Wednesday, February 22, 2017

Major Injury

(To mark twin 50th anniversaries in 2017, as a fulltime running journalist and as a marathoner, I am posting a piece for each of those years. This one comes from 1973.)

NO RUNNING injury is minor if it happens to you. None is minor if interferes with your running. None is minor it won’t go away.

Mine seemed minor only at its start, a normal after-effect of running long. One Saturday I took the two-hour run that was customary on non-race weekends. The next morning my left heel was sore.

That’s odd, I thought. This is my good heel, not the one that had been lumpy and tender to the touch since age 12.

Of course I didn’t let this latest injury stand in the way of continued running. Long runs often left me sore-footed. I thought it was a bruise that would disappear, as always, in a few days.

This problem stuck around. By late 1972 an ugly lump had formed on the upper back of the heel bone. This spot the size of a thumb tip glowed red from the irritation and inflammation inside.

My runs had shortened and slowed, and racing had disappeared. This was more than a bruise. But what, exactly, and what to do about it?

Then I found the right doctor – or rather, he found me first. Dr. Steve Subotnick, a podiatrist, called to ask if I’d be interested in hearing about his research on running injuries and their treatment.

He wanted to write about it for Runner’s World and invited me to visit his Saturday clinic for injured athletes. I wanted to talk about my injury, and he fit me in among a dozen other runners for an exam.

He quickly diagnosed my problem as a “rectocalcaneal exostosis.” A rectal what?

“That’s a bony growth on your heel bone,” he explained. “The bigger it grows, the more it irritates the surrounding tissue. You need to make some changes that will ease the irritation.”

Dr. Subotnick concluded that my injury had passed beyond the reach of conservative treatments (which I had tried). He mentioned surgery, which he promised would not mean the end of running but a new beginning.


YOU DON’T fully appreciate running until you’ve almost lost it. I would never again take it for granted after going almost a year without a pain-free run.

After many months of denial, then many more of trying treatments that didn’t work well enough, I had little left to lose. I chose the last hope for relief.

When I told Dr. Subotnick that “I’m ready for surgery,” he said, “How about next Tuesday?” That was four days away, which didn’t give my imagination much time to run wild.

Then he had to postpone the operation for several more days, which gave time for dread to erode the hope. What if the knife slipped? What if the expected month off my feet stretched to several months, or forever?

This was to be relatively minor surgery, without general anaesthesia, as a short-stay patient who’d go home the same day. The doctor would go in and chisel away the excess bone at the heel, then sew me up. Almost as simple as pulling an infected tooth.

But “minor surgery” is someone else’s. If Dr. Subotnick took a chunk out of my heel bone, that was major enough for me.

The doctor said I could be 99-percent sure of full recovery from this procedure – and that by hurting a lot for a little while I could avoid hurting a little for a long time. I placed my faith in his good judgment and firm hand. But even he couldn’t control the one-percent chance that something would go wrong and that I’d be stuck for life with a defective foot.

A shot at waist level deadened both legs. A drape blocked me from seeing the gory details down below.

Finally Dr. Subotnick told a student, “You can close it up now.” Then a nurse held up a clear plastic pill bottle and said, “Here’s the troublemaker.”

Floating in pink liquid were two rough-edged white chunks with stringy red thread attached. As recently as that morning these parts of me had sawed into soft tissue when I ran.

“Normally casts are optional in cases like this,” said Dr. Subotnick. “I put some patients into a walking boot right away.

“But I know you runners. You’re like hyperactive 13-year-olds. If I didn’t give you a hard cast, you’d be out trying to run in two days and would mess up the good work we’ve done on you here.”

He slapped on extra strips of plaster, “just to make sure you don’t try anything funny,” and ordered me onto crutches for the next week. “Then I’ll add a heel so you can walk on the cast. You’ll be out of it three weeks from now.”

“How long until I can run again?” I asked him. He said, “Don’t try until the stitches come out in another week.”

I tried running the same day he unstitched me, a month post-surgery. I lasted one lap of a high school track, shuffled it in five minutes as walkers passed me. Never had so little meant so much.


Photo: Dr. Steve Subotnick gave me back the running that I had almost lost to a long-lasting heel injury.


[Many books of mine, old and recent, are now available in two different formats: in print and as ebooks from Amazon.com. Latest released was Miles to Go. Other titles: Going Far, Home Runs, Joe’s Journal, Joe’s Team, Learning to Walk, Long Run Solution, Long Slow Distance, Pacesetters, Run Right Now, Run Right Now Training Log, See How We Run, and Starting Lines, plus Rich Englehart’s book about me, Slow Joe.]


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