I Toeld You So

What is it that knocks us wannabe duffer Fred racers off our bikes and onto our asses?

Sometimes it's not the usual ill-managed life challenges like work, paying the mortgage, or the wife's unreasonable threat of divorce if we head out on Thanksgiving Day for even one more 7 hour L2 ride to help us win the January Training Crit Series.

Sometimes it's real injuries, and with masters racers, the walking wounded of amateur bike racing, it's often chronic stuff that kills us year after year. We're talking about herniated discs from starting the Daimler-Puch with a hand crank; blown out knees from helping the Wright Brothers push their aerio-plane to the top of a hill in Kitty Hawk for launch, or in my case a toe broken playing soccer against Fowler H.S. in 1984, when I made a violent slide tackle to stop what would have been a winning goal. I think. It's a bit hazy.



Those of you who remember back when this blog used to be regularly updated, may recall tales of my cankles - sudden inflammations of my feet and ankles, raging cases of tendinitis, chronic abuse of the RICE (Rest, Ice, Compression, Elevation) recovery technique. If you recall - you'd have no reason to, I just said "if you recall" as a convenient literary device - the doctors at first thought it was gout, definitely gout (/RainMan Voice) then other stuff. A podiatrist was sure that a combination of gout medicine, bunion surgery, and repeated billing of my insurance company until it went bankrupt was the cure.
Eventually, I stumbled upon a good orthopedic surgeon who is a foot and ankle specialist. (When Baltimore Orioles are leaving the office as you walk in, he's good). He said my main problem was wear and tear on the feet from a very active life, and he prescribed some orthotics, and maybe surgery. The problem was complex; messed up toe joints would get inflamed, cause me to walk funny, and then the feet would get severe tendinitis. This would appear to spread from right to left or vice versa, but the Doc explained when you walk funny with one foot, the other foot, both knees, the hips, and if you're Sandy Koufax the throwing arm, can all be affected.

The orthotics helped stabilize things for a while but surgery on the left foot was required to straighten out a toe joint that had a lot of spurs, causing it to pinch on a lot of nerves and flesh, and to effectively start fusing itself in place. We did that, and the newly reshaped foot joint has worked perfectly since. That surgery fixed most of the problems for a while, but over the last year the other foot - Ol' Righty - turned up the heat from a low simmer of pain, to a hard boil. This isn't a surprise; the Orthopedist told me it was coming, the toe joints are chronically messed up, there's a little arthritis, and if I want to stay active they need to be fixed.

That's all medical crap. What it boils down to in the only area that matters, bicycling (okay, and chasing my kid around), is that this put me off my bike a couple times this year for 2+ weeks, this in the midst of the toughest year I've had for training since I returned to riding. (I.e. I'm really fat and out of shape and this don't help none). Back to the Doc for further consultations.

Here's the problem, in pictures. This is what a healthy big toe looks like - on a computer screen with aspect ratio problems.

You'll notice the joints look nice and smooth, the bones are a uniform color (reflecting uniform density and state of repair) and so on. Now here's what my right big toe looks like.

The circled bits are spurs sticking into the joint in the middle of my big toe. They basically prevent movement of that toe and cause really severe pain. Those little circles in that area are what doctors have thought was gout for a number of years - yet I didn't really have severe pain in that joint until recently.
If you head a little south from that rat-chewed mess, you'll notice the next joint down - the "ball of the foot" - isn't a more or less square or gently arced curve. It's a fairly sharp turn. That also makes bending the toe very difficult, and the reduced motion leads to chronic pain and a funny gait... and the Cankle.

Now, the big reveal.

You see where those red lines are? That's where the spiral fracture occurred while playing soccer in 11th grade. Those little triangular flanges of bone broke off and floated around for a while. They didn't used to use screws or anything back then, they just assumed the toes would heal fine. 25 years of Army, rugby, being fat but running nevertheless and never-quite-properly-fitting shoes finally caught up to me, and that messed up joint just gave up the ghost. The orthopedist said that the location of the original fractures explained the gouty looking damage to the bone - something to the effect that a badly healed or unhealed fracture there would have caused cysts, which would then rub on the bone and ultimately destroy the joint.

Well. That's good to know. So now what?

Same drill as last time, it turns out. He's going to resection the joint and bone comprising the ball of the foot - a chilectomy - but fuse the toe joint. Evidently it's too far gone to rehab and not worth the trouble.

It's going to be a pain, it's going to cost a few hundred bucks, rehab is going to be two months... but I don't care. The dogdamn foot problem has been en enormous limiter for over four years and it's time to get it fixed. This isn't going to make me a great cyclist, but maybe it'll help me get back to Cat 4 Road / Cat 3 CX shape. Shit, at this point, I'd settle for being able to ride easy for a couple hours without getting brutal hotspots on that foot.

Sometimes are limiters are self-imposed, soft barriers put in place to keep us from progressing.

Other times, they're as hard as bone.

You have to take advantage of any chance you have to get rid of one of those limiters. Failing to do so might leave those limiters in place for 4 years or 30, or forever.