Midfoot Pain: A Cautionary Tale

[Wokabaut_Meri]

Time to set down my cautionary and sorry tale... apologies as it's a bit long - to be read with a good cuppa...

In April and May this year I walked the Camino Frances with my husband and a friend new to long distance walks. Our friend had great difficulty on the the first day crossing the Pyrenees and I ended up pushing and pulling her most of the way up before my husband and I took turns carrying her pack to Orisson. At one point she just gave up and fell back on me - pack and all (both she and her pack were heavier than me and mine). That was the moment I really pushed and drove with my right leg to prevent her falling and taking me with her. I felt something strain and hurt but continued on. My doctors are fairly sure that this was the trauma point which caused my subsequent injury. Being run over a few days later by a pram with chubby bub (I kid you not!) in Puente la Reina added soft tissue insult to the injury.

That first night I noticed a sharp pain when I climbed up and down the ladder to my top bunk and thought it odd but just put it down to the effort of the day/first day of a long walk etc etc. My husband and I have regularly trekked in remote parts of Australia and all over the world so are used to the vagaries of our chosen recreational activities.

With a dull ache to occasional stabbing pain in my midfoot, which I strapped and medicated along the Way, I limped the 800kms into Santiago 43 days later thinking that, at worst, I had strained something and a few sessions with my physio at home would resolve the issue.

Was I ever wrong! Diagnosis sequence as follows:

• treating Physio believes foot fracture may be cuboid following 3/4 weeks non response to both conservative and active treatment > GP > xray (negative) > GP > CT Spect scan (hotspots all over right midfoot too dense for any diagnosis also problems with 2,3,4 metatarsal joints) > GP > cortisone injections in metatarsal joints, swelling goes down but midfoot problem remains > GP > Rheumatologist for Rheumatoid Arthritis assessment (negative) > believes Inflammatory Osteoarthritis (negative) and need to rule out Osteoporosis > Bone Density scan (will probably develop Osteoporosis when I am 100, I'll take that!) & MRI > MRI shows fracture navicular bone > fortunately see Physio same day decide refer Sports Doctor for management > Sports Doctor takes one look & refers to Sports Physician due to complexity > Sports Physician immobilises immediately and sends me for another detailed CT scan of navicular to assess whether surgery is required
• time from presentation till diagnosis 11 weeks, which is well within the 4 -7 month average for this type of injury
• time from injury to diagnosis 19 weeks
• physio almost spot on with the diagnosis
• opinion is that I fractured bone on day 1 of 44 walking days
• I told my husband that it was soooorrreee!!!
• saw Sports Physician again with detailed CT scan
• no surgery required in the first instance - yayyy!!
• treatment 8 weeks in non weight bearing boot followed by 4-6 weeks in weight bearing boot and further 2 weeks if required
• review in 4 weeks for clinical assessment as scans will lag healing. If not good then surgery (hardware & bone graft) and start on whole timeline again as above - NOT preferred outcome but possible
• I should be walking on two feet again by Christmas - celebrations pencilled in
• injury atypical to athletes - Tour de France winner Chris Froome latest (this cheers me up somewhat)
• injury that usually ends AFL footballers careers (this has opposite effect but not planning to kick ball about)
• have crutches and a wonderful gadget called a knee walker aka knee scooter so am relatively but cumbersomely mobile
• at risk of DVT & PE and need to monitor
• El Hombre (THE Man) is my designated carer. This is going to be a really loooonnngggg recovery process all round.

So... that's my story . Doing all that I can in the hope of avoiding surgery. For an extremely active person this imposed restriction is driving me nuts - 'cat in a cage' my hubby calls it. He is also very mechanical and is making me a knee trolley so that I can get about the house and be able to have both hands free. He is out in his shed putting the finishing touches to it as I write.

Now, before any lectures etc etc , the pain really wasn't that bad. This is atypical of the injury to this bone where it will settle after resting for a while. It was more of a niggle and I was quite often pain free. If anything it was worse when I took my walking boots off in the evening. I now know that the boots acted as a splint for the injury.

The main point of my post is that this type of injury, as well as stress fractures of the navicular, are routinely difficult to diagnose unless seen by a Sports Physician. My physio was very close to the correct diagnosis but it took many scans and $$$s to finally confirm. Given that I am a female in my 60s, there were a host of other conditions that fitted the symptoms.

It's been an interesting journey so far... Day 18 of 56 NWB (non weight bearing)

Oh - and we organised for our friend to have her pack chauffeured to Santiago from Orisson onwards and she powered into Santiago to complete her Camino.

 

[joeboybollo]

Meri? well done for finishing. But may I say you should have been a medical secretary.
Best of luck with your recovery. Let's hope you are dancing at Christmas and planning your next Camino(without your friend-obviously!!)

 

[Wokabaut_Meri]

Meri? well done for finishing. But may I say you should have been a medical secretary.
Best of luck with your recovery. Let's hope you are dancing at Christmas and planning your next Camino(without your friend-obviously!!)

Thank you. I always say that it's amazing what you don't know you don't know until you have to learn. In my case, anatomy and medical tests, procedures and mobility aids by injury. This is not my first broken bone on a walk/trek. I did manage to break and crack some ribs when a calf cramp dropped me midstep on a downhill on the Kokoda Track. I walked out 2 days with that as well but knew I had broken something. I am in awe of our trekking gear as I discovered that a backpack is a great brace for ribs.

And while I usually never repeat a walk, there is something about the Camino...

I see that you are from the West Midlands. I was born in Redditch and left for Australia when I was 11. Small world.

 

[Magwood]

Best wishes for your recovery. I'm sure many of us tend to ignore pain that should be investigated.

 

[Wokabaut_Meri]

Best wishes for your recovery. I'm sure many of us tend to ignore pain that should be investigated.

Thanks, Magwood. One of the reasons that I posted was that the pain really wasn't so bad - just niggly, the occasional sharp burst and hours truly pain free. The scans show that I adapted and walked around it hence stirring up some inflammation in other areas.

The joys of 20/20 vision in hindsight.

 

[LauraK]

Ouch! I can't imagine being non weight bearing for so long. I wish you a speedy recovery. Thanks for posting. I think it is a good reminder for all pilgrims to stop and have possible injuries checked. Amazing how our pain tolerance increases on the camino. On the CF I had a sharp stabbing pain on the top of my right foot that would occur randomly getting worse every day. I found if I stopped often and re-tied my boot it relieved the pain. After two weeks I figured out to put a big piece of padded moleskin across the top of my foot which helped. After returning home I found I had injured a nerve (maybe tieing my boot too tight). Three years later I still have numbness on my first and second toe and can get shooting pains when walking very long distances. I now pad this area daily when walking my caminos. I can't help wondering if I could have avoided the damage if I had stopped to check in with a doctor.

 

[Ann Abfalter]

What a sto

Time to set down my cautionary and sorry tale... apologies as it's a bit long - to be read with a good cuppa...

In April and May this year I walked the Camino Frances with my husband and a friend new to long distance walks. Our friend had great difficulty on the the first day crossing the Pyrenees and I ended up pushing and pulling her most of the way up before my husband and I took turns carrying her pack to Orisson. At one point she just gave up and fell back on me - pack and all (both she and her pack were heavier than me and mine). That was the moment I really pushed and drove with my right leg to prevent her falling and taking me with her. I felt something strain and hurt but continued on. My doctors are fairly sure that this was the trauma point which caused my subsequent injury. Being run over a few days later by a pram with chubby bub (I kid you not!) in Puente la Reina added soft tissue insult to the injury.

