New Running Shoes, Perilous Decisions

Not many weeks ago I took the first uncertain steps to resume running after an injury interrupted a many-years-long stint; I wrote about it here. I have a new pair of running shoes to prove it, hard-won shoes begat by the sweat of my own brow and a little research, and a long drive to a neighboring state.

Posterior Tib 2A

In the intervening days and weeks I have undertaken a running regimen one of my colleagues reviewed for an online publication. It’s aimed at folks who are athletic slugs with a keen desire to exercise, but without effective strategies for starting and sticking with it. The typical scenario of failure, as the program’s creator describes it, is resolving to run, and then over-reaching the first time out, soon throwing in the towel when the body balks.

That does not describe me. I am the runner who once started each day with a quick swig of water, a leashed dog or two, and then covered no fewer than four or five miles at a respectable clip before the sun had fully breached the eastern horizon. I remember the first time I ever tried this, tiptoeing out the back door a few minutes past five a.m., opening a squeaky iron gate quietly as I could to keep from waking the neighbors, stepping off the curb onto the chilly pavement with two eager Siberian Huskies whose excited breath showed in the amber light of the street lamps. The only sounds were the dogs’ toenails against the pavement, the occasional soft clinking of their tags, and our collective breathing. Somehow I did this crazy thing again the next day. And the next, and for many, many years, with different combinations of family dogs. I came to love this hour that was sometimes the only peace in my day.

We were so easily spooked in those early mornings by whatever we imagined lurked in the shadows of neighborhood trees and hedges. (Human or canine, the mind plays sinister tricks on itself in the darkness.) Out on the main road rolled newspapers sailed over the top of the paper carrier’s car in the darkness, each one set aloft by his expert arm but still landing with a quiet thwap in one driveway and then another (this action sometimes evoked a low growl in the dogs); we could hear baritone radio voices muted inside passing luxury sedans pointed towards the big teaching hospital just across the river, the doctors on call starting their rounds; we could smell other people’s toast and coffee; more than once skittish urban foxes and coyotes crossed our paths; finally we witnessed the street lamps flickering off as daylight overcame dawn. Each day my dogs and I watched the neighborhood wake up; by the time we arrived back home they were tired out, our own house was stirring, there was a child who needed to be gotten up and readied for school, breakfast to be made, schedules to follow. My quiet time for the day was over.

This lifestyle continued unchecked for years and I honestly believe brought me a measure of sanity I could derive from nothing else. But soon after I moved to Vermont for a new teaching position, and shortly before I lost my beloved German Shepherd Clarence in early 2014, chronic posterior tibial tendonitis forced me into running retirement. It’s a mouthful but mainly describes inflammation in the muscle and its associated tendon that reaches down from the calf and wraps under the heel by way of the ankle bone on the inside of the leg. Mine is painfully distended and swollen in the region of the heel itself near the attachment, and behaves badly most of the time. It does not respond well to stress, which would include long distance running. It does not take a shining to classical ballet, either, and one movement in particular, called relevé (think calf raises)—a movement that occurs many, many times over the course of a single 90-minute ballet class—is particularly aggravating. And of course it does not respond well to the other kind of stress, either—the emotional kind.

Add afternoons of teaching ballet class for a three- or four-hour stretch (actively dancing and demonstrating relevé and lots of other body-challenging movement), to mornings of vigorous long-distance running, and a congenital heel deformity that adds wear and tear to the soft tissue, and then throw in a little happy weight gain just for good measure, and the body will finally protest so loudly you can’t ignore it another second. Dang posterior tibial tendon: an orthopedic surgeon diagnosed it as compromised many years earlier, but it was decent enough to allow me to keep on keepin’ on. Now it was throwing the worst imaginable fist-pounding, screaming, spitting tantrum. It certainly had my undivided attention, as nature intended.

Posterior Tib 9A

My foot looks normal every morning but by day’s end is swollen and tight and yellow; it does this whether I run or do nothing, but it’s worse when I spend the day on my feet. Lately it has sprouted new capillary growth I can see just under the skin. But in my professional life now I spend most of an eight hour stretch sitting: this has brought welcome relief to the offending foot and heel. And in the last couple of months…could it be? I swear I could feel actual healing in that foot. The rest of me has felt like a slug, like the wanna-be runners for whom this interval training app is intended.

