Ankle update

Saw the Doctor this morning for my 20 day follow-up.   Lot’s to digest so let me just bullet point it:
  • I was worried yesterday about the base of the 5th metatarsal, so that’s where he started.  It was sore and in general the middle of the foot felt tight and inflamed.  And the base of the metatarsal was sore to pressure.  PT’s resonance test on it was fine, so it was unlikely to be a stress fracture, but I wanted the doc to check it out.  He immediately ruled out stress fracture there, and just called it tarsometatarsal joint inflammation.
  • Main cause of that is not wearing the boot long enough, but worse (in his mind), I was wearing my Luna sandals.  And that’s mostly what I’ve worn the past week or more, other than when on the bike trainer and I’ve put on my bike shoes (not clipless, just platform shoes).  That includes all the walking around Carowinds on Friday, Saturday soccer game and errands, etc.  I did have the brace on for the most part until Sunday afternoon when I stopped wearing it.   And I walked barefoot around the house and on the treadmill when not in Luna’s.  He just pointed out that with barefoot or sandals, the load on the tarsals is much higher, and right now, the foot needs less stress, not more.  So he wants me in a shoe for a while.   I’ve got on my bike shoe right now which is pretty stiff and shouldn’t allow much movement.
  • There is still lots of soreness all over – peroneal tendon, peroneal muscle, ATFL, calcaneousfibular ligament, anterior tibialis, etc.  Some of those are likely due to lack of shoe per above above but some of course due to the original injury.
  • He said if it’s really sore, wear the boot.  (It’s not really sore, in my mind.)  He said the brace is really just for aversion and wouldn’t help much with where I am right now.
  • He mostly wants to see inflammation go down and recommends topical and oral NSAIDs, elevation, massage, maybe a bit of ice.
  • He wrote a prescription for Rayos, a delayed release prednisone, that he said I could take at night, to combat the body’s inflammation.  I’m a bit torn, as I really don’t like taking things like steroids or NSAIDs unless I really have to.  I would take this at night, and the delayed release means it limits the body’s inflammation response which is greatest while sleeping.  I’ll have a think on this and read up on it before making a decision.
  • (I have been doing the topical NSAID 2x per day, but have limited oral NSAIDs unless it’s really bothersome.  I have been taking minerva and using collagen in a shake to try to help with inflammation and speed up natural recovery.)
  • He didn’t say anything about when I could run, just listen to your body, and when there’s no pain, then I can do whatever.  As there’s some pain / discomfort now, I’m certain he was implying don’t run yet, and don’t walk too much yet!  At least not without a more supportive shoe.
  • He did say cycling was fine as long as it doesn’t cause additional pain/discomfort.  I rode 85 miles last week and only feel that’s been a good thing, albeit starting to get boring.  (I’ve only ridden on the trainer, not outside!)
I’m still not too concerned with no running since I have no races until late August.  But even then, I am in this for the long game and want to be running when I’m 70+.  So making sure this heals properly now is key.  I’m most concerned with the possibility of having chronic ankle sprains going forward.  In all my many years of trail and off-trail running, while my ankles have rolled many times, they have never sprained!  So ensuring strength and mobility in all the tendons, ligaments, and muscles, is most key to me right now.
Here are some photos over time:
Day 2:
IMG_0761
Day 3:
IMG_0765Day 7:IMG_0770
Day 13IMG_0783
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