That first night I noticed a sharp pain when I climbed up and down the ladder to my top bunk and thought it odd but just put it down to the effort of the day/first day of a long walk etc etc. My husband and I have regularly trekked in remote parts of Australia and all over the world so are used to the vagaries of our chosen recreational activities.

With a dull ache to occasional stabbing pain in my midfoot, which I strapped and medicated along the Way, I limped the 800kms into Santiago 43 days later thinking that, at worst, I had strained something and a few sessions with my physio at home would resolve the issue.

Was I ever wrong! Diagnosis sequence as follows:

• treating Physio believes foot fracture may be cuboid following 3/4 weeks non response to both conservative and active treatment > GP > xray (negative) > GP > CT Spect scan (hotspots all over right midfoot too dense for any diagnosis also problems with 2,3,4 metatarsal joints) > GP > cortisone injections in metatarsal joints, swelling goes down but midfoot problem remains > GP > Rheumatologist for Rheumatoid Arthritis assessment (negative) > believes Inflammatory Osteoarthritis (negative) and need to rule out Osteoporosis > Bone Density scan (will probably develop Osteoporosis when I am 100, I'll take that!) & MRI > MRI shows fracture navicular bone > fortunately see Physio same day decide refer Sports Doctor for management > Sports Doctor takes one look & refers to Sports Physician due to complexity > Sports Physician immobilises immediately and sends me for another detailed CT scan of navicular to assess whether surgery is required
• time from presentation till diagnosis 11 weeks, which is well within the 4 -7 month average for this type of injury
• time from injury to diagnosis 19 weeks
• physio almost spot on with the diagnosis
• opinion is that I fractured bone on day 1 of 44 walking days
• I told my husband that it was soooorrreee!!!
• saw Sports Physician again with detailed CT scan
• no surgery required in the first instance - yayyy!!
• treatment 8 weeks in non weight bearing boot followed by 4-6 weeks in weight bearing boot and further 2 weeks if required
• review in 4 weeks for clinical assessment as scans will lag healing. If not good then surgery (hardware & bone graft) and start on whole timeline again as above - NOT preferred outcome but possible
• I should be walking on two feet again by Christmas - celebrations pencilled in
• injury atypical to athletes - Tour de France winner Chris Froome latest (this cheers me up somewhat)
• injury that usually ends AFL footballers careers (this has opposite effect but not planning to kick ball about)
• have crutches and a wonderful gadget called a knee walker aka knee scooter so am relatively but cumbersomely mobile
• at risk of DVT & PE and need to monitor
• El Hombre (THE Man) is my designated carer. This is going to be a really loooonnngggg recovery process all round.

So... that's my story . Doing all that I can in the hope of avoiding surgery. For an extremely active person this imposed restriction is driving me nuts - 'cat in a cage' my hubby calls it. He is also very mechanical and is making me a knee trolley so that I can get about the house and be able to have both hands free. He is out in his shed putting the finishing touches to it as I write.

Now, before any lectures etc etc , the pain really wasn't that bad. This is atypical of the injury to this bone where it will settle after resting for a while. It was more of a niggle and I was quite often pain free. If anything it was worse when I took my walking boots off in the evening. I now know that the boots acted as a splint for the injury.

The main point of my post is that this type of injury, as well as stress fractures of the navicular, are routinely difficult to diagnose unless seen by a Sports Physician. My physio was very close to the correct diagnosis but it took many scans and $$$s to finally confirm. Given that I am a female in my 60s, there were a host of other conditions that fitted the symptoms.

It's been an interesting journey so far... Day 18 of 56 NWB (non weight bearing)

Oh - and we organised for our friend to have her pack chauffeured to Santiago from Orisson onwards and she powered into Santiago to complete her Camino.

What a story! Hopefully your recovery will be good going forward

 

[gracethepilgrim]

Thank you. I always say that it's amazing what you don't know you don't know until you have to learn. In my case, anatomy and medical tests, procedures and mobility aids by injury. This is not my first broken bone on a walk/trek. I did manage to break and crack some ribs when a calf cramp dropped me midstep on a downhill on the Kokoda Track. I walked out 2 days with that as well but knew I had broken something. I am in awe of our trekking gear as I discovered that a backpack is a great brace for ribs.

And while I usually never repeat a walk, there is something about the Camino...

I see that you are from the West Midlands. I was born in Redditch and left for Australia when I was 11. Small world.

Hi Meri, wow you have certainly been through the mill with diagnosis. Great that you know what it is now. I noticed your avatar and was wondering if you are wearing an Aarn pack? I’ve just bought one for my upcoming CPI (Portugal Interior) camino and love the training walks. It’s sooooo comfy and the loaded weight feels half what I’d expect. I’m thrilled with it so far.
Good luck with your recovery. Cheers

 

[Arminius]

Time to set down my cautionary and sorry tale... apologies as it's a bit long - to be read with a good cuppa...

In April and May this year I walked the Camino Frances with my husband and a friend new to long distance walks. Our friend had great difficulty on the the first day crossing the Pyrenees and I ended up pushing and pulling her most of the way up before my husband and I took turns carrying her pack to Orisson. At one point she just gave up and fell back on me - pack and all (both she and her pack were heavier than me and mine). That was the moment I really pushed and drove with my right leg to prevent her falling and taking me with her. I felt something strain and hurt but continued on. My doctors are fairly sure that this was the trauma point which caused my subsequent injury. Being run over a few days later by a pram with chubby bub (I kid you not!) in Puente la Reina added soft tissue insult to the injury.

That first night I noticed a sharp pain when I climbed up and down the ladder to my top bunk and thought it odd but just put it down to the effort of the day/first day of a long walk etc etc. My husband and I have regularly trekked in remote parts of Australia and all over the world so are used to the vagaries of our chosen recreational activities.

With a dull ache to occasional stabbing pain in my midfoot, which I strapped and medicated along the Way, I limped the 800kms into Santiago 43 days later thinking that, at worst, I had strained something and a few sessions with my physio at home would resolve the issue.

Was I ever wrong! Diagnosis sequence as follows:

• treating Physio believes foot fracture may be cuboid following 3/4 weeks non response to both conservative and active treatment > GP > xray (negative) > GP > CT Spect scan (hotspots all over right midfoot too dense for any diagnosis also problems with 2,3,4 metatarsal joints) > GP > cortisone injections in metatarsal joints, swelling goes down but midfoot problem remains > GP > Rheumatologist for Rheumatoid Arthritis assessment (negative) > believes Inflammatory Osteoarthritis (negative) and need to rule out Osteoporosis > Bone Density scan (will probably develop Osteoporosis when I am 100, I'll take that!) & MRI > MRI shows fracture navicular bone > fortunately see Physio same day decide refer Sports Doctor for management > Sports Doctor takes one look & refers to Sports Physician due to complexity > Sports Physician immobilises immediately and sends me for another detailed CT scan of navicular to assess whether surgery is required
• time from presentation till diagnosis 11 weeks, which is well within the 4 -7 month average for this type of injury
• time from injury to diagnosis 19 weeks
• physio almost spot on with the diagnosis
• opinion is that I fractured bone on day 1 of 44 walking days
• I told my husband that it was soooorrreee!!!
• saw Sports Physician again with detailed CT scan
• no surgery required in the first instance - yayyy!!
• treatment 8 weeks in non weight bearing boot followed by 4-6 weeks in weight bearing boot and further 2 weeks if required
• review in 4 weeks for clinical assessment as scans will lag healing. If not good then surgery (hardware & bone graft) and start on whole timeline again as above - NOT preferred outcome but possible
• I should be walking on two feet again by Christmas - celebrations pencilled in
• injury atypical to athletes - Tour de France winner Chris Froome latest (this cheers me up somewhat)
• injury that usually ends AFL footballers careers (this has opposite effect but not planning to kick ball about)
• have crutches and a wonderful gadget called a knee walker aka knee scooter so am relatively but cumbersomely mobile
• at risk of DVT & PE and need to monitor
• El Hombre (THE Man) is my designated carer. This is going to be a really loooonnngggg recovery process all round.

