Gainful pain

 

Tyre slam Jul 2019

Here I am, banging on again

There is something soothing about slamming a very heavy hammer on to a tyre, swapping the hammer hand over hand as you rhythmically swing the weight in a figure of eight, squatting deep as the two rubber surfaces make contact, preparing yourself for the bounceback and the next blow. You can pretend the tyre is the head of someone you loathe. Or, if you’re not that way inclined, just be grateful that it’s a whole body exercise. A weight bearing one. Good for the bones of a middle aged woman with her own, permanent tyre to worry about.

Tyre hammering is just one of the many cross-training activities I throw myself into with some gusto at a Team 6 training session with the legendary Erik-Lee Briscoe.  The poor man has had to put up with a bellyful of my Achilles tendon woes, too, like almost everyone else of my acquaintance. And now matters have come to a head, thanks to an invitation from Lewisham and Greenwich NHS Trust to present myself for Achilles surgery at my earliest convenience. I chose early October, as I am a busy professional woman.

Now a decision has to be made. For three long years I have tried every non-surgical approach I can think of. I’ve spent my meagre wages on physiotherapy, podiatry, acupuncture, orthotics and, most recently, a course of shockwave therapy.

This last procedure used to be know as lithotripsy, but it’s not as exciting as it sounds. It’s a treatment that was originally used for kidney stones. I had a course of four sessions in July. It involved a sort of electronic hammering on the area where the Achilles inserts into the calcaneus (heel bone) . It will hopefully bring  a better blood supply into an area that has precious little blood, and break up anything that’s calcified on my ropy old frayed tendon, whose fibres, according to the physiotherapist who administered the therapy, look like tangled spaghetti. I had the last session six weeks ago. In six weeks, said the physio, so long as I do the rehab training in the gym to load the tendon adequately, I should know if the shockwave therapy has done any good.

So has it done any good? I think, some. But I want to run with no pain. I don’t want to limp the day after a run. And now my head has been turned by the prospect of surgery to deal with the swelling and pain around the insertion of the Achilles.

BUT, says the wise physiotherapist, I need to get my head around the notion of pain, and the individual’s management of same.

Ever since I was a kid, I’ve had fairly typical existential angst about what it feels to be me. I think it’s quite common. I wonder if, say, my best friend suddenly found herself inside my skin, bones and nervous system, how would she feel? Would she find my body was wracked with pain, or, conversely, would she wonder at the ease with which my body moves through space?

Pain is only what our head tells us it is. We have a whole language for it: burning, searing, stabbing, throbbing…I’ve used so much of it in my diary, trying to keep a record of what us really going on in this here left foot. I have evidence of damage, certainly. There’s the heel bump, the swelling, the fact that I am all crooked and limping sometimes, But then I talk to my friend Len, who’s my age and runs a sub-three hour marathon every year (it used to be nearer 2.5hours in his forties, now he’s disgusted by his 2:57 and feels he must try harder. Sigh). Len shows me his ankle bump and swelling and mentions he gets a bit sore in the Achilles department sometimes,but chooses to ignore it.

Would I find his body impossible to live in? Then there are those people who say they live in constant pain, and yet the medics they consult can’t see any reason for it. But these patients know what they are feeling, and the distress it causes has very real consequences.

And now I have read yet more on the subject of moving easily in ones own body, the idea of anatomy in motion, as written about most inspirationally by Adharanand Finn in Runners’ World. He didn’t take his Achilles to the surgeon, then face a one-year layoff from running while his body healed from that trauma. No, Mr Finn went to one Gary Ward, who made him stand on a piece of paper, while holding his left wrist, which had been broken three times in Finn’s lifetime. And there are a few more details, and a whole catalogue of movements that Finn does not share with us, which he practises in his training for an ultramarathon. And guess what, he runs 100K pain free and writes books about it. Cool story.

It’s the kind of feature that I devour and chalk up as another contra-indication of the wisdom of surgery (and ‘at my age!’) keeps popping into my head. It was sent to me by a new fell-running Twitter friend, who tells me he wishes he’d read the piece before having surgery.

I’ve a feeling that I’ve miles to go before I sleep (the anaesthetised sleep of the operating theatre). A probably a shedload more money to part with. Gary Ward is based in North London, I read with interest…

 

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