I had my first follow-up orthopedic appointment this morning. It’s been 5+ weeks since the pain first began and 4+ weeks since I got the boot, the crutches, and the grade 1 anterior tibial stress fracture diagnosis.
So how’s it been?
As I wrote about earlier, the first 3 weeks on crutches were hell. I barely left my dad’s house during the second week and my apartment the first and third weeks; Chip and I were miserable on every pathetic “walk” we took; and the pain was pretty intense. Then we survived 4 hours in the car to get to our happy place – my family’s cottage in the Adirondacks. It was like a switch flipped.
On Friday, when I woke up in the Adirondacks for the start of my 10-day vacation, I decided to only use my crutches when going out. So I didn’t use them around the house but I did when going grocery shopping, out to eat, otherwise out in public. Two reasons for using them while out:
- People give me a break/feel bad for me when I’m slow, need help carrying something, or are just generally in my way.
- I didn’t want to push it. I haven’t had pain since Tuesday night (June 26th), but didn’t want to suddenly go from 24/7 partial-weight-bearing to 24/7 full-weight-bearing in one day.
By Monday, I wasn’t even using them to go out to eat (and we went out to eat for every breakfast and dinner to escape the heat).
I went to bed on Friday, Saturday, Sunday, Monday, and Tuesday with zero pain. I iced my shin at least once or twice throughout the day, and wore my boot except when sleeping, resting, or swimming. The only dicey moments were on Sunday and Tuesday when I went to the Town of Providence public beach to do my first two deep water runs. The beach is rocky to begin with (and I couldn’t find my water shoes when I was packing last week), so getting from my chair on the shore to deep enough water where I could start swimming – without crutches and not wearing my boot – was logistically challenging. I survived, but it was probably a bit too much unprotected weight on my tibia.
As for the deep water running, it went much better than expected! I wore a flotation belt which is designed to keep you afloat so that you can focus on the running motion rather than trying to tread water. The water was well over my head only about 15 feet from shore, and still within the roped-off official beach area, but the lifeguard gave me permission to go out as far as I needed. I secured my watch to my ponytail elastic, started it, and did my first “lap” of running. It was weird to say the least, but by the end of the first lap, I had figured out that I truly did need to just pretend I was running on ground, but without touching the bottom. At first I tried to “swim” with my arms and scoop the water to propel me forward, but then I realized that I would actually propel ever-so-slightly forward just with the running motion in my legs and normal swings of my arms with closed fists. It took about 1:10 to do each 50-ish foot lap, but I was “running” with a normal 10:00/mile effort, so after 30 minutes I decided to call that 3 miles and quit.
I was definitely tired and felt as winded as I would had I been running on pavement, but there was no pain in my tibia and I wasn’t sweating despite the 104-degree heat index because I was submersed up to my neck! I did the same thing on Tuesday, except I went for 35 minutes, which I called 3.5 miles. A lady who was there both day playing catch with her son in the deep end commented on how good it must feel on my leg, and I told her she was right. My left ankle didn’t feel so hot – probably because it was flopping around (I wasn’t sure whether to point or flex my feet so I just kind of forgot about them) when it has been used to being at 90 degrees for the last month – and my arms & shoulders were sore the next mornings, but man did it feel good to move. Especially in nice, cool water (in the deep end – the shallow end felt like bath water) on insanely hot, sunny days.
Wednesday involved a lot of walking, between cheering my dad on in the Firecracker 4 (4-mile road race in Saratoga Springs) and walking around a cruise ship for our dinner & fireworks cruise that night. I went to bed in a fair amount of pain, but fortunately it was gone by the next morning and I pretty much went back to not using my crutches at all.
I even went to work on Monday for the first time in a month! Before vacation, I worked from home exclusively, because my office is just too big to deal with on crutches. It was honestly nice to come back to being around other humans while I worked, seeing my co-workers, and enjoying central AC.
Week 5 Follow-Up Appointment
On Tuesday, I started my morning with an 8am X-ray followed by an 8:40am orthopedic appointment – with waaaaay too much time in between. When it was finally my turn to see the doctor, she came bearing good news. She said the radiologist confirmed new bone formation over the stress fracture, which means it is healing. She pressed on the tibia from my ankle to my knee, and it only hurt where the fracture is, and not nearly as bad as it did a month ago. Same thing with the tuning fork test.
BUT pain is pain, and that meant the boot was here to stay for at least another 2-3 weeks. She said once there is no longer pain upon palpation, I can start with short walks without the boot as well as riding a recumbent bike with zero resistance. If the pain returns, I know to scale back and possibly put the boot back on for a few more days. She also said starting now, when I get up in the middle of the night to use the bathroom or if I need to grab a glass of water while relaxing on the couch, I don’t need to use the boot. A few unprotected steps around my apartment are totally safe, albeit scary! She does recommend wearing the boot regardless for things like Mondays-Thursdays at the office (the building is enormous, a decent walk from the nearest parking spot, and everything is really spread out, including the bathroom and kitchen).
I see the doctor again in exactly 6 weeks, which means there will be zero weight-bearing exercise until at least August 21. It might be longer, and I’m OK with that. I knew I wasn’t going to get any exercise clearance today. I hoped I might be able to start biking or even using the elliptical, but deep down I knew that was unrealistic. After reminding her that my ultimate goal is to run Boston 2019 completely pain-free, she knew that I was OK with and can be trusted on being conservative & patient for as long as it takes, which could be up to 12 weeks.