Tupper's 2 Cents

Feet on the path and eyes wide open...

Category: Alternate forms of exercise

Snacking on Humble Pie

I originally intended to call this post “Eating Humble Pie”. If I am fully honest with myself and my readers, however,  I realize I am not ready for a whole pie or even a whole piece. But I know I can handle a few bites. Let me explain…

The Humbling Situation

I’ve had complications from recent surgeries, as many of you know. Some of this I’ve said before, but in this recounting, I am being honest as to my responsibility in pushing too much too soon, the part that is hardest for me to admit — to myself and to others.

Right knee replacement, 11/14/16.

The aftermath of this has been pretty good, although I still have significant pain at times. Never having had a joint replaced, I don’t know how much of this pain is “normal” and when I should be concerned. I also have a distinct “clunking” noise and feeling in my knee each and every time I move it in a particular way. Part of the plan, or something awry?  I don’t know. I have been assured and reassured that my knee replacement is solid, and that I can’t hurt anything. Those are dangerous words for someone like me, who can and will put up with a lot of pain to do what I love. I was out on trails and walking as early as 3 weeks after this surgery. The  complexity of  the knee replacement was furthered when, at just 5.5 weeks post op, I had foot/ankle surgery on the left side.  I was on crutches in various capacities for 5 weeks after that surgery, using the right leg for full weight bearing. That was, simply put, hard on the new knee. Now, 3.5 months post-op, I am still with pain and uncertainty about the status of my knee.

Left foot/ankle surgery, 12/22/16.

This recovery started out fantastically, the best yet of all eight foot/ankle surgeries. I was walking without crutches early, and taking long hikes in the post-op boot —  feeling on top of the world and certainly my recovery. Then, a fall in the snow over three weeks ago caused an initial setback, from which I recovered quickly after five more days in the boot.  I took myself out of the boot and started walking again, believing I was ready. On each of my first five days post-boot round two, I walked. The mall on day one, Lake Padden on day 2 (2.6 miles),  the interurban trail on day 3 (4 miles), adding slightly more miles each day. Each day I noticed a bit of pain in my forefoot, but told myself it was nothing. On day 4, I walked Lake Padden before work, worked all day, then walked it again after. A very normal activity for me, usually.  But by the second walk, I could barely do it and hobbled all the way around. I knew something was up. Again, I told myself it was just muscles in my foot getting used to working again after being on vacation for 7 weeks…but deep down, I recognized that the pain was different. Stubborn as I am, on day 5, I took a scheduled walk with a friend, but I was limping so badly I could barely walk. I am embarrassed to say I walked five miles like that, each step a painful reminder that I shouldn’t keep going.

It was all I could do to keep a shoe on after that walk. My foot was swollen and very tender. But I  went about the rest of my day, which involved an outcall massage, all the while trying as hard as I could not to limp. It was almost impossible, but I am good at compartmentalizing pain and discomfort, physical and emotional, and did what I needed to do. The massage finished and back home, I took my shoe off to rest my poor foot. It was inflamed and exquisitely alive with pain, the kind where you don’t even want to touch the affected part. I hoped and prayed it would recover overnight. That wasn’t completely out of line, as many times on long hikes or after intensely physical days, I go to bed with significant aches and pains that DO almost magically go away overnight….or at least move again to a manageable level.

But this was not a normal ache or pain, I could tell. Tuesday morning, day 6 out of the boot, I still couldn’t walk without a significant limp. The pain was intense with every single step. Fortunately, I had my six week post-op check that morning. (I was actually almost eight weeks post-op: for various reasons, all related to weather, either the office or I had to cancel two previous appointments). The reason I mention this is because I had to, or chose to, make decisions during this two week time frame about how and what I would do. I even went so far as to email the PA and tell him after the first appointment cancellation that I was taking myself out of the boot, and I hoped that was ok. To his credit and my discredit, he replied that he could not medically authorize that without seeing me and getting x-rays first. I chose to be rogue and go AMA (against medical advice), and I paid the price  — twice. First with the fall on my first day in round one without the boot, then with the whole episode of progressively worsening pain in round two walking in shoes. THIS was my first inkling that there was pie to be eaten…

The current reality…

I hobbled to my visit with the PA, on day six of round two AMA. I told him the whole story, and confessed all my transgressions. I’ve seen the same PA for most of my post-op visits, and he has been involved in at least two of my four foot/ankle surgeries with my foot surgeon, Dr. T.  Both Dr. T and the PA know my feet, ankles, and psychology well! Including my desire and need to get back out on the trails as soon as possible after surgery. To a degree, they both endorse this, as long as it doesn’t jeopardize their surgical work and my recovery in any way. This time, though, the X-rays showed a new stress fracture in my foot, and that really put me in my place. The surgical sites and structures were well healed, but this new problem had crept up quickly. In short, my walking too much too soon once out of the boot led to the development of a stress fracture in the third Metatarsal bone.  Perhaps the bones were softer from not being used, and apparently I went at the walking too aggressively, relieved as I was to finally be out of the boot. I have had a stress fracture before, and the pain and symptoms certainly fit with his diagnosis. The way I left it with the PA is that I would rest the foot for four more weeks, then return for further X-rays. And no more walking of any distance without the boot. I left the office humbled and depressed.

The aftermath…and a few words about my psychology.

End of the Lake Whatcom Trail…this is why I walk.

I lasted three full days without a walk. During that time, I sunk deeper into depression. Here is where things get interesting.  I write this believing that some of you can relate to my struggle for balance. Sharing and being honest and forthcoming about this part of my psychology is both an attempt to explain WHY I continually push the limits of what my body will allow physically, and an exploration into the whole question of “how much is enough, and how much is too much?”  I am not ignorant or unaware of the risks or trying to put my recovery in jeopardy. I do these things because, deep down, my NEED for some type of physical movement and especially contact with the outdoors is deep seated and real, such that I will go to extremes to make it happen. THIS particular struggle and balancing act, how much I can do following injury, surgery, or some other medical issue, has been a constant companion in my life for over 30 years. My stories about getting out too soon following something run round in my head like a broken reel tape. Why, then, don’t I stop pushing so hard? Why not just sit around and do nothing for days or weeks on end, letting my body heal and trust that things will take their course? To my credit, I can and do usually do that for at least a week following surgery. Then, my restless nature gets to me and I start scheming ways to get out and about.

It’s always the same, the struggle to know how much is enough and what is too much. I tend to err on the side of the latter, yet my ongoing quest is to find the former. Exercise and endorphins are addictive, yes, but I don’t need that so much. What I need is to be outside. Some part of me dies when I can’t be. For me, walking trails and being in nature feeds my soul to an immense degree. Hence the name of this blog, and my whole pursuit of walking, hiking, and backpacking. I am driven to go and to be there, in whatever capacity I can, and as soon as I can. So, after three days of no walks, being inside and sinking further into depression, I decided to go back into the boot for walks and hikes outside. The boot was and is trashed and duct taped almost beyond repair, and had to be retrieved out of the garbage.  But I made a decision on that Friday, three days after my visit and diagnosis, to go back into the boot and hike for the remaining weeks until I return to the PA for x rays. I had to restore balance.

The next steps…

Lake Padden with recent snow…

It’s been two weeks and a handful of days, and the hiking in the boot strategy is working! My foot is much better, and I have stayed 100% true to my pledge and promise not to hike in a shoe. I have taken hikes to places and in conditions that I would have missed had I not gone back to the boot. I am working and doing daily life in street shoes, a compromise the PA and I agreed upon. I can say with conviction that healing is taking place, and I am happy about that. And I know I will stick with the protocol. My knee, always troublesome, is another story. In the spirit of non-denial,  I made an appointment this week to see the knee surgeon, to determine if the pain and clunking is normal or something to be concerned about. I will take his advice to heart, and that’s a promise too.

