Friday, January 29, 2010

My Achilles Heel: Stressed. Out.

I'll try to keep this brief.

I'm reminded of a movie quote, though I can't remember who said it in what film. It goes, "I hate it when I'm right." Everything I wrote in the previous post came to pass. I DO have a stress fracture in my heel and I won't be running the 5K on Sunday. So...

An MRI image of my heel. The yellow arrow is pointing to the primary fracture, but the white area around it also indicates weakening of the bone. My heel should look evenly dark like the other bones displayed.

I honestly don't know how this would have happened. As a barefoot runner, I use a forefoot strike which should completely eliminate stressful forces on the heel. I can only surmise that all of the walking I do at work in minimalist (read: uncushioned) shoes plus the forces of my achilles pulling on my heel while running weakened my heel bone enough to cause this fracture.

So I'll be doing no load-bearing exercise for the next four weeks. That means no running. I also will wear a boot, at least to work, in order to allow my heel to heal. That, along with a note saying I should "limit the amount of walking (I do) throughout the day," will probably be enough to allow this problem to fix itself. I'm going to pursue using a motorized scooter of some sort at work so that the long walks to the other end of the facility are a lot shorter and less strenuous on the feet. My employer needs to accommodate my injury, so we'll see what our Occupational Health department has to say.

The doctor doesn't seem overly concerned about me wearing the boot all of the time. He believes the problem should resolve itself so long as I don't run and wear the boot at work. I take that to mean that generally avoiding strenuous activity or heavy use of the foot should be enough. I think I'll probably still try to go barefoot around the house. I often walk with a forefoot strike and gently touch my heels to the ground when barefoot, so that should be okay. I'll also sleep barefoot.

So, thus begins four weeks of taking it easy on the feet even if I still try to get workouts in. I want to try to find alternate ways to do cardio. The good doctor recommended a stationary bike or swimming as good non-load-bearing exercises. I'm sure our city's community center has inexpensive memberships available to use their gym, so that sounds like a good option for the bike. A local middle school has an indoor swimming pool, so I'll investigate what usage costs there are. I can always also do core exercises as they don't require significant forces on the heels.

In a way, I'm kind of glad that this happened now. If I'd gotten a stress fracture right in the middle of the spring-through-autumn months, that would have really given a hit to my barefooting. This way I'll be able to heal up, get reconditioned and go enjoy a number of runs this summer AND do them all barefoot. Sounds like a plan.

Thanks for reading. I welcome your comments below.

Thursday, January 28, 2010

My Achilles Heel: A Quacked Calcaneus?

Interesting things have occurred since last I spoke to you about my ankle. You might recall from my Jan. 22 post that I was diagnosed with Achilles Tendinitis. I wore a cast boot, did heat therapy and took an anti-inflammatory drug for a week in the hopes that it would clear up. If I did, in fact, have Achilles Tendinitis, I believe that it cleared up.

But there's still pain in my ankle that has lingered. More specifically, when you squeeze in particular spots on the sides of my heel it triggers hearty amounts of pain. Now, the X-ray I'd gotten didn't show anything, so my sports medicine doctor wisely decided to send me for an MRI. Magnetic resonance imaging, in case you don't know, is a very sensitive series of pictures of the body's internals. It can show many things that X-rays can't, like the condition I now think I probably have. He wanted to see what exactly is going on in there, but didn't make any assertions as to what the problem really could be.

One thing he DID do, however, is clear me to run in the 5K I'd been planning on for this Sunday. He said, "It's only a 5K. It's not like you're running a marathon. Go for it." Now, while that might seem insulting to some readers, I took no offense and realized that he meant that the relatively-short 3.1 mile race could do very little extra harm to my heel/ankle.

So I left his office with just as many questions as answers. What would the MRI show? What if the MRI showed something bad enough that I really CAN'T run the 5K? If the issue isn't Achilles Tendinitis, what could it possibly be?

