很多人看到我依靠拐杖寸步难行，感到惊讶。公寓相识的朋友、打扫工人、保安都纷纷慰问。一跛一拐地到巴刹买个早餐，也是到处都有人睁大眼珠相询。补习班的学生知道我是个不爱婆妈的怪人，在看到我拿着拐杖上课时，虽然讶异却也不敢多问。
我不知道重复了多少遍：我的脚跟腱发炎，医生警告如果再跑步的话恐怕会把脚跟腱拉断。我还怕解释后人们还是不清楚我的伤势，所以我就把著名的跨栏好手刘翔给请出来。
问我为何会弄到脚跟腱发炎。我其实真的很不愿意承认那是我“过分”跑步所招致的。这么多人都在努力地跑着，为何偏偏就是我一个的脚跟腱受伤？我始终不觉得我的跑步活动是“过分”的。我给人们的答复是：这是纠缠着我好几年的旧患，我一直强忍痛楚在跑步着，现在脚跟腱终于支撑不下去了，闹情绪了，所以我必须好好让它休息了。
坦白说，我自己也真的不清楚为什么脚跟腱会忽然疼痛到要我必须依赖拐杖才能走路。我清楚记得，自我跑完布央谷赛跑回来后，我就连续5天没有跑步，尽量让双脚休息；怎知道不休息还好，一休息就弄出这样的大件事来。
我在想：如果跑完布央谷的比赛回来后我还是照旧每天都跑10公里的路程，到底后果会是怎样呢？我的脚跟腱没事，可以照样跑环市赛跑？抑或我在练习跑步时拉断脚跟腱而必须送院治疗？
答案肯定没人知道。
世事就是这么奥妙：每样事都有很多可能性，可是真正发生的就只有一个。
所以我从来很少去为生活中所发生的事儿操心烦恼，也不会对自己所做的决定感到后悔。
可惜好多人却不是这么想。人们总爱为未知的事感到担忧，也爱为已发生的事情懊悔沮丧。这样值得吗？
2009年10月5日星期一
怀念《环市赛跑》
2006年中我接受老同学的邀约，决定每个星期六傍晚参与他们一起跑步，一来锻炼日渐走下坡的身体，二来可以和这群旧日同窗联络情谊。
当时我的体重超过90公斤，是个大胖子。顶着大大的肚腩，气喘如牛，千辛万苦地跑在这群同学的后头。当时没有什么奢望，只期盼能够通过跑步来改善自己的健康，毕竟中年男人容易患上心血管疾病。我真的不想我的下半生是在病苦中度过的。
还是大合照。
这是我从一个相识的“退休”跑者的网站找到的相片。真巧，他竟然在我骑摩托车从中路转入Penang Road时无意地把我摄入镜头。看到我放在摩托车篮子里的拐杖吧！
当时我的体重超过90公斤，是个大胖子。顶着大大的肚腩，气喘如牛，千辛万苦地跑在这群同学的后头。当时没有什么奢望，只期盼能够通过跑步来改善自己的健康，毕竟中年男人容易患上心血管疾病。我真的不想我的下半生是在病苦中度过的。
犹记得当时我们只是玩票性质地从青年公园跑进植物园，然后在里头跑1或2圈。当时我们觉得这样的跑步已经很“了不起”了，感觉上我们就是一群很会跑步的健将。实际上，我们一直把自己封闭在我们的天地里，没有出外去参加比赛，不知外面的世界里还有很多比我们跑得快的人！
就在那一年的11月，我建议大伙儿报名参加光华日报主办的“环市赛跑”，那是槟城历史蛮久的一项常年运动比赛，我们年轻时也曾参加过这项比赛。
由于报名参加比赛，我们开始认真地增加我们跑步的路程，从1、2圈，慢慢增加到3、4，然后是5圈。而我也趁着年尾部分补习班关闭的空闲时间自己一个人到青年公园“暗练”，看着自己的成绩越来越进步，信心就越强烈。
终于，在06年11月29日，我们终于跨出自己的小天地，出外参加比赛。我们的“处女作”就是06年的《光华日报环市赛跑》。
比赛回来，我们终于明白，外面的世界能跑的人实在太多，连一些上了年纪五、六十岁的阿伯阿姨都跑得比我们快！我们终于开窍了！我们开始认真看待我们的跑步活动。在我的积极带动之下，我们不断地到处参加比赛。而我们的表现也越来越进步了。我们开始提起勇气去参加挑战性蛮高的Malakoff 26 km比赛。我们也很正面地看待今年年尾举行的槟威大桥半马拉松赛。
由于大家都进步不少，所以我们开始要选择性地参加比赛。我们开始想要放弃参加一些路程太短的比赛，宁愿把周日早晨的时间拿来自己进行21公里的训练。
然而，我始终认为光华日报主办的《环市赛跑》是一定要参加的。这个赛会对我们是具有重大意义的比赛。如果不是参加当年的《环市赛跑》，我们可能还是一群封闭在自己小天地里的井底之蛙。
所以，我今年照旧帮自己和死党报名了环市赛跑。由于今年的环市赛跑路线有所更改，特别让选手经过槟城的古迹区，所以我更是迫不及待地期盼这个比赛的到来。我还信心满满地认为自己今年的成绩一定会有大突破。
可是，天不从人愿！我在比赛前一天因为脚伤恶化而倒下来了！心里的失望真的是可想而知！
虽然我没得参加比赛，可是我在比赛当天还是到达赛场。我真的不舍得错过这个对我有特别意义的比赛。
比赛当天的天气不是很好。天空乌云密布。果然，比赛一开始之后，天空就开始下起雨来了。我冒着雨，骑着电单车赶在选手会跑过的路线之前，为我的同学们拍照留念。
看着别人跑步的情景，又看看自己必须依赖拐杖才能站立的样子，都市感觉凄凉不已。
无奈，这就是命运。
这是我们每次赛后要求旁人帮忙拍摄的合照。
还是大合照。
这是我从一个相识的“退休”跑者的网站找到的相片。真巧，他竟然在我骑摩托车从中路转入Penang Road时无意地把我摄入镜头。看到我放在摩托车篮子里的拐杖吧！2009年10月4日星期日
Achilles Tendonitis（3）
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The Surgical Treatment of Achilles Tendonosis
Following the MRI or ultrasound scan the extent of degenerative change will have been defined. The two main types of operative intervention for Achilles tendonosis are either a stripping of the outer sheath (paratenon) and longitudinal incisions into the tendon or a major debridement of large portions of the tendon and then reconstruction of the remaining tendon using a flexor hallucis longus tendon transfer.
What Is The Rationale Behind The Operations for Achilles Tendonosis?