But here is what I know. I know this “enough/too much” battle will continue. I am not out of the woods yet, I may never be completely. I get humbled by these experiences, and I do learn my lessons. I do take bites of that humble pie, and I think about what it would take for me to eat the whole thing.  But even as I do so, I know my tendency will always be too get out just as soon as I can, and sometimes that will be sooner than ideal. SO many people in my life have told me to be careful, to slow down, to not be so driven, to cut back. For all of those, I take a bite.  I am aware I “use” exercise and movement as tools to keep myself sane, no question about it. I am reliant on that, and it is hands down may best coping mechanism for dealing with stress. Sometimes it’s too much and too soon.  What I want to say is that I AM listening, and that I am getting the message!

It’s a work in progress, and a repetitive theme of my life — not just with exercise, but in all areas. As I work on writing my memoir, I am exploring this theme of how much is enough and what is too much, in depth. I have settled into my exploration, with full awareness of my tendencies, and full commitment to discern for myself my own boundaries in this area. I will continue to share on this topic, and would welcome your thoughts. EVERYONE has an area of life in which they must ask themselves these same hard questions.  I believe that by getting open and honest about our deepest areas of struggle we can make headway into dealing with them.

My hope is that, by writing this post and laying it out there,  you may be inspired to ask yourself the same hard questions. Where in life do you push too hard and pay a price? Work? Over commitment? Lack of sleep? Poor nutrition? Substance use? Care-taking others over yourself?  Too much electronic escape? When is it all enough, when is it too much?  Unquestionably, life is a long , sometimes arduous, complicated journey filled with ups and downs. Sometimes, it’s only about surviving and making it through one day at a time. We all have our fallbacks and coping mechanisms that we use to get through these times. Some are clearly more destructive than others. I am the first to admit I have dabbled and jumped head on into far more dangerous territory than reliance on exercise in my past.  I have conquered significant mountains of overcoming, the specifics of which I am currently reliving as I write my memoir. On the whole I feel quite satisfied with where I am in my ongoing quest to find balance in life. Right now the exercise vs. rest is my biggest challenge.

What is yours?

 

Feel the Reluctance and Do It Anyway!

A rough morning leads to a worthwhile experiment…

Have you ever had one of those days where everything seems a struggle from the get go, making you feel like crawling back into bed instead of getting on with the day?  I am sure you have, because we all have them. How do you manage to stay on top of yourself and your game when it seems nothing is working and difficult circumstances keep flocking around you? What are your coping strategies during those times when you can’t exactly pinpoint what’s wrong, but life feels overwhelmingly challenging? In my experience, when the chips are really down, and I am in a full on crisis, it’s easier to take the steps necessary to problem solve the immediate concern. But when I am feeling just OFF, and I can’t seem to make my life work, even though no major catastrophe is at hand, those are the hardest days. At times like that I feel like giving up, giving into past destructive habits, or just completely blowing off my responsibilities…AND the things that I know will ultimately help me to feel better about myself.

Today started out as one of those days. Nothing disastrous, but for various reasons I couldn’t seem to pull my usually positive and motivated self together. Instead of giving into it, I decided to approach my day very intentionally. I wanted to see what would happen if I openly made a commitment to myself and a handful of people (for accountability purposes) to show up in life no matter what, keep all my scheduled plans even if I didn’t feel like it, and keep an open mind about the day. I wanted to see if I could turn the tide around by going with the flow, and doing everything I intended, no matter how difficult it was.

The Contributing Factors

There were several things going on in my life that contributed to my morning feeling of depression, discouragement, and despair on this Wednesday in late February.  The day’s problems weren’t earth shaking, but health challenges and financial concerns were at the  top of my list when I awoke this morning.

Health Challenges

I had foot and ankle surgery on 12/22/16, to repair completely torn out ligaments in the ankle and improve an overcorrection of a previous Bunionectomy. I had an easy initial recovery, walking in the boot  less than four weeks after surgery and doing many ambitious hikes, including a challenging half marathon course, while still in the boot. I told everyone it was my easiest recovery yet. I even did three blog posts on exercising post op with crutches and in the boot.

Then, on my first day out of the boot and in street shoes,  I took a fall in the snow (three weeks ago). That put me back into the boot again for another week. I was so excited to get out of the boot after that setback, two weeks ago, that I immediately started walking. Not anything major, no 14 milers, but I did head to the mall for several loops my first day in street shoes, then to Lake Padden on my second day, and so on. I walked five days in a row without the boot, and each walk got progressively more difficult and painful. I tried to ignore the pain (BIG MISTAKE!), thinking it was just my foot readjusting to being out of the boot and that the aches and pains would pass.

But they didn’t. After five days, I couldn’t walk at all without severe pain and a significant limp. I knew something was up. I had a doctor’s appointment last Tuesday, at the end of the five days of regular shoe walking. The PA diagnosed me with a stress fracture in the third Metatarsal bone of my post-surgical foot — nothing directly related to the surgery, those sites were good and healed. But somehow, getting out too much, too soon, even though the walks were short, did me in. My foot was vulnerable, the bones maybe softer from non-use, and I did a number on my foot without realizing it. UGH. It fit, though, as I have had a stress fracture before. And I know they don’t heal unless you back way off, exactly what I don’t want to do.  It’s 4 – 6 MORE weeks of rest, with no walking without the boot, no swimming, no anything that will stress the foot. After the doctor’s visit, I felt defeated, discouraged and very frustrated,  states that have persisted to varying degrees over the last week.

Financial Concerns

On top of this, a trip to the bank yesterday gave me a startling reality that my finances are alarmingly tight. After so much time off work (as a massage therapist) during my various recoveries, bills mounted up. I am back to work now, but with knee replacement in November and foot/ankle surgery in December, things caught up with me, and money is tighter than I realized. I really let this get me down, feeling trapped and worrying all day that I might not be able to keep my head above water. I went to bed last night feeling down, discouraged, and stressed.  No surprise, I woke up this morning still feeling all those things. My usual strategy for lessening the intensity of concerns or frustrations, a good walk in nature, is not a good option right now for obvious reasons.  I felt the heaviness of despair all morning, and zero enthusiasm for the day  ahead. Usually I can shake it; this morning, it persisted with a vengeance.

The Plan

After texting back and forth with my sister early this morning about my mood and feelings of despair, I had to make a choice. Was I going to just give up on the day, call it a wash, or could I somehow turn it around?  There were things I could cancel in the day, but I wondered what it would be like if I did them all with intention and as best I could, despite my reluctance. After all, how many times have I said encouragingly to others, “Just show up and see what happens!” Here was a good opportunity to test this theory out myself.

The Events of the Day

The first thing on my list outside the house was a meditation group at 10:00. Thankfully, my meditation group contains kind, forgiving, and generous hearted folks. Most members have at one time or another shown up down, discouraged, worked up, frustrated, or in some other not calm and meditative state. I knew I would be OK there, and it was nice to get hugs and affirmations. I told the group of my intention for the day.

Next was an outcall massage at Semiahmoo in Blaine. I had about an hour to kill before the appointment. I hastily ate my sandwich in the car, asking myself why was I being so hasty? It’s simply habit, always eating on the go, and running from one thing to the next. I forced myself to slow down and take a breath. Since I had time, I stopped at the Co-op Bakery for a gluten-free chocolate chip cookie and hot water to make a Via instant coffee. I enjoyed both on the drive to Blaine, 30 minutes from Bellingham. I drove without speeding, relishing the fact that I was not in a hurry for once. I wanted to be in a good headspace for the massage.

