Late last year, I DNS’ed what would have been my first return to running post-childbirth at the Malakoff Run, because I stubbed my little toe – of all the things. It was not a running-related injury, other than the fact that I kicked a wooden bench really hard while rushing out of the house for a Sunday morning run. The toe was swollen by the time I parked my car at the Lake Gardens, and I could not get my foot into the Vibrams without wincing in pain. Needless to say, that morning’s run did not proceed. A visit to the orthopaedic specialist ensued. Doc suspected a hairline fracture, though the x-rays were inconclusive. I wore slippers for weeks and the toe eventually healed.
The next war story is more running related.
My aching ball-of-foot had been bugging me for a while, and my pilates instructor (also a runner and qualified physiotherapist) finally suggested kinesio taping. I’ve always wondered how that worked and so was happy to try.
My gait was examined and it appeared that the ankle of the affected foot was rotating outwards more than it should, resulting in repeated pressure on the outer side of the ball of the foot. The rotation itself wasn’t too surprising as I supinate/underpronate naturally. When I started running, a lot of research and effort had to be put in to adjust my running gait and pronation by trial and error, to eventually run without experiencing pain in the outer sides of my knees. Well, it appeared that the supination was back.
The likely verdict was that there may have been some injury to the small muscles in the foot (possibly a tendon based on the location of the ache) as a result of all this – compounded with body changes post-childbirth – a massive drop in weight (in the vicinity of 15kg) over a relatively short period of time, water retention in limbs, joints in the hip area readjusting back to their old self, the accompanying change in centre of gravity. The return of the supination itself could have been an effect of post-childbirth changes, and I had not quite sensed it as the tell-tale signs – knee pain – were not there (or had not happened yet, thank goodness!)
Although it was always at the back of my mind, I had underestimated the impact on the body of losing weight and regaining strength after having a baby, particularly in the context of returning to a significant physical activity or sport.
Most moms (understandably) focus on their waistline and the size of their jeans, and would also be prudent enough to take care that their posture doesn’t take a beating when carrying a baby on a daily basis right after a significant change in their bodies. Returning to a high-impact activity (like running) would, in all probability, amplify the cause-and-effect of these bodily adjustments, beyond what the regular post-childbirth mom would experience.
It was much more than having to sell off a brand-new pair of Vibrams sitting in the shoe cupboard that were in my pre-pregnancy shoe size. Mothers’ forums and parenting sites tell you loads about breastfeeding and bringing up baby, but this mother runner forgot, in her quest for endorphins, to be in constant vigilance over changes in centre of gravity, weaker feet, oh well, weaker everything generally. While pregnant, I handled the transition in running postures and gaits with an expanding tummy pretty well throughout months #1 to #7, but I guess once baby is delivered, it’s all too easy to forget that it would probably take all of 9 months or more for the body to really return to its previous state.
To top off all that, I had also been doing a fair number of long runs (and diving back into a month of tap dance for the International Tap Dance Day flash mob) until the recent haze finally forced me to cease all activity. Well, whaddya know, the foot probably didn’t have much of a chance to properly recover.
Back to the kinesio tape. The tape was applied in a way that restricts the outward rolling motion of the ankle, providing opportunity for the affected area to recover. The tension of the tape should also help me be more conscious of how I should re-adjust my gait to minimize the rotation of the ankle. The tape stays on and retains its tension for up to 3 days. And so the experiment began. There appeared to be noticeable results, in terms of a reduction in the chronic ache during the time the tape was on. I used to subconsciously attempt to compensate for the aching ball of the foot by altering my stride in a way I could never figure out properly – I was relieved to find that I did not have to do this now, as the tension from the tape helped support the outer side of the foot as I rolled off each step. All in all, it was encouraging. I wanted to get re-taped after Day 3, but didn’t manage it due to clashes in schedules and a family holiday.
The family holiday came and went. I made sure I wore walking shoes with proper support, lest I aggravated the foot again. There was still a lingering ache, and I finally made an appointment with my orthopaedic specialist to get to the bottom of it.
In retrospect, I may have all too excitedly jumped back into running too much too soon vis-à-vis my current physical limits. Distance-wise, ceteris paribus, it wasn’t much of an increase in mileage, well within the so-called 10% rule (though recently some have questioned the efficacy of the 10% figure), but I had forgotten about other variables and factors; explored new terrains.
That included an over-enthusiastic attempt at going completely barefoot, in the circumstances. Given that I was already running in minimalist shoes for a year, the short (2.4km) barefoot endeavour would not have been an issue but for the fact that I had also been running weekly distances of more than anything I had ever done, without room for any aches to really disappear. I had delved into the barefoot run not in top form. *slap slap*
Based on my description of the symptoms, Doc conjectures that the ache could have been due to a tendon injury, as suspected by pilates instructor, although it appears to have almost healed, as Doc was pressing everywhere on the foot, and I was asked to walk on my toes, heels, sides of the foot, but there was no pain. If I had ceased all running activity earlier on, it would have healed in 6 weeks, but it been about 8 weeks and running (pun intended), no thanks to my subjecting the foot to a further bashing in the Mizuno 16K in mid-June right after the foot ‘started to feel better’. I had hobbled around for about 2 days after Mizuno, finally realizing that something was quite wrong, and was pretty sure that if the haze didn’t postpone the Standard Chartered KL Marathon, I would have voluntarily DNS’ed my 21K if my foot was not 100% pain-free by June 30th.
I asked how the tendon injury could have developed. Doc posited that one difference between running shod and barefoot in the pushing-off movement of the foot, is that, with shoes on, the foot tends to take off from the ground without flexing as much (i.e. with a flatter arch throughout) as one would when barefoot, because of the cushioning afforded by most shoes. (NB. This was not a criticism of running with or without shoes on, but a description, to a layperson, of what happens at the stage of the gait when one propels off from having landed, comparing shod vs. unshod.) I was likely to have overexerted during the transition from shod to completely barefoot, including not having concentrated enough on foot stretching exercises. Coupled with the darned supination, that would explain the outer-side-of-ball-of-foot location of the ache. I was reminded to focus more on stretching exercises (for the feet and in general) when I return to running after the ball of foot has healed.
In any event, I’m glad the worst is over. Approximately two more weeks of rest and I should be ache-free. Keeping my fingers crossed!