Tuesday, October 4, 2016

Tendon



On Saturday I played an enthusiastic game of soccer with Moses, during which I injured my ankle. Having just briefly researched both sprains and strains, I’m not sure it was either – there was no bruising and only mild swelling, and though the pain was tear-jerkingly intense by the end of the first day, it had dramatically reduced on the second so that my limp was far less pronounced, and by the third day I was walking almost normally with only occasional pangs if I accidentally moved my foot in the wrong way.

(The first and second day, though, were no fun, and being unable to walk well is the worst. Actually, being unable to walk well and actually having to walk, rather than lying around with limb elevated, is the worst. The desire for bed must be partly driven by pain, obviously, but also partly by the knowledge that you would be unable to run from a knife-wielding attacker, for example, should one happen to knock on the front door (says my anxiety: I’ve prepared for every possible scenario! You’re welcome!). Overriding both the pain and the survival instinct in order to participate in normal life – rather than spending the day recumbent – is exhausting.)

The throbbing pain and lack-of-ability-to-walk triggered sensations I hadn’t felt since rupturing my Achilles tendon in 2009, and unsettled a cloud of emotions that seemed completely disproportionate to the smallness of my current injury. I remember in the days after my tendon snapped, my doctor told me she was writing a medical certificate for me to take 6 weeks off work and I obviously looked shocked because she sternly explained the seriousness of my injury. The word “trauma” was used, which I thought a tad OTT at the time but which later made perfect sense.
The day it happened was a regular day in August. I’d had an awful year, dealing with a horrendous bout of depression followed by a horrendous bout of dentistry (I had a root canal, multiple fillings, and all of my wisdom teeth removed, one every few weeks). But I was fit; I’d been playing soccer with workmates a couple of lunchtimes per week, and going to a weekly group fitness class. On that particular day, I warmed up with my team and stretched like normal. I’d never experienced any pain in my tendon and had no reason to worry about it. (The orthopaedic surgeon later said there was no obvious cause, I was just unlucky. I’d wanted him to point out something specific I could avoid or at least look out for in future; to blame it on luck felt deeply unsatisfying.) And then it happened: I was on the field for only a few minutes before I went to run and felt as though I’d been kicked (hard) in the back of my foot. I turned to face the culprit and noticed there was no one there; I then noticed I couldn’t propel myself forward when I tried to walk. I hobbled off the field, confused.

Getting to the car and then from the car to the doctor involved a lot of hopping; fortunately, during the latter trip, two of my teammates spotted me, pulled over, and carried me the rest of the way (I felt guilty for being heavy and awkward to hold and incapacitated). The doctor sent me for an ultrasound, my mum (who – in what turned out to be bizarre timing – had turned up to watch the game) hired me some crutches. The sonographer tsked sympathetically when she saw the screen. “Oh, sweetheart,” she sighed. “It’s a complete rupture.” Back to the doctor, and then, the next day, to the orthopaedic surgeon, where I opted for surgery to stitch the torn ends together, hoping that would mean a faster healing process than simply waiting for them to reunite by themselves.
My first cast
The operation was the following week, at Mona Vale. The view from the window by my hospital bed was better than views I’d paid to wake up to on holidays. The pain in my tendon post-surgery was worse than anything I’d experienced until then, or since. I left hospital in a hard cast which held my foot pointing like a ballerina’s, and I spent the next 6 weeks showering with my leg outside the stall and watching stacks of DVDs and reading about others’ injuries and recovery online and injecting myself nightly with Clexane and crying and keeping my leg horizontal as much as possible (the blood quickly rushed to my foot when I stood, a sensation which convinced me it was about to explode) and feeling bored and helpless. I remember thinking a lot about the Bible verse which I’d thought said God would never give me more than I could handle, and thinking, “He got it way wrong this time. This was too much.”
Me in the shower
My left leg was strong; with a little help from my crutches, it singlefootedly carried me around for months. The bottom of my right leg was wrapped in a cast (a second one, which was lighter than the first) and therefore not visible; the top was atrophied and made me desperately sad to look at. (I was at a friend’s house one night and she joked that she’d like the same injury if it meant her leg could get as tiny as mine. I refrained from hopping across the room and throttling her with a crutch.) The day my cast came off I was shocked at how hairy and scaly and small and weak my lower leg looked. I was given a boot, which I could take off at bedtime. Alan dropped me home from the doctor and headed to work; I took myself straight to the bathroom and sat on the side of the bath. I tenderly scrubbed away the dead skin and cradled my leg as I shaved it. I felt protective of it, as if it was a small child in need of care instead of a body part attached to me.

I returned to work, sitting at a new desk with room alongside to pull up a chair upon which I could rest my leg. Before I learned how to get through doors myself, a workmate would accompany me to the bathroom. I felt terrible for the time I’d had to take off work, and I felt terrible being back there, distracted by the discomfort in my foot and the effort it took to get around. There was one afternoon when my crutch slipped on a wet foyer floor, and I fell heavily on my healing foot. (The pain made me cry out in a way I later recalled being loud and embarrassing.) I was convinced I’d re-torn my tendon; I sobbed for the rest of the day. I found a physiotherapist, Vince, and saw him every week. He attached buzzing machines to my foot and massaged me painfully and encouraged me to do heel-raises, and told me one day I’d be able to do them on the edge of a step (I didn’t believe him). I hated the feeling of raising myself up on tiptoes (it still feels strange), but Vince made me do it. My sewn-up tendon was thick and tough-seeming; Vince told me it was mostly scar tissue which he’d prefer to be lean and stretchy, but I preferred the solid look of it to my left tendon, which seemed insufficiently skinny. My greatest fear was that my left tendon would snap unexpectedly one day; I decided I could live without running for the rest of my life if it meant I’d never again have to live through the recovery process. I wasn’t strong enough to do it twice.
My second cast
I originally kept the calendar from 2009 to remind me of how long I wore the cast and then the boot, but I chucked it when I realised I’d thrown out the calendar on which I’d recorded all of Mo’s milestones in his first year, and that hanging on to one but not the other was odd. I can’t remember, therefore, the dates that I first drove a car or wore a complete pair of shoes for the first time after the injury mid-August. I know I was still on crutches in October, when we moved from Lane Cove to Canterbury. I worked that day because it was clear I’d be of absolutely no help to Alan or the removalists, who had to carry all of our furniture and boxes up three flights of stairs to our new apartment. I know I was still limping (from stiffness in my tendon rather than pain) the following January, because I was in the early weeks of pregnancy with Moses and I remember many hobbly trips to the toilet at all hours of the night and day.

It was 20I4 when I started running again, accidentally; I took a gym class which unexpectedly involved running on the spot, and then laps around the room. I started tentatively, terrified that I was moments away from injury. And though I survived the class, and then the next one, and the one after that, every time I started to run I’d check in with my tendon and make sure it was coping okay. I thought I’d never run again without thinking at least once of the possibility of rupture, but then earlier this year I realised I’d done it. It seems there are effects of the injury which will always linger, though. On winter mornings it takes a little while for my tendon to warm up and stretch enough for my heel to reach the floor again. My scar’s faded but still visible, and my right leg will probably always be smaller than my left. And I don’t think I’ll ever again be able to twist my ankle without completely overreacting.
My asymmetrical legs, and the scar