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Thursday, September 24, 2015

Letting Go and Moving On

September has been a very emotional month for me.  While most of August was full of health related highs (getting back into shape, following a healthy exercise routine, continuing half marathon training and loving it), September has felt like the exact opposite.

Unfortunately, it was my physical ambitions in August which set me up to fail in September, and now I haven't been able to do any vigorous exercise the entire month.  My workplace does an Iron August challenge every year, during which you try to accomplish the distances of an Iron Man over the course of the month.  This includes 26.2 miles running, 112 miles biking, and 2.4 miles swimming.  Since I was already in training for the Nike Women's Half Marathon, I knew I'd have the running component down.  My boyfriend and I had been biking a little on the weekends and since stationary bike also counted, I figured I'd be able to get that in, too.  I thought that swimming would be my biggest hurdle.  Surprisingly, swimming wasn't as hard as I expected.  Biking was.  I had saved way too many miles for the last week in August, and stupidly decided that going from biking an average of 10-15 miles in a week to 70 miles in a week would be okay because it was "low-impact".

I know now that I was wrong.

I woke up the last Sunday in August, ready to go out on my 7.5 mile training run.  Then I felt my feet hurt.  This was not just a feeling of fatigue either.  It was my sesamoids, and it was in both my feet this time.

In July 2014, I had begun training for the Giant Race 10k, eager to try to beat the previous year's time.  A couple weeks in, I noticed that my left foot was beginning to hurt when I walked, right under my big toe on the ball of my foot.  Not knowing what it was and figuring it was just fatigue, I kept pushing forward, slowing my pace a bit during my runs.  It wasn't until a week after it started hurting, when I did the AIDS Walk 10k, that I decided it was time to go to the doctor.

I had sesamoiditis.  I had never heard of it, and neither had many folks I mentioned it to.  Sesamoiditis is the term given to pain and inflammation caused by irritation to the sesamoid bones.  These are two little free-floating bones (kind of like your knee cap), that sit just below your big toe and assist with the tendon movement along the first metatarsal.  If those bones are irritated in some way, whether from stress, genetics, poor shoes, etc., they can be knocked out of place, bruised or worse, fractured, all of which causing painful inflammation in the tendon.

In order to heal, you need to rest your foot, which is difficult when you use that part of your foot in every single step.  Any kind of intense ball of foot weight bearing activity is suddenly forbidden.  Lunges?  Forget it.  Planks? Nuh-uh.  Those are never happening again, unless modified.  Basically, the process of healing takes extremely long (anywhere from weeks to months) because of poor blood supply and constant impact with everyday walking.  And since you want your body's healing cells to work primarily in that area to repair the bone and tendons as soon as possible, you tend to refrain from doing any vigorous exercise that would distract your body's cells due to the new muscle tissue that needs repair because of the exercise.  Another fun fact?  Sesamoiditis often becomes chronic, and will flare-up with overuse, so you have to train very carefully.  It's not impossible, but it takes more thought and dedication than just lacing up your sneaks and heading out to the pavement every day.

Fast forward to this year.  I had had some small flare-ups earlier in the summer when I started trying to train for the Nike Women's Half, but was able to quickly adjust my training schedule and recovered in just a few weeks.  At the time it was only June so I had plenty of time to catch up in my training.  I decided to focus on just one run per week, the long run, and would increase at a rate of one mile per week.  I would also focus on slowing my pace to a simple 50/50 run/walk.  PR was not the goal, finishing without pain or injury was the new goal.  During the rest of the week, I would cross-train, strength-train, and focus on other parts of my body to help support my stride and running muscles when I did my long runs on the weekends.

It was going very well.  I would go out on my long run on Saturdays or Sundays and it felt amazing.  I was falling in love with running all over again.  And since I was focusing on other parts of my body the rest of the week, I was also starting to see strength building up in other muscles around my arms and core.  I felt like I was hitting a healthy stride and couldn't wait to complete my first half marathon in October.

Then I decided to complete Iron August.  During that last week in August, when the biking mileage seemed so high, a small voice inside me thought, "Maybe I should just give up, try again another time."  But as usual, I tend to have very high ambitions and those often overrule logic, so I pushed myself.  I didn't even think about the leap I was asking my body to make by biking that many miles in one week when I had barely biked that many miles in a month or two.

And that was it.  That was all it took to put my feet out of commission for practically the entire month of September.  I don't know how much longer I have to full recovery, but I'm on my way.  I'm finally out of a walking boot, but still ironically stuck in my running shoes with $500 orthotics (not covered by insurance, by the way).  My new podiatrist wants to put me in some more cushioned versions which will cost another $275 (also not covered by insurance).  The sesamoids in both my feet are bruised from cycling so much in such a short amount of time and so I imagine I still have a while to go before a full recovery and before I can get back to running.