In cases of Achilles tendonosis with more minor degrees of degeneration such areas of tendon can be stimulated to repair themselves by incising the tendon, in the line of the fibres, which stimulates an ingrowth of blood vessels and results in the healing response. With severe Achilles tendonosis, if a large area of painful tendon needs to be excised then a large defect is left. This defect needs to be filled and this is best done by transferring the flexor hallucis longus muscle belly and tendon, which is adjacent to the Achilles tendon.
Achilles Tendonitis (2)
Symptoms of Achilles Tendonitis
The main problem with Achilles tendonitis, or Achilles tendonosis, is one of pain. This generally remains well localised to the problematic area of the tendon. Initially symptoms are intermittent and may just occur following periods of activity. The pain with Achilles tendonitis may initially occur just during or after activity. It may produce symptoms at rest or occasionally even at night. It is also possible that some patients with degenerative tendon problems (Achilles tendonosis) may have little in the way of symptoms initially.
Causes of Achilles Tendonitis
Achilles tendons, like all musculo-skeletal tissue, are exposed to multiple episodes of minor trauma during their activity. All tendons are constructed very much for strength and have relatively little in the way of blood vessels associated with them .This means they are slow to repair themselves. Over a period of time, if the Achilles tendons’ capacity for repair is continually exceeded, structural changes will occur. These symptoms and structural changes, may take longer to manifest themselves as in the case of Achilles tendonosis. Not all people are equally susceptible to these type of soft tissue problems. Some people’s Achilles genes are just better than others.
Treatments for Achilles Tendonitis
Both operative and non-operative managements are available for Achilles tendonitis. Generally, one would be advised to try non-operative management first though dependent upon length and severity of symptoms this is open to discussion of course. There are two, seemingly diametrically opposed, ways of managing Achilles tendonitis non-operatively. On the one hand one may go down the route of splinting用夹板托着, immobilisation and resting of the Achilles tendonitis. On the other hand one may go down the route of physiotherapy, supervised massage, stretches and strengthening type exercises for Achilles tendonitis. Both routes seem to work with equal likelihood. It is not possible to know who would benefit from one route and who would benefit from another.
Physiotherapy for Achilles Tendonitis
In the acute phases ultrasound, restriction of activity and rest for the Achilles tendon are likely to be advised. Later deep friction massage of the tendon will be started and exercises to stretch the Achilles tendon will be taught. Non-steroidal anti-inflammatory tablets such as Brufen may be useful if these are not contra-indicated.
