Saturday, 26 October 2019

Broken Ankle to Half Marathon


I’m finishing writing this on the eve of Worksop Hallowe’en Half Marathon – my first half marathon since recovering from a broken ankle earlier this year.

Time to “stop pulling the broken ankle excuse,” as Rob Payne so delicately put it when I opted out of one of his ‘no Payne, no gain’ training sessions a few weeks ago! I’m at the point when if someone asks me how my recovery is going, I have to say, “I think it’s complete!”  I acknowledge some resistance to do so, because that means the only thing that’s holding me back is fitness – and that means I need to put some work in!  In a position of “coming back from injury”, there’s always an excuse!  Suddenly the excuse has ceased to be! So, I’m going to put it all down here and it’s onward and upward from here on in!

“Sorry, guys, I’m not OK!”


On 3rd February 2019, I set off on a training run with this lovely lot, the plan being to run from Scartho to Louth on the Silver Lincs Way.  This was an off road run of 25 miles as part of our training for the Millennium Way – a 41 mile ultra on 3rd March.  



It was a beautiful fresh and frosty but bright and sunny day; perfect for a long run with friends.  So it was that we set off - Sarah and Mike, Chris R, Claire & Andy Byatt from the start and with Claire Bates joining us after 5 or 6 miles. 

It was going well. As I recall we were chatting away and everyone was running ok and looking forward to the rest of the day.  Then I fell over.  Ironically, I felt I was running fairly carefully and avoiding icy puddles – but it was a frozen tractor track that got the better of me.  You know how sometimes you can fall over and twist your ankle a bit but after a few seconds you can say, “it’s ok, I’m fine” and then carry on?  Well, this wasn’t like that!  I knew straight away that something wasn’t right: “I’m sorry, guys I’m, not ok.”  

Claire (Bates) went off to get her car, along with Andy and Mike, (who got on the phone to Chris to get him to come for me), while Sarah and Claire (Byatt) helped me up the hill we’d just run down (as I feared if Claire brought her car down, she’d never get it back up!) and Chris R picked up my discarded shoe and put an extra jacket round me.  Team work!

A & E

By the time they got me back to the road, Chris arrived and although I was in pain and knew I couldn’t put my foot down (I tried!), I did wonder whether I was just causing a big fuss for nothing. I suggested I go home, have some paracetamol in and a couple of glasses of wine and see how it was the next day.  Claire Byatt – who was the only one who saw the angle my ankle and foot went when I fell – has told me since that she was standing behind me, shaking her head and mouthing to Chris, “hospital!”  So that’s where we headed. 

I was seen quite quickly, triaged, given some pain relief and a nice warm blanket as I was shivering by that point.  An X-ray showed a comminuted fracture of the distal fibula and I was then given some more pain relief. A nurse explained that this meant that my ankle was broken in two places and the bit between the breaks was displaced.  This would need putting back in place either by manipulation or surgery and they would bring an orthopaedic doctor to have a look as it needed working on quickly.

The doc duly came, pressed a couple of other places on my ankle – which made me jump and wince a lot.  He said, “Ah yes.  We know where to press!”  He said that he would try to manipulate it, and called upon a nurse to be ready with the plaster, which would hold it in place if he was successful. 

I was handed a gas and air mask and told how to use it. I was a bit surprised and didn’t think I’d need it – after all I’ve given birth twice without pain relief.  Surely I’m hard core?  In any case, when you see them click something back into place on Casualty on TV, it only takes a few seconds. But I had a little drag on the gas and air as I was assured I would need it.  Too bloody right I needed it!!  OMG – I am wincing just recalling it!  It did NOT  take a few seconds. 

There was lots of pressing the bone and pulling about – really deeply pressing it (presumably with his thumb – I wasn’t looking) and then squeezing my whole ankle.  I was sucking on that gas and air as though my life depended on it!  I can’t say it reduced the pain – just made me feel light headed and the, because I’d hyperventilated, it sort of resembled panic and I struggled to calm down.  Eugh.  The manipulation lasted about 5 or 6 minutes (seemed longer) and then getting the pot on was painful as the doc held the bones in place while the nurse potted it up.  I was then sent for a check- xray, to see whether the manipulation had worked.  It hadn’t.  The doc explained that it had gone partly back into place and if I was an 80 year old person who wasn’t bothered about being very active, then it would probably be good enough, but with me being... wait for it (I’m still dining out on this) ... an athlete (evidenced by my running gear!) it would require surgery to enable me to have the best mobility possible.

 “You’re staying in.”

I was admitted and placed on a bed with my leg elevated and told not to try to get out of bed on my own – not even to the loo.  It was important to prevent swelling.  If it didn’t swell, I could have the surgery the next day.  If it swelled, I faced a wait of a week to 10 days to let the swelling go down.  I behaved myself.  

