Standing on my own two feet

One of the aspects of breaking an ankle which you don’t realise until it happens to you is how much independence you lose. Breaking my ankle didn’t just mean I couldn’t run (incredibly frustrating though that aspect was). It also meant I couldn’t walk; couldn’t carry anything from place A to place B; couldn’t get from my house to anywhere, pretty much, without assistance, as I couldn’t get very far on crutches, couldn’t cycle and couldn’t drive. Simply fetching something from the other side of the room became a major, and painful, undertaking. If I’d left something upstairs and was alone in the house, I had to think seriously about how important it was, whether it was worth the expedition up the stairs and down again – and whether I would be able to carry it anyway.

By 10 weeks post-op, I was able to walk around the house, and even outside, without crutches, and with that increased mobility I gradually regained my ability to do things for myself. I could carry mugs, plates of food etc. across or between rooms without the laborious method of “lean down and place mug on the floor in front of you, use crutches to move past the mug, reach down and pick up the mug, turn and place it down in front of you… repeat until you arrive at your destination”. I could even walk, slowly and with one crutch for increased comfort, to the local supermarket and carry some items (not too many) back again in a small backpack.

I started being much more able to do my fair share of the household chores, from cooking to washing up, feeding the cat to hanging out the washing. And I’m very aware how much harder these last weeks would have been without my husband, and without my in-laws taking me to hospital appointments.

Three months post-op and I’ve finally been able to let my husband have a lie in on a Saturday morning. Ever since the day after the accident, he’s been driving me to Lloyd Park for 8am on Saturday for Lloyd parkrun, carried equipment and water bottles from the car to our registration area, sorted me out with chairs to sit on and rest my injured leg on… generally enabled me to continue in my Lloyd parkrun volunteering. He’s been wonderful, but it’s great that I can now get to the park and do everything I need to do without that extra help – and he can get an extra hour or two in bed!

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Learning to walk

Before you can run, you have to learn to walk. At the moment, I’m re-learning how to walk.

At the Fracture Clinic, six weeks post-op, I was told that, having spent the past seven weeks totally non-weight bearing, I should start partial weight bearing (PWB), wearing the Aircast boot, and progress to fully weight bearing (FWB) in the boot in 7-10 days. Once I’d done that, I was to try without the boot, PWB and aiming to be FWB (i.e. no crutches) within 7-14 days.

That seemed like a very short time to return to walking, and it would have been nice to have some hints HOW to increase weight bearing. I got lots of support from an online discussion group of people with broken ankles/legs, and some good tips from people who had been through this. At three days I thought there was no way I would progress fast enough. At six days I still thought I would be lucky to be walking in the boot by 10 days, but by eight days I was walking short distances with no crutches – amazing.

Now I’m progressing through the “no boot” partial weight bearing. In some ways it’s easier than with the boot: the foot is the correct size not horribly large; the leg is the same length as the other one, not nearly two inches longer; the boot isn’t pressing or rubbing against my ankle bones, so there’s less pain; and my ankle can flex, rather than being held rigid with my foot at 90 degrees to my leg. The  ankle does, however, feel rather vulnerable.

I’ve also had my initial physio assessment. At the Fracture Clinic I had been cleared to start some basic range of motion (ROM) exercises, so I’d been doing those. The physio thought that my ROM and lower leg/foot muscle strength were pretty good, considering. He also really appreciated that I had written out a full clinical history for him, so he didn’t have to spend 20 minutes asking questions to find out what damage I’d done and how far along I was in healing. I’d also taken in printouts of possible exercises, so he could just confirm which ones I was to start doing, rather than having to go into lots of detail describing them and showing them to me. It also helps that most of the exercises are the same as the ones I had to do to regain mobility and strength after my posterior tibial tendon tear.

So, now it’s basically up to me to do the exercises to strengthen the leg and get the ankle moving again, and to reach fully weight bearing without the boot for support.