Once in Blaine, I still had  time to kill, so I pulled off the road right by the water, and sat in my car taking stock. Ten years ago, I lived in Blaine, and where I pulled off was right next to beaches I would walk on in an effort to get my head straight back then. Those six months in Blaine were some of the toughest times of my adult life, and it didn’t take long to realize that, despite current challenges, things in my life today are MUCH improved from the Blaine days. This gave me a wonderful perspective, and I took a moment to text my sister about this.

The outcall massage was with a kind and charming, newly retired woman at her and her husband’s beautiful townhouse. Both were as sweet as can be, and everything about the visit was smooth and easy. I left their house at 2:30 with my mood buoyed, but not looking forward to the hours still left in the afternoon.

Late afternoon and evening are my toughest times when I am feeling down. If I was a napper, I’d go home and sleep. But I don’t nap well, and I KNEW if I went home, I would feel restless and unsettled for the entire rest of the day. I had to do something transitional to get from afternoon into evening, and the gym had been on my to do list. I knew even as I drove there that this would be the hardest part of the day. 50 times on the drive there, I considered bailing. But I steered the car to an open parking spot, where I sat outside for a good ten minutes trying to convince myself to go in. You’d think I would be happy to get a workout in, but I don’t like gyms.  I MUCH prefer being outside, and sometimes it’s almost impossible to convince myself to go. Today, I wanted to bail so badly, but I also knew I would feel better if I went, and I had said I was going to do everything I planned to, and that was on the list.

After ten minutes, I made myself open the car door, drag in my bag with clothes, headphones, stuff to shower, the works. I figured if I could at least get the right clothes on, I might get into it. And if not, at least I could say I tried. Time slowed down, as all my actions became reluctant and unwilling. But I did all the upper body weights, then all my floor exercises and stretching that my physical therapist had given me months ago. That part of the workout took over an hour.

Then came the hardest part, hauling myself upstairs to get on the stationary bike. This, the aerobic workout, is where the best possibility of a mood change would come, as endorphins, no matter how reluctantly achieved, always help to elevate my mood. And riding the bike, while I really don’t like it, is something I can do safely and without foot pain. I told myself I’d do 40 minutes, and I ended up doing 50. It wasn’t my most stellar or ambitious ride, and it took me a long while to settle into it. But I did it, and, not surprisingly, felt considerably better after. The best I’d felt all day, in fact.  I showered, dressed, and returned home by 6:15 pm. I made cookies for a friend’s birthday tomorrow, made myself dinner, and sat down to write this post. I had done the day, everything I said I would, and that felt pretty darn good.

Taking stock, again.

How did it go?  Was my experiment a success? It was, in the sense that I did everything I set out to do. It also did everything with the best attitude I could under the circumstances. I am reasonably sure, no one knew how rough of a day I was having unless I let on. Some folks, like the meditation group, I could tell them I was having a hard day. Others, like the outcall couple, I just did my thing. Still others, like at the gym, I didn’t have to talk or interact with anyone, and I could be off in my own world and trying to sort out my own thoughts. On the whole, my mood did improve, and I proved to  myself that I can successfully do life even when I don’t feel like it. It’s not that I haven’t done it before — for all of us I’m sure, there are times when we just have to put our ‘noses to the grindstone’, as my dad would say, and do it anyway. On this day, however, I had choice to a degree, I could have bailed on some things, but I didn’t want to. I wanted to give it my best shot.  And my best shot ended up being not all that bad. It felt surprisingly good to show up, be present, and know that I did the best I could.

And now, I really CAN crawl back under the covers, and tomorrow IS another day.

 

NOTE: I’d love to hear how you manage days like this. What do you do to get through when you feel like doing anything but? 

 

 

My Own Private Half Marathon

Fragrance Lake Half Marathon Route…in the Boot!

Origins of the idea

The inspiration to do this 13.1 mile hike came to me with the force of other ideas I have not been able to ignore — like hiking the John Muir Trail solo last summer, for instance. I was out on a hike on Chuckanut Ridge with my friend Michael on January 23, 2017.  I had been walking and then hiking in a post-op boot for two weeks following December 22nd’s  foot and ankle surgery. Gradually increasing both mileage and difficulty of terrain, I felt ready for the challenge of Chuckanut Ridge Trail (near Bellingham, where I live). Using poles and moving carefully,  I found I was able to successfully negotiate the steep, rocky, heavily rooted Ridge Trail, even in the boot, AND do all that for 3 hours. That got me wondering just how much I COULD do in a boot, and my curiosity and goal orientation took over.

“Michael”, I said.  “I have an idea…”

“Oh no”, he said, knowing full well that is a dangerous statement coming from me. “What is it?”

“Are you free next Monday? January 31st? I want to do the entire Fragrance Lake 1/2 Marathon course while I am still in the boot.” The actual event, I knew,  was Saturday February 11th, a day I have to work. “You’ll love the route — Two Dollar trail, Fragrance Lake, the Rock Trail, and the Chuckanut Ridge Trail. The hardest parts of it are the Rock trail and this Ridge trail. But I think I can do it.”

Two Dollar Trail

Michael, I know, is always up for an adventure and is slowly pushing his own limits of what’s possible hiking-wise, in this case distance. He laughed.  “I know that once it’s in your head, Kathie, you won’t let it go. So sure, let’s plan on it.”

It’s important to note that I have done the whole Fragrance Lake 1/2  marathon course three times before, so I know the route well.  Only once did I actually do the event itself, and that was three years ago on 2/15/14. THAT particular time I had serious demons to confront and unravel before, during, and after the course.

The Fragrance Lake Half of 2014

Inspiration for that Event

I signed up for 2014’s event rather spontaneously with my then boyfriend of three years. We were out on a hike in the Chuckanuts (a term locals use to describe both Chuckanut and adjoining Blanchard Mountain’s complex array of trail systems) in November of 2013 when, unexpectedly, multitudes of runners started passing us. We quickly discovered they were doing a marathon and half marathon on the trails we were hiking on. We continued our hike, keeping out of their way, and watching as they cruised by us in a steady stream.  As we watched the runners, some fast and some almost walking themselves, what struck us most was the variety of body types and running styles.  While many were thin, wiry, efficient running types, there were also heavier, less svelte almost awkward types too. Even though neither of us was running at the time, we were inspired by the diversity of runners, and started talking about the idea of run/walking a trail half marathon ourselves. Back at his house later that evening, we perused upcoming half’s and came upon the Fragrance Lake Half Marathon, scheduled for mid- February of the upcoming year. Motivated by the day’s events, we both signed up, with just three months to prepare.

Unexpected Challenges

Unfortunately and very unexpectedly, things in the relationship soon took a turn for the worse. In early December, my boyfriend/life partner/one who I thought was IT, started becoming increasingly distant. I didn’t understand this abrupt change, his lack of response to texts, not wanting to get together,  etc., and it drove me crazy for two weeks. Finally, in mid-December, we talked. He came to my house and said he needed time alone to work on personal issues. He did his best to explain and I did my best to listen and be compassionate and understanding. It was a painful and emotional conversation, out of which came his request for time away, and my willingness to give it to him. It wasn’t termed a break-up, at least I didn’t hear it that way. Because of my tendency to be the dominant one in relationships, he asked that let him contact me when he was ready to re-engage. I agreed, not realizing at the time what all I was leaving hanging out there in the zone of uncertainty.

