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How well does the NHS look after runners?
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I like your ideas of a specialist service, that'd be amazing. Walk in, see a Physio get an assessment from someone who just sees runners day in day out. Maybe include gait analysis and input from podiatry, sports massage therapists and running coaches....
....sadly I can't see the NHS spending the money required to create and maintain this!
That said we are trying! We've just started using some slow mo gait analysis in our NHS clinic but we can't offer a walk in clinic yet...maybe in future.
Tom
I think the NHS should employ a few of us! It seems even with our basic or non expert experience borne knowlegde we know far more then the GPs do, even really basic stuff and the more threads I read where someone has gone to a GP who hasn't helped for various really simple problems the more it just shocks me.
Maybe we should set up our own consultancy group- never worry about the lack of a pension again!
ten weeks on and I've still no idea what's wrong with my leg and am getting no answers.
That's really bad.
I'd be happy to help if I can, feel free to send me a private message with some details of what's happened and I can see if there is anything I can suggest to help.
Tom
I think it can depend on the actual HCP you see, and what they deal with as well.
Take this week for example. I went to GP on Mon with a swollen ankle and a bit sore/tender. Despite saying I was a runner, I was just given NSAID's and sent on my way without any examination.
I then had a very good experience on Tuesday after having a severe reaction to said NSAID's. The radiographer taking my x-rays is a runner, so took an extra shot to be certain that if there was a break it would be spotted, as in his words, he understood how vital our feet/legs are for us runners.
I then had a 'medical' cons review the x-rays and not find anything. I was encouraged by a third party, to get a second opinion from a bone doctor who straight away spotted a break, but because its very stable it was missed.
I do think there should be far more oppotunity to see a GP with some sports experience. Surely it would save the NHS money in the long run? If my break had not been spotted, it could have had a dramatic impact on me, requiring surgery, physio, hosp stays.... Instead of just a boot and crutches.
I hope the NHS treat runners better then they do footballers.
When I broke my foot I was just given the rolled eyes treatment and told it was too swollen to x-ray. I was also advised not to play football.
On my next vistit, the consultant just told me to rest for a couple of weeks which was nowhere near long enough.
I know sports injuries are self-inflicted and are a drain on the NHS resources but surely the obesity problem is a greater concern in this country. With the attitude of virtually every doctor I've spoken to, it's no wonder people are scared play competitive sport.
I've not yet had a serious running injury that has required immediate hospital treatment. Any niggles, sprains or more chronic problems I've had were treated by a physio. I appreciate that I am lucky enough to be able to go private (although it only cost £15 for a 20 minute session).
I honestly wouldn't bother the NHS with anything that was not an emergency.
Hmm. I'm currently in the serious running injury phrase, and you definitely get more attention. The doctor at the first hospital did misdiagnose me (and to be honest did seem to be a bit dismissive of runners, it was all "hey ho another marathon casualty") but it didn't really have an impact. I've since been referred to another hospital for ongoing care with the fracture clinic and it's much better: x-rays immediately, second opinions, prompt MRI. I think I've also been lucky in that my consultant, if not a runner himself, definitely gets it.
People keep warning me though that it will all change when I get to the physio stage. It seems to just be an accepted thing that if you might need physio than you should have sorted yourself out with private medical insurance.
First of all, great thread!
I was diagnosed with ITBS in 2007 whilst training for my first London Marathon, I have since seen (all private) Physio's, Podiatrists, Chiropractors, Acupunture, Osteopath's. My physio recommended having an MRI I couldn't afford to pay for one privately so this is when she wrote a letter to my GP and refered me back to him, he agreed that I should go for an MRI due to the severity of my ITBS as I would swell up and become very sore oftern just through walking any more than a mile so this impacted my day to day living including work and sleep.