So... that's my story . Doing all that I can in the hope of avoiding surgery. For an extremely active person this imposed restriction is driving me nuts - 'cat in a cage' my hubby calls it. He is also very mechanical and is making me a knee trolley so that I can get about the house and be able to have both hands free. He is out in his shed putting the finishing touches to it as I write.

Now, before any lectures etc etc , the pain really wasn't that bad. This is atypical of the injury to this bone where it will settle after resting for a while. It was more of a niggle and I was quite often pain free. If anything it was worse when I took my walking boots off in the evening. I now know that the boots acted as a splint for the injury.

The main point of my post is that this type of injury, as well as stress fractures of the navicular, are routinely difficult to diagnose unless seen by a Sports Physician. My physio was very close to the correct diagnosis but it took many scans and $$$s to finally confirm. Given that I am a female in my 60s, there were a host of other conditions that fitted the symptoms.

It's been an interesting journey so far... Day 18 of 56 NWB (non weight bearing)

Oh - and we organised for our friend to have her pack chauffeured to Santiago from Orisson onwards and she powered into Santiago to complete her Camino.

Meri, not a pleasant camino story. I wish you fast recovery, with many new perspectives.

 

[C clearly]

I have been recovering from a garden-variety stress fracture. It was hard enough to spend 6 weeks doing virtually no walking, so I can imagine your struggle! Similarly, my pain was not severe - I always said "my foot is sore", not that it "hurt" a lot. So I kept walking for a few months until I realized that it simply wasn't getting better. Now it is good, but I am always nervous when I feel any twinge in it. It is still hard to know whether to keep walking or rest.

 

[Wokabaut_Meri]

Ouch! I can't imagine being non weight bearing for so long ... After returning home I found I had injured a nerve (maybe tieing my boot too tight). Three years later I still have numbness on my first and second toe and can get shooting pains when walking very long distances. I now pad this area daily when walking my caminos. I can't help wondering if I could have avoided the damage if I had stopped to check in with a doctor.

Ouch back! Sorry to hear that your problem persists but good to know that it isn't stopping you from walking.

Hindsight is a wondrous thing but, given the long process and varied diagnosis of my own fracture, you need to see a health professional at the time who has had experience with your exact problem and all the X-rays and scans in the correct order before the correct diagnosis. It's easy for me to look back now and go - aha! that's when it happened - but it was such a small strain at the time. I also manage osteoarthritis in that foot so it was simply another condition which I managed.

My Sports Doctors have been wonderful and we have talked over all sort of scenarios. They are just amazed at how little secondary damage I have done given that I walked on and around the injury to complete the Camino. But then I was also walking on that foot for 11 weeks back home before the correct diagnosis. The doctors also believe that my boots acted as a splint and held the foot together.

Yes, the non weight bearing is a true test of discipline. I have spoken with many athletes now who have had the same injury and they all say - Patience, Patience, Patience. It certainly is an experience to be mobility impaired in a world that is centred around the able bodied. It has given me a real insight into the efforts and frustrations of people with disabilities. At least I will be walking again.

 

[Wokabaut_Meri]

What a sto

What a story! Hopefully your recovery will be good going forward

Thanks. I'm 3 weeks NWB tomorrow and hopeful for non surgery on review in another week.

 

[Wokabaut_Meri]

Hi Meri, wow you have certainly been through the mill with diagnosis. Great that you know what it is now. I noticed your avatar and was wondering if you are wearing an Aarn pack? I’ve just bought one for my upcoming CPI (Portugal Interior) camino and love the training walks. It’s sooooo comfy and the loaded weight feels half what I’d expect. I’m thrilled with it so far.
Good luck with your recovery. Cheers

Thank you! Yes... it's an Aarn. Be warned - it's addictive and infinitely adjustable - I can fiddle and tweak it to my heart's content and it drives my hubby nuts. I have been an Aarn follower for many years through the experimental, bad and amazing. It isn't for everyone but I find that it suits me well. It is so convenient to be able to get your water, food, maps etc out of the front pockets as you walk.

I just find that I walk much more upright with it and have no shoulder or back issues at all. The only addition I have made is to have a pack cover (I got a lightweight cuban fibre one from Z Packs and it worked well) and I waterproofed the front pockets as well as having Z Pack liners. This meant that I could carry my maps and credential and keep them dry.

 

[Wokabaut_Meri]

Meri, not a pleasant camino story. I wish you fast recovery, with many new perspectives.

Thank you! All these good wishes are bound to have a positive effect on my healing.

And I'm certainly discovering new perspectives about mobility impairment.

 

[Wokabaut_Meri]

I have been recovering from a garden-variety stress fracture. It was hard enough to spend 6 weeks doing virtually no walking, so I can imagine your struggle! Similarly, my pain was not severe - I always said "my foot is sore", not that it "hurt" a lot. So I kept walking for a few months until I realized that it simply wasn't getting better. Now it is good, but I am always nervous when I feel any twinge in it. It is still hard to know whether to keep walking or rest.

Think that all fractures deserve respect so you've done well to limit your walking. It is hard though. A true test.

My foot only ever really ached with the occasional stabbing pain. A fracture was never a consideration given the oust that I deal with in that foot. It certainly felt like a minor soft tissue injury.

I can understand the nerves - I have that to come yet but have a very good physio team who respect my outlook and aims and I will work with them through the rehab.

 

[PEI_Heather]

Meri, are there any Bowen practitioners in your area? That would definitely aid in your recovery. (Bowen Technique/Therapy)

Time to set down my cautionary and sorry tale... apologies as it's a bit long - to be read with a good cuppa...

In April and May this year I walked the Camino Frances with my husband and a friend new to long distance walks. Our friend had great difficulty on the the first day crossing the Pyrenees and I ended up pushing and pulling her most of the way up before my husband and I took turns carrying her pack to Orisson. At one point she just gave up and fell back on me - pack and all (both she and her pack were heavier than me and mine). That was the moment I really pushed and drove with my right leg to prevent her falling and taking me with her. I felt something strain and hurt but continued on. My doctors are fairly sure that this was the trauma point which caused my subsequent injury. Being run over a few days later by a pram with chubby bub (I kid you not!) in Puente la Reina added soft tissue insult to the injury.

That first night I noticed a sharp pain when I climbed up and down the ladder to my top bunk and thought it odd but just put it down to the effort of the day/first day of a long walk etc etc. My husband and I have regularly trekked in remote parts of Australia and all over the world so are used to the vagaries of our chosen recreational activities.

With a dull ache to occasional stabbing pain in my midfoot, which I strapped and medicated along the Way, I limped the 800kms into Santiago 43 days later thinking that, at worst, I had strained something and a few sessions with my physio at home would resolve the issue.

