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Posts Tagged ‘gimpy feet’

The Gimpy Feet Guide to Ungimping

(Yeah, I know, I’m posty today. Trying to clear out some links that have been sitting around for a while, that require more discussion than can profitably be done in a linkdump post.)

Someone a while back asked what I was doing about the problem of collapsing arches in my feet. Since most of my foot/ankle problems are interrelated (surprise!), I figured it was worth doing one collated post on all my physical therapy — with bonus link about barefoot running.

This site shows pictures of most of the PT. I’m doing all four exercises in the “resistance band” group on that page, plus two others: with cotton balls between my toes, I’m squeezing the toes together, and I’m also doing the one where you put your foot on a towel and gradually scrunch the fabric up with your toes. Three sets of 15, each day. So far I’ve graduated up two resistance bands; when I can do four sets of 15 with the next (and strongest) band, I’ll probably call it quits with that stuff.

I’m also doing three other exercises, more newly-added to my repertoire. First, I’m standing on one foot. No, really. Aside from the atrophy caused by the surgical recovery, I also had a pre-existing weakness in my tibialis posterior, which is a muscle that runs down the inside of your ankle and splays across the sole of your foot. It’s one of the muscles closely involved in arch support (another being the tibialis anterior, on the outside of the joint), and it plays a big role in balancing. When I try to stand on one foot for any real length of time, I can feel it crapping out on me, causing my ankle to roll inward, with predictable consequences for my balance. So this exercise is remarkably tiring, at least for one tiny part of my leg. The other two are lunges (of the athletic, not the fencing, sort) and one-foot squats, which I can’t really do worth a damn. I’m supposed to stand on one foot and squat down as low as I can (including lowering my back and sticking my butt out; this isn’t a plié), while keeping my heel on the ground. Between the weakness of that one muscle and my possibly structural inability to dorsiflex very far, this turns out to be a carnival of wobbling on my part.

So if you have arch problems, you want to do the inversion and eversion exercises, the ones where you’re moving your foot from side to side against resistance. And it turns out that helps a lot for balance, too: in karate last night, I discovered that when I do one of the rapid 180-degree turns many of the kata include, I’m now landing in zenkutsu-dachi on the far side with MUCH less instability than I used to. I never thought to connect that with the arch issues, but it seems to be related.

Also — on the topic of arch problems — you might want to read up on barefoot running. This is something I only recently encountered, and I’m not a runner myself, so I don’t have much first-hand knowledge on the subject. But there’s a chapter in the book Born to Run that makes a convincing argument for how our highly-engineered running shoes have actually contributed to foot problems, rather than reducing them. And the reasons seem like common sense: the shoe, by stiffening and cushioning the foot, radically changes the mechanics of how we run. I had a deeply suspicious reaction when my primary care doctor told me the solution to my arch problems was putting more support in my shoes; wouldn’t that just further weaken my feet? (You can imagine what my PT said when I asked her.) There’s at least some evidence that running barefoot, or in minimal shoes, with a forefoot or midfoot strike, will actually strengthen your arches by — here’s a wacky idea — using them as evolution intended.

I’m not likely to take up running any time soon, but for those of you who do it, you might want to investigate some of the minimal-shoe options out there.

And now, having dealt with some of the crap cluttering up my browser, I’m off to be productive on a different front. Namely, folding laundry.

The Littlest Blue-with-Black-Stripe Belt Goes Back to Class (with bonus gimpy feet)

I thought I’d be out of karate for two months following the surgery, but my orthopedist and physical therapist both said I could go back sooner, provided I wore the brace and paid close attention to what my ankle had to say. Fortunately, after thirteen years of ballet and other dance training, I am very good at listening to my feet.

So yesterday I returned to class, and god, was it a relief. Seeing people, stretching, getting some exercise . . . and it turned out better than I expected, actually. There are things I can’t do: jumping, for example. And my balance on that foot is very sketchy right now, so kicks are kind of off the menu (of course the senpai running the warm-up chose to do a kick combination across the floor that day). But the only thing really interfering with my ability to move is that I can’t pivot sharply; ask me to move from a left-hand punch to a right-hand one and I’m fine, but reverse the order and I have to just kind of mark it. It’s bloody hard to do sharp movements with the upper half of your body and cautious ones with the lower half, especially when you’ve been working and working and working at integrating your whole body rather than moving in parts.

