The Doc Continues To Surprise……….

In January I tried out a local health club to see if I could get into a swimming routine.  The trial went well enough I decided to join.  I didn’t fully understand the depths of my mental state until I was exercising again.  It feels so good to be doing stuff – even if it’s not yet the activity I really love – running.  Moving.  Getting winded.  Feeling tired afterward.  Feeling like you weren’t a lazy you-know-what.  Looking forward to doing it again.  All of these things pulled me from my bad mental state and helped me have a much more positive attitude.

The routine, in addition to helping my mind, has seemed to have helped my heel.  Overall the discomfort is improving, although as I describe to my PT, it’s happening at “glacier speed”.  As I paid close attention to the pain pattern (When do I get pain?  After what activities?  What makes it feel better?  What seems to make it worse?) I noticed something that seemed very odd:  In some situations I would have pain upon contraction of the calf.  There were a few times the heel wouldn’t hurt when I got in the pool, but it did hurt when I got out.  How weird is that?!?!  My very deeply-held mental model has been that the pain is caused by pounding and shock.  Swimming is the epitome of non-impact.  Why would it hurt as a result of swimming?  I concluded it was primarily a weakness and tightness thing – that the calf was pulling on the heel bone and making it hurt.  So I focused a lot on stretching and strengthening and just sort of went with the flow.  I swam 3-4x/wk.  I also started doing spin classes and a little elliptical. 

Even though I was doing stuff, my heel was improving, and my mental attitude was phenomenally better, I recently hit my frustration limit.  So I call the doc’s office and make an appointment.  The only thing that had changed was my frustration level, and I knew I needed to do something.  The last time I’d seen him (my podiatrist) was in November.  At that time I had a bone bruise and he was recommending a syringe filled with cortisone to help get it calmed down.  I did a polite “Thanks but no thanks.” and went on my way.  I claimed I didn’t want that chemical in me.  Truth be told I was more concerned about the process of delivering the chemical to where it needed to be.  (i.e the shot)

So Monday I’m in his office and and pokes and prods and then he lays his diagnosis on me and I about roll out of the chair:  “You’ve got an irritated nerve.  Some muscles are tense and pinching it.  We need to get those muscles relaxed and the nerve calmed down.”  Holy smokes – I was figuring I’d need to fend off the cortisone again.  Nope – the bone bruise is heeled.  He now thinks this is something different.  All the calf stretching and massage is just what the doctor ordered.  He said sometimes those nerves can get gunked up in the calf, but we feel it in the foot.

So the plan is Voltaren gel (a topical anti-inflammatory cream) for a couple of weeks.  If that doesn’t do the trick there is another topical that has muscle relaxers and such in it that we’ll try.  If that fails apparently there is an infrared treatment that works well on nerves.

Lastly, as I’m leaving the exam room, I ask if continued elliptical and spinning is OK.  He replies “Heck – you can go run if you want.”  EXCUSE ME?  Did I hear you correctly?  It turns out I did hear him correctly.  That doesn’t mean running makes my heel feel very good.   I certainly don’t feel compelled to go out and run a whole bunch.  But I was pleasantly surprised to hear he thinks I can do some running and not make things terribly worse. 

Here’s to calm nerves – both in my head and in my foot.

Jim