Orthotic 矫正术for Achilles Tendonitis
The minimum is to try a heel raise. This is a wedge of material which raises the heel relatively to the foot, thus removing some of the tension from the Achilles tendon.You may feel easier wearing high heels, though for men this probably should be limited just to Friday or Saturday nights (and when your wife is out). An alternative form of treatment of Achilles tendonitis is to wear an Achilles Aircast walking boot. This should be used for all weight bearing activity and the back part of the boot should be rested in bed at night. Short periods of driving during treatment for Achilles tendonitis are possible. Full weight bearing in the Aircast boot is also possible during treatment for Achilles tendonitis.
How Soon Should Non-Operative Treatment of Achilles Tendonitis Improve Symptoms
Some symptoms from the Achilles tendon should improve soon, perhaps within days or weeks. Lasting improvement however takes longer and it may be up to 3-6 months before significant inroads are made into the symptoms. If the symptoms of Achilles tendonitis have failed to improve much by this stage, then they are unlikely to do so with further conservative treatment. All told, success rate in the region of 50-75% can be expected with conservative management of the Achilles tendonitis.
The main problem with Achilles tendonitis, or Achilles tendonosis, is one of pain. This generally remains well localised to the problematic area of the tendon. Initially symptoms are intermittent and may just occur following periods of activity. The pain with Achilles tendonitis may initially occur just during or after activity. It may produce symptoms at rest or occasionally even at night. It is also possible that some patients with degenerative tendon problems (Achilles tendonosis) may have little in the way of symptoms initially.
Causes of Achilles Tendonitis
Achilles tendons, like all musculo-skeletal tissue, are exposed to multiple episodes of minor trauma during their activity. All tendons are constructed very much for strength and have relatively little in the way of blood vessels associated with them .This means they are slow to repair themselves. Over a period of time, if the Achilles tendons’ capacity for repair is continually exceeded, structural changes will occur. These symptoms and structural changes, may take longer to manifest themselves as in the case of Achilles tendonosis. Not all people are equally susceptible to these type of soft tissue problems. Some people’s Achilles genes are just better than others.
Treatments for Achilles Tendonitis
Both operative and non-operative managements are available for Achilles tendonitis. Generally, one would be advised to try non-operative management first though dependent upon length and severity of symptoms this is open to discussion of course. There are two, seemingly diametrically opposed, ways of managing Achilles tendonitis non-operatively. On the one hand one may go down the route of splinting用夹板托着, immobilisation and resting of the Achilles tendonitis. On the other hand one may go down the route of physiotherapy, supervised massage, stretches and strengthening type exercises for Achilles tendonitis. Both routes seem to work with equal likelihood. It is not possible to know who would benefit from one route and who would benefit from another.
Physiotherapy for Achilles Tendonitis
In the acute phases ultrasound, restriction of activity and rest for the Achilles tendon are likely to be advised. Later deep friction massage of the tendon will be started and exercises to stretch the Achilles tendon will be taught. Non-steroidal anti-inflammatory tablets such as Brufen may be useful if these are not contra-indicated.
Orthotic 矫正术for Achilles Tendonitis
The minimum is to try a heel raise. This is a wedge of material which raises the heel relatively to the foot, thus removing some of the tension from the Achilles tendon.You may feel easier wearing high heels, though for men this probably should be limited just to Friday or Saturday nights (and when your wife is out). An alternative form of treatment of Achilles tendonitis is to wear an Achilles Aircast walking boot. This should be used for all weight bearing activity and the back part of the boot should be rested in bed at night. Short periods of driving during treatment for Achilles tendonitis are possible. Full weight bearing in the Aircast boot is also possible during treatment for Achilles tendonitis.
How Soon Should Non-Operative Treatment of Achilles Tendonitis Improve Symptoms
Some symptoms from the Achilles tendon should improve soon, perhaps within days or weeks. Lasting improvement however takes longer and it may be up to 3-6 months before significant inroads are made into the symptoms. If the symptoms of Achilles tendonitis have failed to improve much by this stage, then they are unlikely to do so with further conservative treatment. All told, success rate in the region of 50-75% can be expected with conservative management of the Achilles tendonitis.
Achilles Tendonitis (1)
What is Achilles Tendonitis?
Often, and inaccurately, any pain around the Achilles is referred to as Achilles tendonitis. Achilles tendonitis refers to one specific and defined pathology of several which exist, and can co-exist. It is useful to divide the different problems of the Achilles tendon into those which affect the main “body” of the Achilles tendon (these conditions are tendonitis, tendonosis and rupture) and those conditions with affect the insertion of the Achilles tendon into the bone (insertional tendonosis of the Achilles tendon, a Hagglunds deformity).