Kumite (sparring) is still way in my future, but at least I can do kata, cautiously. As I said to several people, even if I could only do 40% of the work, that’s still a lot more than the 0% I had before. And it turns out I can do more than 40%. This makes me very pleased indeed.

in which the gimpy feet begin to ungimp

Went for a walk around the neighborhood today. Partly because, although I don’t want to court skin cancer, I’m a little appalled at how pasty I’ve gotten; it means I’ve spent too much time indoors. Partly because yesterday a trip to the Stanford library (which requires a moderate bit of walking) was way more exhausting than it should have been, and if I’m going to walk around London again, I need to get me some endurance back.

Thursday was my first physical therapy appointment. The woman tested strength and range of motion on my left foot (for a baseline) and then on my right, and we talked about the ancillary problems I’ve got aside from the surgical recovery — collapsing arches, plantar fascitis, metatarsalphalangeal sprain (say that one five times fast), and some mechanics issues of long standing, to whit, my extremely limited range of dorsiflexion. For the time being, my primary assignment is to stretch out all the muscles stiffened by my time in the boot; to that end, I’m actually not wearing the brace all the time, because it would just continue restricting my range of motion. Plus it presses on one of the two incisions in a moderately uncomfortable way, which is less than ideal.

The orthopedist cleared me to start biking again, though he advised wearing the brace. I’ll probably give that a few days more before I try it, but the idea appeals. It gets me out in the sun (which we’re finally getting a bit of), and helps regain what endurance I had, and I can accomplish some errands in the bargain. All good stuff.

In the meantime, I sit around and make faces while I point my toes. I will get this mobility back; it’ll just take some time and mild suffering. But that’s okay by me.

I tell ya, my brain . . . .

I rarely remember my dreams, but I know that last night my brain decided it should mash together the two big things sitting around in it. Which is how I ended up trying to find my orthopedist’s office in the V&A.

I don’t know; I just work here.

Speaking of work, time to finish Eliza’s adventures in Regent Street and get to the bit where Special Branch is breathing down her neck.

Freeeeeeeedommmmmmmm!

BRACE!!!

Ahem. That is to say, I have achieved Early Release from the boot (the four weeks will be up on Friday), and am now back to the ankle brace I was wearing prior to surgery.

Man, I had really grown to hate this thing in March. Now? It’s my bestest friend. Because it isn’t the boot.

I’m sitting here in my jeans — jeans!!! I haven’t worn these things for almost a month!!! — and I could put on a second shoe if I really wanted to, and I could also drive, or walk to the bank to deposit checks, though I’m not going to do that because it would be really easy to overdo this. I’ve already discovered that we’ll still be going down stairs the two-feet-on-one-step method for a while; trying to walk down them normally produced a twinge that said clearly, you’re not ready for this yet. Okay. Fair enough. Heck, I still feel off-kilter after (nearly) four weeks of having my right foot be higher than my left. Standing flat feels like my left leg is now longer than my right.

Physical therapy starts Thursday. I am very much looking forward to it.

in which I blame the gimpy feet

I’ve reached this weird point of procrastination, where I feel like I’m putting off practically everything until I get out of this damned boot. Folding laundry? I can do it later. Cooking anything? We’ll get back to that in a week or so. Research reading? I have no idea how I manage to blame this one on my foot, but I do. Everything can wait until I’m more mobile again.

So if you haven’t gotten a reply to some e-mail or LJ comment, blame my foot. It’s what I’m doing.

Things I am looking forward to, once I’m out of the boot:

  • Wearing two shoes again.
  • Wearing something other than sweatpants.
  • Carrying things down the stairs without worrying that full hands will compromise my already-compromised balance badly enough for me to fall.
  • Taking a shower without being paralyzed by an utterly irrational fear that I will somehow, against all odds, contrive to slip and fall and rip the ligament apart again.
  • Driving.
  • Physical therapy.

Yes, I really am looking forward to physical therapy. Because it’s something I can do, beyond just waiting. As I said after the surgery, this is the boring stage; I’m eager to get on to the stage that involves active progress, even if it’s tedious and/or painful to do.

my problem

Everything I think of that’s plausible enough to be a convincing April Fool’s Day prank is also something I don’t want to joke about. Like, I could tell you I slipped in the shower last night and ripped out the stitches that are holding my ligament in place so I’m headed back to the hospital today for another surgery — but dude, NOT FUNNY. And if I can’t amuse myself with a joke, what’s the point?

