Monthly Archives: January 2012

Beloved Shoes

Prior to ankle doomsday, I enjoyed wearing various types of shoes:  practical, impractical, solid, patterned, etc.  My focus was not on brand, designer, or trend but rather on pure look.  If I thought a pair of shoes was elegant, fun, or could be worn in a specific context, I would get it.

I love these elegant jellies. Sadly, I purchased them just a few months before the accident. I've been known to slip them on during seated portions of fancy events.

I took shoes for granted.  I think most able-bodied people do.  A night on 3-inch heels (I’m tall, so I look silly if I go much higher than that) produced transitory heel pain or insignificant blisters; annoying, but no big deal.

I wore these at home all the time...and to high school on a few occasions (which was silly because they have a soft sole).

I don’t spend my days steeped in self pity over the fact that I now have quite limited shoe options; however, there are some specific pairs of shoes that I do miss:

Unlike the coolest kids, I actually tied my Adidas Superstars in front. No lace tucking for me.

To my pre-accident shoes, which sit untouched and unworn in a clear plastic storage case in my parents’ basement — this post is for you.  I have taken you out of the virtual closet.

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Let’s Get Some Shuz

...and what a lovely family it is.

Can an aching foot find a comfy home?

One of my smallest concerns (essentially a non-concern) post- ankle debacle has been that I can’t wear 90% of the shoes I owned prior to the accident.  I’ve held onto my cutest shoes in hopes that some day I will be able to wear them.  (But if you’re a size 9 [women] and feeling persuasive, you can try me…).

More upfront in my mind is how I can find comfortable, supportive shoes that keep my feet in a neutral position — not plantar-flexed as they are in the Z-Coil shoes below, and not topsy-turvy as they are in a rocker bottom a la MBTs.  In a quest for comfort,

I walked in these puppies for almost a year. I'm amazed I still have friends.

I have had to (try to) sideline the shame accompanied by wearing shoes with springs on the bottom or sperm as the logo.

I am currently wearing a less conspicuous pair of shoes:  Asics Gel Kayanos in white with blue and green trim.  I’ve also recently found some incredibly cushiony, stable boots that do not look one bit orthopedic.

  • What kind of shoes do you wear for cushion and stability?
  • Which shoes do you wear when you work out?
  • Do you know of any companies that make decent-looking ortho shoes?
~Post your ideas and run with them.

Really? You couldn’t have picked a less awkward logo? I colored mine in with black sharpie but it wore off.

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Footless Fitness

Usually the phrase “sitting on my ass” conjures up images of TV, dips. fried foods, laziness — in essence, Superbowl Sunday syndrome.  For people with mobility impairments, however, sitting on one’s ass can be a gateway to exercise.

Here are 3 examples:

1.  Wheelchair basketball.  This sport is emerging as a trendy choice amongst disabled and non-disabled people alike.  Players must become adept at navigating their chair and the ball.  Wheelchair basketball requires manual dexterity, upper body strength, and multi-tasking.  You would likely have trouble finding a player who could eat a churro or dip a chip into guac while playing this game.

2.  Exercise-ball physical therapy.  This option is less exciting than #1 because it involves the word “therapy.”  However, using a firm yet bouncy gym ball can bring back fun childhood memories (Gymboree?).

Could you do this exercise without falling on your face and/or ass?

Staying on the ball without using one’s feet requires balance skills and attention and provides toning of the core.  I thought that using a gym ball was mere child’s play…until my parkour-practicing roommate tried to do my exercises and fell flat on her ass within 5 seconds.

3. ” Sit and Be Fit.”  This award-winning television show, broadcast on public TV with the energetic Mrs. Mary Ann Wilson, is geared towards the senior population — a downside for young people with disabilities.  You can be youthful and fit and still need to exercise while seated.  Nevertheless, I have yet to bite the bullet and join Mary Ann for a workout.  I’m working on it.

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Feeling Cranky: The Arm Ergometer

The arm ergometer, also known as a hand crank, is an exercise apparatus that provides the cranker with a muscle toning and cardiovascular workout.  The target population for this gym device is disabled people with lower body impairments, but several able-bodied people have incorporated the arm ergometer into their workouts in order to bulk up those biceps.

The cranker sits upright — in a chair, wheelchair, or on a gym ball — with the cranks at shoulder height and then proceeds to “bike” with their upper body.

Have you seen one of these machines?