Through-out this all this, I was very keen to know how my running buddies were getting on – the day was moving on and I kept just hoping my incident hadn’t spoiled their run too much.  They’d had quite a delay – not to mention running an extra mile or two – because of my mishap.  I said to Chris at one point that I knew at least Mike and Chris R had their phones with them and asked him to message to ask how it was going and let them know I’m OK.  I think the codeine and morphine were having some effect as I felt reasonably jolly!  Chris just said, “You’re not ok though!.... but I’ll try to find out how they are doing.” As it happened, they ended up running over marathon distance!

I didn’t sleep well – pain, constant interruptions to check my BP, temperature and whether I could wiggle my toes, administer more pain relief and anticoagulant injections made sure of that. Plus, I was hungry.  I wasn’t allowed to eat as they didn’t know what time of day the surgery would be.  A nurse asked me at one point what time I last ate.  I couldn’t remember the time and replied, “I had a baby-bel at about 5 miles in!” I fully expected them to be able to work it out from that!  The drugs, again, I think.

Waiting for the op.

The next day, Monday, seemed endless as I waited for my slot in theatre. My saviour was facebook messenger.  A steady trickle of messages came through and I occupied myself by keeping in touch with everyone and updating on what was happening.  By the time I went to theatre it was 4.45pm and I hadn’t eaten for 30+ hours. I was ready to eat my own arm!
The surgeon and anaesthetist had a good laugh at my “Keep on Running” tattoo, which, of course is on my foot on the same side as the broken ankle!  “Hmmm – it’s running that’s got you into this mess!”  I protested that it wasn’t the running that caused the problem, it was the falling over, and asked how long before I’d be running again!  

The surgeon advised that I’d be non-weight-bearing for 6 weeks after the op, then partial weight bearing for the next 6 weeks.  After that, he suggested cycling for 3 months and resume running gradually after that.  The last thing I thought before the oblivion of anesthesia was, “about the end of July then.”

And when I woke up – I was bionic.  Ankle all put back together with a plate and 9 pins.


Recovering at home.

On discharge, I was told to sit or lie down as much as possible, keeping my ankle elevated above my hip at all times and above my heart whenever possible, to prevent swelling.  I soon found out why this was important.  Whenever I was up and about I would feel it swelling which was very painful.  It felt like the pot was being tightened like a vice around my ankle.

Mid-February, the pot was removed in order to remove the single stitch and I was able to see the site of the surgery for the first time. I slightly freaked at what had gone on inside my body, but was delighted to see that the scar hadn’t impinged on my tattoo and that it looked very neat.  It was then repotted.




Volunteering and Supporting.

Overall, I settled in OK to the rest and didn’t mind being away from work. I was never bored; never a week went by without my chief running buddy, Sarah visiting.  I did plenty of reading and to be honest, I slept a lot.  I got worried at one point about taking too many pain killers but spoke to Laura D (who has had a similar but worse injury) and Lydia (who is a nurse) and just accepted that I needed to take them – and then deal with the constipation later!  With copious pain relief I was able to get about well on crutches so that Chris could take me up to the club when he ran. I didn’t miss many club nights and it was good to support the beginners’ course from the sidelines. I was able to volunteer at parkrun and Chris took me along to support our running buddies at the Millennium Way a month after the accident.  What a great day that was. They are heroes.


Practicalities.

AfterAfter I first got out of hospital my appetite was down a bit.  When it returned, I decided to be very disciplined as I didn’t want to pack on the weight whilst immobile. I’d previously been running 20 to 30 miles a week, so if I carried on eating as though I was still running, I’d be the size of a bus!  I found it easy to stick to eating lightly, partly because it was so much hassle to go to the fridge!  I wasn’t as disciplined with alcohol though and took to frequent rum in my coffee, even starting quite early in the morning.  (Dad would be proud!) It seemed to work well alongside the paracetamol, codeine and ibuprofen!

Showering was a pain in the neck. I had to wear a plastic cover to keep the pot dry, get myself up the step into the shower using crutches keeping my leg up, then lean against the wall to shower.  It was such hard work, I reduced to showering every other day (unless someone was visiting) and on non shower days, sat on the loo to have a strip wash. Don’t try too hard to picture it!  Dry shampoo became my best friend. 

Exercise.

After a while I started to feel sluggish and started to look on You Tube for what exercise I could do with a broken ankle.  I discovered loads of chair based cardio exercise.  Some of it was clearly designed for the elderly / generally immobile / possibly with memory problems too, as the exercises had crazy names that helped you remember the moves.  I’ve had many a laugh describing and demonstrating, “Milking the Giant Cow”, but these chair based exercises were really vigorous and raised my heart rate enough for my Garmin to register a training effect.  I was so convinced my watch was reading my heart rate incorrectly that I used a chest HR monitor a few times.  It proved to be accurate.  I gradually found other chair based exercise and eventually stumbled upon Youtube exercise routines by Caroline Jordan – a fitness trainer who had, herself experienced an ankle injury.  She is super enthusiastic, happy, positive and motivating.  Some would say ‘annoyingly so’, but it worked for me – I needed all that stuff. It made me smile.


