Cut a Hole in Your Shoe

About nine years ago, I first went in to the doctor to get a foot issue checked out. 

By early 2011, I had accomplished a penultimate goal of the ultra runner: a hundred miler. Seventeen previous trail races, paling in their length, preceded the 25 hour endeavor. I was utterly hooked. I loved ultra and everything that came along with it. I think the real reason I loved it so much is because ultra - long visits to the trails - for me, was the apex expression of submission of ego. The longer the distance, the more my contribution to the collective effort was evened out. Time was a construct; no one cared what place you took. All was equal at the finish line. The campfire and cookie cake are available to the fastest and slowest in equal measure. 

Everyone was gathered to experience good suffering together and it was beautiful. 

Until my body began to punish me for not treating it was well as I could have. At 21, you can get away with a lot. Your recovery can flourish, for a time, on beer, pop tarts, and way too much oatmeal. Not that I was totally footloose with what I consumed, but my maintenance routine was far from appreciative of the gift that was the delicacy of human bipedal locomotion. 

I came to a point where I felt I was always right on the verge of injury, so I cut back on my first love, and poured into multi-sport disciplines where my right foot's propensity to swell up and ache was far less likely. 

My first visit to the doctor revealed that I had an enlarged calcaneus that constituted my right heel. Indeed, comparing one side to the other reveals just how much larger that hunk of bone was. Why this was, I could never know outside of the pat answer: "genetics." They suggested to look into surgery or else stop running. My answer was to get into triathlon and revisit ultra later on, hoping that I might find a better solution then. 

But now, with eight-odd seasons of triathlon and cycling under my belt, the call from the single track has grown strong. I dipped my toes into racing back in 2017 at Run the Rock 50k and again in 2019. Most recently, I managed to pound enough sand at the Siuslaw Dunes 50k last March to notch one more finish to my 21 others. It was about all my foot could handle and by May, I was all but totally sidelined from running. 

CrossFit was my remedy for the summer of lockdown and for me, 2020 was a perfect year to take off from racing. I'm actually quite grateful that it came when it did. I've learned so much more about maintenance and overall physical preparedness as a practicing Crossfitter. More than any other sport I've done, CrossFit will rapidly highlight your weaknesses and demand you pay attention now before you seriously injure yourself. Plus, tracking all-new PRs in various olympic lifts has been hugely satisfying. 

But it's not 2020 anymore. Can I get an "amen"? And the trailheads here at Oak Mountain State Park are screaming my name. 

I'm coming, I promise, but I have to find the answer to this chronic heal pain, a decade in the making. But how do I solve a problem that's that old? Let's rewind for a moment and survey what all the "professionals" have told me in my quest to do just that.

(As an aside, I don't mean to denigrate those who work in the medical field whatsoever, but in my own experience, apart from those times they sewed up my lacerations and reset my left ulna, solutions involving biomechanics and endurance metabolism utterly fall short and cause more harm than good.)

So what was the medical establishments' solution?

Foot and ankle specialist (circa 2011): "You have Haglund's deformity. You probably shouldn't run, bro. Consider surgery if you do."

Active Release Technique practitioner (2012): "You have tight calves. That'll be $80." 

Second foot and ankle specialist opinion (circa 2013): "Wear these aircasts and never run hills again." 

Third opinion, Army GP (circa winter 2014): "I can put you on profile if you want. Also, there's a bucket of ibuprofen on your way out."

Physical Therapist (fall 2020): "Do about 15,000 calf drops and come and see me weekly to check in on how those are going." 

Massage Therapist (2012-2020): "You're really tight in your calves. Come see me more often. Our facility also offers acupuncture. Do that."

Acupuncturist (winter 2016): -Not fluent in English. I have no idea what just happened.-

Orthopedic surgeon (winter 2020): "You need more cushion in your shoes and you should wear these enormous heel pads to elevate the foot. Also, sleep with a splint. Also, consider ibuprofen." 

Chiropractor (spring-winter 2020): "High-five." 

After all those visits, I hardly progressed. Nothing was working and I'm not real interested in turning my Altras into high heels. Between reading Kelly Starrett and Christopher McDougall, that solution did not ring true to me. What on earth was going on? I got more into doing my own research and came across an alternate solution that was so stupidly simple. 

irunfar blog: "Cut a hole in your shoe." 

The removal of something that would otherwise serve a function in an optimal setting was just the trick. I had to accept that my right heel bone was enlarged - was not, perhaps, what it was supposed to be - before I could move forward with a solution. 

How often do we fail to accept the reality of a problem, of something that is, on its surface, not what it ought to be, but we continue to behave as if it is? How many relationships are hamstrung because one party is not willing to accept a perceived deformity in another, putting pressure on an area resulting in nothing more but sustained inflammation?

We have problems by design. The optimal way of living - call it a law code, an ethic, symmetry, or convention - is a guide in how to fix those problems, not a reflection of how things actually are. A 14,000 foot mountain must have a lifeless top to generate the abundant buzz of life on its slopes. Is it possible to genuinely live perfectly, optimally? 

The answer is never, so long as our comparison is with convention. Yet our conventions, the idea of perfect, is necessary to help us direct our aim. But more commonly, at least for me, we tend to assume that we must adhere to that perfection - or radical orderliness if you like - and abide by that paradigm all the time, or else we are compelled to put pressure on an area prior to allowing for the negative space of acceptance. Maybe just a touch of gentle pressure around a deformity to keep the shoe on is the best we can do. Maybe that's perfect.

In a home with three young kids, a house kept in "perfect" order might be said to have all dishes clean, all trash taken out, all crumbs vacuumed out of sight. Yet, the very instant one achieves a perfectly clean home, the moment the children invade, that image is erased despite all your hard work. To guard yourself from insanity, perhaps a redefinition of a perfect house may be in perfect order. 

Maybe mildly messy is practically perfect. Maybe the conventions must fail in order for life to carry on. To try and maintain a spotless house while conducting normal life, let alone with kids, is a practice in near tyranny. Why would we want to scorn the possibility of stains on the rug? Allowance for spilled milk is an allowance for what it means to be human, and that means accepting that living perfectly may not be the same as a strict adherence to perfect convention (and that's assuming the convention is perfect anyways).

So I cut holes in my shoes. I accepted that my foot is deformed an let it be, literally took the pressure off, and had the best run this morning in a long, long time.