You're a Little Small for a Stormtrooper

Today, I heard the phrase a man never wants to hear: "You're smaller than I thought you would be." Ahh, thanks?

That comment came from my new podiatrist, Dr. Lisch. He came into the exam room thinking that, like most people with chronic heel pain, I would be large. The fact that I don't spend time at work on my feet probably made him think this even more, so he was surprised at my 155 pound or so frame. As is obvious now, I decided to go to Dr. Sokolow to get a referal to finally get someone to look at my left foot. It's been hurting since August, and though I've had bouts where it felt pretty normal, it hasn't shown a willingness to fully heal. Of particular near-term concern is Spring speed workouts, as fast running seems to torque it off more than normal.

Doc Lisch did what I was hoping for; he took two x-rays of my foot to check for bone spurs. Before looking at it he said he would be "shocked if someone of your size, who wears good shoes, has a heel spur." He was right; my bones aren't growing! He told me that at the base of the plantar fascia is a sack of fluid. The sack gets all swole, pushes on the surrounding nerves, and thus causes pain. The sack tends to swell when you're asleep or seated, thus the pain in the mornings or after long car rides. He gave me a pamphlet with a variety of things I can do to help heal up, and many of the items were new to me, so I'm hopeful they'll help. Then, he got a very large needle.

He told me that he was going to give me a cortisone shot in the offending fluid sack to go ahead and un-inflame it. A shot, in the sole of my foot?!? That doesn't sound pleasant! So off he went and came back with the a large, though narrow needle, and some spray to numb my foot. It will only "hurt a little, and only briefly", he stuck in the needle, my foot started feeling "prickly", and then it was over. When I asked him if I would be able to run the Austin Half, he said I could run tonight if I wanted! I need to come back in a week for a second shot, but as he was "only giving me a little bit of cortisone" no need to limit my activity.

Then I started sweating, a lot. When giving blood, having blood work, or in similar needle situations, I sometime tend to get, a bit, shall we say, fainty. After giving me the shot, we started walking out front and I knew, from past experience, that my brain just wasn't getting enough oxygen to make a go of it. He realized this at about the time I was going to ask for a chair, and I was quickly seated so my heart would have an easier go of getting blood to my brain. He explained that my reaction is because my body, out of pyscological fear of the needle, goes into a small "fight or flight" reaction. In fight or flight, your blood vessels constrict so as to limit blood lose from the coming attack. Problem is, as he put it, that since this is a half-assed fight or flight response, my heart doesn't kick up my heart rate and blood pressue; not enough blood to the brain through the constricted vessels, and then Keith goes night-night! He said my running, which gives me a low heart rate and blood pressure, only makes the chance of passing out greater. I knew running was bad for me!

After about 10 minutes of chilling, I was recovered and went on my way, but decided to go home and sleep off the hangover of almost taking a unexpected nap. I still don't feel 100%, but at least my foot feels fine!

A couple of other interesting things the good doctor told me. He said, from looking at my feet, that I was a poor candidate for orthodics. The bones below my ankle "sag down a bit", and would not appreciate the firm orthodic that I would need to wear. I shared with him the pain the ArchMold orthodics I wore caused me, so I guess he was on the money with that one! He also said that, despite my strong pronation, I didn't need to wear a stable shoe (one that counteracts the pronation). He said I should find a shoe that let's my foot move the way it wants to, and that feels comfortable. I really don't know how to implement that advice, because it would seem that any shoe under the sun is not at my disposal. The only pointed shoe advice he gave me was pretty funny; he said to not wear New Balance. In short, he said New Balance use a large footbed to limit movement, and that, as his advice pointed out, was not what you want. Kind of funny that he dogged the shoes I so loyally wore for five or so years, but true to his advice, I do prefer the Mizuno I've been running in since the Summer.

Needles, they are my friend. I guess I'll get to see if believe that when I go in for my next shot.