Now I was cooking with gas.  Going around on crutches, with the bad leg off the ground, was a big effort and raised my heart rate a lot.  But too much of it resulted in swelling and pain.  With these fitness videos, I could get all the benefits of exercise, including the raised endorphins, with minimal swelling.  I used to wear my running gear and get a water bottle and towel to hand too – making a proper occasion of it!

Fast forward to 15th March and I had the pot removed for good to reveal a leg as hairy as a dog and a very scabby looking, skin-flaking foot.  The scar, however was very neat. It had been itching for weeks and I was desperate to give it a good scratch, but when I tried to scratch it, it was absolutely too painful!



A bit of a scary time.

I felt pleased to have the pot off, but nervous.  Having gone nearly 7 weeks without putting my foot down it was a bit of a scary prospect to try to walk on it. I entered the consultant’s office on crutches and he told me to put my foot down. I did, but kept the weight on the crutches and other foot.  I tried to gradually ease some weight onto the bad foot but it was agony and felt so weak.  There were a few minutes of despondency there. Especially when he quite dismissively said, we’ll put you in a boot - just increase the walking and weight bearing and gradually get rid of the crutches; you can go back to work in a couple of weeks.  I asked how much I should be trying to walk on it and he just said, “be guided by the pain”!  If I’d done that, I’d just have sat down and not bothered! 

I had about a week to 10 days waiting for a physiotherapy appointment and that was probably the most difficult time. I had no guidance, a lot of pain and was quietly fearful that I wouldn’t get walking properly again, let alone running.  The boot was uncomfortable but at least enabled me to put a little weight on my foot, still mostly supporting myself on crutches.  But whenever I ‘walked’ anywhere, the ankle and foot swelled again and became painful – as in this pic taken on 20th March after supporting at Gainsborough 10k.  But at least, unlike the pot, I could remove the boot and get some ice around my ankle.  

It was at this time I discovered Therapearl.  These are much more flexible than regular gel ice packs and some come with a strap attached, making it easier to keep the ‘ice’ in close contact with the pain.  As much as analgesics dulled the pain, there’s nothing like being able to get some cold onto a painful inflamed limb.  It provided some instant relief. If you want to check them out, click here for Amazon or click here for Ebay.


Physiotherapy – the turn around.

My physio appointment was a massive turning point. I was assessed and my main goal established – to be running again as soon as possible.  Claire, the physio listened first, then examined my ankle and gave me a structured plan.  I like structure. I like plans.  This was just what I needed.  Initially, I was to massage around the scar as much as possible to start to desensitise it.  Then start to walk, with the crutches, barefoot on as many different surfaces as possible, indoors and out.  I was told it was best to do this for a few minutes every hour than try to do it for a long period once or twice a day.  Other advice was: wear the boot for going out and about as it would offer a lot of protection and help me to feel less vulnerable when around a lot of other people; as soon as the swelling would allow, put my trainers on and start to walk around, with the crutches, gradually increasing the weight on the bad foot; take plenty of pain relief; elevate the foot as much as possible between activity and ice as necessary.  Once I could wear my trainers, she booked me onto the Ankle Rehabilitation Group, which I affectionately renamed Ankle Club.  First rule of Ankle Club: we don’t talk about Ankle Club!

Ankle club.

Ankle club consisted of a circuit of 9 exercises each lasting 1½ minutes and repeated twice during the session.  They involved balancing, ankle raises, lunges, walking forwards, backwards and sidewards, walking on heels and tip toes, stand-up-sit-down on gradually lowering seats / bench and – my favourite – walking and running on the spot on a mini trampoline! There were 4 levels of difficulty for each exercise and I started on levels 1 & 2 with them all.... thoroughly determined to get to level 4 as quickly as possible.  I attended for the 6 week course, and it was suggested I go for another 2 weeks to nail the tip toe walking and single leg heel raises as I found these really difficult and hadn’t made it to level 4.  To be fair, I’ve shown the single leg heel raise exercise to a lot of people and they’ve found it difficult even without an injury, so I don’t feel too bad about that.  I can do it now, but still don’t feel awfully strong on the ex-bad ankle.  Give it a go.  You have to stand with your toes on the bottom step of the stairs, heels over the edge, use your hand on the rail to balance, but not to support or pull yourself up.  Raise up on to both toes. Now, lift your good leg up so that all the weight is on the bad leg.  Slowly (that’s the difficult bit – slowly) lower your heel down below the level of the step, hold for a few seconds and then raise yourself up on your tip toe again.  It’s tough.  Initially, my foot would just drop into the ‘heel below the level of the step’ position (no, ‘slowly’ about it) and I couldn’t get back up from there.  I still practice this in shoes and bare foot as recommended as ongoing rehab. This is where I am now. 


