21 days later

Three weeks ago today I was struggling to hop around the house and was popping pills to dull the pain. What a difference a few weeks can make. This past Monday I had my second appointment with the orthopedist. I had previously removed the stitches around the fourteenth day. The incision was healed and they were causing some tension during my range of motion exercises. On Monday, 6/3/13, I was instructed

to remove the stiff orthopedic shoe I had been wearing since the surgery. The doctor prescribed a carbon fiber plate for my regular shoe. He also mentioned to continue my range of motion exercises and ice. Interestingly, on my post-op form it said "No Ice." However, things change and we must adapt.

I had to make a quick visit to the orthotic department to get the plate. This sturdy and stiff plate is very lightweight and fits directly under my shoe inserts. It was great getting back into my regular shoe. The device allows a reduced amount of metatarsophalangeal dorsiflexion but more-so than the stiff post-op shoe would allow. The idea behind rehab is to slowly increase the motion of the joint while weight-bearing but manually move the joint throughout the day to allow proper cartilage formation and healing. Fortunately being back in a regular show it allows more of a normal gait cycle, though still not normal. Swelling is significantly reduced since surgery. Some swelling is still present on the medial aspect of the MTP joint especially after manual flexion and extension exercises. I mentioned in my previous post about clicking or popping. That is sometimes present during flexion but seems to be somewhat reduced over the last week. Another positive I have noted is the feeling of a more medial motion of the great toe. Prior to the surgery there seemed to be increased resistance when raising the toe upward. Currently that motion is difficult- primarily due to inflammation, scarring, and swelling around the extensor hallucis longus muscle, which allows flexion of the great toe.

I've been continuing to maintain some type of aerobic fitness by using the stationary bike. I plan to increase

the duration on the bike by lowering the intensity. It is difficult to replicate a similar running heart rate while cycling so a lot of the training is designed to keep a high cadence of pedaling which is somewhat similar to running turnover. I am also able create an ankle motion while on the stationary bike that activates the calf muscle. Free weights, machines, leg exercises, and stretching are also part of my current fitness plan. I hope to introduce a "long ride" on the road bike each weekend to further benefit my cardiovascular fitness. It is difficult to maintain ideal weight with zero running but theses exercises will minimize the degradation of my fitness since the surgery. I remain skeptically optimistic that my foot will continue to heal and I will again be able to run without pain. Until then, I'll keep on keeping on.