My motivation is high to progress in the walking: once I can walk properly (and have strengthened the leg up a bit) I can start returning to running!

Dreaming of Running

It’s now more than six weeks since I broke my ankle, five since the fractured fibula was fixed surgically, and I’m counting down the days (four!) until my six-week post-op check-up. I am really, really hoping that the x-rays will show good bone healing. If they do, I will be allowed to start partial weight bearing and what should be a six week rehabilitation period to return to normal walking, if all goes well. For the moment, all I can do is wiggle my toes, GENTLY move my foot forwards and backwards in a straight line, and a few leg exercises, while wearing the Aircast boot, to try to maintain some of my upper leg muscles, even if my calf muscles are horribly wasted.

By day, I sit on my sofa, leg propped up on pillows, sofa and coffee table converted into a temporary home office, getting my work done.

By night I lie with my leg well propped up on pillows, and I dream of running: parkrunning, woodland trail running, even road running. Occasionally I dream that I’ve got out of bed and walked across the room, and then I remember I’m not allowed to do that yet and I wake up feeling guilty – then realise I didn’t actually do it!

I am thoroughly fed up of spending 14 hours a day sitting on the sofa, even if it is quite a comfortable sofa. Thankfully, my wonderful husband has given up his Saturday morning lie-ins in order to take me to Lloyd parkrun. As during my other periods of injury-enforced breaks from running, volunteering at Lloyd parkrun has been the highlight of each week.

The first week, the only role I dared take was barcode scanning, meaning that I only needed to get from the car past the cafe to the registartion tables, then sit down. However, as the pain has reduced and I’ve become more mobile on my crutches, I’ve managed to get as far as the finish chute to be (while sitting down) photographer or timer, and (again with my husband’s assistance for juggling megaphone and crutch) even Run Director. Everyone has been very supportive, with Jenny Booth taking on Run Director most weeks and number Checker even the time I was Run Director. I’m hoping to be mobile enough to try that as well, soon.

I’ve also managed to volunteer for a couple of events associated with my running club, Striders of Croydon, including the local veteran’s league athletics match two weeks ago and our club handicap last Wednesday. Good to be out and about, and socialising with people, and able to DO something.

Many thanks to Stuart and to Selena, for transportation on those two occasions.

Three weeks…

It’s now three weeks since my fractured fibula was plated. Just another three weeks to go until my next appointment at the hospital. Hopefully the radiographs (x-rays) then will show that the bone has mended appropriately and I will be cleared to start rehabiitation.

The intra-operative x-rays showed that the plate holding the bone nicely in place, with the ankle joint space even (good, as it hadn’t been in the pics taken the day after the fracture – it had been wider on the medial (inner) side), and that the syndesmosis – the attachment between the fibula and the larger lower leg bone, the tibia, was intact (also good).

I’m presently wearing an Aircast boot rather than a cast. The surgeon allowed me to switch to this with the STRICT instruction from him, and promises from me, that I wouldn’t try any weightbearing on the foot until the end of the six week post-op period (and then only if the x-rays say it’s safe to do so). However, I can very gently move my foot up and down and start the joint moving a bit, which is a bonus.

The biggest advantage, and the main reason I asked for the boot, is that I can take the boot OFF so long as I can keep the leg raised up and supported, on cushions or pillows. This is a huge thing for me, because I have problems with a condition called allodynia. Basically, steady pressure on my ankle bones, my Achilles’ tendon, or the top of my foot gets translated into pain by my nervous system. Rather a problem when you’re wearing a cast putting pressure onto those areas all the time. A week after the op I was given a fiberglass cast with a strip about an inch wide taken out the front so I could lever the cast open a bit to take the pressure off my anle bones when necessary (which I had to do several times a day). Being able to actually remove it is much better!

The biggest disadvantage is the the boot is large and heavy – much heavier than the fiberglass cast was, so carrying it about is more work. Less pain makes that well worthwhile.

