April 06, 2006

Come On Baby, Let's Do The Twist

Morning Workout
20 minutes
Heart Rate Zone: Aerobic (Zone 1) / Lactate Threshold (Zone 2)

40 minutes
Heart Rate Zone: Aerobic (Zone 1)

3400 yards
Main Set: 4 x 200 yards (off 15 seconds rest) + 6 x 100 yards (off 15 seconds rest) + 4 x 50 yards (off 50 second intervals). It tires me out just writing it down.

Random Comments: I finally realized that the only way I can run is if I bike first, so that's what I did today. I laid out my morning paper on the stationary bike next to all the other morning paper reading, stationary bike pedaling, gym going early birds and I read the latest news as I pedaled off into absolutely nowhere. Twenty minutes later my legs were hypothetically loosened up so I galavanted over to the treadmill for what was going to be a 10 minute brisk walk followed by a 10 minute slow jog. Well, I'm really not one for walking. Ironically enough, I'm a terrible walker. I go very slowly and seem to trip on air pockets at random moments. Needless to say, 15 minutes into my walk I had just about enough, so I kicked up the volume a little bit and started jogging. And it felt great. So I sped 'er up a little more. Then a little more. And I kept running and it kept feeling great and the next thing I knew it was 40 minutes into the run and I was so damn happy that I didn't have achilles problems that I practically jumped for joy - until I realized I have achilles problems so that's probably not a good idea. So instead I went swimming.

Have I told you about my double tarsal coalition?

Not many people know about it. I try not to flaunt it. Sometimes the double tarsal coalition makes others feel uncomfortable. I can understand - it's a very private thing. It's also a very rare thing, or so I'm told. I didn't know I was so...how shall we say.... "special." But apparently I am.

It all started nine years ago...

I was training for the Big Sur marathon which, as it turns out, I never got a chance to run. Training was going very well until that one particular run in which I twisted the bejesus out of my ankle. I probably haven't told you this but I'm a serial ankle twister. I've twisted my ankle more times than Chubby Checker. Sometimes its from losing my balance climbing over rocks or hiking on uneven terrain. Other times its from just plain ole walking and tripping - like those miscellaneous air pockets I mentioned earlier. Either way, my ankles have seen better days.

So anyhoo, there I am training for the Big Sur marathon and somehow, while in the middle of a stride, the ground jumped up at me and slammed into my foot, catching me off-guard and heretofor twisting the foot in an unnatural position and consequently injuring aforementioned ankle. Ouch. Within minutes it was swollen as big as a jackalope's burrow. Within an hour I couldn't walk. Within a day I was in severe pain. Within two days I reached deep into my ass and pulled my head out, at which point I then went to the hospital to get my ankle x-rayed.

So there I am, post-xray, sitting on the doctor's table waiting for him to come in. Fifteen to twenty hours later, he shows up carrying the x-rays. OK, he says. Lets take a look at this. And he puts the x-ray up on the big lightboard they have situated for exactly these circumstances. The x-ray is up there and he's looking at it.

Hmmm, he says.
Interesting, he repeats.
Hmmmm, he says more emphatically.

He looks at me.
Then back at the x-ray.
I'll be right back, he says as he walks out the door, leaving me perplexed and quite a bit nervous, if I must admit (which I feel like I must).

Forty-five hours later the door opens again and the doctor is walking in with another of his colleagues. This is what I was talking about, the first doctor says pointing at the x-ray. The second doctor stares at the lightboard.

Wow, doctor two says. You're right.
I've never seen one of those before, doctor one exclaims.
Yeah, me neither, Doctor two concurs quietly, all the while eyes not leaving the bone-shaped glow of the x-ray lightboard.

They both look at me.
Then back at the x-ray.

OK, guys, I finally say. I don't mean to interrupt your little x-ray party over there, but will one of you please explain to me what is going on and why it takes two of you to marvel over it?

They both look at each other in a silent chess match, wondering which one will speak first. Finally Doctor two begins to talk. Well, he says slowly. And with a big breathe, lays it on me - Apparently you have a double tarsal coalition.

