Black.Death.Foot.

Sort of just rolls off the tongue, doesn’t it?

Evolution of black death foot by pictures (I’ll spare you and post small photos.  You can click through if you want to see them in higher resolution):

April 2010

January 16, 2011

March 12, 2011

November 18, 2011

Yes, I take a lot of pictures of my foot.  Maybe moreso than food, even.  Last winter, after 8~ months with no issues or grumbling from my foot, it made a quick turn for the worse and died.  I did not chronicle the beginning of it, only the during and aftermath.  So this time around, I’m taking note of everything, and taking pictures.  I need to know what it looks like so if it starts to happen again I know what to pay attention to specifically, before it gets bad.

It’s been awhile since I went over my history and let it all out, so to speak.

Justin and I, through trial, error, searching, doctors, etc. have basically determined a few things about “my foot”

1. It didn’t die before I was seriously training on the bike (though 6 years ago I led a sedentary and non-athletic lifestyle, so who knows) – while I recall at some point in the last 8 years purchasing OTC orthotics for an unspecified foot pain, I can’t recall what year or what the problem was, if it was even related to the ball of my foot at all, though I suspect at some point it was.
2. It doesn’t die in the summer or warmer months of the year whether I am riding a lot or putting in a lot of intensity – I rode 24 hours in 6 days in Idaho and Colorado while camping (no carpet or hotels for my foot or body, but also no concrete or 8 hour days at the desk) this past summer, and in August 2010 put in one of my biggest volume weeks at the same time as probably the most intense training block I’ve ever done with no complications.
3. It probably isn’t sesamoiditis – one recommended Ortho surgeon said, and I quote, “If it is your sesamoids, then having them removed would probably solve the problem.”  IF?  Probably?  Another ortho that guy recommended specifically said, “I wouldn’t have the sesamoids removed if it were me – your foot would fall apart.”  One of the top ortho docs in So Cal said, “I’ve never seen anything like it before, but it isn’t sesamoiditis.”  Strike 3.
4. It has happened in late February (2010) when I transitioned from base to build period on the bike, and after some extended rides in the cold, and the first of January the week after a big volume (but not intensity) week of training, with some cold weather, and lots of extended rides.  
5. It is recurring and it does happen when it is cold.

So, taking the above into consideration, our goals for this winter were to get heated socks (check, ordered a very pricey pair that the size chart was wildly incorrect on, so they are a size too big), and to get winter shoes (Fail).

I’ve worn my heated socks on 3 rides, with my Specialized Women’s Pro MTB shoes and lined shoe covers.  My toes still have felt cold, despite my feet feeling the heat.  So, I think there’s still a disconnect with normal shoes and booties letting the cold air in.

Justin also just did a post on my foot. Yes, I have OCD about some things, and now my foot is one of them.  I constantly am checking it, having Justin check it, changing my shoes, changing my wool socks, wearing my heated socks, trying to ride my bikes differently:

• I have become an ambidextrous descender – I can put my right or left foot forward at any point and feel perfectly comfortable.  I used to descend with my right foot forward (check this out – when boarding are you goofy [right foot forward] or regular [left foward]?  Do you bike the opposite?  Most do) and my left foot “planted” and more rear-ward.  That sometimes caused fatigue in my right leg – could that contribute?  I’ll switch it up then.  Now I descend with my left foot forward.
• I go back and forth when clipping in and out of pedals on road rides.  I used to always start with my left foot clipped in and then clip in right foot.  Riding, racing, etc.  Last year when I first had pain and discomfort I never unclipped my right foot (it hurt too much to clip back in), and I wondered if the more frequent “pounding/stomping” of clipping in caused any issues.  Now I wonder if remaining clipped in isn’t a contributor – no change in blood flow!

It never ends.

In 2010, I remember (and noted in TrainingPeaks!)…

The weekend before Sagebrush we did a big ride in the cold in the mountains, and then headed down to San Diego to try to pre-ride the course on Sunday.  It was frigid, raining, slick, etc. We didn’t make it very far before giving up.  I wound up getting new Keen shoes that afternoon.  Similar to a pair I had, but slightly different.  I wore them Monday.  I remember that evening and the next day my foot didn’t feel good. Slightly bruised and some discomfort/pain in the ball of my right foot.  I assumed it was the way the shoe fit me.  I went back to my trusty old pair of shoes.  The next weekend was the start of build.  Justin and I did 3.5 hours in the rain and wind and cold, and then raced Sagebrush in the cold the next day (2.5 hour race).