Was I ever wrong! Diagnosis sequence as follows:

• treating Physio believes foot fracture may be cuboid following 3/4 weeks non response to both conservative and active treatment > GP > xray (negative) > GP > CT Spect scan (hotspots all over right midfoot too dense for any diagnosis also problems with 2,3,4 metatarsal joints) > GP > cortisone injections in metatarsal joints, swelling goes down but midfoot problem remains > GP > Rheumatologist for Rheumatoid Arthritis assessment (negative) > believes Inflammatory Osteoarthritis (negative) and need to rule out Osteoporosis > Bone Density scan (will probably develop Osteoporosis when I am 100, I'll take that!) & MRI > MRI shows fracture navicular bone > fortunately see Physio same day decide refer Sports Doctor for management > Sports Doctor takes one look & refers to Sports Physician due to complexity > Sports Physician immobilises immediately and sends me for another detailed CT scan of navicular to assess whether surgery is required
• time from presentation till diagnosis 11 weeks, which is well within the 4 -7 month average for this type of injury
• time from injury to diagnosis 19 weeks
• physio almost spot on with the diagnosis
• opinion is that I fractured bone on day 1 of 44 walking days
• I told my husband that it was soooorrreee!!!
• saw Sports Physician again with detailed CT scan
• no surgery required in the first instance - yayyy!!
• treatment 8 weeks in non weight bearing boot followed by 4-6 weeks in weight bearing boot and further 2 weeks if required
• review in 4 weeks for clinical assessment as scans will lag healing. If not good then surgery (hardware & bone graft) and start on whole timeline again as above - NOT preferred outcome but possible
• I should be walking on two feet again by Christmas - celebrations pencilled in
• injury atypical to athletes - Tour de France winner Chris Froome latest (this cheers me up somewhat)
• injury that usually ends AFL footballers careers (this has opposite effect but not planning to kick ball about)
• have crutches and a wonderful gadget called a knee walker aka knee scooter so am relatively but cumbersomely mobile
• at risk of DVT & PE and need to monitor
• El Hombre (THE Man) is my designated carer. This is going to be a really loooonnngggg recovery process all round.

So... that's my story . Doing all that I can in the hope of avoiding surgery. For an extremely active person this imposed restriction is driving me nuts - 'cat in a cage' my hubby calls it. He is also very mechanical and is making me a knee trolley so that I can get about the house and be able to have both hands free. He is out in his shed putting the finishing touches to it as I write.

Now, before any lectures etc etc , the pain really wasn't that bad. This is atypical of the injury to this bone where it will settle after resting for a while. It was more of a niggle and I was quite often pain free. If anything it was worse when I took my walking boots off in the evening. I now know that the boots acted as a splint for the injury.

The main point of my post is that this type of injury, as well as stress fractures of the navicular, are routinely difficult to diagnose unless seen by a Sports Physician. My physio was very close to the correct diagnosis but it took many scans and $$$s to finally confirm. Given that I am a female in my 60s, there were a host of other conditions that fitted the symptoms.

It's been an interesting journey so far... Day 18 of 56 NWB (non weight bearing)

Oh - and we organised for our friend to have her pack chauffeured to Santiago from Orisson onwards and she powered into Santiago to complete her Camino.

 

[CaminoDebrita]

Time to set down my cautionary and sorry tale... apologies as it's a bit long - to be read with a good cuppa...

In April and May this year I walked the Camino Frances with my husband and a friend new to long distance walks. Our friend had great difficulty on the the first day crossing the Pyrenees and I ended up pushing and pulling her most of the way up before my husband and I took turns carrying her pack to Orisson. At one point she just gave up and fell back on me - pack and all (both she and her pack were heavier than me and mine). That was the moment I really pushed and drove with my right leg to prevent her falling and taking me with her. I felt something strain and hurt but continued on. My doctors are fairly sure that this was the trauma point which caused my subsequent injury. Being run over a few days later by a pram with chubby bub (I kid you not!) in Puente la Reina added soft tissue insult to the injury.

That first night I noticed a sharp pain when I climbed up and down the ladder to my top bunk and thought it odd but just put it down to the effort of the day/first day of a long walk etc etc. My husband and I have regularly trekked in remote parts of Australia and all over the world so are used to the vagaries of our chosen recreational activities.

With a dull ache to occasional stabbing pain in my midfoot, which I strapped and medicated along the Way, I limped the 800kms into Santiago 43 days later thinking that, at worst, I had strained something and a few sessions with my physio at home would resolve the issue.

Was I ever wrong! Diagnosis sequence as follows:

• treating Physio believes foot fracture may be cuboid following 3/4 weeks non response to both conservative and active treatment > GP > xray (negative) > GP > CT Spect scan (hotspots all over right midfoot too dense for any diagnosis also problems with 2,3,4 metatarsal joints) > GP > cortisone injections in metatarsal joints, swelling goes down but midfoot problem remains > GP > Rheumatologist for Rheumatoid Arthritis assessment (negative) > believes Inflammatory Osteoarthritis (negative) and need to rule out Osteoporosis > Bone Density scan (will probably develop Osteoporosis when I am 100, I'll take that!) & MRI > MRI shows fracture navicular bone > fortunately see Physio same day decide refer Sports Doctor for management > Sports Doctor takes one look & refers to Sports Physician due to complexity > Sports Physician immobilises immediately and sends me for another detailed CT scan of navicular to assess whether surgery is required
• time from presentation till diagnosis 11 weeks, which is well within the 4 -7 month average for this type of injury
• time from injury to diagnosis 19 weeks
• physio almost spot on with the diagnosis
• opinion is that I fractured bone on day 1 of 44 walking days
• I told my husband that it was soooorrreee!!!
• saw Sports Physician again with detailed CT scan
• no surgery required in the first instance - yayyy!!
• treatment 8 weeks in non weight bearing boot followed by 4-6 weeks in weight bearing boot and further 2 weeks if required
• review in 4 weeks for clinical assessment as scans will lag healing. If not good then surgery (hardware & bone graft) and start on whole timeline again as above - NOT preferred outcome but possible
• I should be walking on two feet again by Christmas - celebrations pencilled in
• injury atypical to athletes - Tour de France winner Chris Froome latest (this cheers me up somewhat)
• injury that usually ends AFL footballers careers (this has opposite effect but not planning to kick ball about)
• have crutches and a wonderful gadget called a knee walker aka knee scooter so am relatively but cumbersomely mobile
• at risk of DVT & PE and need to monitor
• El Hombre (THE Man) is my designated carer. This is going to be a really loooonnngggg recovery process all round.

So... that's my story . Doing all that I can in the hope of avoiding surgery. For an extremely active person this imposed restriction is driving me nuts - 'cat in a cage' my hubby calls it. He is also very mechanical and is making me a knee trolley so that I can get about the house and be able to have both hands free. He is out in his shed putting the finishing touches to it as I write.

Now, before any lectures etc etc , the pain really wasn't that bad. This is atypical of the injury to this bone where it will settle after resting for a while. It was more of a niggle and I was quite often pain free. If anything it was worse when I took my walking boots off in the evening. I now know that the boots acted as a splint for the injury.

The main point of my post is that this type of injury, as well as stress fractures of the navicular, are routinely difficult to diagnose unless seen by a Sports Physician. My physio was very close to the correct diagnosis but it took many scans and $$$s to finally confirm. Given that I am a female in my 60s, there were a host of other conditions that fitted the symptoms.

It's been an interesting journey so far... Day 18 of 56 NWB (non weight bearing)

Oh - and we organised for our friend to have her pack chauffeured to Santiago from Orisson onwards and she powered into Santiago to complete her Camino.

Oh, what a tale! I bet you will become masterful at arm weights and sit ups!

 

[Wokabaut_Meri]

Oh, what a tale! I bet you will become masterful at arm weights and sit ups!

Not to speak of hopping about on one foot! No issues with a lot of my one legged yoga poses either.

 

[Wokabaut_Meri]

Meri, are there any Bowen practitioners in your area? That would definitely aid in your recovery. (Bowen Technique/Therapy)

Thanks PEI_Heather. Yes there are. will ring one and have a chat about my situation.

