Saturday, November 26, 2011

Progress in rehab

25 days since the cortisone injections. I have had several physion sessions where he performs a load test, and does a bit of trigger manipulation in calf.

I have been doing 3x15 eccentric heel drops twice a day on left foot only. The load test is performed like so:

- Hop once on left foot. Pain rating out of ten
- Hop three times on left foot. Pain rating out of ten
- Increase to five, ten etc

When I first visited the physio, I could do 1 at 6/10 pain level on left foot, 3 at 7/10, 10 at very painful. The right foot was not as bad but still painful.

Visited physio yesterday 25 November 2011, and could do ten on left foot with NO pain. Right foot, the normally good one I did 1,3,5,10 and pain was about 2/10.

The theory right now is that the right foot hurts because I am favoring the left, hence why the left is being treated.

From now on I am doing 3x15 eccentric heel drops twice a day on the left, and once a day on the right.

Things are looking good. I have finally got myself a Elliptical cross trainer. Been using it once a day for about a week, and only 20 minutes. I begin with 5 minutes forwards, then do five minutes backwards, and finish off with 10 minutes forward fast. It seems that 20 minutes allows me to do near enough to '8km'  according to the computer on the training machine, which is surprisingly fast. If I could do 8km in 20 minutes running I'd be well pleased.

I am so looking forward to getting back into running. It will be like a new beginning. I plan to stick to a gradual build up, maintaining a good pace and form in training. I strongly feel that much of the problem I have had with my heels was caused by poor running form. And the poor running form is caused by running while tired. I was running the long runs because I needed to get them done in my training plan, where as I would have been better off not having the Marathon race goal and steadily building up the distance over a longer period.

When I return to running I am going to stick to runs where my form is good, and as soon as it starts to deteriorate, stop.

Tuesday, November 8, 2011

Boring as bat poo - physio :)

Continuing with my boring as bat poo theme I have today attended my first appointment with physio. The plan in general terms:

  • eccentric heel drops, 3 sets of 15, twice a day. Work on the BAD heel  first, the left one only.
  • self massage on alternate days one leg at a time - Deep massage, in calf muscle to loosen it all up, once a day.
  • Visit once a week for one on one for the next few weeks
  • Commence cross training as I want, recommend Elliptical Cross Trainer, 40-50 minutes a day, and avoid speed sessions. Want to avoid heel tension
The above plan will continue for probably 2 months. That gives me a possible schedule of late January before I get back to running again. More likely 3 months, and thus February.

And my return to running has to be careful and gradual even then. SO I will probably do a 10km race in July and aim for a Half Marathon later in the year 2012.

Monday, November 7, 2011

Day six since the injections

The improvement is quite remarkable. All day I was walking without pain, something that in general I had not done for at least 18 months.

Only this afternoon after work did I feel a slight bit of pain in the left heel. I made an appointment and will see the Physio tomorrow at 10AM. Really looking forward to getting a plan, and am very optimistic that I will be running again pretty soon.

Saturday, November 5, 2011

Another update - 85%

Things are gradually getting better, the right heel is completely 100% right now. The left heel all day has been brilliant, only this evening after a couple of hours TV watching ( Cannot do much else these days) it has felt a bit sore when I walk. I rate it at about 85% now.
All I have to do is think back to Monday 31 October, the day before the injections, and I realise how much better both heels are. I go through cycles where I am so happy that the heels are not hurting, and get all ambitious and motivated for another stab at a marathon, then I feel a twinge and get all dejected again. Its terribly frustrating to have _everything_ good, knees, hips, ankles toes, hamstrings.. And have one stabby pain in the left heel holding me back. I never have had patience for anything. I am having patience forced upon me , and have at least 6 weeks before I am going to hit the road again.
I am sort of piecing together a strategy for training, but I want to talk to my Physio before I actually start doing anything. I have a letter of referral from the Dr that gave me the Cortisone injections to see a Physion at QSMC, and apparently he has a special interest in the injury I have experienced.
What I want to do is get an elliptical cross trainer machine, as I found previously in gyms that they give me a good work out. I will try to build up to one hour a day on the machine, and then gradually introduce running again, in addition to the cross trainer. The aim is to get a whole lot of fitness with less actual running time. Its sad that what I enjoy the most is what buggered up my feet.. The challenge will be to make the elliptical cross training sessions are not dead boring.. Hmm, TV ??

Thursday, November 3, 2011

Progress after Cortisone heel injections

Injections were done around 11AM Tuesday 1st November 2011. Injected both Cortisone and anaesthetic into both heels , directly into the bursa's.
Initial pain was bad enough, with discomfort from the pressure the most significant issue to deal with. Made me sweat a bit.
Immediately after injections, pain subsided completely in both heels, due to local aesthetic.
Pain 24 hours later was minimal, but slightly tender in left heel ( the worst one) and in the right the pain was due to the needle stick mostly I think. Pain steadily worsened...
Woke up today, Thursday, and as I write this its 48 hours after the injections. Left heel is still slightly tender, and I am still cautious about walking after resting for a while, but in general its a massive improvement to how I was prior to injections.

Cortisones effect is supposed to kick in about 48 - 72 hours after injection, so if there is more improvement to come, I am pretty optimistic.

Tuesday, November 1, 2011

Heel injections

Got to Dr, made the appointment. Gosh he is a good bloke, like him a lot.

We discussed the injury again, and one of the things we discussed was the fact that both heels have a similar problem. Left is the worst and it was the one that had MRI scan.

The MRI scan showed obvious Bursa problem, and marginal tendon involvement, with Haglunds lump possibly involved. And so it was decided that the most likely source of pain is Bursa, and not Tendon issues.

The reasons for doing the worst one ( left heel ) on its own:
- See if cortisone has significant effect, if so consider doing the right later
- Injection carries risk - Infection, flare up of bursa, more pain etc. Thus doing one means at least I won't be limping on both until it recovers.

SO we discussed, and in a 30 second moment of consideration, we decided to do both. The biggest reason to do one at a time is that because it hurts so much I maybe won't tolerate the second one in quick succession. Anyway we did both because I said I think I can handle it ;)

The pain was quite a lot, but certainly not as bad as I had anticipated. As I said to the Dr it is not something I'd line up for..But not the worst I had experienced, In fact sometimes the pain at the beginning of a training run was worse.

The worst heel (left) I expected to hurt a whole lot, but in fact while it stung initially, and I felt discomfort and pressure while he pushed the needle in, it really did bring almost immediate relief. The right heel is the least painful and it seemed to hurt more.

Anyway its done and relief is generally immediate. I am habitually cautious when I walk after sitting for a long period, but I realise quite soon that it just does not hurt like it has for the last 18 months. 11 hours after the injection I write this.

5 days from now, I see a Physio, and begin a rehab program. I hope on that day I am walking freely and ready to go!!