Injury #

I’m a pretty strong believer in the therapeutic benefits and aesthetic purity of cardiovascular exercise. In particular, I have found running very soothing for the past eight years. At first I ran to lose weight in a transition out of a very stressful period of my life in my mid-twenties. For the first couple of months it was extremely difficult, my muscles ached, and I was constantly out of breath, but I got better, lost a bit of weight, and the peak of my running hobby was when I ran a half-marathon in Tel Aviv in February 2016.

The meditative side effect took me a while to discover. I don’t think you will have this feeling if you’re just starting to run and everything is hard and hurts and you’re constantly out of breath. But sticking with it, and becoming better, and becoming properly fit, it becomes a very different beast altogether. No two runs are exactly the same, but on a good day, when the weather is right, and your muscles aren’t too sore and you aren’t too tired or irritable, it can be a transcendent experience.

Runners speak of “the zone”, some mythical headspace you can enter when the rythmic sameness of the run becomes meditative and trance-like. I don’t think this is possible indoors on a treadmill, that sad imitation of the outdoors stuck inside an air-conditioned and foul-smelling room. But outside, in the air, you begin to feel yourself move through the landscape as though disconnected from your body. Rather than counting the metres, or the seconds, you begin to feel the kilometres drift by, to feel as if there’s nothing stopping you running forever.

Walking, cycling and swimming all also have the potential for this I think, but in usual day-to-day circumstances it’s harder to find the space, physically and mentally, to achieve the conditions required in these activities. Long, meditative walks (for example the recent, awe-inspiring one undertaken by Craig Mod are sublime, but require immense amounts of time. Long, meditative cycles are impossible in cities and can be dangerous on the road. And swimming requires more preparation, and of course access to a permitting body of water, which can be expensive, or highly dependent on the weather, or both.

So although I walk and cycle my fair share, and swim when I can, running has always been for me my preferred way to exercise, to stay fit and healthy, and to clear my head and stay calm.

In the last year and a half my relationship with running has been troubled by a stress fracture in my left foot. For the uninitiated (and fortunate), a stress fracture is a very small fracture in a bone caused by excessive stress. It’s not something that usually shows up in an X-ray, and it doesn’t cause debilitating pain like an actual fracture, but if you ignore the signs and continue to put stress on the offending area, it can lead to serious problems.

I was walking and running quite a lot a year and a half ago, in shoes that in hindsight were probably not up to the task anymore. It’s a common thing to miss, but the foam soles in modern running shoes is only effective in absorbing the shock caused by running on pavement for around 800km, sometimes less. Running shoes need to be replaced whenever this distance has been clocked on them.

It got to the point where I had to stop running because of the pain. At first I thought maybe it was something in my muscle, so I stopped for a couple of days and tried again, but it kept returning, so eventually I stopped completely. An X-ray didn’t show anything but the doctors’ opinions were that it was probably a stress fracture and I should stop running until it healed, which could be three to four months.

This diagnosis floored me. Running was and still is such an integral part of how I keep myself together that the thought of not being able to do it is very difficult to entertain. Running helps regulate my anxiety, my sleep, my appetite and my weight. All of these things have a tremendous impact on my day-to-day happiness.

At the same time I was between jobs which meant that my life was stressful enough to eclipse the lack of running. I started a new job, got absorbed in that for a bit, and after six or eight months had gone by and I hadn’t felt a twinge of pain for some time I decided I could start to run again.

The usual advice is to start slowly and build up from there. I started by walking, first 30 minutes a day and then 60 minutes a day, for a couple of months in the winter to and from work, and felt no pain at all. Taking this as a positive sign, I started to run short distances: 2 kilometres, then 2.5, then 3, and so on over four months until finally I reached 7 kilometres. It felt fantastic to run again. I felt my fitness come back, felt a year’s worth of accumulated flab melt away, and started to really feel like myself again.

And then one morning after a 7km run I woke up with pain in the same place. I almost couldn’t believe it. After the initial diagnosis I had been in constant fear of feeling pain again. Sometimes I imagined there was something niggling me but managed to convince myself it was not the same pain. But this morning it was exactly the same pain, a dull throbbing in my bone that was immediately familiar and recognisable and which ruined my day and my week.

This time I got a definitive diagnosis. The proper way to diagnose a stress fracture is through a nuclear medicine procedure called a bone mapping. You are injected with the nuclear isotope technetium-99, and then a machine reads the gamma rays it emits during its two-hour halflife which react slightly differently with the inflamed bone tissue around a stress fracture, causing the areas to light up in the image. The same technique is used to diagnose bone cancer.

So the images came back showing a clear area of stress in my foot exactly where the pain is. I’m lost for what my next steps should be. I did exactly what I was told to do last time, even let the recovery period take twice as long to be extra certain that I had healed, and still the damn thing came back. This probably is indicative of some structural problem in my foot, some sort of weird sideways movement that puts too much pressure on a certain part of my foot. The usual way to fix this is with thousand-dollar foam inserts in your shoes. But I can’t tell if this is just snakeoil or if it’s properly effective.

I miss so badly the feeling of being on a run, and even more that feeling just after a run, when you know you did it, when you can feel the kilometres in your legs, in your chest, and your mind is as clear as it gets. I’m worried I’m not able to find that feeling somewhere else.