 

[VNwalking]

it's amazing what you don't know you don't know until you have to learn

Very wise words, Meri...and quite an amazing story.
So thank you for making sure we know what you didn't. How many of us would have done exactly what you did, continuing to walk with a niggling pain, and not thinking much of it? Certainly I would have done no differently....
Wishing you an abundance of patience to deal with the non-weightbearing time, the best possible results for the review, and speedy healing!

 

[Wokabaut_Meri]

Very wise words, Meri...and quite an amazing story.
So thank you for making sure we know what you didn't. How many of us would have done exactly what you did, continuing to walk with a niggling pain, and not thinking much of it? Certainly I would have done no differently....
Wishing you an abundance of patience to deal with the non-weightbearing time, the best possible results for the review, and speedy healing!

Thank you for your kind wishes. This was exactly why I posted - so that anyone with similar symptoms might pause and have the issue checked out.

Will update as my recovery continues. Positive signs already as I can manipulate around the injury without the pain that previously presented.

Day 24 of 56 NWB (non weight bearing)

 

[PEI_Heather]

Thanks PEI_Heather. Yes there are. will ring one and have a chat about my situation.

Great! If you haven't tried it before, I hope it will amaze you! It's the most progressive and spectacular therapy I've ever seen, worked with and have been treated with. Let me know how you do!

 

[VNwalking]

We will be sending all good wishes and will be happy to know how you go...

 

[Wokabaut_Meri]

Update: Day 40 of 59 (an extra 3 days due to timing of Specialist appointment ) NWB (non weight bearing)

Well, the good news is that my Sports Doctor has confirmed that my navicular fracture is healing well and will not require surgery. All my medicos are pleasantly surprised as they were expecting that I would require surgical intervention given what I did post the initial injury. Have said a quiet 'Thank you' to St James and the Camino. However, I am still in the non weight bearing boot for another 2½ weeks and then can begin a very slow and gradual return to full weight bearing, still in the boot, over a further 6 weeks. Another review at this stage and then more physio without the boot. So... I am planning that first bushwalk for Christmas.

While I am not a medical professional, nor does this substitute for medical advice, a useful diagnostic for this particular fracture is 'N' (for NAVICULAR!!) spot tenderness. A good photograph of this test can be found on the Sports Medicine Physiotherapy website about halfway down the page. In my case, this spot presented super sensitive to any touch i.e. on the pain scale, thump anyone who tries! The fact that this spot can now be prodded without any discomfort is a good indicator that healing is occurring.

Another useful tool to be added to my SportsMed collection.

The past 5½ mobility impaired weeks have been a real eye opener as to how our society is geared to the able bodied. I have given my local council and several shopping centres some useful feedback on improving accessibility. My knee walker and homemade knee trolley have been indispensable for maintaining my sanity and some level of independence. My husband drops me and my knee trolley off at a shopping mall or hardware store 2/3 times a week and goes off for some caffeine fuelled respite while I carefully hoon about. The kids love me and are quite envious.

Leg exercises and compression stockings are working for me so far with no evidence of DVT. I'm sure that the good old legs up the wall yoga pose has helped as well. I have my physio standing by to begin my rehabilitation and have found a Bowen practitioner that I will also see once I am weight bearing again.

Thanks again all for your insight and good wishes. Will continue to update on my healing Camino.

 

[Wokabaut_Meri]

Update: Day 2 Weight Bearing

Whoo Hoo!! Saw my Sports Physician yesterday and got my marching orders so am officially a Biped again.

Great news given a DVT (deep vein thrombosis) scare a week ago that, fortunately, proved negative.

Now start a long rehabilitation program, still in the boot, and a gradual return to full weight bearing - softly, softly... foot and leg feel like a block of wood and that first step was seriously weird. Now have to calm down and not panic at each twang and tiny ache. My medical team have set the upper limits for my daily exercises (most unusual as they normally have to encourage patients to meet the minimum) and I return for a review in 2 weeks. They are still amazed that it has healed as well as it appears.

So... staying patient (ha! ha! looove the play on words) and focused and thinking happy thoughts.

 

[Kanga]

Good to hear your news Meri. Sounds like keeping yourself in check will be the hardest part of the recovery.

 

[pudgypilgrim]

What good news! And I'm so glad you posted this. I was walking the Voie de Tours from Paris last month during a couple of weeks of very heavy rain. The second day we were walking in very deep fallen leaves in the forêt de St Aubin and there was a big hidden gully that the rain had scooped out under the leaves. I managed to put one walking stick and my left leg into that and fell, which wouldn't have been a big deal, but I fell on my poles. At the time I thought I had broken my arm and cracked a rib and took the pain in my foot for a hot spot from walking so long with soaked feet. But everything else cleared up after the pharmacie put me on Arnicalm and Arnigel. But by Cloyes-sur-le-Loir (about another 100k) my foot was seriously bothering me. They told me I'd have to stop for at least a week, then no pack and not more than 5 km a day for a while, which is impossible on that route, so I gave up and came home for now, only to find it really was a fracture, but at least not a navicular break.

Reading your st0ry makes me extra glad I didn't just push on, which I was tempted to do.

I'm jealous of your knee trolley, though. I hate crutches!

 

[Wokabaut_Meri]

What good news! And I'm so glad you posted this. I was walking the Voie de Tours from Paris last month during a couple of weeks of very heavy rain. The second day we were walking in very deep fallen leaves in the forêt de St Aubin and there was a big hidden gully that the rain had scooped out under the leaves. I managed to put one walking stick and my left leg into that and fell, which wouldn't have been a big deal, but I fell on my poles. At the time I thought I had broken my arm and cracked a rib and took the pain in my foot for a hot spot from walking so long with soaked feet. But everything else cleared up after the pharmacie put me on Arnicalm and Arnigel. But by Cloyes-sur-le-Loir (about another 100k) my foot was seriously bothering me. They told me I'd have to stop for at least a week, then no pack and not more than 5 km a day for a while, which is impossible on that route, so I gave up and came home for now, only to find it really was a fracture, but at least not a navicular break.

Reading your st0ry makes me extra glad I didn't just push on, which I was tempted to do.

I'm jealous of your knee trolley, though. I hate crutches!

Sorry to hear of your fall and injury. The pharmacies are a constant Aladdin Cave and the mix of traditional and modern treatment and therapies a delight. I only continued on because my pain was more dull ache with occasional short sharp bursts of pain. I really thought that it was soft tissue or, at worst, muscular. Strapped it, medicated and walked on. Jumping into a swimming pool at our hotel in Santiago was when I realised that something else was wrong.

Good luck with your Healing Camino. I see that you're in the USA - lucky you! You can even get a knee rover over there - a serious 4wd go anywhere knee scooter. If my non weight bearing continued any longer, I was sooo going to get one of those. It would mean that I could get out and about in the bush. I hate crutches too. The only 2 falls that I had in the 8½ weeks were off the crutches.

Tongue-in-cheek warning! This is a card that a kind nurse friend sent to me while I was recovering.

 

[pudgypilgrim]

The only 2 falls that I had in the 8½ weeks were off the crutches.

Ouch! Sorry to hear about that. Luckily my days on the crutches are just about done. I'm supposed to start with just the boot in a few days (my break isn't as bad as yours and my orthopedic surgeon is very leery of crutches and told me he often puts patients in the hospital because he can see they'll never manage with crutches without putting weight on the joint, especially if it's ankles). That knee rover would have been great, though, especially having the basket. My biggest problem right now is trigger finger from leaning on the crutches. (I already had nerve damage in that finger from long ago and it was a bit aggravated from the walking poles even before I got the crutches.)

