Hi Docs,
I'm hoping I can get an opinion (or two) on a diagnosis I received today that I have a soft tissue "crush injury" - with related inflammation - from stepping on a rock a few weeks ago. I was given a post-op shoe (or the option of a boot) and told not to even walk my dogs or walk from the train station to my office! I was also told I should start PT right away - which will involve, as I understand, myofascial release to break up the scar tissue that has formed.
Here's some background:
I successfully ran barefoot for about 2+ years, and ultimately ran a full marathon. Never had any injuries. Due to a new commute and new puppy, I took about 18 months off (with a couple half marathons and irregular running in between).
I recently started running barefoot again (starting from scratch, it feels like), primarily on my treadmill. On my first outdoor run November 14, I stepped on a sharp rock while running - right under the ball of my foot - and it hurt! I cursed but ran another block home, favoring the foot. I've stepped on sharp rocks before, and this pain was similar - like a bad bruise - only it has not completely gone away and can be re-aggravated by pressure on that spot.
The day after, it hurt when walking and I favored it enough to walk on the outside of my foot. But I put on my Uggs, didn't run for a week and a half, and the pain seemed to go away for the most part. It returned intermittently if walking barefoot on a hard surface, although if I shifted into a slow jog, the pain would subside because the ball of my foot was hitting the ground in a different spot.
Over the past three weeks, I felt like I was taking it easy though I did run run six times for a total of 22 miles - mix of concrete, beach and trail. A few twinges of pain would come back in the bruised spot (usually while barefoot walking), so I'd take a few days off.
Today, my foot felt fine - until the doc pressed around my feet and was able to isolate the painful spot - and ouch, he woke it up and its angry! He also made something in there click. Took X-rays and there is nothing wrong with the bone, and said it's not a neuroma (I don't have any tingling or anything). But he said that when I landed on the rock (about the size of a big marble only pointier), I crushed the soft tissue containing capillaries, lymphatic system, ligaments, etc., and scar tissue has now formed and is hardened.
He recommended 1) regular massage with a PT to break up scar tissue, and said he is not worried about the massage aggravating the inflammation further; 2) as little walking as possible. In a "few weeks" I'll check in to see if further steps need to be taken (MRI or possible "herbal injections" - I figured going the holistic route was better to start with, but please weigh in!).
My questions for the docs:
- Does this seem like something that can be diagnosed without an MRI? If not, what should I request with respect to an MRI? (certain views, contrasts, other buzzwords?)
- What are your thoughts on myofscial release massage on a now-painful, currently inflamed area with apparent scar tissue? Is there a danger that the massage could aggravate the inflammation futher? If I simply rest it religiously, will it subside on its own? (I practically got carpal tunnel - or some type of major, month long nerve irritation - from a really forceful, badly done thai massage, so I'm spooked by the prospect of any type of deep tissue massage).
- Should I get a second opinion? If so, anything I'm missing that I should mention?
Thanks so much in advance for reading this dissertation. I'm really bummed. Here I was thinking I was being conservative and it was just a standard barefoot bruise, until I started to realize it wasn't.
I'm hoping I can get an opinion (or two) on a diagnosis I received today that I have a soft tissue "crush injury" - with related inflammation - from stepping on a rock a few weeks ago. I was given a post-op shoe (or the option of a boot) and told not to even walk my dogs or walk from the train station to my office! I was also told I should start PT right away - which will involve, as I understand, myofascial release to break up the scar tissue that has formed.
Here's some background:
I successfully ran barefoot for about 2+ years, and ultimately ran a full marathon. Never had any injuries. Due to a new commute and new puppy, I took about 18 months off (with a couple half marathons and irregular running in between).
I recently started running barefoot again (starting from scratch, it feels like), primarily on my treadmill. On my first outdoor run November 14, I stepped on a sharp rock while running - right under the ball of my foot - and it hurt! I cursed but ran another block home, favoring the foot. I've stepped on sharp rocks before, and this pain was similar - like a bad bruise - only it has not completely gone away and can be re-aggravated by pressure on that spot.
The day after, it hurt when walking and I favored it enough to walk on the outside of my foot. But I put on my Uggs, didn't run for a week and a half, and the pain seemed to go away for the most part. It returned intermittently if walking barefoot on a hard surface, although if I shifted into a slow jog, the pain would subside because the ball of my foot was hitting the ground in a different spot.
Over the past three weeks, I felt like I was taking it easy though I did run run six times for a total of 22 miles - mix of concrete, beach and trail. A few twinges of pain would come back in the bruised spot (usually while barefoot walking), so I'd take a few days off.
Today, my foot felt fine - until the doc pressed around my feet and was able to isolate the painful spot - and ouch, he woke it up and its angry! He also made something in there click. Took X-rays and there is nothing wrong with the bone, and said it's not a neuroma (I don't have any tingling or anything). But he said that when I landed on the rock (about the size of a big marble only pointier), I crushed the soft tissue containing capillaries, lymphatic system, ligaments, etc., and scar tissue has now formed and is hardened.
He recommended 1) regular massage with a PT to break up scar tissue, and said he is not worried about the massage aggravating the inflammation further; 2) as little walking as possible. In a "few weeks" I'll check in to see if further steps need to be taken (MRI or possible "herbal injections" - I figured going the holistic route was better to start with, but please weigh in!).
My questions for the docs:
- Does this seem like something that can be diagnosed without an MRI? If not, what should I request with respect to an MRI? (certain views, contrasts, other buzzwords?)
- What are your thoughts on myofscial release massage on a now-painful, currently inflamed area with apparent scar tissue? Is there a danger that the massage could aggravate the inflammation futher? If I simply rest it religiously, will it subside on its own? (I practically got carpal tunnel - or some type of major, month long nerve irritation - from a really forceful, badly done thai massage, so I'm spooked by the prospect of any type of deep tissue massage).
- Should I get a second opinion? If so, anything I'm missing that I should mention?
Thanks so much in advance for reading this dissertation. I'm really bummed. Here I was thinking I was being conservative and it was just a standard barefoot bruise, until I started to realize it wasn't.