Since I can’t fully extend my right shoulder due to scapulothoracic bursitis (also known as ‘snapping scapula syndrome’ — how upbeat and downright snappy) from a year on crutches and extended time compensating for an injured right ankle, I cannot use an arm ergometer in the traditional way; however, my orthopedist has suggested that if I can find a way to immobilize the injured joints in my foot (likely by wearing a customized brace), I could stand in front of the machine, possibly elevated on an exercise block, and crank at waist level.

Next step:  to find a gym with one of these suckers.  Any ideas?  They’re 10K a pop, so individual purchase is not an option.

Please crank out some suggestions.

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The Scoop on the Hoop

Hulahooping.com says it best:  “Hula Hoops from the 50’s were small colorful plastic tubes made primarily for children to play and exercise. Today, hula hooping has come full circle. Children still love them and adults have begun using stronger, larger, heavier hoops for fitness and fun.”

When a friend’s mom recommended that I hula hoop for exercise, the second thing that came to mind (after the physical feasibility of hooping on a bad foot) was how I would ensure that no one would see me with my large, weighted, bright pink hoop.

Today’s hoops enable us to get a sustained cardio and core workout; they stay at our waists (usually).

My first hooping session was exhilarating:  I put on an upbeat playlist, went outside, and hooped for 20 minutes in each direction.  After the burst of endorphins, I realized that I couldn’t walk — too much pain.  I was laid up in bed for several days.

Hula hooping is great, but it’s not worth being stuck at home writing papers in a supine position as you elevate your injured leg.

How can we make hooping more ankle friendly?  

I'm not (too) embarrassed to hoop, but haven't found a way to make it ankle friendly. Any ideas?

Some suggestions:

  • wearing ski boots to limit motion of the foot joints.  result: ski boots tilt you forward.  They are somewhat helpful but end up straining your hips.  Also, it takes about 10 minutes to set them up with your own orthotics.
  • hooping on 1 leg.  result:  I am not dumb enough to try this.  Today’s hoops are heavy, and symmetrical body alignment is crucial to happy hooping.
  • hooping on a cushioned pad.  result:  ankle moves as much as on solid ground.

People who used to hoop in the ’50s (hi, mom!), contemporary hoopers, Burning Man enthusiasts, UCSC alums…please share your hooping stories and ideas!

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This Week’s Theme: Exercise

Thank you to everyone who has provided me with ideas on how to get a workout without flaring up my foot.  Your comments here, on Facebook, and via email have been insightful.

Here are some suggestions I’ve received:

  • Indoor rowing while wearing a brace that would lock the ankle and subtalar joints
  • swimming with a pull buoy
  • walking in a pool
  • cycling while wearing a solid brace

Swimming with a pull buoy was my main form of exercise until this summer.  A lot of time on crutches, an uneven gait, and a year+ of upper-body freestyle caused a severe strain, and subsequent limited mobility, of the right shoulder/upper back.  The body is indeed one interconnected system.

I have realized the importance of exercising routinely and am hoping to find 4 or 5 activities that I could alternate between so that no body part gets too taxed.

Aside from a year of intermittent upper-body swimming, I have not exercised in 4.5 years.  My orthopedist lauds me for staying (somewhat) thin despite my sedentary lifestyle; my heart and lungs are telling my orthopedist to shut up…they need a work out.

Shoulder problems have pulled me away from swimming. What are other creative modes of exercise?

Please exercise your minds to help me find exercise!  At this point, I do not care how silly something might sound or look.  I am willing to tinker, tailor, (soldier, spy) any form of exercise.

Next post:  body hooping.

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Break Your Bones, Not Your Soft Tissue

Inside the radiologist’s office, I learned way more about foot and ankle anatomy than I had ever wished to know.

A summary of the MRI results (I will spare you a verbatim report of the MRI findings, which read like the script of an M. Night Shyamalan film):

-complete tearing of 1 ligament and severe strains on another — anterior talofibular ligament (ATFL) and calcaneo-fibular ligament (some acronym I don’t know and am too lazy to google…likely CFL).

-burst joint capsules, widespread edema in the ankle and subtalar joints

-bone contusions — severe bruising of the talus (the main ankle bone) and calcaneus (heal bone)

In English:  while I did not have any clear breaks in bones (thank you, mom, for convincing me to take a daily calcium supplement), the internal structure of some key bones had been crushed.  My soft tissue was a mess.  A footwreck.

The radiologist’s departing words:  “Man, it’s too bad you didn’t just break something.  Bone heals much faster and more easily than soft tissue.”