I made it through the first few weeks of this with a lot of support from friends and family. I got through Christmas, the anniversary of my Dad’s death on 12/27 (an event that my partner and I shared, and was as impactful and emotional for him as it was for me), New Year’s Eve, and January 2 when we had concert tickets together. And still no word from him. As January continued along, my initial patience with his process started to turn to frustration.  I upped my exercise routine, doing long walks out on the trails and trying to sort out my feelings for and about him, without access to him to do so. I didn’t know what else to do, frankly. So I walked and hiked, even experimented with running a bit, and eventually did the whole half-marathon route, just to see if I could. It was challenging to say the least, and for unknown reasons I ended up getting extremely sick (vomiting, headache) after doing the course that first time.  I wrote a story about it…and sent it via email to my boyfriend (thinking that was an acceptable form of contact), and hoping it might open the door to communication — or at least give me an idea of whether or not he was still planning on doing the Half with me.

He did respond, but only vaguely.  He said nothing about his intentions with the half marathon. I emailed him back directly, saying that if he wasn’t going to do it, my daughter Shannon would sign up and do it with me. Shannon, then 23, and I were living together at the time, and she felt badly for me that he left so abruptly. As much as anyone, Shannon was aware of the complexity of our relationship. When no response came to the second email, I told her she was on. She signed up. Shannon’s birthday is on 2/16, the race was on 2/15, so we decided to turn it into a birthday race – celebration of me trying to run again – anti-Valentine’s Day – screw it, we don’t need men in our lives anyway event!

A Brief History of my Running Past….

A brief word here about my history of running. I started running at the age of 19, after a year of not exercising and weight gain. I ran sporadically through college and through the seven years of my first marriage and two children. Running was always there, like a comfortable and predictable old friend, but never a focus. When I divorced and remarried, I suddenly had time to run as I didn’t have to work with husband #2. We lived in Bellingham, and I ran as much as I could on the trails and roads in and around our home. I started training for a marathon, a goal I’d held in the back of my mind since college, but never really expected to achieve.  LONG story short, I trained for four marathons between 1995 and 1999, and ran zero. I got injured each and every time I would increase my mileage beyond 15 miles or so. My last marathon attempt was an Anchorage Marathon in June, 1999, with Team in Training, a fundraiser for Leukemia. I raised all the money, did the training, but ended up bailing — again — and having back surgery for a herniated disc a week before the marathon. It was a very sad day and a sad time of my life. Six months after surgery, I left my second husband for reasons far too complex to explain here. Suddenly I was on my own with two kids, chronic pain, and no ability to exercise to combat stress.

The next twelve years was an on again, off again struggle — in life and with running. During that time I had knee surgery for chronic ACL problems, a back fusion, and a neck fusion. Between recoveries, I would sometimes be able to get back into running a little bit,  but mostly I became a committed road biker, hiker, and eventually backpacker — not a runner. I totally and completely kept the runner mind-set and desire, I just didn’t have the cooperation of my body to pull it off. I accepted this, but still and always, wanted to run. So with the half-marathon coming up, and Shannon now doing it with me, I decided to give it another go. In early February, I did the course again, this time running where I could and walking the rest, and it took me 4 hours 30 minutes. The cut-off for the race itself was 4:30, and I was determined that if we did it, we would do it to count.

Race Day 2014

By race day, then, I had done the whole course twice, and had a good sense of it. Shannon (who was running some at the time, but not a lot either), agreed to let me decide when we would run and when we would walk. Some of the route is just not runnable (in my view anyway — of course, many die-hards DO run all of it), and I was experiencing calf-cramping every time I ran up hill. With 3300 feet of elevation gain and lots of uneven terrain, that would mean a lot of walking. Somehow, on race day, we arrived late to the starting line. We were running even before the race started! I was exhausted after the first flat mile and a half, and still trying to catch my breath. After that, the hills began in earnest. We evolved into a routine, running the flats and easy downhills, and walking the uphills and the challenging terrain parts of the race. We started at the back of the pack and basically never caught up.

The Rock Trail comes just before the half-way point in the race. It covers only 1.1 miles, through beautiful, fern-adorned boulders and huge rock slabs, with Bellingham Bay peeking out from the trees. But it’s steep, and has many sections of stairs, eventually topping out at the Cyrus Gates Overlook, the high point of the race. At one point on the Rock Trail, Shannon, then a grad student at Western Washington University in Environmental Science,  decided to give me a lesson in the types of trees on the trail. She pointed out Alder, Cedar, Hemlock, Maple, and various evergreen trees. Then she wanted to quiz me as we went along. I was appreciative of her efforts of distraction, but barely hanging in there. I said, with as much patience as I could muster, “Shannon, I will tell you right now, it’s all I can do to  put one foot in front of the other. I am so sorry, but I am not going to be able to recall the names of trees right now. I just have to get through this!” She laughed good-naturedly, and we completed the Rock Trail in companionable silence.

Thankfully, the one refueling stop on the route was at Cyrus Gates overlook.  Volunteers were still there in the wind and drizzle, with food and cheering, though runners had all but passed through. I’d never been last in a race before, and it was hugely encouraging when they cheered us on like we were the first! We allowed ourselves a full stop, chomping  M & M’s and whatever else we could consume quickly. Weather was coming, and we still had the Chuckanut Ridge section to go.

The ridge section, something over two miles, is up and down, rocks and roots, obstacles and uneven ground. Our goal remained to complete the race under 4:30, but uninjured. Both of us are balance challenged and prone to ankle twists, so we took the ridge slowly and carefully. It was tedious and trying. We both tried to cheer each other on, and keep frustration at bay. Neither of us liked the section and it seemed to go on forever.  There were no views, and drizzle had turned to rain.

Shannon and Kathie wet and happy at 2014 finish line

After the ridge, we still had almost five miles to go, mostly downhill. There is one last uphill section on road, then it’s all downhill on trail for the last 3.5 miles. At that point, patience tried by the stopping and starting again to run, Shannon told me she was not going to stop running until the finish line. And that if I wanted to finish with her, I would have to run too. So we did. We pulled off a somewhat convincing last few miles, finishing the race in 4 hours and 2 minutes.  We were 141st  and 142nd out of 149 finishers. The fastest time was 1 hour, 48 minutes– less than half our time. But it felt like a huge victory, and I was on a runner’s high and typically reflective as we feasted on still warm soup and other goodies. Doing the half was in win in so many ways — a statement of independence and OK-ness with being alone, an opportunity to hang with my daughter, and, yes, a mini-comeback with running. As we headed back to the car, soaked but with our bodies replenished,  I joked with Shannon that we could make this an annual event to celebrate her birthday. She said point blank “I don’t think so, Mom. Never again. You are on your own with this one if you want to do it again.”

Back to the Present

Fortunately for Shannon but unfortunately for me, I was on crutches or in a post-op boot recovering from surgery for each of the next two Fragrance Lake Half-Marathons. It wasn’t even on the radar for this year, being similarly in a boot and recovering from both full knee replacement (right) on November 14, and foot and ankle surgery (left) on December 22. It had been a challenging initial recovery phase, using the recently replaced knee to weight bear 100% following foot and ankle surgery.

But after these surgeries healing was happening very quickly, and I started getting out on the trails in the boot earlier this round than previous ones (with the doctor’s approval, of course!)

Plus, three years later, many of the demons I was fighting with in 2014 had been successfully resolved, and it seemed a good time to do the half under different circumstances and with a different set of goals.

