Injury Timeline


Sunday, January 31, 2016

Guest Post: I'm just here so I won't get fined

Hi Bloggers!  I've let my husband (Nate) take over for a blog post this week.  I asked him if he would be so kind as to share his thoughts with my blog friends, since he shares his thoughts with me everyday.   Here he is, totally unedited:

Apparently I've been called out to write a blog post so here I am to answer the challenge. I've decided to go with a top 10 list of advice for the significant other (or maybe it will be more than 10; or less than 10. It's my post, I can do whatever I want).


This injury to my wife has been one of the toughest times of my life. My life has always been in my control and other than dealing a job I didn't have a lot of responsibilities. Suddenly everything changed. For the next 3+ months she isn't going to be able to walk; activities we enjoyed doing together will never happen again; possibly more surgeries if arthritis develops. BOOM! WHAT THE HELL JUST HAPPENED!!!!!

Eventually we found a 'new normal' and life keeps on going. To help the significant others out here, here is my advice to get you there.

  1. Get them a knee scooter and keep the crutches on the sidelines. If they don't have to navigate stairs the knee scooter will get them around a hell of lot easier and faster. It also helps stop the crying (more below).
  2. Eventually you want to play with the knee scooter when they aren't actively using it. Try to keep the speed of the scooter under ~7 MPH. Faster then that and it gets pretty dicey, trust me.
  3. If your SO has to spend the night at the hospital, ignore the signs that say what the visiting hours are. I still regret leaving her alone and suffering in the hospital that night.
  4. Get out of the damn house. Slipping into depression is way too easy and once they are comfortable getting around it's time to take them out on a hot date. This should be a frequent occurrence.
  5. Husbands: There will be crying and there's no predicting when it will happen. Do not try to find a solution. Give them a hug, say something nice and let them cry it out.
  6. Google everything you can about this injury and educate yourself. It's a lot easier to be supportive when you know what the hell is going on.
  7. Watch for cars backing out of parking spaces because your SO can't really move fast enough to get out of the way. Yeah, I chewed out an old lady and I don't feel bad about it!
  8. It's temping to take advantage of the handicap parking sticker when your SO isn't there. Don't, you asshole.
  9. Netflix. Inevitably they will still need lots of time to relax so find some good shows to marathon. They have control so if you end up watching Veronica Mars, just suck it up and enjoy.
  10. Eventually you need to stop trying to be so helpful. Treating them like they are helpless will get you snapped at.
  11. I turned this list up to 11, because I can.



Well, that's my list. There's nothing particularly helpful here but that's just how it goes. Be happy, make your SO laugh every day, tell them you love them and get through it together. There will be tough times but there are also good times. Your responsibility is to make them happy and they deserve it because of all the times they had to put up with YOU, so make it happen.

Thursday, January 28, 2016

Rampage!

Well, I've been boot free, hardware free, and walking in my shoes for a month now!

I should be really excited.  But, I'm kind of not today.  Yesterday, I went in for another physical therapy appointment.  Stephanie always asks about my pain levels and what I still feel is difficult for me.  I started off by saying that I still have pain, or at least some degree of discomfort with every step, but that it was mostly manageable.  I was pretty excited to hit some milestones, such as getting 10,000 steps and going back to the gym 5 days a week.

But, she was concerned about the pain, and not very excited to hear that I was having any, so we took a look at my foot.  I've got a couple of issues going on.  First, my big toe joint is super stiff, and is definitely the source of my pain on the left side of my foot.  It hurts a lot in the "toe knuckle" (?) area and I can feel it all the way down into the arch of my foot.  She said that I am only at about half the range of motion I should be in that toe, and that I need to get upwards of 70 % for a normal gait.  So, lots of stretching needs to be done to help correct it, and I'm supposed to stretch my foot on a wall for 3 sets of 30 seconds, 3 times a day.  I did the first set in the PT office and I could already feel the difference.

Then, the more concerning of the two, is that she says she believes I have the beginnings of a stress fracture on my 3rd metatarsal head.  I was complaining about a pain spot that wasn't anywhere near my incisions, or where I even broke my foot.  She pushed on the sore spot and could definitely see something going on, since it was swollen and she could see her fingerprint indent stick for a couple of seconds after she pushed on the area.  She said that she did not like that at all, and that I would need to dial down my activity for a couple of weeks.  Essentially, my little metatarsal bones cannot keep up with all of the activity I am doing, so they are screaming at me to slow down.  I am also putting a lot of stress on them (~200% of my body weight) because of the issue with my big toe joint.  It's a classic case of overcompensation. Instead of doing physical therapy exercises every day, I will now be doing half sets, every other day.  And, I need to stop walking around so much. WHAT??  I thought I was doing good!! I thought trying to get 10,000 steps was a good thing. I still can do the bike, and the elliptical, since that is non-impacting, and any weightlifting should be done while I am seated.  So, I'm kinda pissed, and angry, and frustrated.  I don't feel like I am doing that much!  I feel like it is such a set back.  She even said that going back into the boot for a bit might be good.  So I spent the entire car ride home, stewing in silence, with the worst case of resting bitch face you've ever seen!  When we got home, Nate asked if I was done rampaging yet.  Nope... savin' that for the blog.