I hope your home is only one story. Stairs sure are challenging, aren't they?

It does give one a whole different perspective on getting around, though, doesn't it? Our local grocery chain is very, very good about having lots of motorized carts and having the baggers drive one out for you so you don't have to clunk all the way through the parking lot, but I had to laugh when I was driving around the store and realized that they've got it arranged so that the only things you can reach while sitting on the cart are their store brand items.

Love the card!

 

[C clearly]

Good to hear about your progress. My metatarsal stress fracture healed in 8 weeks and I'm now on the Camino with no foot problems!

 

[Wokabaut_Meri]

Good to hear your news Meri. Sounds like keeping yourself in check will be the hardest part of the recovery.

Oh yes!

 

[Wokabaut_Meri]

Ouch! Sorry to hear about that. Luckily my days on the crutches are just about done. I'm supposed to start with just the boot in a few days (my break isn't as bad as yours and my orthopedic surgeon is very leery of crutches and told me he often puts patients in the hospital because he can see they'll never manage with crutches without putting weight on the joint, especially if it's ankles). That knee rover would have been great, though, especially having the basket. My biggest problem right now is trigger finger from leaning on the crutches. (I already had nerve damage in that finger from long ago and it was a bit aggravated from the walking poles even before I got the crutches.)

I hope your home is only one story. Stairs sure are challenging, aren't they?

It does give one a whole different perspective on getting around, though, doesn't it? Our local grocery chain is very, very good about having lots of motorized carts and having the baggers drive one out for you so you don't have to clunk all the way through the parking lot, but I had to laugh when I was driving around the store and realized that they've got it arranged so that the only things you can reach while sitting on the cart are their store brand items.

Love the card!

As it's my right foot that was injured, I found that on crutches I was constantly in danger of putting that foot down when going up or down steps or a slope. That's why the crutches only lasted one day as my primary transport and I graduated through a progression of leg scooters to the wonderful indoors leg trolley.

Luckily my home is one storey but has a step at both front and back doors.

Yes, it's a learning experience and you truly, truly appreciate how much easier life is when you are fully mobile and how much time and effort mobility impairment consumes. We also have some great supermarkets here with wide aisles and very considerate staff.

One of our Camino compañeros was so taken by the card that he had a t-shirt made.

This is my 3rd day weight bearing, still in the boot, and the apprehension is slowly settling, as is my foot. It was seriously weird taking that first step though, all sorts of strange pains and sensations. I have a booster attachment called an 'Evenup', akin to a boot crampon for my good foot so that I stand level. My Physio insisted on it. Also I am using Pacer Poles for support as my foot needs a lot of building up after 8½ weeks non weight bearing. As long as I don't do any more than the maximum of my strengthening exercises, my medical team think that it will be 6 weeks before I am out of the boot. I'm off to the swimming pool tomorrow to check out hydrotherapy classes as I can't do any kicking yet to properly swim.

All the best for your return to the Land of Bipeds. We can both appreciate and relish now what we previously took for granted.

 

[Wokabaut_Meri]

Good to hear about your progress. My metatarsal stress fracture healed in 8 weeks and I'm now on the Camino with no foot problems!

Wonderful to hear. Buen Camino!

 

[pudgypilgrim]

All the best for your return to the Land of Bipeds. We can both appreciate and relish now what we previously took for granted.

Thanks. That's for sure. I forgot to say that while I was in Chateaudun I fell in with a little tour given by some local historians, two of whom had walked the Camino. They saw me limping and cheerfully told me that you get extra merit for walking the chemin with a hurt foot. Just think how much you must have!

 

[Wokabaut_Meri]

Thanks. That's for sure. I forgot to say that while I was in Chateaudun I fell in with a little tour given by some local historians, two of whom had walked the Camino. They saw me limping and cheerfully told me that you get extra merit for walking the chemin with a hurt foot. Just think how much you must have!

800kms worth!

 

[Wokabaut_Meri]

Time for an update.

Just over 4 weeks since I began a gradual return to weight-bearing. I was meant to spend 6 weeks still in the CAM (controlled ankle movement) aka Moon boot but my Sports Physician said that I was healing remarkably well and my ankle had locked up so I've been totally free of it for about 12 days now. Came off the support crutches 10 days ago and today was the first day that I felt confident enough to go out without my pacer poles.

Rehabilitation is a long and slow process. Far too slow for me. If I tell you that my zodiac sign is Aries and Chinese sign is a Horse, you get the picture. If my hubby says patience, grasshopper one more time .... although he was in a bit of a huff for a few days after I first got my marching orders and I finally got him to admit that he thought this meant that I'd be walking about normally pretty much straight away It's been a long process all round...

Soooo.... in between visits to the Physio, Podiatrist, Bowen Therapist and Sports Physician, I started with just simple joint mobilisation to get the block of wood to resemble a foot again. I can write the alphabet forwards, backwards and sideways while reading a book. Now I have a whole series of exercises with theraband and wobble board on top of walking around the house doing normal stuff. I never thought that being able to sweep paths and clean floors would be something that I looked forward to. Relax, I'm sure that it will all get to be mundane again. The only rule that is enforced is that if there is any pain or swelling, I take 2 steps back only had to do that once (twice).

The swimming pool has been my saviour. Initially I was in the Rehab pool and Hubby got to push me in a special wheelchair so that I could do a few gentle stretching exercises. There was also a mechanism resembling a dunking stool to enable pool entry but I threatened him with injury if he even considered it. I have now progressed to using a hydro-belt to run about in deep water and I also get to zoom up and down the 50m pool with a pullbuoy to remember what moving at speed in the water was like.

Slow and steady it is but also so much a rollercoaster ride. Every day the foot hurts in new way in a different area and every twinge is examined, every step is considered, the ground ahead scanned for possible hazards and situational awareness is at high alert. If you want to practice total mindfulness, just fracture your foot!

I'm longing to go for a walk but sobered by the possibility of doing further damage in the process so will wait it out. My footballer mates have been a great encouragement and emphasise the patience aspect and regale me with horror stories of fractures gone wrong. Cheerful lot.

The Healing Camino continues...

 

[VNwalking]

Been wondering how you've been doing...

If you want to practice total mindfulness, just fracture your foot!

I do...but I'll pass on the later, thanks.
And I'm sorry you did...but hopefully it will not delay your walking tooooo much longer!

My footballer mates have been a great encouragement and emphasise the patience aspect and regale me with horror stories of fractures gone wrong. Cheerful lot.

No thanks to that, too, Meri! You take care out there, hear? Those guys probably know what they're talking about.

 

[pudgypilgrim]

Oh, you do so have my sympathy, Meri. It's driving me crazy and I've been out of the boot for almost a month now and my little fractures were nowhere near as bad as yours . I'm afraid I'd be impossible to live with in your situation. But I'm really glad that you seem to be ahead of schedule. Hopefully not too much longer now. (I hate the wobble board more than anything--so frustrating!, but picking up the marbles is kind of fun.)

 

[Wokabaut_Meri]

Thanks for the happy thoughts @Viranani

Angels come in all sorts of (dis)guises and my footy boys have been delightful company and wonderful support.

They also recommended RoseHip for any ongoing inflammation and alerted me to Australia's Therapeutic Goods Administration (TGA) review of the safety of the NSAIDS (non-steroidal anti-inflammatory ie ibuprofen, diclofenac and naproxen) following increasing reports of dangerous cardiovascular complications. These medications will carry warnings from next year that they could put people at risk of heart attack and stroke. Even a few weeks of using the drugs could increase a person's risk of a fatal heart attack.

"The TGA said its review found the medications were safe when they were used according to the recommended doses for short durations, as instructed on the label.

