Dr. J on Running


23 July 2012

Saturday morning, I completed a 20-mile run at Onondaga Lake Park. I felt right on track for Utah in four weeks. Monday noon, Angela joined me for an easy four-miler on Perimeter Road. It felt hot. We stopped at Delutis Baseball Field for water. The girls at the concession stand gave us ice cold bottles of water. We gulped some, and resumed running towards the golf course.

Seconds later, I twisted my right ankle at the edge of the road where it meets the tarmac. I landed on my left knee and hand. I collected myself back onto my feet, and resumed running. That lasted two steps. I felt a shooting pain in my right foot. I tried walking, but the pain increased. We turned back towards the baseball field, sat on a bench near the concession stand, and removed my shoe and sock. A blue ring on the right side of my foot left no doubt in my mind – I had fractured it.

Angela ran back to fetch her car and my insurance card. The girls brought me ice in a surgical glove. I rested my foot, iced it, compressed it by tying my sock around the ice glove, and elevated it on the bench – the classic RICE of running injuries. The sun felt good. I closed my eyes.

Angela dropped me off at the urgent care center across the road, and then went to Spresso’s to get me cappuccino and lunch. Bill stopped by on his way to golf. X-rays confirmed a fracture at the base of the fifth metatarsal. Dr. Sparks fitted me with a post-operative wooden shoe and a pair of crutches.

Dealing with running injuries follows the five stages of the grief process. It starts with denial – it could not have happened. Anger comes next, sometimes targeted, often equal-opportunity. Bargaining always proves futile, and gives way to depression. Eventually, acceptance sets in, paving the way to recovery.

I called Marla with the news, packed my stuff, and verified that I could drive safely. I drove home, and RICEd my foot the rest of the evening. I cancelled my flights, hotels and cars for the Utah and Illinois marathons in August and September.

Twenty years ago, on an early morning run with Kathy on a rainy St Patrick’s Day, I stepped in a puddle and fractured my fifth metatarsal. Twelve weeks later, I ran a 5K PR. Then, Dr. Baker put my foot in a hard cast for seven weeks because he did not trust runners. Post-cast, I fashioned a quarter-inch thick aluminum insole, and hit the Stairmaster. I hacked the control computer to allow a full hour per session, and built-up to stepping for 60 minutes at the highest level 10.

This time around, Dr. Cannizzaro suggested initially a boot in lieu of a cast, but I ended up in a toe-to-knee bright red cast for two weeks. I quartered an old New Balance 903 and used the heel for anti-skid cast support. I hobbled around with a mix of crutches and heeled cast. Two weeks later, the cast came off, and a bulky knee-high boot with inflatable bladders replaced it.

The diagnosis was as good as can be expected under the circumstances. The fracture occurred at the head of the metatarsal, not along the bone. A Jones fracture would have required inserting a screw the length of the bone and a lengthy recovery. For all intents and purposes, Dr. C does not expect me to resume running marathons for six months. However, he left the door open to the possibility of walking the Freedom’s Run at Harper’s Ferry, WV, on 13 October.

When I started my 50-state quest, I had budgeted for two six-month injuries. However, after running 19 marathons in 20 months, I grew overconfident to the point of cockiness. This fracture restored me to realism and fallibility. Having skipped Aspen in July due to forest fires, and Utah and Illinois due to injury, I remain optimistic for the return visit to Dr. C and new X-rays after Labor Day. If all goes well, I will have six weeks to go from zero to 26.2 miles.

Dr Kamal Jabbour sported a cast over a broken bone for the fourth time in his running career. Dr. J's RUNNING Column will reappear in Cyberspace once endorphins return.

© 2012 Dr Kamal Jabbour