I want to get better.  I want to go hiking.  I want to WALK WHEREVER, WHENEVER AND HOW MUCH I WANT.  Is this so hard to ask for?  It has been seven months now.  SEVEN.  I feel so deflated by my stupid foot.  I could just cut it off, you know.

So, I have to take it easy.  I've got to cool it with the walking around at work and walking in general, and it looks like my boot will be coming with me on vacation next week.  Stellar.  I want to figure how to work it into a costume somehow, like a pirate with a peg leg.  I think I could pull that off!  I also found that my pair of hiking boots feels so much better than wearing my tennis shoes.  Hardly any pain, and the shoes are super sturdy and offer really good support.  So, I may have to switch to that as my primary shoe if I am doing a lot of walking.  They are purple, so, matching them is kind of a challenge, but IDGAF.

In other news, husband has committed to doing the Spartan Race in Phoenix next month.  I of course am going with him, but will be siloed into supportive wife/water girl this time.  It sucks that I can't do the race with him, but I'm not dumb and I know my foot isn't ready to even attempt something like that.

I have also asked husband to write a guest blog post.  I think it would be great for the blog to get a spouse's perspective on the injury and what a spouse/significant other/close friend could expect with the whole injury process.  Or just general thoughts and feelings.  Maybe some tips to help you deal with a crazy emotionally raging wife?  I don't know.  I'm calling him out officially now though, so it's not an idea I am just kicking around anymore.  It is decided.  Stay tuned!

Monday, January 18, 2016

How to Work Out with a Lisfranc Injury!

Wondering how to work out with a broken foot?  These are my experiences working out with a Lisfranc injury, but I'm sure it could be applied to any lower extremity injury that has you non weight bearing.  I have been working on this post for a while.

Maybe I should have posted this a long time ago, but now that I've been through nearly 5 months of trying to keep my workouts interesting without putting weight on my foot, I thought I'd share how I got through the conundrum.

I've found that there are really two types of people who get Lisfranc injuries:  random freak accidents (falling off a step or a car accident), and crazy athletic people.  Now I know the two are not mutually exclusive and there are plenty in between, but I fall into the "insane gym rat" kind of people.  Before my injury, I went to the gym every day (sometimes twice a day), and on the weekends I went hiking or snowshoeing or biking or running, anything outdoorsy.  If I didn't time myself at the gym, there's a good chance I could be there for hours.  Or all day.  And now all of a sudden I was faced with an injury that completely flipped my world upside down and took away what I loved most.  Instead of the pity party, I moved past it, and got creative with what I could do.

Three things:  1) Get comfortable with weight lifting (yes, girls!) and 2) Say goodbye to cardio for a while (more on that later..) 3) If you are going to a public gym (aka not your set of weights and a bench in your basement kind of gym), people will want to talk to you about your injury, whether it is about the scooter, or boot, or why you are crazy enough to come to the gym with a broken foot.  Most of the time, I was more than happy to talk to people.  Other times I wanted to get in my workout and be done!

If you're a seasoned gym rat (we can smell our own) you've probably already figured out these on your own.  But if not, or you feel a bit lost, here are some ideas!  I mainly stuck to dumbells (DB), resistance bands (RB), and body weight (BW).  **Disclaimer:  Obviously, I am not a doctor or a certified fitness trainer.   Do these at your own risk and after you've consulted with your doc that it's OK.**  



Shoulders (aka my "glamour" muscles - since I love showing them off in a tank top)
I either sat on the workout bench, or I stood up and rested my knee of my injured leg on the bench - whatever is more comfortable.
Shoulder Press with DB - 3 sets of 15 reps
Upright Row with DB - 3 sets of 10 reps
Shoulder Shrugs with DB - 3 X 20
Front Raise with DB - 3 X 10
Alternating One Arm Front Raise with DB - 3 X 20
Lateral Raise with DB - 3 X 10
Alternating One Arm Lateral Raise with DB - 3 X 20
Reverse Fly with DB - 3 X 10
One Arm Shoulder Press with DB - 3 X 10
Alternating One Arm Shoulder Press with DB - 3 X 10 (5 each arm)