What does Achilles Tendonitis look like?
The Achilles tendon itself structurally can be thought of almost like a horses tail with lots of longitudinal fibres running parallel to each other and packed very tightly. This is the substance of the Achilles tendon(2). Over a period of time, sometimes following multiple smaller injuries, areas of the body of the Achilles tendon can start to lose their normal well defined structure. In these areas the Achilles tendon itself becomes less well defined and the normal longitudinal fibres are less visible. This type of degenerative change within the Achilles tendon is known as tendonosis(1) and this usually results in a symmetrical swelling and area of localised pain in the tendon.The healthy, and unhealthy, Achilles tendon is surround circumferentially by a fine covering known as the paratenon(3). This layer looks something like a sausage skin and has various functions including lubrication and supplying blood to the tendon. When this layer becomes inflamed then the condition is known as Achilles tendonitis. It should be realised that both Achilles tendonitis as well as Achilles tendonosis may co-exist in the same Achilles tendon.
依赖拐杖的日子
脚跟腱受伤，左脚板就是无法平踩在地上，会很痛，简直就像要拉断脚跟腱一样。无奈，只好听从医生的劝告，拿起拐杖，当一个暂时的伤残人士。别以为我伤了脚就会很安定，不四处乱走。其实，我还是像平常一样不能安静坐下来，拿着拐杖到处去。
昨天星期六下午，我还是到青年公园和同学们聚集碰面。我不会因为脚伤了就不出席聚会。我其实还真担心如果我不出席，这群以跑步活动维持老同学情谊的死党会渐渐消散！毕竟我是整个团队里最积极的一个，从来没有缺席聚会；也是因为我的积极，所以我们变成大小赛会都赴约。而今我脚有小伤，不可能就借故离去，因为我担心我脚伤复原后很难再召集这寥寥几个昔日同窗了！也许你们可能觉得我顾虑太多，但是顾虑总好过Take it for granted！
昨天的聚会就因为我的脚伤而来了特别多人。好几个都不是来跑步的，纯粹是来慰问我这个“伤兵”。
我想，柱着拐杖的日子还会持续几天知道脚板能够踩在地板上为止。所以，结下来的补习课我都会以伤残人士的身份出现了。
别以为我会因为行动不便而感到沮丧，其实我这个人还真乐天的，所以，不要以“同情的眼光”看我，应该要“幸灾乐祸”的好好对我进行报复！哈哈！
2009年10月3日星期六
最不想发生的事情终于发生了。。。
一直以来就知道自己的脚跟腱有伤。发炎了。
每一天醒来，左脚着地时真的是痛楚不堪，一拐一拐地走进厕所洗刷后，自然就会去跑步。坦白说，好多次都曾经因为疼痛而不想下楼去跑步，不过我是一个很会忍痛的人，所以多数都会照旧穿起跑步鞋，到楼下去热身准备跑步。
说真的，每一次跑步之前我都会认真问自己：我真的能忍得住脚跟的痛楚吗？脚跟腱会被我这样折腾而断裂吗？
然而，每次我都是以顽强的意志克服脚跟腱的疼痛，看似若无其事地一步一步向前迈进。