At this point one would expect that the entire world fell silent. All of humanity stood at a stand still. The cars stopped, the passers-by halted, the animals stopped grazing - even Bambi, Thumper and all their little furry forest pals stood in wonder. Double tarsal coalition, I imagine they murmurred in their animal speak. He's got a double tarsal coalition. Poor human.

I could feel my face go flush as all the blood in my body immediately evaporated. I was an empty shell of a man crinkling around nervously and uncomfortably on that annoyingly loud paper they put on doctor's tables.

Do we have to cut the foot off?Will I be able to run again?Am I going to live?Tell me doc!!Tell me!! The words were streaming through my brain. Finally, fighting back tears, I was able to speak....

Uh.... what's a double tarsal coalition?

The doctors chuckled at me, as they tend to do in situations like this. It's that chuckle that really makes you feel inadequate, as if there were this big joke and the entire world was in on it except you.

Here's the story, doctor one says as he pulls out one of those skeleton-like models of a foot that shows most, if not all, of the bones. When people are born, he continued, the bones in their feet are fused together. As you get older the bones actually separate to allow for greater flexibility and movement (at which point he started moving the skeleton foot, for reasons I'm still unclear about but assume that it was to demonstrate to me that feet can move).

Every once in awhile, he said, there will be a set of bones that remain fused together. That is what we call a coalition. You, my friend, have not one but two sets of bones on your right foot that are fused together. It is what we call a double tarsal coalition. This is very very rare. Neither of us have ever seen one. And what it is doing is pulling your right foot outward, severely limiting your flexibility. Which explains why you are always spraining your ankle.

Ah, I said comprehendingly, if that's even a word. So, will I still be able to run?

Doctor two spoke up this time. Honestly, it's amazing that you've been able to run at all like you do. So considering the fact that you've managed to run for this long, yes, you will still be able to run.

So apparently, just below the ankle of my right foot, the bones are fused together. They're coalished, if you will. And because of this, my right foot tends to pull itself outwards. And my ankles have become weak. And my knees have become misaligned. And my hips are out of place. And I get a ton of calf injuries. And I get a fair bit of achilles injuries. Which is exactly where I find myself right now - with calf and achilles injuries. And that is the exact reason why I'm going to physical therapy. So that once and for all, I can battle my double tarsal coalition. And believe me, I shall triumph in this battle. I shall win. One day, not too far from today, I shall stand tall on strong ankles with good balance and I will be the victor, the conqueror of my congenital defectiveness. I shall prevail.

Oh yes, I shall prevail.


nancytoby said...

Don't they have a special Race for the Cure for people like you? ;-)

Nate said...

I am also a triathlete with a bilateral tarsal coalition. Do you have it in both feet or just one? I wasn't sure after reading your blog. Also, have you found any suppliments that help you to keep the imflamation down? I really want to keep tri-ing and would really like to do longer than an Olympic, but the pain is really starting to limit my level of enjoyment.

j. said...

nate. i have the bilateral tarsal coalition on my right foot only. fortunately (and what the doctor's don't seem to understand) is that I've been able to run fine for the last 30 years without any inflammation or serious injury. that said, over the past 5-8 years i've been getting serious calf/achilles injuries every year. I'm sure it's related to the 30 years of running with a messed up foot. that said, i don't think i can help you as i don't seem to have major inflammation problems aside from the leg. sorry!

Nate said...

thanks anyway. i'm going to try a joint supplement called runovia and see what happens. my doc told me i have 50 year old arthritic feet and to stop running. we'll see.

Cris said...

My 13 yr old son has bilateral tarsal coalition. I can only find info on the condition but can't find info on people who have it, have had successful surgery or are managing it successfully. We are trying Custom Orthotics, without success and pain meds. aren't helping. He is in constant pain but the Dr's don't want to consider surgery until he has stopped growing, according to Dr's he is going to be 6 ft 4 inch.
I don't know what to do for him, he can't walk without discomfort, can't play baseball, can't do much of anything, his quality of life is becoming less and less and I am heartbroken. Nate, how is it that you are a tri-athlete? I am just looking for some postive feedback from someone...