My goals for the event were straightforward: 1. See what was possible for me post-operatively — both in a boot, and 2.5 months after knee replacement. I had done as much appropriate preparation and lead up to this adventure as possible, but it would still be a significant jump from what I’d been up to; 2. Do the half route again — under different circumstances, and with so many of the stressors of the previous time now a thing of the past (the old boyfriend and I,  after a long period of total separation and angst, have gone through a process of relationship repair that has turned into close friendship); 3. Get out on trails I love in the middle of the winter in Bellingham, despite challenges — an overcoming of obstacles to do something I love and that feeds my soul like nothing else. Period.

The 2017 Half Marathon Event!

Michael and I were at the Lost Lake Trailhead and ready to go right at 10:00 am. We are both prepared hikers, and between us we had more than enough of everything — food, water, caffeine, extra clothes, rain gear, a map, and basic first aid. Michael kindly brought a portable stool for me to elevate my foot if necessary, or if not, for one of us to sit on. The day was cool and cloudy, but with no threat of rain. We both had poles, not necessary on the first flat part of the course, but essential on the tricky parts. I have learned that poles, particularly in a stiff boot, make challenging upward mobility doable. They also provide an extra balance point on any sort of uneven ground, and are a good braking mechanism when going downhill. The only “rules” we had for our hike were: 1. Take it slow — no time schedule here, except to finish before dark; 2. Take frequent breaks — to elevate the foot for me, and to rest for both of us; 3. Get through it without injury or incident; and 4. Have fun!!

First Break at Fragrance Lake

Everything on this day went pretty much as planned. We more or less cruised the first four miles, despite the steady uphill climb on Two Dollar trail to Fragrance Lake. Here we took our first break. It was cool, and sitting chilled us right off, so we moved again quickly. As anticipated, the route got more challenging once we hit the South Lost Lake trail, a mostly uphill traverse along a ridge overlooking Bellingham Bay. Views were obscured, unfortunately, by low clouds and, the higher up we went, by mist. Eventually the trail curves around and heads the other way, in forest, to the Rock Trail. As mentioned, the Rock Trail is challenging for normal hikers, and was much harder in the boot. The stairs were particularly tough, made more so by the still recovering knee replacement on the other side.  It was slow going, one step at a time. I have never counted the stairs on Rock Trail, but there are plenty and they are steep. The coolest part of the rock trail was the mist. As we looked up, the trees were blanketed in a surreal mist, making the whole stretch, already very fairy-like with it’s ferns and mosses sprouting off rocks and trees, even more magical.

Rock Trail

Stairs on Rock Trail

Top of the hike

By Cyrus Gates, we were full on in the mist. We had no views whatsoever, except of the two picnic tables, one of which we chose for lunch. We encountered a few other hikers and one mountain biker there, also out on this cool last day of January. One gal, hiking with her tiny dog, was also a patient of  my current foot doctor and a previous knee doc, and we had a great time swapping stories of surgeries and recoveries as we ate. It was relaxing and fun, but we still had half way to go, starting off with the Chuckanut Ridge section, so we couldn’t get too lackadaisical.

Lunch Break — Michael, Kathie, the pooch, and fog!

Having just done a portion of this section in the boot, and knowing the ridge is challenging no matter what, I didn’t expect anything different. And it was really tough. Particularly difficult was navigating both the awkward left foot and the still recovering right knee, which doesn’t bend much beyond 90 degrees without pain. When doing a trail with obstacles and roots and rock slabs, it’s far preferable to have two fully functioning appendages — well four, actually if you count arms and poles. I had two — the upper two, but the lower two were definitely compromised. So it was slow progress, and we were already at the four hour mark on our journey with over half of the ridge section left to go.  We knew were setting no speed record!

I was relieved when we made it through the ridge without incident. Again, like when Shannon and I did it, the skies were cloudy, and only the vaguest view of a mountain top might appear between clouds and fog as we labored along. But, unlike 2014, we had no rain, for which I was totally grateful. And the trail was dry after a week or so of good weather leading up to our hike,  a blessing as well. I want to state for the record that I would NOT have undertaken this mission in rain or on a wet and muddy trail. It simply would have been too much.

Starting challenging section of Ridge Trail…

Navigating through…

And success!

And down to the finish!

After the ridge trail, it’s mostly downhill, and that is what is most painful about hiking in a boot. The muscles that hold your foot up are constantly working to stabilize in the boot. The boot can’t flex, but the ankle flexors can and do. The muscle fatigue was intense for the last five miles of the hike. It’s like my foot/ankle said “Ok, we got you through the tough stuff, now give us a break!!” It was easy going terrain wise, but really hard going with muscle fatigue and associated pain. We rested again just before the last 2.5 miles, down Fragrance Lake Trail and back to the car. But I was struggling with each step, and it was a mind over body experience. I knew I wasn’t hurting anything in the sense of surgical repair, but I was definitely hurting!

Last break before final descent

We made it back to the car by 5:00 pm, just as the daylight was fading for real. It took us seven hours total.  An event that put Shannon and I in nearly last place at just over 4 hours would definitely have landed Michael and I into the DNF (did not finish) category had we done the race for real. But we DID finish! And it was with a huge sense of accomplishment and relief that I took my boot off in Michael’s car, and celebrated freedom — for my foot, and from the past. Doing this route, on this day, was undoubtedly a celebration of overcoming. Similar to the last Fragrance Lake half with Shannon, it was taking a group of obstacles and a whole lot of reasons not to do something, and turning it around into an accomplishment and victory. I am proud of us for doing it! For Michael, it was his longest hike to date, and for me, it was one of the most challenging in it’s tedium.  But all of that just made the victory that much sweeter! Who needs chocolates on Valentine’s Day after that!

Boot’s a little worse for wear

 

NOTES: There is still time to sign up for the Fragrance Lake Half Marathon on 2/11/17. Click HERE for more information.

Also, for more information on hiking in the Chuckanut Mountains, click HERE.

 

 

 

 

After crutches – The Boot

The transition from crutches to full weight-bearing in a boot

Following time on crutches from an injury or surgery, getting back to full weight bearing will most likely be a gradual process. How gradual and how much weight bearing is allowed varies greatly depending on, among other things, whether or not bone repair was involved (fusion, broken bone, bunion repair) or just soft tissue (ligament, tendon, cartilage).  It also depends on each physician’s protocols and preferences. The usual process following my foot/ankle surgeries has been to start with 25% weight bearing,  then gradually increase to 50%, 75%, and eventually 100%.  That day, the day of full weight bearing, is always like Christmas! The ability to walk, even in a boot, greatly expands the available options for hiking and exploring in my favorite environment, the great outdoors.

This post covers things I’ve learned from extensive boot-hiking — some cautions, and lots of practical tips that make this activity fun and very doable. While it  mostly applies to being in a boot while fully walking, the section on Boot Care applies any time you strike boot to ground, crutches or no crutches.

About the boot

The boot my foot surgeon prefers is made by Top Shelf Orthopedics, and it’s called the Solar Walker. I love the name!  I have been through two of these boots in three years. It’s quite sturdy, although during this round of post-op I have really put it to the test. Hopefully, the boot can hang in there with me until we are done with each other!