这一两年来，我都是这样忍着，忍着。路程越跑越远，速度越来越快，体重越来越轻。看到自己的进步，我真的有更大的梦想：跑半马拉松、跑马拉松。。。
上个星期六，和老同学们远赴双溪大年布央谷参加长途赛跑，结果我竟然在我们的团队当中排名第二！这绝对是一个令自己振奋雀跃的小成就。我开始有信心要在接下来的《光华日报环市赛跑》中创出更好的成绩，甚至有信心会在年尾的《槟威大桥半马拉松》赛中创下自己的最佳成绩。
可是，美梦总是那么的易碎！
昨天早上从公寓走下楼打算骑电单车去巴刹买早餐时忽然觉得左脚很不对劲！当我跨步下楼梯时，一阵激烈的抽痛直袭心头。我暗忖：不妙了！
果然，昨天一整天我就是一拐一拐地，寸步难行！就算不走路，脚跟也是疼痛不已。我是一个很能忍受痛楚的“野蛮人”，可是昨晚真的是难受之极。
今天早上醒来，疼痛只有加剧，没有消退的感觉。于是，觉得应该去医院一趟，给专科医生验一验，毕竟脚跟腱发炎不是一件好玩的事，搞不好就会像中国的跨栏好手刘翔那样，把脚跟腱给拉断了！ （哈！我当然不能和刘翔相比！我提起刘翔，是想让大家更了解我的伤到底是怎么样的一个伤！因为脚跟腱断裂的运动员还有我们的羽毛球好手黄综翰。）
负责帮我诊治的医生是我相识的矫形专科医生，是我中学老师的丈夫。他把我的脚跟翻看几遍，按了又按，摇头对我说：“如果你不想脚跟腱断裂，以后你就别再跑步了！”
这是一个残酷的判决！
虽然我心里有数，知道自己短期内是必须放弃跑步的了。可是，没想到医生竟然叫我完全放弃跑步！这怎么可能？
我慎重地再向医生发问：“真的是一辈子都不用在跑了吗？”
医生严肃地说：“你自己衡量一下，要弄断脚跟腱后动手术而几个月不能走路呢还是要健全的双脚？”
我的心在哭泣。弄得心头苦苦的！
不过，我是一个很会转念安慰自己的人。
我不能跑步，可是我还可以游泳啊！医生还说我可以骑单车啊！我都还不是残废！
可是，我是真的舍不得跑步呵！我更舍不得那群跑步的死党！
想到那群死党，我立刻拿出手机，给他们发了信息：告诉你们一个坏消息，我以后不能再和你们跑步了。。。
每一天醒来，左脚着地时真的是痛楚不堪，一拐一拐地走进厕所洗刷后，自然就会去跑步。坦白说，好多次都曾经因为疼痛而不想下楼去跑步，不过我是一个很会忍痛的人，所以多数都会照旧穿起跑步鞋，到楼下去热身准备跑步。
说真的，每一次跑步之前我都会认真问自己：我真的能忍得住脚跟的痛楚吗？脚跟腱会被我这样折腾而断裂吗？
然而，每次我都是以顽强的意志克服脚跟腱的疼痛，看似若无其事地一步一步向前迈进。
这一两年来，我都是这样忍着，忍着。路程越跑越远，速度越来越快，体重越来越轻。看到自己的进步，我真的有更大的梦想：跑半马拉松、跑马拉松。。。
上个星期六，和老同学们远赴双溪大年布央谷参加长途赛跑，结果我竟然在我们的团队当中排名第二！这绝对是一个令自己振奋雀跃的小成就。我开始有信心要在接下来的《光华日报环市赛跑》中创出更好的成绩，甚至有信心会在年尾的《槟威大桥半马拉松》赛中创下自己的最佳成绩。
可是，美梦总是那么的易碎！
昨天早上从公寓走下楼打算骑电单车去巴刹买早餐时忽然觉得左脚很不对劲！当我跨步下楼梯时，一阵激烈的抽痛直袭心头。我暗忖：不妙了！
果然，昨天一整天我就是一拐一拐地，寸步难行！就算不走路，脚跟也是疼痛不已。我是一个很能忍受痛楚的“野蛮人”，可是昨晚真的是难受之极。
今天早上醒来，疼痛只有加剧，没有消退的感觉。于是，觉得应该去医院一趟，给专科医生验一验，毕竟脚跟腱发炎不是一件好玩的事，搞不好就会像中国的跨栏好手刘翔那样，把脚跟腱给拉断了！ （哈！我当然不能和刘翔相比！我提起刘翔，是想让大家更了解我的伤到底是怎么样的一个伤！因为脚跟腱断裂的运动员还有我们的羽毛球好手黄综翰。）
负责帮我诊治的医生是我相识的矫形专科医生，是我中学老师的丈夫。他把我的脚跟翻看几遍，按了又按，摇头对我说：“如果你不想脚跟腱断裂，以后你就别再跑步了！”
这是一个残酷的判决！
虽然我心里有数，知道自己短期内是必须放弃跑步的了。可是，没想到医生竟然叫我完全放弃跑步！这怎么可能？
我慎重地再向医生发问：“真的是一辈子都不用在跑了吗？”
医生严肃地说：“你自己衡量一下，要弄断脚跟腱后动手术而几个月不能走路呢还是要健全的双脚？”
我的心在哭泣。弄得心头苦苦的！
不过，我是一个很会转念安慰自己的人。
我不能跑步，可是我还可以游泳啊！医生还说我可以骑单车啊！我都还不是残废！
可是，我是真的舍不得跑步呵！我更舍不得那群跑步的死党！
想到那群死党，我立刻拿出手机，给他们发了信息：告诉你们一个坏消息，我以后不能再和你们跑步了。。。
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