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Friday, 7 October 2011

Sporting Injuries and the NHS

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Talk about a can of worms.

Having spoken to a few people (fell runners) recently about nightmares with ligament ruptures and misdiagnosed breakages, I thought I might write a little something on here.
When you "do" sport, you tend to put yourself under a fair bit of risk. Some sports are more risky than others, but the vast majority have the opportunity in which to do something pretty nasty to your body, should you mess it up.

Its interesting that if you go to the doctor with hypertension, overweight, general un-wellbeing and feeling rubbish, they will tell you to get out more and lead a healthy life. Do some sport, stop sitting around being unhealthy.
However, go into a GP with muscle injuries or aches and pains from doing a sport, and if you haven't got the fortune to go to someone who has a genuine interest in Sports injuries, the chances are, you are going to be given some pain killers, some fairly generic advice and told to go away and stop doing it until it heals.

So imagine I've been out running for a good number of years, and my knee starts hurting. Ouch. Not a good thing. Right. Not to worry. I'll carry on running and see if it gets worse. Yep.
Ouch. That REALLY hurts.
An average runner (from what I've seen) will continue on with this cycle for about 6-8 months, changing terrain, running shorter and shorter distances, getting frustrated, and generally hurting more and more, until it actually starts hurting when they walk.
At this point, ooooh, now it REALLY REALLY hurts, I think I should go to the doctor. They fix bodies.

So they go to a GP and get a response of, oh, there doesn't seem to be any structural damage. Here's a prescription for some decent pain killers. Go away, stop running, and take pain killers and everything will be alright.
(I'm paraphrasing here, obviously, and different doctors will say different things).
So the idea is that you stop hurting because you are taking pain suppressants. Great. So you aren't actually NOT in pain, you are still actually in pain, its just that the pain killers are stopping you from feeling that pain. So the thing that is actually causing the pain is still there, but you can't feel it.
That's why, when you finish the course of pain killers, you go back to running (or whatever) and it STILL hurts. The original problem has not been fixed.
Other times, the GP may not even prescribe you pain killers. From personal experience, I went to one with pain in my shoulder, and was in not so many words told not to waste her time. Great. So now I have a pain in my shoulder, and the only guidance is not to do what I normally do. Yes, I could get a referral to a physio, but there is another problem associated with that.

If you are the runner that I have mentioned earlier, and have been running on the knee that hurts for 6 months, you eventually go to the GP, who refers you to a physio - that takes about 6 weeks. So now you've been waiting 7 and a half months to get an injury seen to that is going to cause compensation issues for a year or so, maybe more, down the line.

Quickly back up to personal experience again. Knee injury skiing. Bummer. However, still able to walk, but not run, in any shape or form. We suspect a meniscus tear, so we go to see the GP, who after a while agrees to refer to a knee specialist. Great. That takes 6 weeks to come through, and he recommends an x-ray. Lovely, a 5 week wait, then the x-ray, another 3 weeks until you get an appointment with the specialist again for him to say - nope, there is nothing showing up on that. Great. We request an MRI, it may have been on the cards, but we push for it anyway. Another 6 weeks waiting and finally get the scan. Then 3-4 weeks wait and see the knee specialist again who says that yes, indeed, there is a meniscus tear. Its taken THAT long, and that's going to see the GP straight away and not trying to run on it for a while before going to see anyone about it. Injury done in Feb and finally got someone to talk to us about whether or not to get an operation in about July/August. And that was in London.
Things do not run quickly.

OK, so that's a bit of an extreme case which needed an MRI, but think about other issues that don't need drugs, but do need some kind of help. Do you want someone to cursorily prod your arm/knee for 3 mins of the 7 that are allocated to you by someone who mainly deals out prescriptions to ill people. The GP is generally more concerned about giving out or withholding drugs. They are more likely than not tell you to stop what you are doing, and as a secondary thought, refer you to a physio.

Not wishing to blow my own trumpet, wouldn't it be better to go to a Soft Tissue Therapist, or a physio who can test, prod, poke, feel and understand what is going on with your injured limb/shoulder and see how the compensation patterns are distributing across the body, rather than dosing it up with excessive pain killers.
Yes, it costs money.
Yes, it may take time. But it will take an hour of your time. It won't take months of waiting, not knowing what is going on, and constant pain when you try to run.

If you get injured, get it seen to. Go to a GP if you wish, but I'd rather not waste their or my time.

GPs are great for some things. If I have a stomach upset, viral infection, or another issue that can be solved with drugs, or if something has happened that I don't understand with my digestive system etc. that is the place I will go. They are stressed people, and they should be given respect. They do a lot of things that I, and many other people cannot do.
I'm just saying that when it comes to sporting injuries, there are better places to go and get understanding of what is happening. If the therapist is not able to help, or recognises that you need a scan or to see a doctor, they will send you straight there.

At the end of the day, its your body, decide what it is worth to you. If it isn't worth much, don't waste your money on it. If it is, I'd suggest spending all you can on it. You only get one. Maintain it.

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