I noted the following Tuesday after a hill climb workout that my right foot hurt.  I had done the gym (plyos and legs) the day before.  Noted my foot hurt.  I trained the rest of the week, did a local XC race, and then another 4 hours in the cold the following Sunday.  The next day I did a regen ride and my foot still hurt.  Was taking Ibuprofen for the swelling. I think I remember it hurting the 3rd weekend in a row, at the Bonelli Triple Crown.  But I didn’t comment on it.  Then it was an easy recovery week with walking, a few days off, and almost 8 hours of steady riding the following weekend.  I got new bike shoes in case something was irritating my foot on my old pair.  No dice.

Next week was the lead-up to the Pro XCT Fontana race.  Monday easy – foot hurt!  Had seen a doctor at some point, likely the week before, and started padding up my foot area.  Had to stop to mess with it at least once that week. I got my first big race podium that Saturday at Fontana, and Sunday sitting in the heat trying to get prepped for Short Track I was crying, with my shoe off, wondering what was wrong with my foot.

The following week a local podiatrist who diagnosed it as sesamoiditis.  No fracture.  He said to take some time off and let it heal.  So that’s what I was going to do.  And then Justin crashed.  I was 2.5 weeks off the bike, got custom fitted hard orthotics for my every day and cycling shoes, and by the time I felt ok leaving him at home to go ride, my foot was healing up just fine.  I had no further issues throughout 2010 that I can recall.

In 2011… well, technically it was New Year’s Eve.  I was on my last 2 days of my biggest volume week ever (my first 20!), New Year’s Eve, new shoes (I know, again, right?) and that night hanging around Jefe’s house I felt an odd pang of discomfort and bruising in my right foot, and was afraid to take off my shoes with orthotics.  I basically moved past it, figured it was fine, and finished out my week of training.  I didn’t note anything in my training log until Sunday, that my foot was definitely bugging me again.  Back again on Ibuprofen, easier few days, then tried riding again.  Then it was 3 weeks off before riding again on the road nice and easy.  My foot generally felt bad no matter what I did.  Stock shoe insoles, modified custom orthotics, it didn’t matter.

January, I swam.

Then, as February dawned, I got plantar fasciitis and Achilles pain.  I went to PT.  It didn’t help. I was trying all sorts of weird stuff in February, sometimes having pain, sometimes not.

By March I was back off the bike, frustrated, angry… and took 28 days completely off of exercise.

I got a camera instead, and took a lot of pictures.

After 4 weeks, I rode again, for 30 straight days, and then I raced.

And, basically I’ve been riding ever since.  I got back to “training” for Nationals in late May, had some fun over the summer just doing a LOT of chill riding, and now it’s just slow and steady for me through essentially the rest of fall and most of winter.

My foot has bothered me off and on since I got back on the bike in mid-April. No tissue death, no lingering pain or discomfort.  But, by then, in May… we thought we had it figured out…that it was likely the cold.  And it wasn’t cold anymore. Sure there was a day here or there, and some rainy cold races, but I pushed through, and it was back to warmth.

Now, it’s nearing the end of November.  It’s been chilly or cold for almost a month now.  We’ve had 3-4 steady weekends of rain and chill.  Sure, it isn’t Green Bay in January, but I have a history here.

Re-reading my blogs from earlier this year, I’m still just stuck in the middle. Go figure.

So, if I’ve got it “figured out” (to the best of my knowledge, anyway), why the paranoia?  Why, indeed.  Because it could happen again, and derail “life” as I know it entirely.  And, no, I’m not curing cancer, and no, my life wouldn’t be “over”, but it’d be a vastly different picture, and it isn’t one I’m ready to see just yet.  I want to ride my bike, I want to race my bike.  I want to get through this fall and winter and come out on the other side next spring much stronger, faster, fitter, and knowing that I can get through it.

Sometimes it just doesn’t feel like that’s going to happen.  But, sometimes life is what you make it.

So, from here on out, I’ll be wearing my heated socks.  A lot, like right now for instance.  And I’ll keep my foot warm, and I’ll be the one in full tights and booties while you’re wearing shorts and going without gloves.

And you know what?  I’m going to make it through. My foot will stay healthy and warm the rest of fall (another 4 weeks) and on through winter. When I hit February I’ll be making strides, hitting the intensity, and preparing for a big summer.

Just one more twist and turn on this singletrack ride…

Keep on pedalin’.  I know I will be!