After getting the MRI done last night, being given a CD of the images and surfing the interwebs for pictures of heels and MRIs, I've used my junior radiologist deduction techniques to make a prediction of what is wrong with my ankle. It's all I can do until the radiologist gives his/her report to my doc. So I can't be sure until 8 a.m. tomorrow morning when I have a followup, but a guy can still make an educated guess, can't he?

And boy, what an educated guess this is. I'd like to think I'm a smart guy. I am kind of "techie" by trade and actually work in a hospital, so I am sure of two things about reading medical imaging: 1) MRIs are REALLY cool and really detailed in what they show & 2) Medical films are REALLY hard to read. That said...

Based on my continuing symptoms and MRI, I think it is highly likely that I have a stress fracture in my calcaneus (heel) bone. After looking at the MRI images of my ankle/heel and comparing them to images readily available via a simple Google image search, I believe there are striking similarities between them. Check it out below. On the left you see an image I found on the Radsource Web site. It shows an T2-weighted MRI of a calcaneus with a stress fracture (indicated by the white arrow). On the right, I have displayed an almost exact T2-weighted image of my calcaneus with what I believe is a stress fracture (indicated by the yellow arrow).

(Click image for larger version)

There's other evidence in my set of MRI images that lead me to believe I have a stress fracture, but the similarities between the two indicated parts of the images above cannot be ignored. Heck, the dark line in my heel (on the right) even curves in a very similar way to the fracture in the left photo.

So, where does that leave me? It leaves me waiting to see my doctor tomorrow morning to find out what's REALLY going on. I also have to wonder what kind of treatment and limitations I might have in the near future. Most articles about calcaneal stress fractures indicate that a standard treatment is a lot of rest for up to 8 weeks. That may even include a cast and no weight bearing for that period.

If I do have a stress fracture and I have to wear some kind of cast or cast boot, I'd need to work with my doc to see if it'd be acceptable to do some walking in order to fulfill my job responsibilities. As someone who typically walks about 11,000 steps a day at work -- and who only has about 1 1/2 weeks of sick time accrued -- I would really need to find workarounds so I can heal but still work. I've thought about proposing using a rented scooter to motor around my workplace and then park it when I get to whatever room I need to work in. When finished at a particular location, I could scoot away to somewhere else. Minimal walking while the job still gets done. It's worth a shot.

And the 5K? Well, if I really do have a stress fracture I doubt the good doctor would still be okay with me running it. After all, it might have been running that caused the problem in the first place.

But hey, I suppose there's a possibility that I don't have a stress fracture. Maybe, even though the MRI looks ridiculously similar to other confirmed cases of stress fracture AND the fact that I have symptoms that are completely consistent with said condition, I don't actually have it. We'll see. But as I've told my wife and a few others today, "If it walks like a duck and it quacks like a's probably a stress fracture." Wait, what?

I'm planning an update to the blog tomorrow with the final news. To stay remotely on point with this blog, however, I will finish by saying that I have a feeling this is going to negatively affect my barefooting mojo...again. Hopefully, I'll be all better by the time warm weather comes around and it's prime barefooting season. I guess we'll see.

I welcome your comments below.

Detective image:
Scooter image:

Monday, January 25, 2010

Listen to My Thoughts on Barefooting

Want to hear my thoughts on barefooting beyond what you read here? The good folks over at Living Barefoot have released their ninth episode of The Living Barefoot Show. It's the recording of the live call-in show in which I participated back in October. Hear my thoughts on what makes a "barefooter," why I don't go barefooted everywhere and more. Check it out at the following link or download off of iTunes (search for "The Living Barefoot Show"). My participation begins at about the three-minute mark.

The Living Barefoot Show Episode 9 - LIVE Call-In Show from Oct. 2009
"An Ode to Baby Wipes," the blog post I referenced in the show.