I hope you all are having fun fooling each other today, though.

progress of the gimpy feet

Today I downgraded myself from Vicodin to large doses of Advil. This has the virtue of fewer side effects, and also slightly less efficacy — yes, that latter is a good thing, as it means I’m less likely to overreach myself, walking around more than I should.

But I’ll go back to Vicodin for the night. I haven’t managed properly uninterrupted sleep yet, and am hoping for better success this time.

less dead than expected

Oddly, what’s laid me low is not so much the surgery and Vicodin, but the cold I picked up a few days ago. So in addition to antibiotics and painkillers, I’m also dosing myself with antihistamines and decongestants, and observing with some entertainment the war between Vicodin (may make you drowsy!) and Sudafed (never lets me sleep well).

So far, though, so good. Surgery was quick — apparently kniedzw hadn’t even finished his danish in the cafeteria when I arrived in Recovery — and while they gave me crutches to steady me on the journey home, that was just because of lingering anaesthetic effects. I’m walking just fine, if a bit gingerly, with suitable caution because the Vicodin makes me a little dizzy. Fortunately I’m getting by on one pill of the 1-2 they recommend taking; I’ve gotten more pain from elevating my foot (leading to loss of circulation in a couple of toes, leading to pain when I shift position and the blood comes rushing back) than I have from the incisions themselves.

Many thanks to everyone who sent along good wishes, cards, offers of help, etc. The plan for the next couple of days is to take it easy and see if I can wean myself off the Vicodin in favor of ibuprofen. Tuesday I have a follow-up appointment with the orthopedist, and then it’s pretty much just a matter of waiting for the four weeks to be up so I can get out of this boot and start physical therapy. The exciting part’s over; what comes next is boredom.

Last day of freedom

Tomorrow is the ankle surgery, after which I will be stoned on Vicodin for a while. So if you don’t hear from me, blame the drugs.

Before I go, some linky:

Generic Movie Trailer — oh god, it’s like “Title of the Song.” A hilarious (because accurate) structural breakdown of trailers for the kind of movie that’s trying to win an Oscar, done as a trailer. “And then the music . . . gets . . . hopeful . . . .”

An open letter to conservatives — less funny, but more useful in the long run. Your one-stop-shop for evidence as to what’s wrong with the Republican Party today. Conservatism as a concept, I often think is wrong in the sense of “I disagree with you;” conservatism as it’s most visibly being practiced today in America, I often think is wrong in the sense of “what the hell is wrong with you people?” The letter includes a billion and one links documenting, as it says, the “hypocrisy, hyperbole, historical inaccuracy and hatred” currently afflicting the party’s loudest voices.

Marissa Lingen on “fake swears” — back to the funny. Having recalled it during the course of commenting, I think I will revive “son of a hairless kumquat” as an insult in my repertoire.

“Scientific Romance,” by Tim Pratt — best love poem ever. (At least if you’re a geek.)

on a brighter note, ICFA was great

I was going to post some lengthy ruminations about travel problems and how people respond to them, but y’know, I’ve lost steam on it. I’m currently parked in the lobby of my hotel, since they have free wireless, comfortable furniture, peace and quiet, and nobody tripping over my suitcase, none of which the Atlanta airport can supply. So now seems like a nice time to talk about ICFA.

First things first: the Super-Sekrit Awesome Jacket was a resounding success. I bought this thing last summer and test-drove it at the Dickens Fair in November, but the real idea was that I was going to debut it publicly at the ICFA banquet. There will be pictures eventually, I’m sure — even if I look like a radioactive ghost in most of them; ye gods have I gotten pale — but in the meantime, I can say that it is a black brocade jacket of Victorian appearance, wide-necked with satin lapels, a narrow double-breasted closure just below the bustline, and then tails in front and back. I wore it with an underbust corset (since the front is cut high enough that it needs some kind of waistcoaty thing to look right), a semi-vintage shirt, and a long skirt, and got many admiring reactions. Unfortunately, as it came from Black Peace Now, which is the goth end of a Japanese fashion boutique that has an outpost in San Francisco, nobody is likely to be able to buy one for themselves.

