Lost in the mobility maze

A big part of the identity crisis that I’ve been struggling with lately is feeling really uncertain about my physical capabilities. Until two years ago, being physically active was been a hugely important part of how I identified myself and spent my time. Not only are two of my favorite hobbies active (cycling and hiking), but being carfree means being active as a matter of course, something I wrote about just weeks after injuring my left ankle for the first time in July 2012.

At that time I didn’t know I was going to embark on a year-long odyssey to get healed up (something I never wrote about here, although I have an old draft discussing my aggravation/reinjury about a month later). Then a year later I injured myself again, same foot, different piece of soft tissue. Too depressing and irritating for words, really. At first I thought maybe I’d get the normal healing rate this time around, but about two months in I had a flareup, and started the whole mysterious odyssey again. It’s been just under six months now and I’m only starting to feel okay in my daily life again. Predicted recovery times for ankle injuries are six to twelve weeks.

It’s taken me a long time to realize that the hardest part, on a day to day basis, is the self-doubt. Things kept going wrong. First I saw a doctor who didn’t recognize the extent of the sprain, then I overdid it partially as a result of that misdiagnosis and basically had to start from scratch. Then I had a lot of swelling and it seemed to take me longer than expected to heal, and I didn’t get physical therapy. After I did get physical therapy, my therapist was encouraging me to be more active, and then I had a relapse into pain and swelling for no obvious reason (in an MRI taken a couple weeks after the relapse, no tissue injury was found). After more physical therapy, finally I started to feel better and was able to go hiking again. I was stable for only a year, and with some ongoing stiffness (but no activity restriction), before I injured myself again. Thrown back to square one, I tried to do everything right, and I still had a relapse with additional pain and swelling two months in. My doctor and physical therapist both kept encouraging me to try to do more because it was important to build endurance, but the relapses would just come out of nowhere. Any increase in effort, if it didn’t cause a relapse, would cause heat, pain, and often swelling. I could never do as much as they thought I should be able to. And I found it virtually impossible to successfully both do as much as I could (important to increase capacity), and not do more (important to avoid damage or increasing sensitivity). Feet are so involved in everything one does; never overdoing would require a magic portable wheelchair that I could generate out of thin air, or else carrying crutches everywhere all the time, which, are you kidding me?

Because I’ve tried to do everything right, and everything’s gone wrong, I have no confidence now in myself or my leg. The least little twinge could herald a fresh relapse, so I’m hypersensitive to pain and heat buildup, and tend to under-do and over-rely on my other foot and leg, which reinforces the negative pattern of not using the left foot and creates problems in the right foot as well. I’m constantly vigilant, which leads to greater tension, contributing to pain in the foot and exacerbating the chances of relapse or reinjury. And I don’t really know how to break the cycle. I believe I’ve gotten the best advice that my doctor and physical therapist have to give, but they don’t have a clear explanation for my tendency to pain (the doctor says the ligamentous tissue is healed) and they don’t show a lot of understanding of my uncertainty. Not that they’re unsympathetic people, but it’s easy for a practitioner to say “Well, just don’t worry about it! You’re doing fine! Keep trying!” And although I believe that there’s a good chance that some or all of my remaining pain is due to some sort of neural miswiring, overattention, etc. I’m also reluctant to trust myself to purely mental therapy, because it’s not completely clear to me that I’m not doing myself damage, or aggravating some existing damage, when I’m more active.

What I really want is someone who really understands both sides of how I feel. It would also be great if I can find someone who can help me with both empathy and skill. And while I’m asking for things, how about a unicorn and a rainbow too?

Or maybe some internet links! Also this one.

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