On the couch

The world's most famous sufferer of gout.

While I have the podiatrist booked in for next week I found out that the resident physio at the Royal was around last night so I took the opportunity to get another opinion. I really wanted someone to see the state of my foot while it was ballooned up in the hope that that might make a diagnosis more accurate. Que an email to Linda the physioterrorist with my various ailments post DW and an apology at the bottom, 'I'm normally fit and healthy.'  (Although I'm not sure I believe that anymore)

We started with the wrist and numb fingers. She jabbed a thumb into my forearm and within a couple of minutes the numbness started to abate. To be fair, it's been getting much better lately anyway, particualry at night when I've found it most annoying but  I had felt something in my wrist give way during the race so I knew that there must be some damage and swelling in there. It still feels a little strange if I try to use a screwdriver or open a jam jar but it is much, much better, but Linda gave me a couple of exercises to do in order to keep it going.

We then turned to my foot and the slight numbness I have in my left big toe. This toe always suffers. If my feet get cold on the bike or in the water then this toe is my little personal barometer which tells me I'm cold and will be the first and usually only thing to go numb. It seems that my sciatic nerve has pressure on it still, and is causing the toe to get pins and needles (or as little wheezy says, 'go fizzy'). Again, more dynamic and static exercises to stretch out my hams where the nerve has to thread its way through, in the hope this will release the pressure over time.

Now to the swelling on my foot. She was not happy about this at all and fairly quickly ruled out anything to do with the plantar fascia which does not usually cause swelling of this sort. And she was quite impressed (or disgusted; not sure which) about the colour of my foot compared to my other one, being a rather unhealthy red. Linda came up with 2 potential causes. Firstly, a stress fracture. In my mind this seems to make sense to me. Two days after the Tadworth 10 and really motoring downhill I get an attack; last week, two days after doing jump squats I get an attack. However there have been quite a few times when it's happened but I cannot pin down what the trigger could have been, except for the fact of course that I may have been jogging with an 18kg kayak on my shoulder and just doing a long run and one would assume that would be enough to aggravate it, although I wouldn't realise it.

The other option? Gout!! My diet isn't the best in the world but I'm hardly having a fry up for breakfast everyday. Usually the pain for gout occurs in the big toe and not where I have it  (maybe the numbness is it? Linda seems to think not) It seems unlikely that it is gout but there's no doubt I would be upset if it was, although Linda was at pains to tell me that it's not just diet related and restricted to people who drink too much and it would be a lot easier to treat than a stress fracture.

Okay, so, armed with this I went to my GP again today. Thankfully, my foot was still swollen so I was able to show my GP what state it was in. Again, she ruled out PF straight away. I mentioned gout and so she booked me in for a blood test next week to hopefully rule this out. She felt it was not a stress fracture due to the recurring nature of the pain. This kind of makes sense but maybe it's small so settles after time but can be aggravated by a larger force than usual, like running down hill for instance? She seemed to think it was some form of tendonitis that is continually being aggravated. Anyway, she packed me off to the hospital to get x-rayed.

From what I have read it seems unlikely that a stress fracture would show up on an x-ray. In fact the radiologist asked me to hang around so that they could check the x-ray as he was quite impressed with the swelling as well and I think assumed I had really broken my foot somewhere.  The fact that 2 minutes later he sent me home, rather indicates that probably, very little will come of the x-ray. Huuummpppffff. I go back in a week's time to get the results (or lack thereof)

So what should I do now? I guess, the best thing I can do is assume it's a stress fracture or tendonitis and treat for that, which basically means a complete break from running for an extended period. I think I should take a good 8 weeks off and continue to do my core and conditioning (without the jump squats of course) and do some cycling and paddling which both being low impact should not be a problem. That makes an autumn marathon very unlikely and frankly, quite risky, so it looks like a focus on half marathons towards the end of the year. Not what I'd planned, but at the moment, very little is.

A consolation is this photograph. While it was taken about 20 seconds into the DW, we are in time, our hands are high and we've got pretty good extension (rotation could be better though! ;-)  Thank's Bob!! Proof that coaching works.