Tuesday, October 18, 2011

Pulled the Trigger

I'm going under the knife again. This time voluntarily. I've decided to get my titanium hardware removed. My last bicycle race was a week ago. Normally I like to start getting on the rollerskis this time of year in preparation for the ski season. But I won't be doing much of anything for six weeks. My surgery is scheduled for next Tuesday.

Dr Heaps, who put the hardware in, will be taking it out. I like Dr Heaps. He understands the needs of an athletic person and appreciates my concerns and desires to get back into action.

After my first rollerski session late last week, I knew I would struggle all winter again with misfitting boots and pain. I called for a consultation with Dr Heaps. The medial screws are definitely contributing to the pronounced knob on that side of my ankle. There is reasonable probability that I will have much less discomfort in a skate ski boot after having the hardware taken out. Why struggle with this the rest of my life?

A few weeks ago, I had a chance encounter with another cyclist on the Kancamagus Hwy. He broke his ankle in an alpine skiing mishap. He had EXACTLY the same hardware put in, a plate with six screws in the fibula, and two pins in the tibia. The following winter, he had to deal with severe discomfort in a downhill ski boot. He had all the hardware removed and hadn't had any problems since. That was probably 20-30 years ago, since this happened to him when he was 29. Hearing this was kind of a deal clincher for me.

The deal with taking this stuff out is it leaves behind voids in bones. These voids create stress risers when the bone is put under force, and stress risers can lead to fractures if you are not careful. Dr Heaps does not want me doing any running for six weeks after surgery. No rollerskiing for at least four weeks, but prefers six weeks for that too. A fall on skis with a twist could set me back a year. Walking will be fine as soon as I'm comfortable with it. Same with cycling, I can get back on as soon as I'm ready, but probably not mountain biking. The screw voids need time to fill, which take about six weeks.

I was hoping to try a few winter triathlons, which start in January. I will still probably do these, but with a big lull in running and skiing, I have to adjust my expectations accordingly. I rollerskied again today, this time with some hill content. I must say, the combination of running this year and regular push-ups and sit-ups has put me in much better shape for skiing than just rollerskiing alone in the past has done.

Speaking of running, not all has been flawless on that front. I didn't say much about it here, as it gives the Buckley's out there "told you so" fodder. About four weeks ago I dabbled in trail running. I liked it. On my fourth trail run at lunch one day, I developed sudden outside the left knee pain. It nearly forced me to walk. I limped all the way back to work. The pain went away as soon as I stopped. I didn't think much of it until I ran again. I didn't get a mile until the same debilitating pain set in. I started with zero pain, than bang, just like a switch, it starts. Talking with runner colleagues and searching the web, it was classic IT Band syndrome. The trail running must have put me over the edge or tweaked something just enough.

I started icing, taking NSAIDs, and stretching. I bought a foam roller. What a torturous device! At first I couldn't do it at all. Maybe after I tore all the fibrous connective tissue loose that isn't supposed to be there, it got more confortable. I do other ITB stretches too. I was disheartened for a while. I couldn't run more than a mile or two before the pain set in. Eventually though, time and stretching worked things out. I ran 5.6mi at 7.4min pace yesterday with negligible pain. It is almost gone.

Maybe it is a good thing this happened, as I'm super tight in so many ways, and a warning volley like this forces me to deal with another aspect of tightness. Hamstrings are my historical problem area, and the IT band is closely related.

What else... Oh, I created a forum for the Six Gaps page on Northeastcycling.com. Hopefully Six Gaps enthusiasts will embrace this for sharing information and seeking out companions to do the ride with. I also created a mountain biking specific trail map for Bear Brook State Park. This is my favorite local place to ride, and the official state map has always been lacking.

That's all for now. Looking forward to holding some titanium trinkets in my hand. Thanks for reading.


Anonymous said...

That BB map is great! Can you do Pawtuckaway next?

Anonymous said...

Make sure they save your hardware. I had a rod removed from my femur (it was inside the femoral canal) when I was younger. It was sent to pathology (I was told "to prove that it was removed"....) and then they threw it out!

You might want to look into getting a Theracane to work on the trigger points in your quads/glutes/calves etc... I find it very helpful. Also, Tptherapy makes a nice roller called "the grid" that is similar to a foam roller, but stiffer with raised sections to enhance the effect. Once you start rolling stuff out it won't be as painful as the first few times.

Thanks for posting your ride reports. Based on the last one I'm going to try and hit Sandwich Notch/Algonquin Rd this week.


CB2 said...

Note to self:
Develop "space age" anti-septic polymer to fill in voids in Doug's bones.

bikesmith74 said...

Doug, great map. It's been a long time coming. I see a potential side project in your near future working with Souther NH NEMBA. We've been in need of some standardized maps for some time. Thanks for constructing this. I have a buddy that has a ti-rod in his leg from when he broke his leg at Lowell coming down the rock face. He has some screws and can't ski anymore due to the discomfort. Take it out! I wish you a speedy recovery.

Brian B said...

godspeed on the surgery.

Yup. Foamroller...it's a wonder once you get consistent. Funny as I read your symptoms...exactly what i said to myself...i was in the midst of a multi-day backpacking trip years ago..and bamm!...sharp pain outside of knee..debilitating...off-camber stuff really fires it up fast..got home..went to ortho..sent me to a PT...hooked up w/ foamrolling.

Peter Minde said...


You didn't specify whether you have hamstring problems on one or both legs. If you're experiencing chronic pain, there may be a muscle imbalance that causes your hamstrings to work too hard.

A good physical therapist can diagnose this stuff for you. After 7 years with PT for bad hamstring/IT band every summer, I finally found that my problems were caused by a weak gluteus medius.

It might be worth checking out. Good luck and get well soon.