The Dangers of Winter Running - Part I

Thursday morning was an interesting one.  It started out normal enough - up at 445a to get myself together for a usual morning run.  Depending on the day, the number of us running could be as many as 8 or 9, but yesterday it was just my good friend Tom and I.  We met at 530a at our usual spot and headed off on one of our regular running loops - about 6 miles total for me round trip.

Cut to: about 3 miles into the run, we came to a section that had a lot of piled snow.  It's in a section of a small subdivision that is bisected by creek - the snow is piled up around and on the bridge that lets us cross.  Again, this is one of our regular loops, so we knew it was coming, and started to navigate our way over it.  We got to the other side of the bridge (only 15 feet or so) and as we half jogged, half walked, over the snow section I hopped over the last small mound of snow to get back to clear roads. 

As soon as my left foot went down, I knew I was in trouble.  It only took a second but it felt like forever.

I hit a patch of ice, and my left foot twisted and pronated in.  At the same time my leg twisted around the ankle - still underneath me - and all my weight came down on my left leg.  I had a flash in my mind of "oh, this is not good" and I went down hard.  I hadn't felt pain like that in a long, long, time.  I was on the ground, grabbing my lower left leg and trying to keep it from flexing and torquing in the middle of the shin / calf.  I calmed down enough to lay still, and could flex my foot - sort of - so I was beginning to think that it was just a bad sprain and in a few minutes the pain would start to go away.  My friend Tom had his hand on me, telling me to relax and take my time.  Eventually we tried to get me on my feet.  That was a short lived exercise.  As soon as I put weight on my left leg I went down again in just as much pain as before.  I remember Tom saying "oh my god" a few times and then we had to figure out what the heck we were going to do.

The pain was tremendous in my ankle, and strangely up high on my shin.  Hence, every time my leg would flex or torque, it would hurt everywhere. I had no idea what this meant at the time, but I was just happy to be able to flex my foot.

Tom did a nice 5K (roughly) sprint home to get his car.  I lay on the ground, in lovely 20F weather, and was just starting to get cold when he made it back.  I hopped into the front seat of his car and he got me to my house, and inside, and into a chair.  Tom told my wife JL,  what happened.  She hurriedly got her things together and we headed to the emergency room.  All this before JL had her 2nd cup of coffee!

It wasn't yet 700a when we got to the ER.  Check in was quick and everyone was great.  It took a bit of time to get me through the triage process and I sat in the hallway in a wheel chair waiting for radiology to come get me for some scans.

Waiting for the Radiologist

The radiology tech was great.  He was taking the scans, and being careful with my leg.  At one point, I was trying to convince myself that it was just a bad ankle and / or high ankle sprain.  You hear about some athletes getting these and it sounded good to me.  However, after one of scans, I realized he was on the phone talking to someone and I heard my name mentioned.  He came back to me and said he "saw something" higher up my leg, where half the pain was, and wants to rescan the ankle now to double-check something else.  The radiologist on-call came in, and they talked for a bit longer while I remained on the X-Ray table.

He then broke the news that he saw a fracture on my fibula and "something" in my ankle. 

The first words out of my mouth? "Oh, Fuc# me!"  I apologized for the outburst, to which he replied that he'd heard that one a few times before and not to worry.  I was wheeled back out to the hall in the ER where JL was holding station, and I sat and waited with an ice-pack on my ankle.  I told JL what he saw and said.  I was just beside myself.  The doc stopped by and said they were calling the Orthopedist on-call to review the scans.  She had office hours that morning, so shortly after 900a she called back - had looked at the scans - and asked that we should drive over to her office immediately.

So, with crutches and a lightweight ankle brace, we headed to the Orthopedist office.   Upon arrival it looked like a lot of the docs at this office are sports medicine docs.  That was comforting in some way.   Long story short here - more scans, and a bit of a more revealing diagnosis.

It looks like, most likely, the ankle twisting and pronating, combined with my leg twisting around it, snapped the tendon that holds the fibula and tibia together in the ankle.  This allowed the two bones to snap apart and causing a chain reaction up my leg that caused the fracture high up on my fibula just below my knee.  And tragically there was indeed a fracture in my ankle.

Lots of talk about "gaps" and "spaces" in my ankle.  Then the statement that I needed to come back tomorrow (well, today) to talk with one of the surgeons about the potential need to put a couple screws in there to get things back together.  Awesome.

Day 2: What, this isn't a normal ankle size?

So, we've been back to the Ortho to speak with the surgeon.  He didn't see enough "distance" in the gaps between some bones on my ankle X-Ray to be certain of next steps just yet.  And after torturing me on the table asking "does it hurt when I do this? (and then proceeding to twist my foot and ankle) he needed more information.  He ordered an MRI - stat - to determine if the ligaments and tendons (primarily the deltoid ligament) were damaged to the point of needing repair or if they're just stretched.

I'm booked for surgery on Monday, as he can get me in, and his opinion is that if it's needed, let's do it now.  He'll cancel it if need be based on the results of the MRI.  So, I'm scheduled for the MRI later today, and they've been instructed to call my Orthopedist as soon as it's done.  He said he'd call me later tonight or tomorrow and we'll make our final decisions.

More to come.......