7.15.2008,8:11 PM
Lizard brain at it again.
Lizard brain did it again. It broke a chain in my foot and released me.

Tuesday afternoons are Torture Days: grueling physical therapy sessions with Ross, a sadist PT that specializes in sports medicine. He did his post-PhD work in Dr. E. Richter's lab (Denmark), a researcher that I've followed for many years because of his work in muscle-insulin-glucose physiology. Ross treated me three years ago with the left broken ankle and we spent hours over the two months of sessions chatting biology, physiology, psychology, anatomy, and sports. It made the pain enjoyable.

Working with athletes, Ross knows the attitudes, limits, stubborness and psychology of his patients. We're not the average patient. So several weeks before the orthopedic surgeon expected to release me from crutches and begin therapy, I called the campus PT clinic and made appointments with Ross. His initial greeting at the beginning of that first session was as I expected: "Now what did you do??"

Today, after relating to him some concerns about sharp pains along the fibula during the heel strike on the ground (normal gait= heel strike, roll forward on the foot, flex on the ball of the foot and toe/push off), I expressed my fear of screws spewing out from under the skin, projectiles as if shot from a gun. He laughed and assured me that they won't move unless I fall on them again; they should be well calcified in place by now. What's happening is adhesions of fascia and ligament are breaking loose. I felt better and grimaced less.

After my confession of riding the little 250cc ("Aha!! I knew you would do that sooner than later!"), we discussed the asymmetrical strength, balance, stability and mobility between the two legs and feet. I admitted to him my reservations of riding the bigger bike until all these issues were resolved and full function and strength are regained in the right lower body. He agreed and predicted that would not be until October.

My eyes got big and I forcefully suppressed a protest that welled up from inside. I closed my mouth and looked at him, "I was predicting mid to late August."

One eyebrow rose and his face loomed closer to mine. "You really think you are going to regain full, and I mean FULL, function of your glutes, leg and ankle in four weeks?"

I felt like a deer in his headlights, or the teenager that got caught sneaking out the bedroom window before I even did it. "Um. No...... But I'm working on it!!!!!!" Inside I cringed but conceded; he was right.

After leg presses with only the right leg (of which I reached failure at four reps on the second set of eight; how disgusting), toe crunches with a towel, and manual manipulation of the ankle, Ross proceeded to manually manipulate the large metatarsal, or the ball of the foot at the bottom of the big toe. Now, THAT hurt! The rest I can bear with no grimace or outburst, but rolling forward on the foot and flexing the metatarsal is...... hellishly painful. And he grins while mashing it between his hands and fingers, wobbling the bones, ligaments and fat pad like a madman shaping clay. He reminded me to breathe; I was holding my breath with my eyes rolling back in their sockets.

At the end of each session, he normally packs my foot and ankle in freezing cold gel pads which sucks the heat, soreness and inflammation right out and soothes the limb like nothing else can. It's almost orgasmic. He giggles and shakes his head when x-rated groans and moans escape my mouth; it's such a relief. But today's session was at the end of the day and I had a shuttle to catch to the train station. No ice today.

After leaving the elevator on the first floor I walked towards the outside door and glanced out the big windows in front. The shuttle was just pulling in front of the door. And was not going to stop unless a person was waiting outside by the curb.

For a second I forgot the dysfunctional leg and lizard brain yelled: "RUN!!!!!" In the midst of the right foot heading for the floor, it flexed to push off and propel me forward. CRACK!!!

In a millisecond I heard a loud gasp emit from my mouth as the ankle reminded my brain that it was still 'broken', and what the hell was that noise and feeling that just reverberated up my leg from my foot? Before the rest of the brain kicked in, the cane in my left hand supported my weight as it immediately shifted off the right foot and before I went crashing to the floor.

As the right foot was immediately withdrawn from the floor, my left foot, leg and the cane saving me, a clash of thoughts and questions went spinning around in my head. "Did I break it again? What was that snap? Where did it originate in the ankle? Can I get out the door, around the corner of the building and catch the shuttle as it goes around? Will I make it? Uh oh, I feel something swelling. Hey, nothing hurts. Maybe I didn't break anything. Wow, I have more dorsiflexion! Okay, what happened?"

Standing on the sidewalk and flagging the shuttle, in the back of my mind was paranoia of a re-break and a quiet assurance that a tendon had just popped and let go. That would explain the increase in dorsiflexion. But it amazed me, and still does, that no matter how much I, we, worked at getting that ankle to bend further for the last two weeks, it took a quick force to just snap the tendon and free the joint. Because I wasn't thinking about it and protecting it.

Lizard brain did it. I know it did.

I drove home tonight, for the first time in four months, with my right foot. Maybe I'll be on the big bike sooner than October after all.


posted by Macrobe
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