Rehab IX: Walking and Wolling

I must be better -- I jaywalked today.  Crossed the street on red, then made a right turn, going across the second street before I even reached the sidewalk.  Pain in the ankle is pretty much gone.  Now it hurts on the top of the foot, above the toes.  This pain I can tolerate.  When I had ankle sprains or blisters in the past, I'd limp for a while, then the limping would start affecting my other leg and back and I'd get mad and stop limping, forcing myself to walk through pain.  This inevitably led to fairly rapid improvement.  Optimistically, I think I am at that point now.  I can walk tolerably through this pain on top of the foot.  It affects my gait, but not so much.  I'm getting better.

I saw Dr. Jake last week, the rendezvous preceded by another x-ray.  This one was different, taken standing up for the first time.  All looks well.  I finally had a good look at my third, unscrewed fracture in the back of the joint.  Contrary to what I'd thought, this one is not behind my Achilles tendon, but in the back of the outside ankle bone.  So, in fact, I broke that bone in two places: back and outside.  The outside was fixed.  The one in the back is still there.  The bone did not break off, but splintered and it looks somewhat like a narrow "Y."  Dr. Jake said it'll take some time before bone fills in that gap.  I hope it does before I see him again -- in October.

On Saturday, I did a decent outdoor ride -- Redwood-Pinehurst, a hilly 25 miler.  Three months ago, this was a warm up.  On Saturday, it was plenty.  I was pleased with how the ride went.  I had good energy and adequate legs, considering I hadn't done a ride of that distance since March.  In the afternoon, I required a two-hour nap, however, so it appears I'm some time away from even a metric century, never mind an English double.  Small steps.  I'll get there eventually.

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Rehab VIII: Walking and Wheeling

I had a jogging dream the other night.  In it, was walking along, then I thought, "how would jogging feel?"  So, I tried it, very lightly.  A gentle jog, just prancing, focusing on the form, not on speed.  It felt fine, just right.  Then I woke up and remembered that I wasn't quite there yet.  After lunch with Howie, as I told him about the dream, I tried jogging.  The attempt lasted one painful step.  You can fake walking -- limping, compensating, leaning, reducing the load on the bad foot.  You can't fake running -- too much weight coming down on each foot.  With each running step, because of the momentum and the fact that we come down from a height, there is more impact on the foot.  It'll be a while before I try running again.

On good news front, I took my first outdoor ride yesterday.  As much as I've struggled in VeloSF classes, I had very low expectations, hoping I wouldn't struggle too much on the five-mile climb up Tunnel-Skyline (OK, there's about one-third of a mile that's flat).  It went as well as I could have expected.  I tried to spin, shifting down when grade increased, focusing on keeping my cadence up because I wasn't confident about standing up to pedal -- it felt awkward and hurt a little.  Spinning didn't hurt a bit.  I rode at a decent clip without overexerting myself, chasing riders I could see up the road.

I met Howie at the top of the hill and we rode along Skyline, freezing, under-dressed for this foggy, windy, mid-50s afternoon.  We descended Joaquin Miller and stopped for coffee in Montclair.  Fifteen miles and the foot felt good during the ride, though it swelled quite a bit after I took off the compression sock.  Wayne said it would keep swelling for six months, as blood vessels repair themselves from the initial injury and the surgery, so this was not surprising.  I am very encouraged.

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Rehab VII: Tilting at Sidewalks

The second day of one-crutching around went as well as the first, and I learned something.  Sidewalks in San Francisco's financial district slope from buildings toward the streets.  The slope makes me pronate or suponate, depending on the direction I am walking.  Pronating (foot rolling inward), which my feet do naturally, hurts.  Suponating (foot rolling outward) doesn't.  Now I walk on the right side of every street, suponating as much as the sidewalks allow.

Does your city have sloping sidewalks?

Living up to the blog's title, I will report that today I did a mellow and happy hour at VeloSF.

And one more thing, it's uncanny how my body reacts to things Wayne recommends.  He says use one crutch and roll the foot, "It's easier to get rid or a crutch than a bad habit."  I use one crutch and roll the foot almost comfortably.  The foot hurts while he manipulates it and I tell him, so he presses another part of the foot or lower leg and the pain wanes.  He tapes my arch with Leukotape and the foot hurts less.  He gives me a compression sock, I put it on in the morning, and the foot feels better immediately.  How does he know?  He knows.  I guess that's why he has four diplomas on his wall.

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Rehab VI: Locomotions

During my first crutch-less week, walking wasn't getting noticeably better.  I was limping to protect the foot, anticipating pain with every foot fall.  It hurt in the same places: across the top of the joint and below the outside ankle bone.  So, today Wayne said, "use a cane."  I tried a cane in his office and didn't like it -- too unstable.  So, Wayne said, "use a crutch."  The theory is the crutch will protect the foot by letting me take weight off of it when necessary, but also allowing me to roll from heel to toe, strengthening the calf and muscles of the foot.  I went back to a crutch.  It was much better.  Putting theory to practice, the foot hurt less and I really rolled from heel to toe.  That Wayne, he knows what he's talking about.

Last Sunday, I switched cars with my parents, going back to my Mazda 6 with a standard transmission after driving my mom's automatic Civic for six weeks.  I've always known that my Mazda's clutch is tight.  Driving around it's not a problem.  Where it is problematic is while starting the car.  The pedal feels as if it tightens progressively.  The farther I press, the tighter it gets.  The farther I press, the more it hurts.  The pedal wants to be pressed all the way to the floor before the car agrees to start.  Since I only have to do that once per trip it's not a big deal, but I have to brace myself for the upcoming stab in the foot every time I turn the key.  Shifting requires about 2/3 of pedal travel it needs for starting, so it's painless.  But as I sat in uphill traffic for 15 minutes in downtown San Francisco on the way home today, shifting from first to second, back to neutral, and again to first was annoying, making me pine for the Civic.  My driving desires are starting to show their age; or my age?

Today, I went to VeloSF for the second time since the injury.  Did 50 easy minutes with a minute of one-broken-legged pedaling every five minutes.  One-legged went pretty well, I pedaled pretty smoothly and circularly.  I ventured briefly into low Zone 2 (165 watts) to see how that would feel.  Two months ago that barely caused me to break a sweat.  Today, I broke a sweat and was almost out of breath.  In March that didn't happen until I got into mid Zone 3 (~220 watts).  Deconditioning, thy name is trimalleolar fracture.  But I am glad to be back on the bike and glad to be able to do 50 minutes.  Will try to replicate the effort tomorrow.

No boating, horseback riding, or skating (god forbid) tales to tell, just the above three ways of getting around.

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