Boot Hiking Strategies

  1. Wear a long sock underneath. Hands down, the best thing I have found to wear under the boot is long, over-the-knee socks. I purchased two pairs of Hue knee high socks at Macy’s three years ago, and those four socks have been a total win. The sock obviously covers my toes, and comes up over my knee. Sometimes it slips down, but never so far that it doesn’t reach above the top of the boot. When it is particularly cold outside, I wear an extra regular sock over the knee-high to keep my toes warm.
  2. Inflate the boot fully when walking for exercise. My boot has an inflate/deflate mechanism, which pumps air into all the padding surrounding the front of the leg and top of the foot. When hiking, I inflate it fully to add extra protection in those areas. Walking in a boot automatically throws your weight forward, and without extra padding on the shin this can be uncomfortable over a long period of time.
  3. Wear a shoe on the alternate foot that is of similar height to the boot.  This is challenging, as the boot sole is quite thick. To normalize my gait as much as possible, I have tried various different shoes and insoles in my shoes. The Altra Olympus (as opposed to the Altra Lone Peak that I usually wear) has a higher sole, and I have used that shoe some. Hoka’s also have a higher sole.  I know many trail runners love those, although I have not tried them. I have tried using two insoles in a Lone Peak, and that seems to help too. It’s a balancing act here, in more ways than one. I have to make sure the right foot is supported and comfortable while dealing with the left (in boot) and trying to walk as evenly as possible. My advice? Experiment with lifts in the shoe, or higher and thicker soles, to see what works best for you.
  4. ALWAYS USE POLES!  After my first foot/ankle surgery in January 2015, I was talking to the PA during that magical check up that gave me the OK to fully weight bear. He suggested walking with a cane to help with balance and lessen the intensity and awkwardness of walking any distance in the boot. Somehow, I couldn’t see myself out on the local trails with a cane. I asked him about hiking poles. He said yes, that would be a good alternative. In that moment, I became a complete and total hiking-with-poles advocate! I had owned poles for a few years, but rarely used them to hike. I (ignorantly and incorrectly) assumed poles were “just for old people” and therefore I didn’t need them. I could count on one hand the number of times I had used them before this conversation. Now, suddenly, they were an ally that would allow me to get out and about much sooner! I started using poles for each and every walk/hike I take with the boot. Even on a simple trail like Lake Padden I use them (at least in the beginning). Poles help generate the extra support necessary to get up hills in a boot that offers no ankle flexion. And they help slow and control downhill motion by acting as brakes. Numerous studies show that using poles reduces impact on joints by 20%, as well as dispersing the load off of the lower body by incorporating in the upper. And it goes without saying that using poles helps with balance. I can’t say enough about these advantages of using poles both in a boot and not. I simply would not be able to do the amount of post-op hiking, or hiking and backpacking in general with foot/ankle/knee surgical history, without them.

Boot Care

Here is the reality of winter hiking on trails in and around Bellingham — it’s muddy! I have tried various methods in an attempt to keep the boot clean while hiking in wet and muddy conditions — among them a garbage bag over the boot, and a thick sock over the boot. In my experience, I have yet to find a solution that works, as the action of walking has destroyed any cover I’ve put on the boot, and I end up walking in mud anyway. Hence, I now skip the covers, and deal with mud and pine needles on a daily basis. Here are some things that DO work for helping fight dirty-boot syndrome:

  1. Keep towels in the car.  Some people have dog towels in their car, I have boot towels. And a water source to get one wet. I always take the boot off and shake it out and clean it as thoroughly as possible after a walk. It’s never perfect, but allows me to go on with my day without tracking mud and such to my post-hike activities.
  2. Shake the boot over a throw carpet at home.  When I remove the boot, I do so over something I can shake outside. Even with meticulous cleaning, needles and dirt remain, and I can better contain the mess if I can shake it outside and not get it all over the house.
  3. Sleep in a pillow case!  This is a new strategy learned this year. At the end of this round,  I will have been over four weeks in the boot — day and night. With all the hiking,  I kept encountering small pebbles, pine needles, and other particulate in the bed despite my best efforts. The PA suggested sleeping with a pillow case over the boot, and VOILA! I have no more trail debris in bed with me at night. 🙂

    Boot ready for bed!

Some cautions about hiking with a boot:

  1. Start slowly!  Like crutching for exercise, don’t go out three miles on your first boot hike! Start with a manageable distance that you KNOW you can do. Build from there. It takes different muscles and taxes the body differently to hike in a boot. Feeling good for two miles doesn’t mean you will feel good for four. Build up slowly to both more distance and more challenging terrain.
  2. Remember, you have no ankle flexion.  Walking in a boot reminds me of what my dad went through for the last 20 years of his life. By the age of 63, after numerous failed ankle surgeries, my dad had both ankles completely fused. This left him with no ability to flex his foot up (dorsiflex) or down (plantar flex). I remember trying to take him rock climbing at Joshua Tree National Park in California back when I was really into that.  What was an easy route for my then husband and me was simply not doable for him, as he could not dorsiflex his ankles enough to ascend even an easy climb. That is what walking in a boot is like. The normal heel/toe rock of walking all takes place in a stiff boot with no ability to flex the ankle. On flat ground, it’s not too bad, but add in some elevation, and it gets really challenging. Add in elevation AND obstacles or uneven terrain (like roots, rocks, or a slanted trail), and it definitely requires full focus to make it happen. Here is where poles and caution really come in. The surface of the boot is much broader (and stiffer) than a normal shoe, so wedging it in or angling it with agility is not going to happen. Conquering hills requires slowing down, using poles, and leaning in a bit more to use the tip of my boot. Caution must be used with the latter if your ailment is in the forefoot, as putting too much pressure here can be painful and, worse, detrimental to healing.
  3. Common areas of pain to watch for. In addition to the obvious ones from your particular surgery, the most common types of pain I experience specific to the boot are the back of the knee (where the hamstrings connect — because all the walking, especially up hill, is with a more or less straight leg, and the hamstrings have to pick up the slack on this). The calf muscle in a boot is rendered useless, as anyone can tell you if they have ever been in a boot or cast and viewed their withered calf at the end of it. And, in the boot itself, the muscles responsible for dorsiflexion are constantly stressed inside the boot in an effort to stabilize and simply to make the action of going uphill happen.  Those muscles are the ones most likely to cry out during a long hike and for awhile afterwards. I always see how recovery goes overnight…if I feel fine in the morning, I am OK for another round.
  4. Take breaks to elevate the foot on long hikes.  Much foot and ankle surgery involves long periods of time sitting with an elevated foot. To go out on a long walk (or back to work all day standing up) takes easing back into. Take breaks during your hike to stop and elevate your foot.  I try to prop my foot up at lunch and at regular intervals on long hikes.

    This method of duct taping did not work…

    Wear and tear…notice the heel is down to metal

  5. Too much hiking causes the boot to fall apart!  This post-operative round is the first time my boot has disintegrated significantly on the bottom. Either this boot is less well made the previous, or I have just used it more. Regardless of the reason, I have struggled immensely with the heel portion of the boot falling apart and coming off. The reason I mention it here under cautions, is because the only time I have fallen in the boot was when I slipped, on dry pavement, with the heel of the boot that is worn down to metal. Metal on pavement and me not expecting it led to a rather spectacular fall, with both feet flying out from under me! No injuries, but now I am acutely aware of walking on a hard flat surface. And I am still trying to figure out how to get duct tape to hold together for a long hike.

What constitutes a long hike in a boot?

With this being my third (and hopefully last!) year of surgeries, I have started to expand what I thought was previously possible hiking in a boot. I have added in Galbraith Mountain, a mountain bikers mecca with an extensive, never-ending array of trails. I have also hiked to Oyster Dome, via Lily and Lizard Lakes and the Samish Overlook, a total of about 11 miles. I have also taken the boot for a spin up on Chuckanut Ridge Trail, which offered the most challenging terrain so far. This hike on Chuckanut inspired me, for various reasons, to consider doing the Fragrance Lake Half Marathon route…not the race itself, as I could not make the cut off time and would feel very silly doing it in a boot,  but the designated 13.1 mile route. I have done it several times before, and love where goes — including Chuckanut Ridge, Fragrance Lake, and the Rock Trail. I hope to do that on Monday, 1/31, a final boot hurrah before getting out of it (I hope) on 2/6.