Image from Sagworks

Friday, January 22, 2010

My Achilles Heel: These Boots Weren't Made for Barefooters

Well, it's now been just over a week since I initially hurt my ankle.I went to a sports medicine doctor two days ago and was diagnosed with Achilles Tendonitis. Since then I've been wearing a cast boot, taking an anti-inflammatory, doing heat therapy and trying to rest as much as possible.

This Wednesday I go for a one-week followup to see how things have progressed and find out if I'll be able to run the 5K on January 31 that I've been training for. I'm hoping that he'll give me the go ahead and I can use kinesio tape such as KT Tape to support my achilles during the run.

So how is my achilles right now?

As of this morning my ankle doesn't feel much better at all, actually. It doesn't hurt while I'm wearing the boot, however any time I walk without it on, my ankle starts hurting in exactly the same way it has been. It also continues to be just as swollen even after two days of the (strong) anti-inflammatory drug.

Injuring my achilles has turned my barefooted world upside down!

My barefooted "spirits" are down, too. For a guy who normally always wants to go barefooted or wear only minimalist shoes, wearing a cast boot and regular boot (to offset the height difference of the thick sole) is almost like a prison sentence; punishment for my wrongdoing of overtraining for the 5K. Sigh.

What this does do is reinforce my feelings about going barefooted. I'd been unshod or minimalist for so long that going back to such restrictive footwear -- even in the form of a "regular" boot -- is a good reminder of how truly comfortable and unrestrictive bare feet really can be.

Honestly, I've really wanted to rip this stuff off of me. Last night, while at a youth event that I'm helping support for my church, I cam so close to getting my elastic wrap, ditching the boots, wrapping my achilles and going essentially barefooted the rest of the night. But alas, I knew that wouldn't be best. I've got to fight the good fight and be patient for my achilles to heal and me to be able to return to walking, running and living barefooted.

So we'll see what happens. If there's any more news I'll share it here, Twitter, Facebook, blah, blah, blah.

Tuesday, January 19, 2010

Injured Achilles/Ankle and Upcoming 5K

I've decided to pursue medical attention for my left ankle ahead of my scheduled 5K on Jan. 31. If the doc says to not run the race, I won't.

I hurt my ankle last week on what ended up being a pretty good run. Afterward it started hurting from what I thought was pressure caused by my Vibram Fivefinger shoes, and I took a couple days off. The big mistake was to go out and run again on Saturday and push myself too hard while still in pain.

At this point I'm almost totally certain that I have, at a minimum, achilles tendinitis in my ankle from overuse/overtraining. I'm beginning to wonder if the persistent swelling and pain is an indication that I could have a partial achilles tear as well.

It KILLS me to potentially give up racing my first 5K on Jan. 31, but it's appropriate for a medical pro to look further into the problem and determine whether or not my ankle will be able to tolerate it. Better to take it easy and recover than potentially make it worse.

If you're a person of faith, please keep me in your prayers, thanks.

Monday, January 11, 2010

Mark My Words: Accidents Happen

I was at a gathering yesterday when the topic of my barefooting came up. A close person in my life, who's made it very clear they don't think my preference for bare feet is a good idea, said to me...

"Mark my words, Michael. Someday you are going to get seriously hurt."

This person shared with me that they seriously hurt their foot when they were younger because they weren't wearing shoes. I hear this a LOT.

I can't tell you how many times someone's told me, "I don't go barefoot because I ______ my foot by ______ when I was a kid." For the first blank space you could insert the words hurt, cut, broke, punctured, burned or one of many others. The second space could be completed with stepping on a bee, stepping on a nail, stepping on a knife, stepping on a rock, pouring boiling water on it, running into a wall or something equally traumatic and painful.

To these sentiments, my response is always the same by sharing my own stories. I, Barefoot Michael, stepped on a bee at a swimming pool AND punctured my foot by stepping on a nail when I was kid. So, I know it sucks. I know it's not fun. But you know what? I recovered.

