Weeks 29/30/31: On the Road Again

Just over seven months out at this point. You would think that not a lot would be changing at this point in my recovery, but in fact, I have updates!

Basically, my leg is finally getting back to normal. I am bouldering indoors four days a week. Falling is much better than it was a month ago: I am no longer afraid to fall, and 90% of the time, it feels the same in both legs. Additionally, while there are still some moves I can’t do because of my leg — high heel hooks that require a lot of strength (muscles surrounding my knee still aren’t fully developed), or big moves that involve pulling with the left toe — they are fewer and further between. 95% of the time, I have no reason to think about my leg anymore while climbing.

I am also starting to run outside! I’ve gone four times now, with the longest distance being 2.25 mi. I can definitely still feel a difference between the two legs while running, but well, it’s getting better. About a week ago, I ran two miles at a 9:23 (avg) pace. My guess is that my more recent run was maybe done around a 9:10 pace?

Finally, and I mean FINALLY, my legs feel exactly the same while walking. I haven’t had a limp or anything I’d call painful for over a month, but it really took until about week 30 to have no difference in sensation at all between the two legs.

 

I also will shamefully admit that I’ve stopped doing PT exercises. I know that my left leg is still weaker than my right — I still can’t skip symmetrically, for example, and of course I can feel it running, etc., but I can tell that it is still getting stronger just through climbing and running themselves. and ellipticalling, which I am still doing. After six months of PT exercises, seriously, I just want to live my life for a bit. I think this is okay.

Week 24: Running and Bouldering

PART 1

I am no longer walking with pain. I have some pain going down stairs, but that is about it. It is glorious.

Here are some thoughts and tips:

• The lateral elliptical is amazing. If you are reading this because you are recovering, I can’t recommend it enough, if you have access to one. Particularly if you use the “X” mode, it is a great workout that really works on your leg muscles, both for stability and strength.
• Generally, my advice is to get on an elliptical as soon as you can — the spin bike is great for cardio, but all it does is build your upper legs. With the regular elliptical, there is still no lateral movement, but it’s much closer to walking/running and you get some calf work in there. I think that switching to the elliptical this week has been huge for me.
• My running is progressing so well, which is keeping me super motivated. It’s almost like the beginning of the recovery process when things moved so quickly. Within five days I moved from 0.2km to 0.8km, and dropped my min/mile time by 4 minutes. I am running with a limp for sure, but it is really cool to have bigger and bigger strides each day, and be able to toe off more and more, as opposed to doing a super exaggerated heel strike. Would not be at all surprised if I could run a mile at a 10 min/mile pace soon. Though my goal is simply to be able to run to the climbing gym (0.4 mi) when I get back. I have no idea if running outside will be different than on a treadmill.
• I have a bump on my knee — and have had since surgery — which feels like the head of my tibia sticking out too far. It prevents me from doing things like kneeling on a hard surface. My physical therapist said that it was swelling, which seemed hard to believe, since it felt so hard/like bone. But indeed, it has gone down. I can probably kneel on a hardwood floor at this point, though it wouldn’t be particularly comfortable. But still, progress.
• If you google tib/fib fracture, you’ll find a lot of people on the internet really really keen on getting their hardware taken out. If not the rod, at least the screws. I am convinced that my surgeon was really good, but these thoughts don’t even cross my mind. As far as I can tell, I have no irritation from the screws, and certainly the rod is just in there doing its job with no side effects. Just writing this here so that people know that not everyone wants their hardware out — probably just a vocal minority.

 

PART 2 (because it slightly contradicts Part 1)

Also, I went…BOULDERING! (indoors) I went to a climbing gym, rented a harness (didn’t bring mine with me on this trip) planning to spend at least half the time autobelaying, but after hating the first two routes I climbed, I was like, I’m going to go see what it’s like to fall. At first I climbed up so that my feet were about 4″ off the mat, held onto some jugs, and let my feet off the wall so that I was dead hanging. And dropped. It was fine. I did this a few more times, getting higher and higher. Luckily this was a pretty short bouldering area. With a pretty squishy mat. (Squishier than my home gym for sure.) I wound up bouldering for about an hour and a half, until I got a flapper. I had at least one uncontrolled fall. And was fine.

Honestly, the real problem was exactly what it was last time I climbed, which is pushing up on the toe of my bad leg. I am not going to lie and say that that didn’t hurt at times, and that it didn’t cause some pain while walking both last night after I went, and this morning. But it was definitely better this time, and bouldering is actually easier on the leg than top roping, in that so much more weight is typically on your arms. At least when you climb overhang, which is mostly what I did. Oh, and I heel hooked, which was a tiny bit sketchy because the muscles/ligaments around my knee aren’t 100% yet, but was pretty okay.