However, inappropriate use or overuse of these medicines could pose a significant risk of cardiovascular events and, in the case of diclofenac, (liver toxicity)," it said.

All forms of ibuprofen, diclofenac and naproxen will now carry a warning that using them at high doses can increase your risk of high blood pressure, heart attack and stroke. The warning will state: Do not use for more than a few days at a time unless a doctor has told you to. Do not exceed the recommended dose. Excessive use can be harmful and increase the risk of heart attack, stroke or liver damage.

Most medications will be expected to carry the label by July 2016, although some have been given an extension until January 2017."

 

[Wokabaut_Meri]

Oh, you do so have my sympathy, Meri. It's driving me crazy and I've been out of the boot for almost a month now and my little fractures were nowhere near as bad as yours . I'm afraid I'd be impossible to live with in your situation. But I'm really glad that you seem to be ahead of schedule. Hopefully not too much longer now. (I hate the wobble board more than anything--so frustrating!, but picking up the marbles is kind of fun.)

Hope that you're travelling well on your Healing Camino too. All I can do with the marbles at the moment is play football as my foot is still too stiff.

 

[C clearly]

Glad to hear about your progress. You might remember that I had a stress fractured metatarsal earlier this year. I am currently on the Camino, having walked some 700 km, and my metatarsals have been great! Other parts are sore, but the metatarsal bones have healed. You'll be back.

 

[Wokabaut_Meri]

Glad to hear about your progress. You might remember that I had a stress fractured metatarsal earlier this year. I am currently on the Camino, having walked some 700 km, and my metatarsals have been great! Other parts are sore, but the metatarsal bones have healed. You'll be back.

Hold
On
Pain
Ends

Stay
Optimistic



Thanks! So good to hear.

Buen Camino

 

[Saint Mike II]

Hola / G'day Meri - I appologise in advance but your tail of diagnosis almost had me in stitches (laughing), but acknowledging every single factor of the diagnosis trail. I went through something similar with my problem (left) foot. It was almost 13 months before an accurate diagnosis was determined - the downside, only rest will cure it, but not guaranteed.
To finally get to the bottom of your complaint must have provided psychological if not physiological relief. To know that eventually "it will get better" is a positive. It's now almost Christmas - so hopefully you have the moon-boot off and the bubbly on ice!! Cheers

 

[Wokabaut_Meri]

Hola / G'day Meri - I appologise in advance but your tail of diagnosis almost had me in stitches (laughing), but acknowledging every single factor of the diagnosis trail. I went through something similar with my problem (left) foot. It was almost 13 months before an accurate diagnosis was determined - the downside, only rest will cure it, but not guaranteed.
To finally get to the bottom of your complaint must have provided psychological if not physiological relief. To know that eventually "it will get better" is a positive. It's now almost Christmas - so hopefully you have the moon-boot off and the bubbly on ice!! Cheers

No need to apologise. I have dissolved into (manic) laughter on many occasions during this journey. It was a relief to finally get a diagnosis and I was so glad that I persisted as it would have been easy to just give up and hobble away. In the end going to a Sports Doctor was the best decision as they deal with these type of injuries and understand that all you want to do is get back to full physical strength and mobility and not sit around 'enjoying' the rest.

And... while it is almost Christmas I'm not walking - yet. Will update further as soon as I have another campfire meeting with my ever expanding treating team but due to the 8½ weeks non weight bearing and immobilisation I have disuse osteopaenia (bone thinning as a result of non weight bearing and not exercising) and have been scaled back in my activities to just walking about the house plus spinning on my exercise bike. I am only allowed out to go swimming or on crutches I am holding up relatively well but it's a bummer!

As you've stated, only rest (with gradual loading) will cure. Can I pry and ask what your diagnosis was?

 

[pudgypilgrim]

Oh man, Meri, what a bummer! I hope you start to heal faster faster soon.

If nothing else you'll have more patience than anyone else on the camino next time.

 

[Saint Mike II]

As you've stated, only rest (with gradual loading) will cure. Can I pry and ask what your diagnosis was?

Sure although I can not find the medical report - the upstart was that between the old Roman roads on the Via de la Plata (between Merida and Alconetar) and the incorrect padding provided by my walking boots, the nerve and associated muscles between the second and third toes were effectively destroyed. I had two or three different medical specialists poke their noses into the problem - 4 or 5 MRIs and finally my podiatrist suggested an ultrasound (it was the only thing that had not been used). Then we had the benefit of a technician who went the extra metre/mile - she did what she was asked (on the left foot) but then did the right (just to have something to compare against) and that was how the muscle/nerve atrophy was determined. A final MRI confirmed the ultrasound and the news from surgeon - rest, limited walking and maybe there might be improvement. Surgery was out - more likely to do more damage than repair.
So 30 months down the track there has been some improvement, but if I am to return and walk the parts of the Camino Frances I omitted from the recent cycle ride (about 200/250 km) it will require new walking shoes (with a lot more padding) and a backpack of not more than 10kg (including food/water) and maybe 10km max days. Cheers

 

[Wokabaut_Meri]

Sure although I can not find the medical report - the upstart was that between the old Roman roads on the Via de la Plata (between Merida and Alconetar) and the incorrect padding provided by my walking boots, the nerve and associated muscles between the second and third toes were effectively destroyed. I had two or three different medical specialists poke their noses into the problem - 4 or 5 MRIs and finally my podiatrist suggested an ultrasound (it was the only thing that had not been used). Then we had the benefit of a technician who went the extra metre/mile - she did what she was asked (on the left foot) but then did the right (just to have something to compare against) and that was how the muscle/nerve atrophy was determined. A final MRI confirmed the ultrasound and the news from surgeon - rest, limited walking and maybe there might be improvement. Surgery was out - more likely to do more damage than repair.
So 30 months down the track there has been some improvement, but if I am to return and walk the parts of the Camino Frances I omitted from the recent cycle ride (about 200/250 km) it will require new walking shoes (with a lot more padding) and a backpack of not more than 10kg (including food/water) and maybe 10km max days. Cheers

Bummer x 2! I am walking about the house in a pair of HOKA ONE ONE Meta- Rocker trail shoes (bought on sale at a much cheaper price tag!) that have the most amazing cushioning and support. They are recommended by my podiatrist and when I start proper walking towards far horizons again, I'll try out one of their hiking shoes or boots. Something to discuss with your own podiatrist.

It's wonderful when you find that clinician/technician who goes the extra kilometre-mile. I expect that you have quite a collection of scans. Surgery is often not the answer and in cases such as mine, best avoided if possible.

30 months eeeekkk!!! how are you bearing up to it all? It certainly is a test of character one learns first hand what acceptance means

Some inspiration:
The world breaks every one and afterward many are strong at the broken places.
Ernest Hemingway: A Farewell to Arms

Here's to seeing you out along the Way sometime

 

[Wokabaut_Meri]

Oh man, Meri, what a bummer! I hope you start to heal faster faster soon.

If nothing else you'll have more patience than anyone else on the camino next time.

Thank you for kind wishes. Fortunately I am healing well and fast but keep finding other things that need healing. It certainly is a lesson in consequences to (forced) inactivity. A veritable cascade of small and not so small issues. I'm lucky in that I have a team around me who confer (so that I can't get away with anything!) and work together to resolve whatever comes up and needs attention.

Patience.... I am thankful to all my spiritual teachers from all faiths who taught me acceptance from an early age. It's a wonderful gift. That doesn't mean that I don't feel frustrated to the point of wanting to throw a tantrum. It's just that I realise that the energy would be better spent directed at healing and in the end, the healing still remains. One of my wonderful Buddhist teachers once told me that the best thing that you can do when it is raining in your life, is just to let it rain...

