb for around that length of time), and then the anaesthetic would wear off and it would be extremely painful. I shrugged that off as something not to worry too much about, as my foot had been in so much pain for a good while that I couldn't imagine it not being that way. I'd also read stories of runners having the shot and being right as rain within about 48 hours, pain-free and ready to start training again.

I couldn't walk at all for the first few hours. I could barely stand. The pain from the shot wasn't like the burning, tingling pain I'd had before, but more like someone was trying to break out from inside of my foot by pushing the tissue apart. This lasted for almost the whole weekend, and ice was the only thing that brought relief. Lesson learned: steroid shots are not a cure-all, and not an easy route.

Since then, I've been to physiotherapy, been walking more, and been better able to push through the day in general. I have daily stretches to do, including one that involves me simply balancing on one leg (I look like the resident office flamingo at work), and I've also had custom orthotics fitted to my running shoes. I'm never allowed to wear heels - which I didn't much anyway - and any shoes without under-foot support or with narrow toe boxes are banned. I have to build up my exercise gradually, with short walks and gentle cross-training over the next 1-3 weeks. When I feel confident about that, I can start short runs, and go from there. The goal is to get back before the pain starts up, to make sure the nerve is not being irritated again. 

While this is frustrating, I'm not longer impatient or angry. It is entirely possible that I'd not ever be able to run again were I not to listen to the doctors' advice. More importantly than running, just living every day in a world where I have to, for example, weigh up my basic need to go to the bathroom vs. the pain it will cause me to get there has given me a small taste of what it would be like if I hurt myself permanently - and what it must be like for people who have had to deal with this and much, much worse their whole lives. I feel very grateful that there is hope.

Today, I went for my first "proper" walk with my altered running shoes. It felt good. I don't think I'll ever be totally pain-free again, but the nerve didn't flare up and I got back home without feeling I overdid it. The girls were patient with me needing to be slow, and we had a lovely time looking out at the lake by the new house. 

Here's to the next step.