Friday, May 18, 2012

Oh Those Bones, Oh Those Skeleton Bones


I've been thinking about that with every step I take for the last three weeks in an effort to retrain myself to walk properly.  Some kinda mantra, eh?

My physical therapist had determined that some trauma to my foot had caused the joint between my ankle and heel, the sub-talus, to seize up.  That joint allows the heal to slip around, provides shock absorption with each heel-strike, and allows the foot to flatten mid-stride, so that we launch off our big toes at the end of the stride.

At the same time our foot flattens, our tibia rotates inward so that the knee is pretty much right over our big toes at that point.  The femur and the hips roll in at the same time.

A whole lotta shakin' goin' on!

But my locked-up sub-talus wasn't allowing any of that.  I was launching off my little toes, and my femur wasn't rotating inwards.  That pes anserinus* attaches the tendons of three muscles to the femur.  Those muscles come from around the inside of the thigh.  Without the femur rotating inward, those tendons were getting stretched with every step.

Putting a pack on my back and starting to hammer the miles was the proverbial straw.

While conjecturing as to how this happened, I cataloged my long history of spectacular crashes involving broken bones. I told him the story of when I got hit nearly head-on in an auto accident six years ago.

It was a freak April snow storm. The only other car on the lonely country road was coming towards me. She lost control of her mini-van and started swerving and sliding into my lane.  I headed for the ditch, but she hit my front left fender, snapping my axel, and driving the front wheel up through my floorboards. That broke my left big toe in two places, and fractured my right heal.  He suggested that might have caused the sub-talus to lock up. I told him I babied that broken toe for several months and probably learned to launch off the outside of my foot at that time.  He agreed that could very well be the case.

I went home and dug through my closet looking at old shoes.  I found a pair that I had been wearing at work for the last several years and found they were worn out by the little toes - A classic sign of under-pronation. I looked at all the shoes I wore at my last job before I moved to Michigan.  None of them had unusual wear patterns... That accident was in between the time I wore those old shoes, and the not-so-old shoes.

Can you tell I've been watching all the Sherlock Holmes movies?

Not sure that logic would hold up in a court of law, but it makes sense to me.  It shows us that a trauma like a car accident can cause problems years later - And it makes for a strong argument to make PT a part of any post-trauma care.

For the last three weeks I've been thinking of how my heel strikes, how I flatten my foot, setting up to launch off my big toes, and checking to see if my knee is directly over those toeses - With every freaking step I take ...

Yesterday, my PT decided that my tendon issue is almost completely healed, that my subtalus was working fine, and that my leg was moving the way it should, He's confident that we've fixed the skeletal issues, and that I'm not likely to have a reoccurrence of the injury.  He said that it's time to start working on strength, and prescribed walking Saugatuck Dunes State Park, and bike riding. I'm going to see him once a week for a few more weeks so that he can monitor my progress.

Looking like an early to mid-June departure is gonna be possible.


* For those of you who didn't take latin, pes anserinus means "goose's foot."