After an approximate wait of 20 weeks for an MRI scan and under remcommendation of my GP to not run at all when I went for my MRI it didnt show a whole a lot other than there was no other damage to my knee. My GP then sent me off to have a cortisone injection in the day surgery clinic at hospital, after a couple of weeks rest I tried running again (taking it really easy) but after a mile or so the dreaded pain on the outside of my knee was back again. On my follow up appointment at the hospital with the specialist he gave me a second cortisone injection but said if this doesnt work he doesn't know what else to do and of course the second injection didnt work at all. He then sent me off to see a "pain management specialist" whose advice was to stop doing the things that make it hurt! - Most helpful!!
I've seen what they have done with Rugby player, basically "You can walk, so you will be ok!"
That's why people go for private healthcare. The NHS is over worked and most of the work force is under paid
A year ago I had a metatarsal stress fracture - typical presentation except complicated by the concurrent extensor tendonis. Classic response to pressure test. GP scraped me off the ceiling, told me to wear a stiff-soled shoe and sent me for radiography. Nothing visible on that (as is common). Six weeks rest later, trying to run again, still painful (due to tendonitis). Frustrated. Saw different GP who said (a) I hadn't had a stress fracture, because the x-ray hadn't shown it (I pointed out that they often don't, in the first couple of days. Ah! he said, well, okay but...); (b) no, he wouldn't send me for another x-ray to check it had healed before I went for (private) physio, because (a) I hadn't had a stress fracture; (b) I just needed to wear orthotics, like he did, and I'd be fine! Told me he wouldn't even consider doing anything else until I'd gone out and bought the OTC orthotics he recommended and tried those for several weeks. Went to see (private) physio, then, grasping letter from physio requesting radiography, I managed to see a third GP in the same practice who agreed to send me for the radiograph to confirm that the physio wasn't about to manipulate an unhealed fracture. Radiographer and I look at the radiograph on screen (I'm a vet) and both clearly see, on the oblique view, periosteal reaction over the affected metatarsal - which hadn't been there six weeks earlier (we'd looked at that one as well). So, stress fracture, healed, confirmed. Telephone GP 10 days later to be told GP reports radiograph shows NAD (no abnormality detected). This turns out to be GP's interpretation of radiologist's findings of "no acute bony injury detected" - Chinese whispers. If the radiologist had bothered to look at both sets of radiographs, the difference would have been obvious, but presumably too busy to do that or nobody thought to mention earlier radiographs... Physio and I are happy that stress fracture has healed, and go on to treat extensor tendonitis. Run 50K 12 months after stress fracture occurred.
Now I don't bother the GPs, just go to physio - although I'm lucky in (a) having medical knowledge; (b) having enough money saved that I can go to a physio; (c) having doctors in the family with whom I can discuss things,such as sensible levels of NSAIDs. Will have to go back to GP when I next run out of diclofenac...
I realise the GPs are busy and under a lot of pressure, but a sports clinic that was affordable and accesible, staffed by people who treat runners as athletes who want to keep running, and don't just prescribe several weeks of rest as a first resort, would be wonderful!
I ruptured my tib post tendon and went to my GP. Firstly it was diagnosed as an ankle fracture, necessitating an xray, after weeks of waiting (if it had been a fracture, it would have healed by the time I'd got to the xray). No fracture showed up on the xray, so back to GP's surgery where different GP diagnosed it as DVT. I wasn't convinced, so discussed DVT with someone I knew who was a nurse - she didn't think that it was DVT either. Finally got to see own GP who immediately diagnosed ruptured tib post tendon, admitted that it was beyond his capabilities and sent me to specialist physio / biomechanical / pod place where diagnosis was made almost as I walked through the door. Foot was strapped and I was put on crutches immediately, followed by appointment with foot specialist, scans and eventual surgery and rehab, but all paid for privately as not available on NHS and I didn't have private medical cover.
The difference in attitude between the GP's surgery and the specialists was marked, similar to that mentioned by Debra above - OK, I was paying for the specialist pre and post-op treatment, but the people treating me were all active sports bods, so understood the frustrations of being injured.
I do think too, that in some cases,where the injury is prolonged, severe or undiagnosed, the NHS fails to consider the psychological impact that a sudden cessation in training can have on an individual. I'm not saying that they should offer counselling, but just something to be considered - blithely announcing that "You won't be doing any more marathons with that injury" isn't the best way of handing the situation.
