Lower leg problems identified and treatment plan – one activity causing problems for another

While I am trying not to slip into that negative space (too much) of feeling bad that I am not able to ski, I am getting answers and taking control of the situation, which always makes you feel better. It is unfortunate that I am getting to experience Jackson Hole in this way, but it is also good to be getting treatment in a place where there are so many athletes and so many health professionals who not only are knowledgeable about skiers/climbers, but understand the importance of these activities to us, and also trust our knowledge of our own bodies and information we have to give them.

I tried not to feel too bad waking up to all this new snow on my car this morning.

I tried not to feel too bad waking up to all this new snow on my car this morning.

Rolling into JH resort this morning

Rolling into JH resort this morning

Pre- 8AM tram line on a powder day (I think the tram eventually opened at 9.30am or so)

Pre- 8AM tram line on a powder day (I think the tram eventually opened at 9.30am or so)

I went to the boot-fitter at the resort base as scheduled. I already knew that the Peroneus longus was the muscle that was hurting and I  have a history of right foot instability and very high arches; but I was interested to see what the boot-fitter would see. This is what he found:

  1. My boot-shell is a good fit for me (this is a good thing to hear after dropping money on ski boots!)
  2. I have a very very flexible right foot without much padding (e.g. he was able to feel all my metatarsals). It was pretty funny seeing this very calm person’s expression bug out when he moved my foot around
  3. My current off-the-shelf-orthotic in my ski boot is good but could be better
  4. There is nothing bad about my ski stance. I do not have strangely shaped tibia (bow-legged), my knee does not drop in, or anything like that

Given the above, there were not a ton of drastic options. But after discussion, we decided the best we could do was to:

  1. Get a custom orthotic to prevent my mid-foot from rolling around. While my current orthotic prevents me from sliding forward/backward and heel-lift, there was still a fair bit of lateral motion causing strain on my peroneus. He charged me half-price, which was nice. I am so used to having to pay what seems like “double” (even though I know it does not scale that way) for things related to my feet/legs.
  2. Heat the boot shell (this was done when I purchased the boot) and stand in it so that the boot can even better conform to the shape of my leg.

Clearly these are things that are not going to fix the acute issue. But I hope, and think, it will help going forward in the longer term.

The next stop was the physiotherapist. I really liked her because she said, Yeah, you know exactly what is going on. What I learned from her was:

  1. I have a “CRAZY flexible” right foot. Again, it was slightly amusing to see her remark how ridiculous it was, except that in this case this is causing problems and not some cool party trick I can show off.  Which leaves the number of cool party tricks I know at zero.
  2. The muscles under my arch are not strong. At all.

I was not aware of my super-human right foot, but I do know #1 stems from all the climbing I do with it and how I force and contort it into all sorts of strange positions. My right foot is also doing a ton of work stabilizing my right leg when I am skiing, climbing etc.. I know I ask a lot out of it and push it, but I did not know these would be the consequences. A case of one sport (climbing) causing problems in another sport (skiing). My indoor and sport-climbing shoe is also quite downturned and aggressive, farther exacerbating/causing these arch weakness issues.

I had some soft-tissue work done, and also ultra-sound to break up any possible starts to tendonitis. I am also starting my prescribed strengthening exercises, doing my hot-cold contrast therapy, and things to get the inflammation down. We also agreed that it was still worthwhile going to the orthopedic specialist on Friday to get the cortisone shot to reduce the inflammation. Her answer would have been different if I lived here, but given my situation and goals, getting a kick-start seemed like a good idea. We will have a better idea on Friday whether I can  ski on the remainder of this trip.

This adaptive business is very tiring some times and I have ambivalent feelings about the term and how it can be sometimes used euphemistically. Yes, we are adapting to our physical limitations, but these adaptations are not normal. They create problems in other sports, and other areas in our lives. So to sugar-coat this term, I think, is slightly disingenuous. Even as I write this, I feel slightly ungrateful, because there are many assets that are handed to us just by luck of the draw: family, socio-economic circumstances we are born into, a particular ethnic group, the place(s) we grow up, physical ability. Yet this strikes a particular nerve because, for the most part, most people are born with functioning, “normal” human bodies. Questioning what is fair and not fair about such things is futile, mostly (social justice issues are a different matter), but it is hard not to some times. I guess we just keep pushing on and make the most of what we have.

I have the okay to some easy snow-shoeing so I am keeping my fingers crossed roads will be clear for me to drive to Grand Teton National Park tomorrow to clear the mind and body a bit.

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