Trails in Northern California

Trails in Northern California

Leave No Trace!

Visit desovw.org for more information about Desolation Wilderness. Visit Recreation.gov or call 1- 877-444-6777 to make park reservations. Visit Campfire Permits to get a permit online. More about Leave No Trace principles.

May 19, 2011

Sports Injuries

A garden of Eden at the top of Horsetail Falls 2009
     Several years ago I was in chronic pain, the kind and severity that kept me up at night.  My foot was diagnosed with a neuroma, and the recommended treatment was cortisone shots into the foot.  After getting shots every few months, the pain continued to the point that walking, hiking, and at times, even sitting, became so severe that a shooting pain would nearly take me to the ground; it was searing and disabling!  The only choice presented to me was to have it surgically removed, so I did.  Guess what!!! The pain did not stop!  A neuroma is scar tissue that develops on a compressed nerve, and the podiatrist explained that the pain I still felt was "phantom limb pain"!  Go figure.  What then I wondered, was the point of surgery?  What was the benefit?  I still walked off kilter, rolled my foot away from the surgical area, and continued to cause myself knee and back problems!  Sleep problems.  And as an avid hiker and active lady, my life was quite disrupted too.
What a mess...but still hiking.
     Later down the road of life, I developed knee problems, no stranger to the hiking community, huh?  My symptoms got worse and worse, also causing sleeplessness from severe pain and offers for medication.  Finally I was sent to physical therapy for a "tendon injury" and asked to stop my hikes for around 6 weeks.  I had difficulty with that, and continued to have problems with my knee pain.  Boulder scrambles were becoming more unrealistic.  I succumbed to the physical therapist's recommendations and let my hiking rest for what came to be several restless months.  I went faithfully to therapy 2-3 times weekly, but then they referred me back to a surgeon, stating the fluid was not going away and my knee was not getting better. 
     Along with copays for therapy, they also told me to invest in various training equipment, new hiking boots, then told me get bigger hiking boots, then even told me to get BIGGER hiking boots (get real folks, your boots HAVE to fit your foot or they will just let your foot slide around in there and get blistered!) Oh, and orthodics...about $100 more.  Before the surgeon got to me the knee settled down enough to resume some hiking and though not without pain, it was possible, and I did complete the Tahoe Rim Trail and other forestry hikes.

     The doctors never helped me and with research I have done on my own, I wish I had known then what I know now about the possible outcomes of neuroma surgery, and cortisone shots: 

  • Statistics vary but as many as 20% don't have satisfactory results
  • Cortisone can break down important support tissue that can lead to fractures of those little bones in your foot! 
  • Then there are issues about not having a nerve in your foot if you are a hiker, and the potential for a septic infection (from a blister that forms without you realizing it) which is a dangerous possibility on a through hike. 
  • The phantom limb syndrome was not explained before surgery either and since I experienced that instead of pain relief,
  • I only ended up with a two inch long scar on the top of my foot (not pretty in sandles) and  with increased risks to my foot.
  • One other issue is that neromas can return anyway!  Mine did when I kicked a dumbell and sprained my foot causing my foot tissue to protect itself with more internal scar tissue....logical, but who knew? 
 If you haven't had surgery and have a neuroma, do some research and think twice about that as a viable answer.
The return hike from our Horsetail Falls backpacking trip in 2009
     The first day of this latest problem with my leg began with a normal in-house workout that included typical hiker training, including lunges, squats, some yoga postures, and weights.  The following day I went through the neighborhood doing my fast walk and included some uphill and downhill work at a nearby levee, then alternated walking and jogging along the river.  There was normal soreness from a decent workout on the third day, but the misfortune for me was that I got assigned a job of sitting or standing in a very small area for the whole shift.  My chair was a little fold up metal one.  Hours of stillness and I was in excrutiating pain with no way out until the end of the day. My hip, knee and foot became serious enough, pain-wise, I could not even carry my lunch bag and book bag to my car after work.  Thankfully my friends did it for me.  The stairs at home were nearly impossible!   I "rolled out" on a cylinder, tried to do some yoga poses that often help me, took some motrin and iced.  I slept, but with interruptions from pain.  I decided I had to do something more proactive for myself and this nagging problem.
      My favorite person to spend time with (Ken) referred me to his "near-miracle worker for sports injuries"  in downtown Sacramento and my first visit was today.  "Lino" watched me walk after a very brief medical overview and told me so much about myself!  Amazing!  He identified the problems as going from my foot to my knee, hip then back, not the reverse.  Agreed.  I have been saying to friends that I felt like I was walking wrong (dating all the way back to the original neuroma).  With the new lumps in my foot, my step has gotten more dysfunctional, and shoe inserts and bigger shoes are NOT the answer.  But Kinetics?
     Let me tell you:
Lino spent about 5 minutes massaging my foot, painfully I must add, though it was not mentioned in my list of complaints for going there.  Then...

 Lino had me walk around....I wish I could explain how astounded you can be over something feeling right for the first time in years! 

I was honestly amazed at what those few painful minutes accomplished for me.  Lino worked a minor miracle! 

He disputed my earlier diagnoses of knee injury and explained his view of the original injury, a torn meniscus.   Still not so sure I agree with that after researching it vs the tendon.

     In addition my hip had gotten so extremely constricted over this last week that I could not even sit "indian style" anymore, much less do groin stretches of any kind.  He pushed hard somewhere on my mid outer thigh (I think I bolted it hurt so much) and then he did a couple of range of motion type manipulations of my hip. He also did some work on two other small points and I am again astounded with the amount he freed up that mess! 
The view from the top of Horsetail Falls on our 2009 backpacking trip.

     I want hikers to be pain free and prepared for challenges.  Our hiking poles are part of our heart and soul, not to be put away or tampered with!  Our boots need to fit, and our step corrected within our body, not just a mass manufactured shoe insert, avoiding focusing on our bodies mechanics working properly and functionally. 


The fine print:
I feel obligated to write a waiver that you alone are ultimately responsible for your medical choices, for informing yourself before making decisions about your care, and include a reminder that I am not a doctor, but a hiker.  My experience being shared is to make you aware of alternate suggestions and of some things that happened to me, effecting my ability to hike and backpack.  Again, I encourage you to ask many questions, make no assumptions, and learn your real options before agreeing to any treatment.

Kinections for Sports Injuries   I am not being given anything for this post, or for adding the link for this business.  This comes from a desperate hiker who sought and found relief and a surgery free return to the trails!

A reader commented today and caused me to review this note. Thank you, by the way! 
     Let me update you.  It is October, 2012 and I am still an avid hiker, occasionally (rarely) using a knee support for safety sake.  I wear boots made for backpacking and good hiking socks, hiking poles still always on hand.  I have not had surgery for any of the above, fortuantely for me, and with precautions, I enjpy hiking up mountains and down iinto canyons!  My best advice is to get second opinions, maybe one from some alternative source like Lino or other sports injury specialist. Demand it.  Many docotors and physical therapists do not understand, despite education, what we put ourselves through and that we can often be healed without surgery and major drug interventions.  And repeating myself, MAKE NO ASSUMPTIONS.  Doctors do this a lot and don't realize things they leave out could alter our decisions for treatment.  My body is my responsibility.
 Healthy Hiking and Happy Trails!
Updated October 2012