Another ironic part to all this, is that other than swimming, cycling is going to be one of the sports I can return to first.  Which I guess works out because I'm participating in a charity bike ride this Saturday.  I'll be the one completing the shortest distance possible with all the families with strollers.  But what I miss the most is running.  Heck, I'd take recreational walking at this point.  But that's still a ways away.

It's encouraging to hear stories of other people with sesamoiditis going on to complete 10ks and even half marathons.  It's that kind of encouragement that has helped me cope with letting go of the Nike Women's Half Marathon this year.  Unfortunately, at this point, the recovery is taking so long that there's no way I could train my feet up in time to even walk the course.  So, I've let go.

It wasn't easy, however.  It was one of the hardest decisions I've had to make in the past year.  And one of the most emotional.  I think the idea that I wouldn't be able to participate at all really started to set in while in Anaheim for the Disneyland Half Marathon Weekend.  Sunday morning, I found myself alone at the Downtown Disney Starbucks, trying to embrace the peaceful morning before another day of park exploring.  I had participated in the 10k the day before (while in the boot, and tapping out at 4.6 miles) and my feet were sore, not surprisingly, so rather than join my friends to cheer our other friends on as they completed the half (the finish line was a far walk away), I told them I'd just meet them for coffee later.

As I sat there with my coffee, I started to really resent my feet, and the pain I was feeling at the moment.  It almost felt like it would never go away.  I saw folks walking around on their healthy feet and I envied them.  How could they take a walk without pain for granted?  Tired from a long weekend and left to nothing but my own thoughts, I started to drift into panic over the upcoming half marathon I had so been looking forward to.  I started googling all the same articles I had read about sesamoiditis before (there aren't that many out there), hoping to pick up on some miracle cure that would help me heal fast enough to go back to training.  I felt desperate.  Then I felt despair.  I saw the Disney half marathoner finishers walking up to the coffee shop with their medals and their healthy feet and I began to cry.  I realized that I would potentially have to give up the Nike Women's Half, and began to fear that I would never be able to complete it.  It's been a life goal of mine to complete the Nike Women's Half Marathon.  I had had it in my reach, it was so close, and then, with one week of cycling, it was gone.

Thankfully, I had my friend, Lindy, with me on that trip.  We got some time alone to pick up a wheelchair for me to ride in around the park (my feet couldn't take another day), and she helped me see that there would still be other opportunities to run, including the Nike Women's, in the future.  This is why, whether she knows it or not, Lindy has been one of my greatest supports in this recovery journey.  She's my running buddy.  She understands the joy in going the extra mile, she understands the ambition to try to get a little faster each time, she just gets it.  Rather than telling me to stop running, she simply said that I would maybe need to take some time off to recover, and then I could try again next year.  And that's what I needed to hear.

Even the walking boot rubs up, causing more pain
One of the most difficult parts of recovery from a chronic condition is not the actual pain that the injury causes, but the constant barrage of folks offering up opinions on what you should or shouldn't do.  Or folks assuming I have plantar fasciitis, which is completely different.  Heck, sometimes I wish I had plantar fasciitis instead, just because there are so many more over-the-counter and ready-made resources for it.

Over the last month, I have had to hear the following statements on several different occasions from several different people, and every time I've had to bite my tongue and nod politely, as if I appreciate the criticism:

"You're hurt, ...again?"
"You should take up swimming."
"You should stop running."
"The running is what caused it, I bet."
"Have you tried cycling?"
"I've had plantar fasciitis, too!  Here's what I did..."

If you are one of these people, I apologize for not mentioning my feelings to you in the moment, but it's exhausting, and please know that I care more about you as a friend or acquaintance than I do in correcting you about what's really going on with my injury.  So, yeah.

Tomorrow I get fitted for new, more padded custom orthotics.  The day after, I will try to cycle 3-5 miles, marking Saturday as the first day I get to do some exercise not on a yoga mat.  I have my fingers crossed that it goes smoothly.  I also have several instant ice packs ready to go for afterwards.

After that, I continue down the long recovery road, during which time I see my podiatrist again in mid-October.  He's eager to get me back into running, too, which I appreciate.  I plan to start seeing a physical therapist, if I can get an appointment with someone who knows about this kind of injury and also takes our insurance.  Also, I plan to take some continued time off of running while I focus on building up other muscles via swimming, strength-training, and ironically, cycling.

Then, when my feet are stronger, I'll try again.  I'll start training, one quarter, one half, one full mile at a time, for next year's Nike Women's Half Marathon.  I'll re-enter the lottery with anxious excitement and hope that I get in.  I'll be smarter about my training, and won't let myself lose focus.

It's been a year since I was diagnosed with sesamoiditis, but I'm still learning what my limits are.  I only hope that I will grow stronger from this latest setback, and that I won't let it squash my ambitions entirely.

Oh, and because this is a knitting blog, here's something I was knitting recently :)


Happy Running, Happy Knitting, Happy Living!