What I’m doing differently for my second Camino-Footwear & Cortisone
Since our last Camino 2 years ago I’ve developed pretty bad arthritis in the basal joint of my right thumb. I also have a partial tear of the subscapularis tendon in my right shoulder as well as a mild SLAP tear at the bicep tendon attachment (all parts of what is known as the “rotator cuff”). And let’s not forget that plantar fasciitis problem that is still present, just to a significantly lesser degree.
On my first Camino I wore Merrell Moab hiking shoes. Big mistake. You are going to read a lot of articles and stories on the Internet on the merits of lightweight footwear. Most people with no foot problems will be just fine wearing hiking shoes or sandals. However, those of us with plantar fasciitis need support and cushioning from the pounding. I had always worn hiking boots for all my backcountry backpacking trips here in Alaska. But I fell for the nonsense being spewed by newbies who believe all the stories being told by elite thru hikers whose legs and feet are conditioned.
So, for this trip I’m wearing my Vasque St. Elias boots. These are the type of lightweight backpacking boots that I have always worn. I’m doing so on the advice of my Podiatrist (who is an actual expert) and yes, my husband who is still saying “I told you so”. So there it is dear Billy. For all the world to read 🙂
Orthotics and Compression Sleeves
Another major mistake that I made my Camino was not wearing my custom orthotics. I use custom orthotics that my podiatrist prescribed which are molded to my particular gait and pronation. They have a small padded area where my metatarsal bones sit. This is because I developed a Morton’s Neuroma in my right foot. This pad should help to keep those nerves stretched and reduce compression while I walk, and hopefully avoid irritating the neuroma.
The second item I’m packing is a pair of Plantar Fasciitis compression sleeves. I’ve been wearing these at home after work and they almost instantly take away the pain. I’ll be using them under my socks after walking to help my feet recover. I made sure to buy a size larger since I know my feet swell after a long day of hiking in the heat.
As I write this post, my shoulder and wrist are in pain and my plantar fasciitis is definitely acting up at the end of the workday. So I have made the decision, with the advice of my orthopedic surgeon and my podiatrist, to get a series of Cortisone shots. I’ve had them before and they last about 3 months.
1) 2 1/2 weeks before I leave for Spain, I will have an anterior subacromial Cortisone shot (front part of my shoulder).
2) A few days after the shoulder injection, I will go for a Cortisone shot in my right wrist at the basal joint.
3) 1 week before leaving (2 weeks before actual walking starts) I will have Cortisone shots in both feet for the plantar fasciitis. I will also get a shot in my right foot for the neuroma. These particular shots are prophylactic and will help keep the fascia from becoming inflamed.
Do Cortisone shots hurt?
For me, the shoulder shot doesn’t really hurt. Just a mild sting when the lidocaine shot is injected (to numb the area) and then some discomfort when the Cortisone is being injected, like a pressure building. There is also what is known as Cortisone flare pain. As soon as the lidocaine wears off after an hour or so, you will likely feel a bad ache that lasts all afternoon and possibly into the next day. It’s normal.
My first wrist shot didn’t hurt. My second shot hurt a lot and more. More lidocaine was needed because the nerve in the area is pretty sensitive. However, the procedure is quick and the pain is stops as soon the Cortisone is injected.
The shots for the plantar fasciitis is a whole different story. My podiatrist uses Biofreeze to numb the side of the heel where she inserts the needle. That is actually the worst part for me and my overly sensitive feet. That insanely cold feeling is painful 🙂 The shots themselves aren’t bad. Yes, it hurts a bit as the Cortisone is injected, but again, as soon as the needle is removed the pain stops. A couple of minutes of moderate discomfort for months worth of pain relief.
You will probably hear or maybe you think that Cortisone shots are bad for you. They can be detrimental to muscle if used too frequently. Consult your specialist but all of mine believe that shots given twice a year (or in the case of my feet 2 years apart) are not harmful. The Mayo Clinic agrees as does every peer-reviewed journal article that I’ve come across in my research.
Daily distance walked
The final thing that I’m doing different on for the Camino de Invierno, is that I’ve set an itinerary that limits the number of kilometers I walk to less than 20 every day. There are a few exceptions, but those are 2 days in the middle and then the last 2 days when my feet should be more conditioned. This is different from the stages that I walked 2 years ago on the Primitivo Route where I was walking 20+ km every day for 2 weeks. I think this combination of more supportive footwear, Cortisone shots, and reduction in daily distance will make a big difference for my feet. My shoulder isn’t a problem as my pack is pretty light and the weight sits on my hips. I will let you all know how this works out. Stay tuned.
We leave April 13th and start walking on the 17th. So just about a month away now.