Hard to describe the process but he comes to mind when I am on the verge of faltering and I can feel again the moment in that meditation hall and then the pent up frustrated energy just dissapates

 

[Wokabaut_Meri]

As Robo says Get Off This Forum - Haven't you got anything better to do?

Well, not at the moment. My staff (dishwasher) are taking care of the dishes, kitchen's clean, breakfast laid out for the morning, hubby in bed and I'm icing my foot so have 20 minutes or more at my leisure...

Time for an update on the foot... was pushing my rehab right up to the limits navicular healing was good but all sorts of other issues in the foot kept cropping up and had to be dealt with. In the end my swollen and stiffened ankle continued to be a problem so was sent for another foot MRI which found all well except for disuse osteopaenia whereupon my doctors immediately grounded me (the week before Christmas!!!) and lectured me on the risks of further stress fractures if I chose to ignore their measured advice.

I was a little bit frustrated and somewhat confused did I mention annoyed ? Couldn't see how keeping weight off my foot and restricting walking was going to help anything but understood their concerns. Went to my scheduled physio appointment and discussed (read vented) at length. Physio (also long distance walker) continued with ankle mobilisation and reviewed doctors advice. Suggested that I scale back walking as advised but perhaps could trade off some of the rehab exercises for a short walk and see how I went. Continue with swimming, aqua-belt pool walking and stationary cycling. Keeping up the icing and regular elevation. Merry Christmas!

Went home, eased back on the rehab and walking for a few days and then pushed my newly imposed tighter limits... hmmm.... think... ponder... stew... research... discuss with footballers who know this injury well... started walking/wading in the sea on our local beach where the waves break surmising (read hoping) that this would be equivalent to my mobilisation exercises but that the cold water would reduce any resulting inflammation... plus it's weight bearing exercise and I can always swim if the walking becomes a problem.

Seems to have done the job ankle swelling markedly reduced ankle articulation greatly improved walking/wading longer distances without the previous aching...

See pod(iatrist) next week for permanent orthotics to replace the temporary ones now swelling reduced, physio and doctor week after to hopefully get marching orders again as well as OK to drive. Hubby has been designated driver for months and months now

2016 is looking good!!

 

[pudgypilgrim]

Oh gosh, Meri, what an ordeal this has been for you, but I'm so glad you're making progress.

 

[Wokabaut_Meri]

Oh gosh, Meri, what an ordeal this has been for you, but I'm so glad you're making progress.

Any progress is a blessing the main issue is that my rehab team is being extra cautious and thorough because I'm not healing just so I can walk around the shops - I'm healing and getting fit enough to walk another Camino

 

[Kanga]

I can also attest to the benefits of wading along in waist high cold sea water - my best rehabilitation after a broken ankle. Plus a chance to enjoy glorious Jervis Bay. Glad to see some progress for you @Wokabaut_Meri

 

[Wokabaut_Meri]

Update walking up to 5kms every other day now... sssshhhhh... my doctors and physio haven't been told yet (see them next week). Saw podiatrist and have orthotic in progress now that my foot has given up on swelling at whim still moans and groans a bit but gets pampered for its efforts - ice/elevation/stretches/massage/compression. @Kanga wading in the sea has been brilliant and I was gifted a school of fish and a (small) octopus for company the other day

Have ordered a new pair of boots to fit my slightly differently shaped foot and await marching orders from my medical team as to where, when and how far I can use them.

 

[mspath]

Happy to read of your progress! Keep on keeping on; this too shall pass.
MM

 

[pudgypilgrim]

That's great news, Meri. How wonderful that you can get out and walk again, even if only a bit so far.

 

[Wokabaut_Meri]

Well here it is almost a year since we started our Camino and f-i-n-a-l-l-y I'm back on my own two feet. What a Camino this one has been! The healing journey is not a gradual, predictable upward and onward route but more of a seismographic trip with unexpected side excursions.

Firstly a heartfelt THANK YOU to all the members of this Forum who have been my compañeros. It's really helped on some of the long and lonely meseta stretches and seemingly endless climbs. My medical team have been supportive and restrictive in equal measure, not afraid to make the hard calls and convince me that this was the Way that we needed to take. And then the surprises... the Aussie footballers who are fellow navicular fracture sufferers and know the journey well. All counselled patience, patience and more patience but always held the belief that it would all end well.

My years of meditation, some within convent walls, more in Buddhist gompas or walked in remote areas of this wondrous planet, gave me the strength to accept whatever presented and live that moment. And I am indebted to the Rudolf Abel character in the Spielberg film Bridge of Spies who, when asked: Aren't you worried? replied: Would it help?

Good Friday was the first evening when I realised that I'd gone the entire day without focusing or worrying about my foot. I'd just walked. My medical team told me that I would know when the foot was fully healed. This was what they'd meant.

Walk on!

 

[VNwalking]

There aren't enough likes for this, Meri!! Congratulations...I'm thrilled for you. And guaranteed your next Camino (whether the actual or life-challenge kind) will build on this one. You've used it so beautifully!

 

[mspath]

"When you walk through a storm, hold your head up high
And don’t be afraid of the dark
At the end of the storm, there’s a golden sky
And the sweet, silver song of a lark
Walk on through the wind
Walk on through the rain
Though your dreams be tossed and blown
Walk on, walk on
With hope in your heart
And you’ll never walk alone
You’ll never walk alone
Walk on, walk on
With hope in your heart
And you’ll never walk alone
You’ll never walk alone!"

Richard Rogers and Oscar Hammerstein, Carrousel, 1945

 

[Wokabaut_Meri]

There aren't enough likes for this, Meri!! Congratulations...I'm thrilled for you. And guaranteed your next Camino (whether the actual or life-challenge kind) will build on this one. You've used it so beautifully!

Thank you Viranani.

Keep forging the path for us on your current camino. We may yet meet on some distant path one day.

Go well!

 

[Wokabaut_Meri]

"When you walk through a storm, hold your head up high
And don’t be afraid of the dark
At the end of the storm, there’s a golden sky
And the sweet, silver song of a lark
Walk on through the wind
Walk on through the rain
Though your dreams be tossed and blown
Walk on, walk on
With hope in your heart
And you’ll never walk alone
You’ll never walk alone
Walk on, walk on
With hope in your heart
And you’ll never walk alone
You’ll never walk alone!"

Ricard Rogers and Oscar Hammerstein, Carrousel, 1945

Thank you and I hope your own healing Camino goes well.

When I was first in the Himalayas, a simple buddhist monk scribbled down this blessing and it has travelled everywhere with me since:

May you walk with your head in the clouds
And your feet firmly on the path
May the gods of the mountains walk with you
and see you safely home
So be it
So be it with you

 

[VNwalking]

Meri may it be so...for all of us! Beautiful.
And Margaret that's downright spooky. What do you think was singing in my head as I walked today from Rabé to Hontanas, head down into a howling cold headwind?

 

[CanPete]

Buen future Caminos !

 

[pudgypilgrim]

Good Friday was the first evening when I realised that I'd gone the entire day without focusing or worrying about my foot. I'd just walked. My medical team told me that I would know when the foot was fully healed. This was what they'd meant.

Yay!

 

[Wokabaut_Meri]

Buen future Caminos !

Thank you Pete!

Different Ways are swirling around my brain as we speak

 

[Wokabaut_Meri]

Yay!

Yay! indeed.

Thanks. I am indeed grateful for and to All.

My podiatrist asked me what it felt like to have my life back I am mindful of those whose Healing Caminos have different destinations.