And here are some pics! Also, I calculated this morning that I have probably done around 1400-1500 pullups in the last 3.5 months. Hence my arms, ha. I have lost all of my endurance and finger strength, but my upper body strength is all still there.

Confidence building: not too far to fall, and it definitely won’t be on my leg!

Muscles: in tact! 

 

 

Week 22: BIG WEEK PEOPLE

So, week 22 was kind of awesome. Here are things that happened: I started walking without pain in the afternoons. I ran on the treadmill for two minutes until I had pain, then I jumped off. I did some jumping (lateral, not vertical), and actually landed with both feet evenly weighted. My gym exercises got even easier and I had to invent new ones. And I went climbing! Oh, and I had my five month breakiversary.

As of this week, my leg just feels constitutionally different than before. I wobble a lot less while putting on pants, and as with my good leg, I’m able to kind of adjust my leg if I start to fall over doing that. It feels just as sturdy as the good one while walking, I have no limp at all, and it just feels like I should be able to take off running. Hard to explain that, but trust me, it’s good.

On the other hand, climbing was probably a bit much, and I knew it while doing it. I just don’t have the strength yet to put all of my weight on my bad leg with my foot on something very small and to push up on it. I did it anyway, but I could feel pain a lot of the time. (Also, while my technique and upper body strength were fine, my endurance was obviously not there, and my footwork was terrible! And my forearms are sore!) I was pleased though that high stepping and flexibility were not problems. I had to tell myself that I was having frequent pain and I should just go home about ten times, and at some point I was like, ok, your leg is kind of throbbing, go home! Which clearly was not great. My leg was in extra pain that day and the day after I went climbing, but two days afterwards it is almost back to where it was before. I don’t think I should climb again for at least two weeks/a while. For the record, I spent half the time (about two hours) autobelaying, and the other half traversing low on a bouldering wall, and making sure to either fall on my butt or hit my good leg first before rolling back. Did jump with both feet on the mat, which felt totally fine. Next time I’ll probably try to start dropping six inches onto both feet. What I’m worried about –rationally — is dropping onto my bad foot and doing muscle damage, though irrationally I’m also worried about dropping and breaking my leg again. Though I probably need to be more worried about doing that on my good leg, if I’m afraid of falling on both legs.

I did discover afterwards that my calf (soleus) muscle is more flexible in my bad leg than my good one at this point. I had to work hard at stretching that right after my break, though it’s probably now due to the fact that that leg is still weaker.

The running on the treadmill was pretty awesome though. It’s funny, I ran at a 16 minute mile pace – and covered 1/10th of a mile – which somehow didn’t feel slow at all. I mean, it felt casual, but not ridiculously slow like I expected it to. I do run with a limp, however, which will clearly go away as I build more strength. As with climbing though, I’m not sure if the best way to build more strength is by continuing to do it, or doing other exercises that will strengthen me in other ways.

Also, I am now leg pressing 47.5 kg on my bad side. Unfortunately, I’m at 67.5 kg on my good side, so I still have a 44 lb differential. Which means I’m at 70% of the strength on my good side on my bad side. Not quite sure how to move that number, since my good leg keeps getting stronger too.

 

Week 3: And Then There Was One (Crutch)

Everytime I think I have reached a short plateau in my recovery, something new happens. It is really amazing.

Highlights of the week:

Day 15

I went to see my doctor for the first time, exactly two weeks after my fall. They took some new Xrays, which showed that my tibia is aligning perfectly. My fibula, which was a segmented break (two places), is not quite so perfect, but my doctor was unconcerned about that for the time being. Also took my stitches and staples out.

Most importantly, I got to ask questions about what I would be able to do with the rod in. The answer was everything, and that only in rare occasions do they take them out, despite everyone on the internet wanting them out. I think I was a little too afraid to ask about bouldering specifically, because I didn’t want to hear that it would be a year before I was able to fall on my leg again. (Somehow I think everyone thinks that I fell accidentally onto a hard surface while roped in, and doesn’t even know what bouldering is.) But it is clear that bouldering is in the cards at some point. I asked about taking another similar fall and he was like, “well, your leg will just be that much stronger with the rod in.” Lesson learned: don’t believe the internet.

I asked about running directly, and he said that most people take 9-12 months. That’s obviously a long time to wait for someone who had run consistently for 15 years, I am hoping that I will be on the short side of this, since I am in such good shape? I honestly think that I will be able to top rope in January — basically once I feel like I can put my full body weight on my leg. (Unfortunately I will be out of the country from Jan 15 – May 15, and my only option where I am going is bouldering.)

My doctor also asked me if I had walked at all without crutches, to which I replied yes — a little. He asked me to show him, and then muttered that I was still doing something or other, but suggested that I go down to one crutch. I was hesitant, because sometimes I need to go all the way across campus, and I’d be so slow on just one crutch. I also wasn’t so sure about stairs.