Chest
Most of these were done just lying down on the bench.
Chest Press with DB or Bar - 3 X 12
Chest Fly with DB - 3 X 12
Close Grip Chest Press with DB or Bar - 3 X 12
Incline Chest Press with DB - 3 X 12
Incline Chest Fly with DB - 3 X 12
Incline Close Grip Chest Press with DB - 3 X 12
Knee push-ups (wide arm, close arm or diamond stance) - 3 X 15
Decline Push-ups (knees and good leg on the bench, hands on the floor) - 3 X 15
Incline push-ups (push-up off the bench with knees on the floor) - 3 X 15

Biceps
Not a ton of options here.  I felt like trying to work my biceps was the most awkward of all the exercises; I couldn't get my stance in a good position for an effective curl.  Mostly, I either sat on the bench or rested the knee of my injured leg on the bench.
Basic Bicep Curl with DB - 3 X 10
Hammer Curl with DB - 3 X 10
Angled Bicep Curl with DB - 3 X 10
Cross-body Bicep Curl with DB - 3 X 10
Bicep Holds with DB - Hold the curl at the halfway point (90 degree angle) for 20 seconds, repeat 3 times.  (You can also hold at the top of your curl or towards the bottom for a more super awesome bicep burn)
Half Curls with DB - Start in a 90 degree/halfway curl position.  Curl from halfway to the top for a set of 10.  Then curl from halfway to the bottom of the curl for a set of 10.
21's with DB - Curl from halfway position to the top for 7.  Curl from halfway to the bottom for 7.  Then do 7 full curls.  (7 + 7 + 7 = 21...I'm good at maths!).  Repeat 3 times.
**Note you can do all of these with a resistance band too!  Just stand on your good foot on the band with your other knee resting on the bench.  Or you can hook the resistance band under the bench legs and sit.

Triceps
These were done either sitting on the bench, or on the floor.  Or resting knee position.
Tricep Kickbacks - 3 X 10 with DB on each arm
Skullcrushers with DB or Barbell - 3 X 10 (Laying down on the bench - Be careful not to smash your face!  Don't take the exercise too literally.)
Overhead Extension with DB or RB - 3 X 15
Dips off the bench - Extend your good leg as far out as you are comfortable; the more straight and farther away your foot is from your body the more you work the tricep.  Rest your injured leg at a 90 degree angle on top of your good leg's thigh.  Do 30 dips, or as many as you can!
Tricep Push-ups - 3 X 15 - Do these pushups on your knees with your arms close to your body in a narrow position.  Bend at the elbow and engage your triceps as you push up and down.

Back
Superman Lifts (Body Weight - laying on your stomach) - 3 X 15.  Hold in "Superman" position for 30 seconds in between each set.  You can pulse or flutter kick with your legs for more super power.
Swimmer - 3 sets of 30 seconds - Like the Superman, but make a swimming motion with your arms and legs as you lift your chest off the ground.
One Arm Row with DB - 3 X 10
Laying Row with DB or Barbell - Lay on your stomach on the bench and lift the DBs or Barbell up like you were doing a standing upright row.
Lat Pull Downs with RB - 3 X 15
Rear Fly with DB - 3 X 10
Seated Rows with RB - 3 X 15 - Hook your resistance band to your good foot or to the legs of a bench and pull back like you were doing a standing row.

Core
Lots and lots and lots of options here!  All of these pretty much are floor exercises.  Add a resistance band, a dumbell, yoga ball, or Bosu ball for more awesome abs.
Plank on knees
Crunches, bicycles, side crunch, leg lifts/lowers, reverse crunch, Russian twists, toe reaches, v-ups, jack-knife crunch, scissor kicks, cross body crunch, "X" crunches, frog crunch, windshield wiper crunch, side heel taps, side bends, full sit-ups

Cardio
Like I mentioned, I really did struggle finding a good, consistent cardio option.  My doctor didn't clear me for swimming, but that is a great no-impact cardio exercise to do if you are cleared for it.  I did use the rowing machine, but only with my good leg.  I kind of hung my injured leg off to the side and just pushed off with my good foot.  I also loved to kickbox before injuring myself (think Billy Blanks/Taebo here, not MMA fighting) so I would sit on the bench and just do upperbody portions of the workout, like punches, speedbag work, etc.  I'm sure I looked like a flailing maniac so I only did that at home!  But, it did get my heart rate up.