The tip-to walking was initially impossible, but with practice was just painful and difficult, which was an improvement!  It was frustrating because no matter how determined I was, everything around the ankle seemed weak.  Here is my early effort videoed on 24th April  2019:



And check out how much easier this is in this video taken 4 months later, at the end of August.



My favourite part of Ankle Club was always the running on the spot on the mini-trampoline.  Louise R at CRC kindly lent me one to use at home and I had great fun devising interval sessions to stop my fitness from dwindling completely. OK, as many people have pointed out, my running form leaves much to be desired, but at least I was moving!


Running

On the whole, I stuck with the advice of the physio and just walked a lot. I had a little secret trial trot just on the local playing field towards the end of April – I say it was secret, but Sarah and Mike are very astute and although this was saved as a walk on Strava (and indeed was mostly walking), they picked up that “it was a very fast walk – if we didn’t know better, we might think there was a little trot in there.” It was too sore and stiff really, so I wound my neck in.  I also had a little trot in May at Liverpool when a gang of us went to Princes parkrun – just a few little trots within parkrun and a trot on Sunday on the mile run (as I’d transferred from my HM place to the mile).  We did a lot of walking that weekend too – anaesthetised with alcohol and a few pain killers!  It was ok at the time, but I suffered the next week with pain and swelling. Once again I eased off.   It was in June when I got started seriously on an adapted version of C25k. I was supported by many people on these run-walks; husband Chris, and my super running buddy, Sarah particularly were always by my side.

My first parkrun

On 3rd August, exactly 6 months after the incident, I completed my C25K by running Market Rasen Racecourse parkrun non-stop – once again accompanied by most of the Millennium way gang and other running buddies.  This felt like a huge achievement, and so had to be celebrated, with a fried bread breakfast at the 10 Acres Cafe at Osgodby. Friends and prosecco completed the celebration.


Sub 30 min parkrun


The next job was to run a bit quicker. As well as Chris, I was joined by lovely running buddy Claire Bates to help me achieve sub 30 at Cleethorpes parkrun on 17th August. Not only this, but the rest of Team Bates – Ian, Martha and Edith came along to give extra support and of course this needed to be celebrated in the usual style.





My first 10k

It’s no secret that I’m not keen on running 10k.  But soon after 5k was ticked off, a fellow CRC member, Peter Conway, put a place for Mablethorpe 10k up for sale as he was, unfortunately, injured.  I took the place and Chris promptly entered to support me. This was on 8th September, just over 7 months since I fell over.  It was SO tough. Very hot on the way out and head wind on the way back.  Chris was amazing and kept me going, encouraging me to dig deep, which I certainly had to.  I had no time goal, but supposed I’d be somewhere around 1:05 / 1:10 so I was very pleased with my finish time of 01:01:21. 

Chris was in great form on this run, trotting along easily and encouraging me.  It’s incredible to think that 2 days later on 10th September, he would be in A & E himself, following a heart attack on a steady club run. I will revisit this in a future post; for now, suffice to say he is going along nicely.







Gruesome Twosome

Sarah and I are Gruesome partners for life, not just for Christmas, so when it looked like I wouldn’t be fit for it this year, we decided to marshal as a Gruesome pair.  We had such a great time, with Lincolnshire flags, music, a picnic, flask of tea and various percussion instruments and cheering that I forgot to take any pics!  There’s just this one of us celebrating afterwards!







Onward to Half Marathon Distance.

Apart from just not being very fit (and possibly being a little over my best weight) I’m back to normal.  The ankle becomes sore a bit when it gets stiff, especially if I stand still for any significant time. I can feel the plate jarring a bit sometimes when I run – from what I understand, bones have a bit of give and flexibility in them but titanium doesn’t, so this is what causes the jarring feeling.  It ached towards the last third of my 11 mile training run and I expect it to be a bit sore towards the end of tomorrow’s run, but nothing major. I’m happy. Very happy.  I’m not bothered about any fast times just now, but I’m not saying that won’t ever change.  For now, I’m just enjoying running.

Tomorrow, Sarah, Jo-Mo, Laura, Nadine and I will run Worksop Hallowe’en HM resplendent as Purple and Black Winged Devils, complete with mini speaker and Spooky Play List.  It will be so much fun.  I’ll finish this post now with a pic of me having a dress rehearsal and no doubt there will be an addendum in due course, showing pictures of our antics!









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