Top of Oyster Dome

On Chuckanut Ridge Trail

On Lily-Lizard Trail

STAY TUNED TO LEARN IF I HAVE HALF MARATHON SUCCESS!

 

 

Crutching for Exercise

And other ways to stay in shape when life throws you a curve or two…

Or three! I have spent parts of the last three winters on crutches and in a walking boot following bilateral foot, ankle, and knee surgeries. It was part of a three year plan to deal with bunions, severe arthritis, various past injuries, and significantly compromised ligaments and tendons. For obvious reasons, I chose to do these surgeries in winter time, so I would be sufficiently healed up to take on hiking, biking, and backpacking in the summer months. The last round included knee replacement in November and final foot and ankle surgeries in December.  I am extremely happy to report that all surgeons involved believe that I am done with surgery for a good long while.

Over the three winters, I have learned a thing or two about how to stay active and in relatively decent shape, even while on crutches, in a walking boot, or some other mobility-assisting device. I wanted to share those here, in case you should find yourself in this position or are just curious about how far one can go on crutches or in a walking boot. It’s amazing what you can do with a little bit of determination, planning, and creativity!

Stimpson Nature Preserve

Benefits of Crutching for Exercise

  1. Staying in shape.  Crutching for exercise following surgery allows me to resume normal activities, including walking and working as a massage therapist, with much greater ease. Following each winter on crutches I have been able to do extensive hiking and backpacking trips in the summer, an accomplishment I partially attribute to my commitment to staying as active as possible while mobility restricted. I also lift upper body weights at the gym and do a program of floor exercises while I am on crutches, that, sadly, I don’t always maintain when I am not. But the discipline to do it during crutching times is there, as I am somewhat limited in what else I can do.
  2. An opportunity to work on balance.  As we age, it becomes more and more crucial to maintain balance. Balance challenges go hand in hand with crutching, and  I view this as an opportunity to actively work on improving my balance.  Balance is a skill involving a brain body connection that is strengthened with practice. It’s a win/win here — balance improves, and I keep my brain healthy as well!
  3. Getting outside.  There is a innate and fundamental need for me to be in the great outdoors. Often, it’s not enough for me to sit in it.  I want to move in it and explore it to really experience it. Being able to do trails I love in an environment I relish simply feeds my soul like nothing else.

    Frozen pond on Stimpson short loop

  4. Keeping the body moving!  Each time I have long periods of sitting, I can really feel it in my body. For the first ten days to two weeks following surgery, I am usually and appropriately not doing much exercise. After that, the desire to move takes over, and, just in time, I am able to get out and about.
  5. Focussing on something other than the obvious!  Having surgery or something else that interrupts a regular life and exercise routine can bring me or anyone else down. When I get out and about, the activity itself normalizes the experience, and I see myself as less impaired and more still in the game.. despite. It’s a huge psychological boost.

All that being said, I want to clarify that CRUTCHING FOR EXERCISE ISN’T FOR EVERYBODY! There are cautions, drawbacks, and potential side effects that can occur from using crutches for extended periods of time, both in terms of distance “walked”, and in terms of length of time you are on crutches. It’s a process of discerning if it’s is right for you and if the benefits outweigh any side effects. And it isn’t easy, physically, so crutching any distance should be eased in to very gradually, and evaluated regularly to see if it’s a good fit for you. It sure has saved my sanity!

How I got into Crutching for Exercise

It wasn’t planned. The first round of surgeries, in January 2015, was to be the longest time on crutches. Nine weeks of no weight bearing following ankle ligament repair, two fusions of the foot, and a new Anterior Cruciate Ligament (knee), all on the right side, sidelined me completely for a couple of weeks. Just after this, while talking about post-operative driving, someone said “I’ve heard some people drive with their left foot. I don’t know if I’d do it, but I guess some crazy folks do.” At that point, it entered my brain that maybe I could do that to get to our local lake, Lake Padden, and experiment with crutching part of it. At the time, I lived a mere two minutes away, and figured I could do the drive mostly on side roads, and thus decided to try it. I didn’t want to always have to depend on someone for rides, as I knew it was going to be a long haul on crutches. I desperately wanted to get out to enjoy the beauty and calmness of this 2.6 mile unpaved but gentle trail.

Lake Padden, January 2015

Just getting the hang of this crutching thing…January 2015

The first time was nerve racking in all ways. Especially the driving. An important note: I am NOT advocating driving with your left foot — and if you do, do it fully under your own responsibility and with great caution! As I did. The first time I went to Padden, after safely arriving at the parking lot,  I only crutched a half mile and turned around and came back. It went well, and, while fatiguing, it wasn’t that bad.  And day after day, I returned, each time going a little bit farther. Soon I could go all the way around. This was during a notoriously mild winter that was more like spring, so there was no ice and snow to deal with. I did a few other mostly flat trails that first winter, but generally stayed at Padden since it was close to home and very familiar and I felt safe doing it.

Stimpson Trail, 2017

Lake Padden, 2017

In subsequent winters, I branched out in my crutching. Both December 2015’s surgery and this past round were the on left foot and ankle, so driving was no issue. I gradually increased my repertoire of trails crutched to include: the Railroad Trail (in Bellingham, long, flat, and accesses Whatcom Falls Park); the Interurban Trail (also Bellingham, long and mostly flat); North Lake Whatcom Trailhead (just outside of Bellingham, 6 miles round trip, flat and right by the lake); Semiahmoo Spit (in Blaine, two miles round trip, paved, right on the water); Bellingham Marina and Zuanich Park (also short, paved, and on water); Padden horse trails (for variety, much more challenging with hills and mud!); Taylor dock into downtown (from Fairhaven in Bellingham, flat and partly paved); Lake Louse (1.3 miles around a small lake); and Stimpson Family Nature Trails (two loops, 4.4 miles total, with hills and pond and very beautiful). These last two I just added in this winter, as they are close to my current home in Sudden Valley.

A note about Scootering:

At the mall, 2015, when the Seahawks were still in it.

Bellis Fair Mall, 2017, waiting for the thaw

For the first and third winters, I rented a knee scooter. I experimented with using this for exercise as well. It is NOT my favorite, but I was able to use it some to give my under arms a break from crutching. Knee scooters only work well on paved and flat trails ( I hear there is a four-wheel version available, but I haven’t personally experienced it.)  I have used the scooter at the Marina, at Semiahmoo, and on the paved portions of Taylor Dock and Boulevard park. But the best place to scooter I found is the local mall. I did that a lot the first winter, and some this winter since the cold, ice, and snow made scootering outside problematic. I will cover the hazards of crutching in ice and snow in the warnings section…but for those of you who live in Bellingham, you know this winter was much more wintery than the previous two.  I chose for safety sake to do a fair amount of both crutching and scootering at the mall when the conditions were just plain too risky to go outside.

Tips on Crutching for Exercise

After three winters of experience, I have learned some valuable ways to make this form of exercise more doable…and definitely enjoyable!  NOTE: I have only used underarm crutches, not forearm crutches. All of my suggestions apply to the former…if you have experience with the latter, I would love to hear from you!