The Good Leg
I wanted to do a few exercises to keep my good leg strong.  There weren't a ton of options but here were a few basics:
One Legged Glute Bridges (I found it most effective to put my good foot on the gym bench, and press up from that position.  I kept the injured leg at a 90 degree angle while my foot rested on my thigh)
One Legged Leg Press (on the leg press machine in most gyms)
Pilates - I did a lot of Pilates moves on both my legs, laying on each side.  Clam shells, leg lifts, leg pulses.
One Legged Hamstring Curl (with a yoga ball or on the TRX) - I laid on the floor and put my good heel up on the yoga ball/in the TRX strap.  I pressed up into a glute bridge and then would roll in and out on the good leg.
Firehydrants - Kneeling on all fours, I could work my hip flexors in both legs.
Quad Raises - I hooked a resistance band around my foot (or around my ankle) and straightened my leg.  I would then bend it at the knee to a 90 degree angle, pushing through the heel to activate my quad muscles.

If you are working out a lot, try to stick to 1 or 2 muscle groups each day, and alternate different muscle groups during the week.  If you aren't working out as much (like 1 or 2 times a week, focus on one or two exercises per muscle group, and try to get them all in for more of a total body workout.


I hope that this was helpful for you in some way, if you are looking to keep up your fitness while you are dealing with your foot or leg injury.  I know I would have gone crazy if I stopped going to the gym.  My cardio sure suffered, but I wasn't about to let my hard earned muscles waste away!

Now go get your iPod, flip on some tunes and bust out a good sweat!


Friday, January 15, 2016

10k

Good news, everyone!



This week was the first time I've hit my step goal since my injury!  It only took six months.  I have been slowly but surely working up to the goal, getting closer and closer each week, until finally it happened!  I was pretty stoked, once I hit it.  I had a day filled with walking, around the office, during my weight lifting session, a grocery trip, and cooking and cleaning at home.  And surprisingly, I wasn't that sore the next day.  I was a little, but nothing too noticeable.  It did make me a little sad though, because 6 months ago, hitting 10,000 steps was nothing to me.  That was mostly every day.  If I were to hit 25k or 30k steps though, I would get super excited and felt like I'd accomplished something.  Still, I'm just so thrilled to be physically able to walk that much in a day again without it ending in the fetal position.

I also had my first PT session on Wednesday with Stephanie since the hardware removal surgery.  I wanted to address a couple of things with her, and check on my progress.  In my last blog post, I described not really being able to come up on my toes, or push off the ball of my foot when walking.  Basically, she said that I should get that back in time, but there's no guaranteed formula.  I asked about stretches, or strengthening exercises that I could do to make it easier, and she was pretty against doing any of that, and wanted me to wait until my foot was ready naturally.  There are still plenty of tendons in the midfoot that are healing, and she advised to just let that happen and not push through pain at all.  I should do what I can do and what is comfortable, and no more.  That was disappointing, because my mind is skipping ahead to hiking season and I'll need that functionality in my foot if I have any hope of doing some of the ascents I am planning.

Secondly, I asked about weight lifting for my lower body.  Just basic stuff, like squats, deadlifts, lunges.  She wasn't sure, so she called Dr. Van Boerum while I was at the office, and asked him about it.  She said he was none too thrilled at me doing it, ever, but if I'm going to do it (which I AM...duh!) that I will need to wait until the 9 month mark post op (early April) to start doing any lifting.  And, when I start, I need to start at a weight that I am capable of doing 3 sets of 20.  So, what a bummer, I still have 3 more months to wait until I can start my lifting regimen again for my lower bod.  I'm totally going to be the girl that skips her leg days for a while!  



I also asked her about my limp.  I hate my limp and I try really hard not to do it, but it does take some concentration and focus when I am walking.  I was walking down the hall at work the other day, concentrating, and not thinking that I was limping.  But, I ran into someone I hadn't seen in a long time, and he looked down at my leg and asked me what had happened and it looked like I was hurting.  I guess I was limping and didn't even realize it!  Stephanie said that the limp and my gait should start to correct it self the more time that passes.  It is different for everyone.  I could start seeing a difference in a few months, it may take a year, it may be 5 years and I still have it.  Any thought of having a "normal" foot again is kind of out the window at this point, were kind of her words.  I can deal with a limp around my family & close friends, but I feel like I am wearing a gigantic neon blinking disabled sign when I'm in public.




Something I've noticed since I've been completely out of the boot, is that have a tendency to hold my big toe up in a flexed position as a default.  If I'm thinking about it, I'll correct it, and force my big toe down, but it's kind of how it naturally wants to be, especially when I'm barefoot.  I was worried this would somehow cause a problem, so I asked Stephanie about this too.  She said that it was a normal, compensation response because my extensor and tibial muscles are still weak in that foot.  As they get stronger, my foot will do that less and less.

