Radcliffe's foot injury can't be run of the mill

Published on Saturday 20 May 2006 01:37

TWO down, one to go. Having pulled out of the Commonwealth Games and London Marathon, it only remains for Paula Radcliffe to complete the treble by announcing her withdrawal from this summer's European championships.

With over a month gone since Radcliffe's surgery for a foot problem, there must be some concern that her participation in this year's event is in question. The silence from her camp and the lack of any progress report on her recovery, suggest that it is time to get worried that the defence of her 10,000m title is in jeopardy.

An email asking for a brief outline of how the summer would pan out to husband and manager Gary Lough two weeks ago elicited no response, while a similar request to her marketing company, Octagon, did receive a reply, but one stating there were no plans for the summer as yet. At the British Olympic Association hospital in Northwick Park, the doctors treating her were similarly reticent, though they had not been involved in her surgery since she opted to go under the knife in Germany rather than England.

This lack of news with the new season already upon us should come as no surprise. It was in January, we were told, that Radcliffe trod on a stone in training in Albuquerque, injuring herself. After subsequent withdrawals from the Commonwealth Games and the London Marathon, it was then revealed she had had surgery on the foot in Germany.

The delay between the injury and operation was three months, which presumably meant she was training in pain, which in turn means she was not training properly. During this time, if anything was happening, it is to be hoped she was trying conservative treatment for the foot. When that did not work, she bowed to the inevitable - surgery.

But surgery for the condition, known as Morton's Neuroma, brings its own problems and delay in getting back to full fitness. With the Gateshead grand prix only three weeks away, now is the time to be building up to a peak for Gothenburg in two months' time. Even in the best of circumstances, it could be five months between the first official symptoms of injury and donning a pair of running shoes in anger. That is an awfully long gap of interruption to quality training for an elite athlete. What had been presented at the outset like a fairly innocuous report, suddenly takes on the proportions of a major crisis.

So what is Morton's Neuroma? Often caused by tight-fitting shoes, in an athlete's case it is years of impact on a road surface causing a swelling of the nerve between the third and fourth toes, not the sort of condition that is noticeable for normal people, but if you are running well over a hundred miles a week, it can cause excruciating pain. If training is persisted with, the imbalance it causes in the skeleton can easily lead to other injuries caused by over-compensation. One sufferer described it as his foot being on fire, another said he was unable to run for three months.

Whatever the symptoms, all experts are agreed on one thing - prompt surgery is vital and that is precisely what Radcliffe did not get. Another general rule of thumb is that the longer surgery is delayed, the longer the recovery. Tim Jantz, a doctor who regularly performs the surgery, says recovery will "be a lot easier taking it easy for a few weeks to allow the surgical area to heal properly than to risk a lengthy recovery".

The surgical procedure is not without complications. Normally, the foot is operated on from above, where the surgeon has to be very careful as he cuts through numerous blood vessels, nerves and muscles. Once the neuroma is removed, the space can fill with blood, creating a painful bruise and opening up the site to infection. But that is not the end of the affair. The stump of the nerve can re-grow, necessitating further surgery. What is more, other neuromas can appear in other parts of the foot.

The problem an elite runner has is the desperate need to get back running. Apart from long runs which strain the foot, if Radcliffe is to defend her 10,000m title with any degree of success, she will have to do fast track training in spikes, putting enormous strain on the weakened foot.

The most famous occasion when she came unstuck by persisting in training when injured was in Athens. The first anyone knew she had been injured was when her physiotherapist, Gerard Hartmann, told Irish journalists on the eve of the race she had had a problem, but he thought he had sorted it out. The following day, the whole world witnessed how the grand obsession of an Olympic title can lead even the most level headed of competitors into a trap.

The European championships is hardly of the category of an Olympic final and, besides, she already has the title in her cabinet. But it will be interesting to see whether Radcliffe, now 32, will effect a miraculous comeback or bow to the inevitable.