I think part of this is basic bed side manner and respect. It's hard to think of another injury or illness where it would be acceptable to be so glib. Imagine if the doctor went "hey ho, no more cake" every time they diagnosed someone with Type 2 diabetes.
It's a shame some people are so reluctant to treat runners. It might be geeky but I really enjoy treating runners. You know that there are lots of things you can do to help and that runners will do their rehab. So many other patients ignore your recommendations then wonder why they aren't better. In my experience if you choose the right treatments runners usually do really well.
" if you choose the right treatments runners usually do really well. " That's because we really want to get back to running asap so we'll do the exercises etc. - anything, even short-term no running, so long as we have some confidence that this WILL help us get back to running sooner rather than later - and preferably in time for our next race!
I DO understand that GPs are (a) limited for time; (b) under huge funding pressures - therefore reluctance to refer for further investigation/treatment if not necessary; (c) are not sports injury specialists. The quickest, easiest thing for the overworked GP is to say "rest, take some ibuprofen and come back in 2-3/3-4/4-6 weeks time if it's not better". And of course in non-athletes that would work, probably 90% of the time. And it's difficult for the GP to distinguish, in a 10-minute consultation, between the runner with a genuine problem (who has already tried the two weeks of RICE and ibuprofen, which hasn't worked, which is why they've come asking for help) and a Marvin ("I've got this terrible pain in all the diodes down my left side...")
I was fairly lucky in that the GP I saw when private physio and cutting down on the running hadn't fixed my dicky hip didn't tell me to go private or send me away with a flea in my ear, but got me a referral within the month to the sports clinic at the Nuffield (Oxford). The doctors there promptly told me I had weak glutes and sent me off to the physio - who was a runner, and identified that the glute exercises I had been doing were not actually activating the right muscles - he found me a variation that did.
As the return visits multiplied and the nice physio's smile started to wilt, I got given an anaesthetic injection into the hip which confirmed that the problem was in the joint itself. Then they seemed to forget about me a bit but luckily I had Benenden and they paid for a consultant appointment. He said he could refer me for an MRI on the NHS but by then I was a little wary of the meaning of "soon" and opted to go private for it as I had some cover for the cost of that.
By the way, I would at no point like to change places with the overweight folks with Type II. You're often talking about people whose diabetes and weight struggles are complicated by age, osteoarthritis, and difficult personal circumstances (I remember one lady at slimming club who was working all day, visiting people in hospital all evening, was constantly exhausted, had very little time to shop and cook and sod-all money... for example). From what I hear "hey ho, no more cake" is not that far from the brusque and dismissive remarks some doctors make, sadly... which is really going to encourage stressed, ill people who are already very sensitive about their weight to seek help, not.
Went to my local NHS physio drop-in recently with a torn muscle in my left quad, they said it was non-urgent and I was put on a five month waiting list!
5 months is good! I had back pain lasting two years, finally got to see a specialist (rhumatoid doctor) last year in September, can't recall exactly when I saw the GP about it. After that appointment the following appointment was given for 6 months later to talk about the scan I was getting later that week, results being ready same day it was done.
I managed to get the appointment pulled forward, (begged pleaded and begged some more, took 2 months off the next 6 month wait) I was told the scan (an MRI) was all fine yet when I asked to see the scan myself or get a second opinion (being that the last MRI scan I had on my leg from the same hospital was said to be fine, yet when the doctor actually looked at it it was anything but). I was told no second opinion and the back pain wasn't their problem.
I have read so many of your posts above and its really helped me see its not aimed at me- its all of us. Its painful to read. We all know running takes its toll because it does to many extents push us to an extreme. If we have an injury thats not picked up and we are told we are fine, we are more likely to bite our tongues and carry on, very easily making things much worse, creating problems that could easily have been avoided. Even if you fight for more help and do the research, being listened to is neigh impossible with many Doctors!
Are they asking to be sued? Do the NHS doctors have an NHS death wish? (Maybe they are secretly all employed by private health care companies and are using nasty tactics to bring down the compeitition!)