  1. Make sure the crutches fit properly.  The fit of crutches in important, regardless of whether or not you plan to use them for exercise or just getting around. The optimum fit is 1 to 1 1/2 inches of space under your armpit when you are standing straight up. The hand grips should be even with the top of your hips, with a slight bend at the elbows so that the weight transfer doesn’t take place on straight arms. I would recommend having a PT do a proper crutch fit.
  2. Vary it up.   When I crutch any distance, I vary where the weight is taken. Sometimes I take it more under the arms, although there is much caution to be had with this (see warnings). Sometimes, I take it more in the forearms, wrists and hands. I can’t do either for an entire distance. Discerning how and when to vary up the portion of my upper body that is taking the brunt at any one time keeps me from overuse injuries associated with crutching.
  3. Start slowly.  As mentioned, I started with 1/2 mile out and back. I would recommend even 1/4, just to see how your body tolerates the action. It takes awhile to build up the upper body strength necessary to crutch longer distances.
  4. Take breaks!  I stop often when I am out on a longer crutch. On average, I will take a break every mile to give everything a rest — I elevate the foot to give it a break from hanging down, and spell the upper body from the crutching activity.

    Stretch break at Whatcom Falls Park

  5. Allow extra time.  This goes without saying…but, when I first started crutching, I was astounded at how  much longer it took me to do a path. Lake Padden for instance, normally a 40 – 45 minute walk, takes me about an hour on crutches. Over time, I got quite proficient at crutching quickly. But even then, it’s a slower pace than I can walk or hike. And I had to adjust my time frame accordingly.
  6. Wear appropriate clothing.  A couple of things here. Some clothing creeps up with crutching, some does not. It’s a continual process of trail and error. Generally, the longer the coat or upper layers, the less they creep. Tucking in as much as possible helps too.  The next to skin layer is important. I wear something that doesn’t chafe, as crutching does generate friction along the top of the ribs. And crutching generates more heat than walking, so be prepared with layers you can tie around you if necessary. I wear mittens, not gloves, and use hand warmers, as my hands get cold and I can’t ball them up easily for warmth.
  7. Keep your cast or boot clean and your foot inside warm. With a cast, I put a big fuzzy sock over my cast for some extra warmth, and added a garbage bag if it was raining.  The boot is more cumbersome and difficult to cover, but I wear an extra sock underneath for warmth. Keeping the boot clean once I start weight bearing is a real project, and I will cover that more in the next post… Hiking in a Walking Boot.
  8. Use headphones if you don’t want to converse!  My first winter on crutches, I frankly got tired of people commenting or asking questions when I was out crutching. I started listening to audio books with headphones. This habit kept my mind occupied and also limited the number of times I would have to stop for conversation. I still get comments when I crutch, but in my experience, people generally are less likely to want to talk if I have headphones in. If I am not on a time schedule and don’t mind interruptions, I don’t always wear headphones.
  9.  Be conscious of where you are in your recovery process.  Where and what distance I crutched always takes this into account. When not bearing any weight, I tend towards flat, wide, or at least very familiar trails. The risk goes up the more difficult the trail, and I don’t want to slip or fall and land on the bad foot. When I get to the point where I can bear some weight, I am willing to take on more challenging trails, which I will cover more in the next post. It’s worth noting that in my three years of crutching, I have only slipped once, and that was on a mossy sidewalk right by my car at Lake Padden.
  10. Be aware of subtle nuances in terrain. Everything is different on crutches. Very small hills seem like mountains, and variations in the angle of the trail, as well as rocks and roots to navigate, all become much more important than when one is walking. I am always hyper-vigilant on trails because of my bad ankles (which now have both been reconstructed), crutches or no, but crutching does require a higher level of awareness of surroundings. I attribute my lack of slips or falls on trails to this keen awareness of terrain and conditions…crutches or no crutches.

Cautions about Crutching for Exercise

There are many things to be aware of should you choose to take this on.

  1. Watch out for numbness in your hands and fingers. Crutching can press on the Brachial Plexus, an area beginning on each side of the neck where nerve roots from the spinal cord split, extending into the underarm, and feeding each arm’s nerves. Sometimes with crutching, especially if too much weight is taken up under the arms, the radial nerve, after it leaves the brachial plexus and travels to the axilla (arm pit), gets impinged. This nerve travels all the way down the arm and into the hand, and impingement can result in significant numbness in the hands and digits and/or severe nerve pain in various areas (which may include the shoulder, scapula, and neck).   This condition, Brachialplexopathy,  can usually be alleviated by a proper crutch fit and periodically shifting weight to the forearms and hands from the underarms while crutching. I have had the most problem with numbness when I had nine weeks of no weight bearing. Once I could bear some weight with my foot, the problem reduced considerably. But numbness or any nerve pain that does not go away after crutching should not be ignored.
  2. Chafing just below the underarm, above the ribs. This happens as a result of friction from the top handles of the crutches moving against the body. It has happened to me each and every year. I don’t let it stop me, but I do try to wear clothing that constrains the upper body less and moves well. I also use lotion to combat dryness from the rash that inevitably occurs. And, over time, the skin toughens up to more readily handle the pressure. For me, this irritation is a small price to pay for the ability to get outside, and I simply tolerate it.
  3. Other pain hazards: I also have struggled with pain in my elbows, from taking too much pressure on straight arms to get the pressure off my underarms. I have experienced soreness in the palms of my hands, which wearing gloves definitely helps alleviate (an advantage of crutching in winter!) I also experience pain in my hip flexor from holding my leg up, and similarly in the back of my knee of the affected leg. None of these problems persist once I am off crutches. But all are ones I monitor closely to make sure I can manage the discomfort and that pain doesn’t override the benefit of getting out.

    Watching skaters on Lake Padden, January 2017

    Stimpson in the ice and snow!

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  4. Watch out for ice, snow, and mud! Since my recent crutching experiences have been in winter, weather-related factors have been prevalent. In past years, It was mud. This year, it’s been mud, ice, and snow. I expanded out from the mall this year – once I felt confident about being in good physical shape – and into the residual ice and snow. It was very challenging and tedious, and I am sure people thought I was nuts. I crutched around Lake Padden when it was completely frozen over, and the trail had good amounts of ice. I avoided the ice if possible, crutching way up on the lawn to stay clear. Sometimes, I simply had to crutch very slowly over the ice.  I wondered, who was crazier — me crutching around the frozen lake, or the throngs of people out on the lake, skating, biking, and sitting on lawn chairs in the middle? It was a trying experience, but it was worth it because I got to get out in the elements, even on crutches.
  5. Hills are hard — up and down. It takes a lot of energy to crutch up a hill, and going down is even more challenging. Going up, I tend to power into it and get it over with. Going down, I go much more carefully, as the chances of a crutch slipping out greatly increase with an assist from gravity.
  6. Don’t go farther out than you can safely get back.  If I am on an out and back trail, I need to remind myself that I still have to get back. I have made this mistake only twice. Once on the Interurban, I got out two miles, ignoring an increasing pain in one of my pectoral (chest) muscles. At the two mile mark, I knew I had to turn around. The two miles back were excruciatingly  painful with a clearly strained pec muscle. I had to go very, very slowly and it was an uncomfortable and lasting injury that actually side-lined me from crutching for the remainder of that recovery. This year, I ambitiously and swiftly crutched three miles to Whatcom Falls Park, feeling great, but the three miles back were all I could manage.

    At Whatcom Falls Park…still have 3 miles to get back home.

  7. Take your phone in case you do get stuck or need help. I have never had to call for help, but I have come close and I am always prepared.

Overall, use common sense!

Like everything in life, crutching for exercise is a balancing act. I do it because the pros definitely outweigh the cons. It is not easy, and it takes much more focus and concentration and energy than simply walking.  Each winter facing surgery I have asked myself, will I do it again? The answer is always yes. I hope and believe the surgical marathon is over and I know I have earned that” surgical holiday” my foot guy always talks about!  But I also know I have a secret weapon to combat surgical weariness should I need to go that route again.

The next post will be on Transitioning into and Hiking with a Post-Surgical Boot…even more fun but with it’s own set of challenges.

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