Duly noted, Mr. Radiologist.  The next time I damage a body part, I’ll make sure to break bone before tearing ligaments, bursting joint capsules, or acquiring bone contusions.

~~

The flippant remark above stems from my knowledge that the radiologist was correct.  I live with a deep wish that I had just cracked the tibula, fibula, or both and left the other anatomy alone.  But pragmatism>unrealistic dreams…so rather than cursing the bone gods, I’ll ask the blog gods to help me in this effort to gather information about soft tissue damage (and intra-bone damage) to the ankle/subtalar region.

FOOT FOR THOUGHT

How can someone who has limited use of a foot (pain with weight-bearing and motion of the subtalar and ankle joints) and a strained upper back and shoulder (from being on crutches for about a year and overcompensating for lack of lower-body support), stay in aerobic shape?  

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Mr. Foot Can’t Stand It

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When Two Feet Collide

If you’re feeling lazy, you can read the following sentence and skip the rest of this post:  1. always wear your joint braces;  2. in softball, there should be 2 first bases (1 for the runner and 1 for the fielder);  3. because I did not follow my own advice in #1 and others did not follow #2, I wrecked my right ankle.

I’ve been trying to find a way to relay what seems to be critical information for future blog posts — namely, what exactly happened to my ankle — without sounding melodramatic or self pitying.  In an attempt to de-dramatize what for me was indeed traumatic and life altering, I will stick to the facts.

August 2007:  I’m at bat in an intramural softball game.  I swing, make contact, and sprint to first base.  Unbeknownst to me, the inexperienced 1st-base woman has her entire foot on the bag.  I’m focusing on outrunning my pathetic hit, making up for mediocre batting with speed.  In an instant, my foot snaps over the 1st-base woman’s misplaced foot and I collapse.  An eversion sprain (the foot rolls outwards), followed by an inversion sprain (I try to catch myself and end up doing double the damage).  Forgetting I’m not wearing Swede-Os, I stand up, shake my foot, try to “walk it out,” and after 1 to 2 steps collapse on the field.

A few friendly men carry me off of the field and an EMT creates a makeshift splint.  At the ER an hour later, my foot and ankle are at least double their normal size.  According to my orthopedist during my visit the next day, my toes “look like little hot dogs.”  How delicious.

At the ER, I am x-rayed,  pumped with heavy-duty pain medicine, placed in a boot and crutches, and instructed not to weight bear at all.

~

My orthopedist thinks I have a 2nd-degree ankle sprain that should heal up within a few months.  He writes me several prescriptions for narcotics, joking that I can pay for my college books by selling some of the pills (yeah, he’s a cool orthopedist…one of few), and instructs me about icing and eventual weight bearing.

A week later across the country, a radiologist at an imaging center where I have just had an MRI runs into the parking lot and asks, ‘excuse me, are you the young lady who just had an MRI of the right foot?’  I think he knows the answer because my right foot has a solid boot on it and I’m hobbling to our minivan.

‘I’m the radiologist and I’ve read your scan.  Please, could you come into my office for a few minutes?’

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Brace Yourself

Sports have always been an important part of my life.  From toddling around the preschool playground to playing 7 years of competitive soccer, I learned how to cope with dislocated joints, bruises, cuts, and sand in the face (thank you, preschool).  In 3rd grade, I was diagnosed with osteochondritis dissecans of the right knee.  The doctors explained to me that, for some unknown reason, my knee was not receiving adequate blood supply and the bones comprising the joint were slowly dying.  I was ordered to cease physical activity (except for small bits of walking) for an undetermined amount of time.

My youthful cells rose to the occasion and healed my knee within the year. When I hit the soccer pitch, softball field, and basketball and volleyball courts, penalty kicks, fly balls, blocks, and kills were accompanied by exhilarating team camaraderie and less exhilarating bodily sprains — primarily of the ankle.

Hypermobility.  Joint laxity.  Flexible.

These are all promising modifiers when describing a geriatric patient.  But for an athlete, they can indicate problems.  Starting around age 11, I would not step foot on turf or court — practice or official match — unless wearing a sturdy brace on each ankle.  (Thank you, Swede-O, for 8 years of stabilization).

On August 22, 2007, I decided I could pack my Swede-O’s in one of several duffel bags imminently heading with me to my freshman year of college.  Did I need to wear braces for a casual, intramural softball game?  Couldn’t my loose joints withstand a few lateral shuffles to field balls and a couple of trips around the bases (ok — a couple of trips to first base, perhaps second)?

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