People rebound courageously all the time from all kinds of trauma far worse than mine, going on to reach impossible training and professional goals. I decided the “baby steps” approach of this little regimen could be the salve I needed to ease back into running again, this time without all those damaging relevés, and sadly also without a dog at the end of a leash. The first couple of times out I was giddy from the old euphoria that for me comes only from running. Other pursuits have stepped up to the plate in the last year and a half in lieu of it—yoga, weight training classes, bicycling in summer and spin classes in winter, and even swimming. Nothing does for me what running does, but I concede some of them (yoga especially) help make running better, or even possible.

Significantly, I returned home from those first few jaunts pain free: nada. zip. nothing. No pain at all, at least nothing outside of what I consider “normal” pain. Rest must have been the thing that was missing, I concluded, the thing all the dance and sports medicine professionals insist is so important for soft tissue injuries, but is so elusive for driven athletes. I finally gave this tiresome injury what it wanted, or so I believed.

Slowly and surely the pain came back.

I’m soldiering on for the time being, nearing the end of the fourth week of the training program and skipping some of the modules that feel silly to me. Last week I researched running with posterior tibial tendonitis, thinking other runners who have the same problem would report the fix: there must be some cocktail of exercises, stretching, icing, heat, or other things to make this work. In truth I have tried them all in the past (and some I still practice), but held out hope there was something I missed.

Posterior Tib 1A

Instead I found this ominous warning: Stop running, and stop now. Do not attempt to push through the pain. You do this at your own peril, risking permanent damage to your foot, damage that will change its shape and ultimately change how you walk and move. Furthermore, the very instep itself is at risk, as the tendon is what holds it up, giving it the important structure it needs to do its job.

Terrifying advice that leaves me at yet another difficult intersection.

Run at your own peril. Don’t run at all.

There is a particular flavor of nightmare I hate, and it goes like this. You wake up in your own bed and familiar surroundings, and everything seems fine. It is time to get up and start the day. And then some awful thing happens, some terrifying thing, there is a menacing person you don’t recognize standing behind the open bedroom door, or whose shadow just stirred in the hallway beyond. Then you realize, I am not yet awake—this is a nightmare. And you try desperately to stir. You open your eyes again, thinking you’re in the clear, and then that shadow moves again. You are still in the dream, imprisoned by your own mind. Eventually you do wake up and pinch yourself just to be sure, and you start your day in earnest, feeling a sense of disquiet.

Every single morning for an entire year I felt like that, the year I lost everything that had meaning to me, the year before I left Tennessee to start life over in Vermont. Every morning I was caught up in the hope that what was happening to me was only a bad dream, and every morning I was disappointed. Things got dramatically worse before they got better, loss and angst following me right into my new home state, financial ruin, emotional turmoil along with it. I have likened this to being pushed into a deep hole, somehow managing to cling to the edge with only a couple of fingers.

And then I managed to get the other hand to the top, then all ten fingers dug in, and then an elbow, and another. Then one swinging foot found a toehold, bits and pieces of dirt still giving way under it, but in the end the toes won and the other knee made its way almost to the top of the hole.

Daily I reminded myself, you can choose to sink or to swim, advice I heard often growing up in a family with a strong line of matriarchs at the helm.

In the last few weeks I have felt better (in spite of the foot) than I have in the last two years, and not just physically. At first I could not breathe and a couple of times was caught up in comical bouts of coughing that continued over the course of a day. Then gradually my lungs cleared and I felt better. Muscles began settling into a shape I recognized and my clothing felt better on me. Even my head started working better, with  renewed clarity of thought and vision.

So here is what I think about this tricky situation. I could die next week, or tomorrow, or today, for some stupid reason. I could keep on battling middle age weight gain with inadequate tools in my bag, and all the unpleasant problems that sprout from that like obnoxious little tributaries flowing from a big, muddy river. Or I could take a risk, live dangerously. It could be a perilous decision.

Or it could be life-affirming.

As Mr. Balanchine said, there is only now. I choose to live in the moment, to risk peril in a new pair of running shoes.

Posterior Tib 6A