How did I get here???

I have spent most of this year nursing one ache or pain or another. It's a bit maddening because last year I was so healthy... nothing hurt. It all started in January with my first attempt at surfing while vacationing in Costa Rica. It was my second day out and I riding some shallower waves in towards the shore. I jumped off the board after losing my balance. I thought I was landing into about 3 feet of water, turns out it was a little over a foot. Ouch! I went down and immediately had pain on the medial side of the knee near the joint. I thought, "No, not again" because I was only 2 years out from my last knee surgery. It swelled but ended up with nothing badly injured. I still suspect that I may have some torn cartilage but it may just be some bruised bone. I nursed that through spring and early summer but by the time I ran Escape from Alcatraz I was back. I still notice it in the early part of some of my training runs but it doesn't seem to bother me in triathlons. Maybe it's the swim, bike warm-up.

But anything going on with the knee is overshadowed currently by the hand. It some sense I could call this a million-dollar injury much like Forest Gump taking a bullet in the butt. There really isn't anything I can't do with it. The problem lies in how MUCH I can do.

This all happened a month ago when I was riding with my friend, Ann, out in rural southeastern Michigan. We were doing a training ride/wine tour of the local wineries. Ann had this thing about going over railroad tracks. She didn't like doing it. I have sometimes stopped and walked my bike over some sketchy tracks in the past but it was more to protect my bike than myself. We must have gone over at least 6 sets of tracks that day. We were in the last 5 miles of our ride and leaving the town of Tecumseh and we went to pass over yet another set of railroad tracks. Ann was in front and she said, "I'm going to walk" or something like that. I decided to swerve go around her. These tracks were not straight across the road, they went off on an angle and when I turned to the left I must caught my tire in the track and I went down. It all happened so fast that I didn't have time to react. I remember seeing my tires flip up and I know that I first made contact with my wrist and elbow. Somehow my shoes must have come unclipped from my pedals. I just remember lying there clutching my hand and wrist and asking Ann to pick the bike off of me. I was scraped up on every joint on my left side except for my shoulder. I did not hit my head either. We got off the road and the question then turned to whether I could ride. I moved all my joints. Everything was fine but my hand. It had the deepest scrape and was the most painful. I knew I couldn't put pressure on it to ride back.

Later that evening, I was in the ER getting X-rays. Nothing broken. It didn't feel right so I got one of the surgeons at my office to look at it. I was worried that it was a scaphoid fracture because those are so difficult to diagnose and many times they don't heal even with optimal care. He didn't think it was a scaphoid fracture and questioned whether the problem was the large amount of soft tissue damage I had from the road rash. But even then I was adamant that it wasn't the road rash. When it still didn't feel right a week later I had more X-rays. These still showed nothing broken. By this time the road rash was healed but I still had swelling in the wrist and hand so the doctor ordered an MRI.

One month post injury I finally had my diagnosis. A trapezium fracture. This is another bone in the wrist that sits next to the scaphoid. These are extremely rare to be isolated fractures. It had to be that I hit the ground with my elbow bend and my hand at an angle rather than the outstretched arm that usually results in a scaphoid fracture.

Not my X-ray but you get the idea

The Treatment: Keep using it. Mind you, being a physical therapist there is HUGE gap between what your doctor says you can do and what you actually can. I'm sure he was not taking into consideration the large volume of training I do on a normal basis. Many doctors don't understand a lot about the rehab process. Their specialty seems to be meds and surgery which are incredibly helpful in certain circumstances. I wouldn't be racing today if it wasn't in part due to the excellent work of my orthopedic surgeon. The rest of the work though was all me.

Right now, I have a brace for comfort but because of the fact that the fracture is stable I am not being casted. This would all be great except for the carpal tunnel syndrome I developed due to the wrist swelling. My wrist and hand generally feel like they are on fire. It really hurts to cycle and I'm not the most coordinated to be riding one handed. The brace definitely helps. So does submerging my hand in a bucket of ice water afterwards. For the short-term, my co-workers are helping me type my notes since nothing flares it up like typing for an hour. Speaking of which... I should end this now and go get an ice pack. I don't know what I am going to do with rest of my race season. I have a half-Ironman and a full coming up in August. The fracture may be mostly healed by then but if I can't do the training in the meantime, I don't know how well it will go.