Other than that, I read “The Last Wendy” and got fewer laughs than usual, but I think we just had a non-laughing audience; Eileen Gunn said the same thing about her story, which was quite funny. Then I socialized a bunch and hung out by the pool (when it wasn’t raining) and went swimming, which I kept thinking of as My Ankle’s Last Hurrah, seeing as how it’s about to spend four weeks in a plastic boot. The socializing was also key, as I won’t be going to karate for a couple of months (thus removing two social events per week) and may not be able to drive while I’m in the boot (thus removing my ability to get to where other people are).

It was a good ICFA, too. The topic this year being “Race and the Fantastic,” it provoked a lot of good papers and discussions, and Nalo Hopkinson’s luncheon speech was amazing. Sunshine and seeing friends aside, this is what I really love about ICFA: the chance not only to geek about SF/F, but to do so in a critically thoughtful way, among people who won’t look at you funny if you bust out the theoretical jargon. (My jargon is on the rusty side, of course, but still. I like to flex it occasionally.)

That’s pretty much it for con-reportage, I suppose. (Confidential to people who saw me obsessively checking e-mail while I was there: alas, no dice. Got my reply this afternoon, and will be sending the story elsewhere once I get home.) Now I continue to entertain myself for another four hours or so, until Airtran’s one daily flight to San Francisco rolls around.

ankle update

Surgery at the end of March, after ICFA (which means I can swim in the pool there, yay!) Between now and then, I make friends with Mr. Brace, who is my best guard against sudden catastrophic ankle failure.

Not that I think such a thing is likely to happen — but you really, really don’t want to be proven wrong about something like that.

Sadly, I must also swear off kumite (sparring) between now and my recovery, since it occurred to me that probably falls under the umbrella of “basketball and other activities involving sudden changes of motion, especially lateral ones” that I was told would be hazardous. Since I’m supposed to wait until twelve weeks after surgery to do those things (I can go back to karate after eight), that means I won’t be sparring again until mid-June at the earliest.

Well, at least my kata will get really good.

Son of a *bitch*.

I find myself reluctant to post about this, as I have several friends right now dealing with medical complaints of a much more serious nature. But I also know those friends would tell me that their difficulties do not mean I should somehow be happy about my own, and I’m going to have to bring this up sooner or later. So:

I’m having ankle surgery.

Again.

Details within.

medical query, of a physical therapy sort

The arches of my feet are popping again.

Used to be they did this every morning, when I got out of bed. Not always both; sometimes not even one; but popping arches were a fact of life. I’d usually push my foot over the tops of my toes to get it out of the way — a habit left over from ballet. I’d noticed they weren’t doing it as much anymore, but hadn’t really paused to consider the cause.

Turns out my arches1 have started collapsing.

Oddly, this is good news, in a way. Good because the major palpable symptom of this (since I can’t look at my own feet from behind) has been pain in my right ankle, which could also theoretically have been related to the osteochondritis dissecans I had when I was nine. The x-ray showed something indistinct, and if my pain doesn’t clear up we’ll go for an MRI to see what’s happening there, but for the time being the answer is “orthotics” rather than “surgery and six weeks on crutches.” Which I’m grateful for. Been there, done that, don’t want to go back.

So here’s the query part of the whole thing. When my doctor (a general practitioner) explained that my tibialis posterior2 (the muscle-and-tendon set running down the inside of your ankle to the arch of your foot) is weakening/strained, I immediately asked if there were exercises I could do to strengthen it. He said no. Which I frankly don’t buy. We’re talking muscles and tendons, here; even if I somehow can’t work directly on the correct bit, surely I can derive some benefit from strengthening things around them. I have resistance bands; would it help to work with one of those, maybe by pointing my foot inward? How about the thing where you scrunch up a towel with your toes? I’ve got custom insoles now to prop my feet back up to their accustomed shape, but I don’t want to rely on those; I want my arches to be strong enough on their own.

Advice appreciated. I may end up seeing a physical therapist for this, but for the time being I figured I’d ask the Great LJ Overmind.

Edited for clarity: I’m interpreting the popping thing as a sign that the insoles are doing their work; I’ve been wearing shoes around the house, instead of my usual barefoot habits, to hasten what improvement I might get. The lack of popping seems to have been a sign of collapse. Looking back at my post, this was not entirely clear in my original phrasing.

1 When the guy who custom-molds insoles to people’s feet for a living says “wow, you have really high arches . . . yeah.
2 I’m pretty sure that’s the one he named. Wikipedia seems to confirm my guess, but do correct me if I’m wrong.