During my session, we worked on balance in the shoe and without.  It still sucks, but getting better.  I got a new set of exercises to do, most are focused on loading weight laterally (stepping side to side) and twisting my foot in a standing position.  None of which are causing pain.  As far as progress goes, she thinks I am ahead of where I should be, or where others are with a similar level of injury, so that was good at least!  She thinks that I am doing so well that I can start seeing her every 2-3 weeks instead of every week.

I've been settling back into some of my old routines, going to the gym pretty regularly and working on nutrition to get my weight back under control.  I have been doing the elliptical on some days even, despite how much I hate the machine.

I see Stephanie again in a couple of weeks, then it's off to Mardi Gras for a much needed travel vacation! 

Monday, January 4, 2016

6 Months

Happy New Year everyone!

It's officially been six months since my injury, and I'm just a couple days away from it being six months post-op from my original surgery.

I had my stitches removed from my third surgery a week ago.  I've definitely had mixed emotions this past week, and spent quite a bit of time (in my husband's words) blubbering.




The most intense round of blubbering came while we were watching the Spartan World Championship.  Amelia Boone was on there, blubbering about her own knee injury and how it knocked her out of the championship last year, how she had to avoid social media, and all that went along with her injury.  It brought back some familiar feelings that I had when I first injured myself.  So began my own blubbering.  I just really, really, really miss the way I was before.  I miss doing the things I love, like hiking and racing, being outdoors and being active.  The past 6 months have been so hard, and I just want to have this behind me.  But this lisfranc injury keeps nagging at me like a frustrated housewife!  I  know that I'll get there eventually, but I sure am running out of patience.

I also finally got to ditch the boot as of December 28th.  My foot was still feeling pretty sore at that point, 2 weeks post-op.  The doctor is hoping it is just residual pain from the hardware removal surgery or skin irritation from the incisions and sutures, but we can't know for sure yet.  He also explained my prognosis, and that I may need another surgery in 8-10 years to fuse the joints once post-traumatic arthritis sets in.  He advised me to go as long as possible with the pain as I could to put off that surgery as long as possible.  I could need a surgery before then, I may make it 15 years, or I may never need another one.  Really only time will tell.  The more supportive of a shoe I wear, the better my foot will feel.

I've been cleared to do the stationary bike (which I've been doing a few times a week already), the rowing machine, and the elliptical.  I absolutely detest the elliptical.  I think it is the worst machine in the gym, is not an efficient way to work out or burn calories, and is not natural movement for your body.  But, I'm happy to be able to do another machine other than the bike, so I'll suck it up.  I can also do swimming, since it is a completely non-impact exercise.  My next check-up is in 2 months, and my instructions until then are to continue wearing my Superfeet inserts for arch support, stick to non or low impact exercising, and listen to my foot for pain. He did say by early spring, I should be ready to do some hiking!

I'm still not as pain free as I would like to be.  I have some degree of pain with every step, and I'm still limping, especially if I try to go too fast.  So slow, small steps are the key if I want to walk limp free.  I have a little more pain than I did pre-surgery, although it is a different kind of pain and in different areas.  And my left hip has been really hurting.  I still can't really come up on my toes - it is way too painful - so I can't roll from heel to toe properly yet.  I'm sure that will come with time.  It's just hard to reach stuff on the top shelf!




For Christmas, I got an awesome pair of slippers with built in arch support from the hubby! He is so thoughtful. It has really made things nice walking around the house.  I don't have to be confined to my tennis shoes.  They are super comfortable, and very supportive, although, not the cutest on the planet. They kind of look like if an Ugg and a Croc had a baby.   But I've long sworn off cute shoes.  I'd welcome any suggestions any of you have for a dressy orthopedic shoe!


I am traveling next month for the first time since my injury.  I'm definitely anxious about that.  We are going to New Orleans to see family, and for Mardi Gras.  I know it will be such a fun time, but I know that there will be lots of walking and standing.  I have 4 weeks for my foot to get stronger, but I'm not sure how much stamina I am going to have, and that's scary to me.  I don't want to be worrying and thinking about my foot the whole time.  Nate and I went to the mall for some post Christmas shopping, and I didn't last very long before I was limping significantly and needed plenty of rest stops.  According to Nate's Polar M400 (I forgot my Jawbone on the charger) we did about 3 miles at the mall!

It was nice to be able to reassure and comfort my husband for a change.  After our mall trip, I could tell he was frustrated/worried about my foot, and if I'd ever heal.  I know I'm going to heal.  It's going to take a while, but I assured him that I will get better, and we just have to be patient.  And, if worst case scenario, this is as good as it gets, I will make it work!