Finally, I got a prescription for physical therapy, which I will start this coming week.

Day 16

Well, so much for my initial one crutch fear. In the middle of the day, I needed to run an errand that was about 0.3 miles away, and I decided…let’s do this on one crutch. And I did. Having a free hand to carry things was amazing, and I never went back to two. I also decided to start using no crutches in controlled situations, like inside my apartment for example. This was also the day when the feeling that something was stabbing me at the top of my ankle as a walked went away.

Day 18

Decided to walk 0.3 miles (each way) to get coffee, without any crutches. Coffee place was closed (!), but I did it! (very, very slowly) I tried stairs too which weren’t bad at all. Also, I was able to go up a stair or two without matching feet — holding onto a handrail. Very slowly rode a stationary bike at the gym — just to see if I could.https://instagram.com/p/-m8WEfvM0x13u82p4laTy6Rgz-Sy4ljZNSr-M0/

 

Day 19

Took a shower standing up for the first time. Discovered that I can do bodyweight squats — though probably unevenly weighted. Did a very long flight of stairs without matching feet and without crutches — going up only.

Day 20

Did 30 minutes of water running and 15 minutes of kickboarding in the pool. (Am also doing upper body/ab workouts). This was the first time that my leg muscles were really engaged in anyway. Left leg is really starting to atrophy, and I still can’t really fully lock my knee, which I believe is due to the fact that they cut into your patellar tendon in order to insert the rod. I hate the pool but I can tell that this is a great way to strengthen my ankle muscles, and I seem to hate water running and kickboarding less than actual swimming.

Other notes: 

1. A friend of mine got in touch about her own tib/fib break, which was much worse than mine, and the progress of her recovery. Here is what she wrote:

I broke my tib and fib VERY BADLY on Nov 1st, 2010. I had ORIF with 11 screws, 2 plates, 2 hooks, and wire in. It just looked bad. I almost threw up when they removed the cast after 2 weeks and put me in the boot. I cried. Then I got really strong arms from crutches. The winter sucked, but I made new friends who gave me rides and helped me shovel a path to the bus stop.

I went to the pool as soon as the wound healed, one month after surgery. I swam a lot. I put my foot down on Jan 1st. I was bike riding by late January. I could not walk until I completed therapy in March. But I was doing a lot of pilates. I was walking in April. Walking with no pain at all in June. Hiking in July in the mountains and jumping.  Little running in August and a lot of walking. Completely running in September. Removing all the screws and plates and metal stuff in late September.

2. I don’t really understand why so many people have had the same IM nail surgery but were told to keep all weight off of it for an initial period. I mean, I surmise that there have been recent studies that have showed that WBAT is useful in healing, but I feel terribly for people who had to go through that.

3. I feel very lucky to be able to keep my foot relatively elevated — and most significantly, to be able to ice it throughout that day. I think that icing is REALLY helping.

4. I’ve really been trying to do as much crutch free walking as possible, but the transition away from one crutch is not going to happen this week. I can tell that the muscles in my legs are just not strong enough yet for me to properly pronate. Additionally, and probably relatedly, my balance is terrible. All of this makes it hurt at the fracture site when I walk entirely crutchless. On the other hand, I am using the one crutch very lightly, as much supporting me in the horizontal dimension as vertical.

Here are some pictures of my healing yet weakening leg(s). I know that the atrophy isn’t that pronounced, but if you let your eyes go a bit blurry, you can definitely see it. Random question that I’m interested in is will my toe bumps from my climbing shoes, which you can kind of see in the second picture, go away with my break from climbing, or are they permanent?

Also, here is a pic of my knee range of motion. This is actually very similar to that of my right (good) leg, but it is definitely stiffer.

Psychological:

My doctor’s appointment and going down to one crutch were pretty exciting and motivating, and at the beginning of the week, I felt like I was crushing everything. Now that it’s the end of the week, I’m feeling like my life is more or less back to normal — though a new, slower normal. This is good in some ways, but also makes me less super motivated to go to the gym, watch what I eat since I’m not burning nearly as many calories, etc. I am doing those things, I just don’t get the same dopamine rush out of them that I did when I was like, I can’t believe this is happening! I’m also able to focus more on my work, particularly after my doctor’s visit, which is good.

I took some friends who had never climbed indoor bouldering at my gym on Saturday, since it was free for first-timers, and they loved it. The whole experience — hanging out and helping, and just seeing them get into it — really made me happy, and thinking about it does motivate me to try to return to bouldering by the time I get back to the States on May 15.

Looking ahead, I am excited to start physical therapy, and I am really hoping to be able to go crutch free within the next week. Of course there is nothing more that I can really do to achieve this goal, but I’m hoping anyway.