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I told you I was ill!

10/3/2018

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For the past too-many years, I have been living with Haglund's Deformity. 
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No, it's not that kind of deformity, although I am looking increasingly like Keith Richards when I wake up in the morning. 
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Haglunds Deformity is actually a big old lump of bone in the heel, where bone doesn't really need to be. On the x-ray below, the bit that looks like a rhino's nose shouldn't be there; the heel should be a nice round shape that fits beautifully into your slingbacks. 
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In the flesh, it looks like someone stuck half a golf ball under your skin. As we all know, the feet of endurance sport folk already look less than palatable, with a heady mix of fungal infections, missing toenails and skin that you could sharpen knives on. What my feet don't need is another deformity, especially one that doesn't allow me to enter the Paralympics. 
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Considering how obvious the lump looks to the sufferer, it is amazing that most heath care professionals claim to not see anything wrong, even when you limp into their office, dragging your leg behind you, pointing to the source of the pain. We have had everything from podiatrists trying to sell us expensive (and unnecessary) orthotics to acupuncturists doing their voodoo thing and the inevitable cortisone injections, perennially popular with the NHS as it invariably provides several minutes of relief, costs them tuppence a gallon and gets you off the waiting list. Then it all flares up again, and you limp back to clinic to be told that you need to stop this foolish sport nonsense, get a job in a library (I kid you not) and what do you expect at your age?   

Perhaps the most surprising part of this tale is that Maddie had exactly the same problem, also in her right foot. This pre-dates my heroic suffering by some time and unfortunately came at the time when she had qualified for the GB endurance running squad. Very quickly the injury put paid to her running career, and with the wonder of the NHS it only took ten years for a diagnosis and treatment, by which time Maddie could only wear her GB running knickers in the privacy of our house, and needed prolonged assistance and a shoe horn getting in to them.  
My first notion that something was amiss was after a run, especially if I'd jumped straight into the car at the end of it. Getting out the car and getting moving involved an extensive period of heel - toe walking / limping before the pain reached a tolerable level and normal walking could resume. It got so bad that after any car journey I would be limping badly for the first few minutes, I could only walk for 20 minutes or so before having to sit down and have a cake, and running worthy of the name was out of the question. I couldn't use flat pedals, as the pressure of pushing my heel down was too painful, racey bike shoes were just too harsh, and my weekend treat of wearing stilettos round the house had to stop. 

As our job mostly involves wearing steely boots and wellies, and spending a lot of time on our feet, you can imagine that this was quite a problem, especially as my personal volume control precludes me from any library based employment. 
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Maddie finally got lucky. Due to the wonder of Derriford Hospital, she was introduced to the nation's finest foot surgeon, who was not afraid to get the power tools out and get stuck in. The operation is a really big deal and the odds aren't fantastic, but Maddie being Maddie she grasped the nettle, had the work done and stuck rigidly to the rehab, which was slow and frustrating. But now she is back running, setting course records, and generally kicking my arse again. 

​Having seen Maddie's recovery, I marched into my GP's office and demanded a referral to the same saw-bones, which they willingly did, and a mere 8 months later I was sitting opposite the miracle worker, only to be told that as my injury had got so bad, the post-op recovery would be a mind-boggling 5 months. If I still had a proper job, that wouldn't have been a problem, and I would have leapt at the chance of an extensive bit of leg-up sofa action. But I'm self-employed, and to go 5 months with no income was out of the question, so the operation would have to be deferred until I was back being an untrustworthy employee, immediately buggering off on sick leave. So no operation, just another bucket of man-up pills, but a ready excuse for why I was in such bad shape. 
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Wind forward 12 months and something amazing has happened. Through the Power of Greyskull, a can-do attitude and making changes to my footwear, I am back running, walking mostly pain-free and running our of excuses why I continue to be in such terrible shape. 

I don't really remember making conscious decisions about throwing out footwear that could be crippling me, but sticking to certain kinds of running and cycling shoes has paid dividends and got me back in the game.  The footwear that really works for me are - 
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La Sportiva Mutants. These are always tagged as extreme off-road shoes, with massive lugs for tread, only to be used in the event of a National emergency. I use them for just about everything, and the reason why they are so good for Haglund's sufferers is the lack of any padding around the heel. Lots of padding might seem like a nice cushioning affair, but when you crank your laces tight it just presses on the pump-bump and causes mega pain. Lack of padding = happy trails, and the Mutants have been my go-to shoes for years.  
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Sketchers shoes have the magic combo of shoes as soft as baby poo, and a decent heel raise, which I reckon is key to alleviating Haglund's symptoms. I've been wearing the same pair in the gym and boxing for the past couple of years, which is a treat for everyone. The lower the heel, the greater the stress on the Achilles and calf, which is not good news for heel happiness. In fact, I've thrown out all the minimalist shoes that I used to wear regularly, and while I'm not quite in the Tom Cruise cuban heel territory, I make sure that there is a good heel raise in the shoes I choose. 
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On the bike, it's Shimano gimp shoes all the way. They might weigh as much as my bike, but good Lord, they are warm and comfy. Nice soft heel cup, but I can still only wear SPD versions, which is a convenient cop-out of wearing flats. 

I still struggle to wear stuff like wetsuit boots and climbing shoes (both way too tight), getting my wetsuit on and off over the lump is a teeth clenching experience, and if I ever bang my heel against anything harder than a cloud, I can offend a navvy with my colourful Anglo-Saxon. But compared to where I could be, it's not bad at all. 

​So if you're a high arched runner, with a tendency for the foot to roll outwards, who suddenly finds that they can't put their feet up on a hard surface, Haglund's Deformity could be in your future. Get in there early for a happy outcome, but all is not lost and it could get better with some footwear modifications. Your 'just call me Susan' weekends might be over, however. 
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    Jay Horton

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