I’m also much better on the crutches than I was before; I’ve even been out watering the tomato plants, herbs and potatoes – with great care not to get tangled in the hose.

Three weeks also makes it 21 injections into my abdominal area done and 21 to go. Another fun experience (not), although I like the idea of deep vein thrombosis even less, so I keep going with the injections. It will be so nice when I can stop doing this to myself each day.

So, 21 more days, then I sincerely hope the radiographs will show good bone healing and I’ll be able to start the rehabilitation period. Just three more weeks…

Back to square one

Three weeks ago I was looking forward to running my 50th parkrun on the Lloyd parkrun 250th event, followed a week later by the Croydon 30 and then to some nice long trail training runs in preparation for Ladybower 50 in September (plus the final running of The Jog Shop Jog 20, plus Beach Head Marathon, plus…).

Then I walked down a damp grassy bank while talking with a colleague, my left foot slipped and I fell. The foot went sideways with all my weight on it. It hurt.

I was non-weight-bearing immediately but thought/hoped I had a bad sprain. Unfortunately, X-ray showed that I’d broken my ankle (in more technical terms, I had a Weber B fracture of the lateral malleolus (distal fubula) with some displacement and some disruption of the joint space).

To say I was gutted is an understatement. I’d just got back to decent long runs and being able to really enjoy my running without worrying about my ankle, after the cycling accident that tore my left posterior tibial tendon three days after Ladybower 50 in 2013 and here I was, right back to square one.

A week after the accident I had surgery (open reduction, internal fixation) to repair it. I don’t yet know what hardware has been put in place; I should find out next week when I see the surgeon again.

Yesterday I had my first day without pain or serious discomfort – not from the break itself, but from the cast and the swelling. It made a nice change.

I also tried for the first time my “iwalk 2.0”. This is basically a high-tech peg-leg with a padded shelf facing backwards on which your injured lower leg rests. You adjust it to fit, strap yourself in… and walk! It’s amazing. I’m going to be careful not to use it too much, because I’m still having some circulation issue (associated, I think, with bruising and swelling due to oedema (fluid in the tissues) under the cast, but it is so nice to be able to stand and to use my hands while standing.

Official timetable for recovery, if all goes well, is:

  • Six weeks in a cast and non-weightbearing following the surgery (one week down, five to go, I hope);
  • Six weeks after that of rehabilitation – physio, exercises, gradually increasing partial weight-bearing and then full weight-bearing.

After that, hopefully, I will be able to start trying to run short distances and, if all goes well, start working up the distances. Again.

A tale of two Croydon Half Marathons

In 2012, while training for my first marathon, I ran the Croydon Half Marathon, organised by my running club, Striders of Croydon, in a PB of 1:40:24. Last weekend, I ran the Croydon HM again. It was my first half marathon for three years, because I’d spent 2012 working up the distances to 50 miles, and 2013 running five 50-mile races, before the tendon injury from my cycling accident prevented me from running for six months.

My time last week was 1:46:42, a PW for that distance! I did however manage 2nd Fv45 and was part of the winning women’s team for my club.

Looking back, I’ve found it interesting to compare and contrast my state of mind during the two races.

In 2012, I remember feeling nervous while driving to the clubhouse, because in my previous two HMs, in October 2011, I’d not run as well as I’d expected. Then, just before I arrived at the club, I had a revelation: since I’d been training for and run a 50K (London Ultra) and was now training for a marathon, 13.1 miles was no longer “a long way”. I could just set off as fast as I could and really go for it – and I did, taking a good three minutes off my previous PB. It was good, hard running the whole way, really pushing it up the hills, throwing myself along the downhill sections, and I finished very tired but really .pleased with my time

This year, I arrived early to help registering the runners, leaving that task with only about 10 minutes to go before the race started, to change into my running shoes, shed excess clothing and dash to join the crowd behind the start line. In the past few months I’ve regained my ability to run long distances, working up as far as 27.5 or 28 miles, but the only fast running I’ve done has been the occasional parkrun and a few cross-countries. I had only made the decision to enter the race on the Friday and I suddenly realised that I hadn’t the slightest idea what time I wanted to try for or what pace I wanted to run – as well as being still a bit uncertain whether my healing (healed?) tendon would cope with relatively fast running for that distance.

