Thursday, May 30, 2013

Prognosis Positive

I went in for a follow up appt this week with my sports med/ortho Doc and the first thing he said was..."you're still on crutches?  We have to get you off those!" 

X-rays show significant healing in my 5th metatarsal avulsion fracture (look at me with my doctor lingo), especially from the top view x-ray (there goes the doc lingo).  The lateral views didn't show as much healing but the doc didn't see m really at all concerned, he basically said, it is healing and that's what matters.  To this my little triathlete heart jumped for joy.

He did some manual tests, pressing quite forcefully on the injury site, pain levels were moderate, nerves were sky high (hey, buddy, you know that's my BROKEN foot right...please be careful.)  He had me take a couple of steps BAREFOOT in the exam room, again, pain levels were moderate but nerves totally out of control (I haven't been weight bearing in the boot, let alone barefoot in nearly 4 weeks and you want me to walk three steps?)  He did some stretching of my ankle and asked me to flex and point, which I can do, sort of...flexing easier than pointing.

After all that he said, let's wean you off the crutches this week, by the weekend, no crutches.  He also had me fitted for a fancy ankle brace that I'm supposed to transition to after I've been weight bearing in the boot for a bit.  He said going from the boot to the ankle brace is key as getting me out of the boot will start to rebuild the calf/leg muscles that have been pretty much dormant for a month (Saturday will be one month).  He said when I transition to the ankle brace  that I may need one crutch for support for a couple of days but he said if I don't need it to go without.

I was also cleared for exercise other than my Australian pilates friends and my NTC app.  Pain is to be my guide for exercise.  If it hurts don't do it, essentially was the advice.  As far as returning to running, he said possibly in two weeks (which would be 6 week mark) but more likely another month (8 weeks).

All of this is excellent news right?  Then, why am I so scared and nervous?  I'm terrified of making it worse, trying to go out too fast, etc.  I haven't talked to Coach Laura yet but my conservative idea for populating training peaks is something like this:

1) June 1-7, week 4-5: Add pull buoy swimming. Try to take short walks every day in the boot.  Continue ankle flex/point several times a day. Continue with pilates videos, NTC app and weights at the gym (maybe even some hip and quad weights...wonder if I can do wall sits in the boot?).

2) June 8 - 14, week 5-6: Begin physical therapy appts (6/11).  Continue everything from previous week, if feeling good. Try cycling (no resistance)...either recumbent bike or spin bike or trainer (if I'm in a shoe with the ankle brace by then).

3) June 15 - 21, week 6-7: Continue with previous week.  Try pool running and/or elliptical. If I haven't already, transition out of the boot and into the ankle brace.

4) June 22 - 28, week 7-8: Continue with previous week, increase length if feeling good.

5) June 29 - July 9, week 8-9.5: Enjoy tropical vacation.  Continue whatever PT exercises I've been prescribed.  Go for walks. Pool run.  Stay active.

Return from tropical vacation and attempt first run at 10 weeks.

I think this is a conservative plan of action based on what the doc said and I'll certainly adjust as things go along, especially once I get into PT.  However, the LAST thing I want to do is end up in the boot again.  I would rather have the fracture heal properly and take the time now then have plaguing issues the rest of the year.

Have you had an injury that lead to taking significant time off?  If so, when did you return? Were you conservative or aggressive? 

Anyone out there with fracture experience, what was your triumphant return to sport story, let's hear it!