I reminded this acquaintance that if we hurt our hands we don't just start wearing gloves all the time. I might point out, at this time, that I have seriously hurt my hands a few times in my life:
  • I cut a finger with a razor blade as a child and have a scar to prove it.
  • I got a few fingers smashed in a door jam as a kid because I wasn't paying attention.
  • I burned some fingers in college by grabbing a hot lid off the oven.
  • I burned fingers a couple years ago on a bundle of firecrackers with a lively wick.
And yet, I don't wear gloves on a regular basis. We get hurt, we heal and we move on smarter for the experience. It's the same with our feet.

I use an abundance of caution when I go barefooted. I keep an eye out on the ground while I walk. I avoid things on which I could catch or stub a toe. I try not to walk barefooted in places where it would be easy to get hurt. Lastly, I am careful about the possibility of heavy objects falling on or rolling over my feet. But, taking all that into account, I could still get hurt. Accidents happen.

To me, the benefits of going barefooted FAR outweigh the risks. The comfort and health benefits of going barefooted are something that I deeply desire for my feet. If that means that I introduce a little more risk into my life, then so be it.

Thanks for reading! I welcome your comments below.

Drawing from: University of South Florida

Thursday, January 7, 2010

Q&A: Bare Feet and My Children

Do your children go barefoot too?-Jake, from Wisconsin (where we savor the 8 months of the year that we can go barefoot.)

Thanks for the question, Jake! We DO encourage our kids to go barefooted a lot. Research has clearly shown that children's feet should be uninhibited as much as possible while they're still in the process of growing.

Do they go barefooted everywhere all the time? No, but if my wife and I don't perceive a risk of the kids hurting themselves due to inattentiveness of the environment around them then we'll generally let them go unshod.

If we do have them wear shoes, we try to make more flexible "minimalist" footwear available that allows their feet to breathe and move naturally.

In the end, we want our children to grow up knowing that shoes are NOT usually necessary and that they're feet are healthier overall when not confined in footwear.


Question(s) About Barefooted Living?

Monday, January 4, 2010

Report: 6th Annual Polar Barefoot Run

As a barefoot runner, how could I pass up my first opportunity to participate in Barefoot Rick Roeber's 6th Annual Polar Barefoot Run, held January 1 at a local park? The goal of the free event is to get people active in an interesting way for the new year and raise money for Free Wheelchair Mission, a charity that provides low-cost wheelchairs for the disabled poor throughout the world.

It was the coldest Polar Barefoot Run on record, with a temperature of around 11F/-12C degrees at the start. About 12 hardy souls showed up and had a good time socializing with each other. Most bared their soles, though it wasn't required.

Photo courtesy: Barefoot Rick Roeber

I was fine running unshod on the paved parking lot during the first half mile. I originally wanted to run a whole mile barefooted, but my feet chickened out once I hit the snowy second half of the course. They became completely painful and numb all at the same time. I couldn't even get my feet to go into my VFF Sprints (that I carried along just in case), but I managed to get out of the snow and return to my van to warm up the toes. Shortly after that, a local TV news photog showed up, and I managed to get the VFFs on to run a little in the snow so he could get some footage. Afterward we all warmed up with hot cocoa that Rick provided.

Overall, and despite the personal setback, I had a great time! It was nice to meet some other local runners and especially to finally meet Rick. We'd conversed some back and forth on Facebook but hadn't met in person until the run. He's a great guy and very devoted to the Lord. I look forward to conversing and running more with him in the future.

I also look forward to continuing to develop my ability to run barefooted even in snow and bitterly cold temperatures. The VFF Sprints are a good stop-gap, though. They cover my feet just enough to take the "bite" off, but still allow my feet to feel bare and move more naturally.

Here's to many more barefoot runs in the months and years to come! Happy New Year! I welcome your comments or questions below.

More on the Web: Barefoot Rick Roeber's run report
News coverage: Photos from The Kansas City Star

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