Monday, February 8, 2010

Rant: Visit to podiatrist

One thing about which I can be proud is that I do not give up easily. Anyone who knows me will attest to that fact. This episode is no exception. When I am faced with certain symptoms, I spend hours online doing research in search of the answer and this research will continue no matter how long it takes until the problem is solved. Some people say that there is no way that anyone who has had adrenal fatigue can finish a marathon let alone run one in 3:35. I am living proof that it is possible.
Back in 2001, I was diagnosed with tarsal tunnel syndrome, an irritation of the post tibial nerve, by a bone and joint surgeon. My symptoms including numbness, burning, tingling and worse, shooting pain in the area between my ankle bone and achilles tendon. It was the official end to my days as a competitor in my first running life. More than a year later, my continued research led me to believe that my taking Synthroid, which I never should have been prescribed, was a major contributing factor to my development of TTS. I proved to be right. Fortunately, thanks to custom made orthotics and reduced mileage, I was able to continue running. Once I began treating my adrenals, my connective tissue healing improved and I had no significant problems with TTS from 2004-2009 despite the fact that my mileage was higher than ever in '09. I did continue wearing the orthotics as a precaution and found that I might have a mild flare up if I went too long without using the orthotics. Usually, I wore orthotics on my long runs and weekday easy runs. For speed workouts, races and some tempo runs, I opted for racing flats with no orthotics.
Unfortunately, the man who designed my first orthotics went out of business in 2008 so on the advice of a coworker, I went to a local podiatrist who designed a new pair of orthotics made with a material that was harder and more rigid than my old pair. Until about a month ago, I did not have any real problems. When my TTS flared up, I initially wrote it off as being related to my hyperthyroid condition. Maybe it did play a role but my current thyroid function is not half as bad as it was when I was on Synthroid. You know the rest. A few days later, I went down with an Achilles tendon injury. I wondered if the conditions were inter-related.
About 3 weeks after I began researching Achilles tendon injuries and tarsal tunnel syndrome, I finally came across something that was intriguing about TTS. An article stated that yes, orthotics are recommend as a treatment for TTS BUT you may develop TTS by using the wrong type of orthotics, particularly those which are hard and rigid rather than soft and flexible! Bingo! That makes a lot of sense to me. On my first run back, I ran a mile in racing flats with no orthotics with a last 200 at sub-6:00 pace without any significant pain. The next day, I wore the orthotics on a 4 mile Trak Shak run. The TTS flared up in Mile 2 and it wasn't long until I felt some Achilles pain as well. True, 4 miles is a lot harder on the body than 1 mile but on the Trak Shak run, I never ran faster than a 7:20 pace at any time on the course.
Today, I went down to Monty to see the podiatrist in hopes of getting some answers. I had to wait an hour to see him then he told me that under Alabama law, he is not allowed to examine my Achilles tendon. I'll let my readers choose the properly offensive adjective to describe that policy. Yes, I did say that the Achilles was the problem when I scheduled the appointment so the doctor essentially wasted my time and charged me $30. He also that the orthotics were still good!!?? If I can handle a longer run with the racing flats, that will vindicate me. I asked him if there is a chance that the TTS contributed to my strained Achilles. He replied that it is possible just as I suspected. I may have altered my running gait to minimize my TTS pain, which may have put extra stress on my AT. In short, the whole point of this post is that this injury may never have happened if I was given proper orthotics. I am angry as I should be. Good doctors do exist but they sure are hard to find. This is not the first time that I've been burned by a doctor on a matter directly related to my running. I once had a stress fracture misdiagnosed as shin splints despite the fact that I had clear symptoms of a fracture including a lump that was painful to the touch. I was told to start again gradually and turned a 6 week injury into a 3 month layoff.
I will try not to dwell on this. I am happy that I may be able to salvage a racing season this Spring after all. I won't do well at Mercedes but just finishing will be a major victory. I should do fairly well in Atlanta then by the time Nashville rolls around, I could be back to PR shape. By Wednesday, I will be back to running moderate mileage. Despite my nearly painless 6:10 mile tonight, I will not declare victory yet but it sure is looking better than it was 5 days ago.

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