I set off quite conservatively and decided that I would be fine if I came in no slower than 1:50. The course consists of a mini-lap followed by two much longer laps. About halfway through the first full lap, I had something of an epiphany and switched from thinking “only one more time that I have to run up that hill” to “I only get to run up this hill once more in this race!” I felt myself grinning. I was running, in an actual HM, after all those months when I hadn’t been sure I would be able to race, or even to run, ever again. I was so LUCKY to be able to do this! I found myself feeling sorry for the many people who wouldn’t ever feel the delight of a proper long run or long distance race. I started to really have fun.

In the last few miles, while regretting that there was such a short time and short distance of the race remaining, I started to push on a bit, overtaking a few people. For some time I had been able to see two women a few hundred yards ahead of me and now I set my sights on closing the gap. One of them was evidently tiring, even walking for a few strides on the section up Sandilands, and I overtook her with about half a mile to go, then I started to gain on the other woman, speeding up, sprinting from about 200 metres out and accelerating towards the finish line, to complete the race as eighth woman overall.

Looking forward, I do hope to regain some more of my previous speed, as well as to move out again to 30-mile and 50-mile races, but I hope that as I do so I will remember, at all times, how marvellous it is to be able to run like this, how lucky I am to do it – and that I should always, always, have FUN!

26.2!

Every year, Striders of Croydon (my running club)  offers a series of marathon training runs to prepare for the spring marathon season. Starting in early November at a mere 10-12 miles, and initially every fortnight, they become weekly from January and work up to 21 miles.

Last winter of course, unable to run due to my tendon injury, I missed the lot. The previous year, training for specific ultras, I ran some but on other Sundays was off reccing the courses. This year I’ve been enjoying running the majority of these training runs with my clubmates.

Because I wasn’t sure how well or fast my posterior tibial tendon would heal, and to minimise the risk that I would push myself too far too soon and re-injure it, I haven’t entered for any spring marathons.  This has meant that I could back off in training if I felt I needed to. However, I have gradually been increasing the distances I’ve run, returning to running, rather than cycling, to and from the clubhouse for the Sunday runs, which adds a little under three miles each way onto the run.

Last Sunday I ran a total of 24 miles and felt tired but reasonably  comfortable, and I decided then to extend the following run to reach 26.2 miles. When I made that decision, I had forgotten that I was running the fourth and final Surrey Cross Country League match on the Saturday, so I came into Sunday with tired legs. However, I told myself that was excellent training! This was also the first week that the training group I was in decided to include a 1.5 mile section, after about 10 miles, at a faster pace – and I ran that stretch at about 8.15 per mile.

I have to admit that my legs did feel tired throughout, particularly from about miles 20 to 22, that my time wasn’t great (4 hrs 30 mins running time, longer including breaks at the club house etc.) and that I had to resort to Kendal mint cake, jelly beans and green-ear (vegetarian) Percy Pigs for energy (a contrast to last week when I ran 24 miles on nothing but my breakfast cereal and one vegetarian Percy Pig at about 22 miles). However, I -did- reach the 26.2 miles and that felt really, really good.

It’s nice to have been rewarded for my slow, sensible approach to returning to long-distance running. To have come through a weekend of a muddy, slippery five-mile cross-country race – much of it on a camber – followed by a marathon-length long steady training run, without overstressing the recovered posterior tibial tendon or any of the other tendons and muscles in my left foot and ankle, is just fantastic.

I still have quite a way to go to return to my previous level and speed of training, but now I have much greater confidence that I -will- be back on 50-milers within the next year!