Sunday, 16 November 2014

The NHS is not for runners

It's humiliating to almost breaking down in tears in a hospital reception. Your voice starts to waver, your breath shortens and you desperately try to keep your composure, as you look into the receptionist's eye and try to explain your situation. You both know that you are finding the situation so frustrating and feel so powerless, that there's no other outlet for you other than to cry. Having been in this situation twice in the past week, I have come to the conclusion that the NHS is not for runners. 

I have been injured for over five months and I am amazed by how hard it is to solve if you rely in the NHS. I've been injured before, mainly ITB and a few niggles. A bit of internet research and a couple of strength exercises later though and I have managed the injury, reducing training slightly until I have built sufficient strength in the deficient muscles and continued on my way. What I assumed was a niggle in June just hasn't healed. I spoke to a couple of physio friends, but the exercises they suggested had no impact, even when I significantly reduced the mileage and eventually stopped running, so it was apparent that I needed to have a full assessment. 

Before the injury I was the fittest, fastest and strongest I had ever been, so it was incredibly frustrating, but it was only the begining of the Mudstacle League, with the majority of the the main races happening in the Autumn and my main goal for the next year - The Marathon de Sable was not until April.

Ordinarily I would have paid for a physio, but having taken the year off unfunded to launch zipcube, and already paid for two already without a clear direction on what to do from either, I did not really have many options other than the NHS. I could get an appointment with my GP, knowing that I would describe my injury and she would then refer me to a physio once the injury was six weeks old. So instead to save time I sent off the referral form directly; it had been about 6 weeks by then anyway and I didn't want to waste the GP's time needlessly. Then I waited.

It takes approximately six weeks to receive an appointment letter for a physio. This is not an appointment, this is six weeks to then be allowed to schedule an appointment. Seven weeks on I called the central physio team and they had somehow not received or had lost my referral. I confirmed the email address with them on the phone, confirmed the date the email was sent, but the scheduling team don't have access to the emails to confirm that the email was received,  I had to apply again. Despite my seven week wait, my referral would not receive higher priority, as my injury was not an emergency. I had not spent a single week without running in some form for the past seven years, sevens weeks without running felt like an eternity, 13 weeks is an entire marathon program, but I had no choice, so I waited ... again.

Some weeks later I received the letter, allowing me to then book an appointment. It was almost November and I knew that unless I could start training in the next few weeks, I will not have time to train for the marathon de sable, let alone compete at a decent level and having not raced for inov-8 OCR since May, missing the entire season, won't be fit in time to compete in the spring league. 

I meet my new physio Matt and he was great. I explain to him my situation and following an assessment he gives me various strengthening exercises and says that given my situation I should book myself in at reception for 3 appointments next week. Finally, some good news and a light at the end of the tunnel. Unfortunately though Matt was transferring to a different hospital and does not have an available appointment until the end of November and that's when I almost broke down. 

The receptionist was embarrassed by the situation, I was embarrassed by my response, so instead I switched physio and went back the following week. Another full assessment, this time with some massage, but no real progress - keep up with the exercises and come back next week. Before I left though he said I could try riding a bike, because he didn't want the muscles to atrophy!

The following week my physio was ill and having taken the morning off work again, I didn't receive a voicemail or a missed call to inform me, so I wasted more time attending and on hearing the news, begged to see anyone the following day, once again almost in tears. Thankfully there was an appointment the next day, so onto NHS physio 3 (number seven in all).

Despite having two sets of notes by now, I had another assessment. She asked me to explain how the injury felt, but 5 months in, the injury is hard to explain. I know it flares up when I train. I know it's still a problem, but it's been so long since I've been running that my leg isn't in a huge amount of pain. So we hit the bike, then the cross trainer in an attempt to flare my injury, but it normally takes several miles for the injury to rear it's ugly head. She therefore asks me to come back next week, but to go for a run first and to keep up the exercises. Another week and no progress. I asked why the first physio hadn't asked me to run before his appointment, rather than waiting 3 weeks to ask me. I explain that if the point of the exercises is to strengthen so that I can run, my 30 seconds of plank requested are now up to 2.5 minutes, my 20 clams are now up to 150, my squats up to 200, lunges up to 100. Just how much stronger do you need me to become before I can run? 

So here I am, over five months in with what seems like a minor niggle, still not running, still unclear of the solution and no end in sight. All I want is the chance to be able to run again and while I realise that there have been some unfortunate circumstances, the system does not work.

A friend had a very unfortunate cycling accident in June and he broke his ribs, his collar bone and was hosptialised with numerous other complications. He's been pumped up with drugs, through rehab and thankfully has been back running for a month. But unless you have a medical emergency even when the system works perfectly, runners have to wait 6 weeks before they can be referred, 6 weeks for the referral to be processed and then another 1-2 weeks to be able to receive an appointment. Assuming you can get an appointment with your GP straight away, that's 13-14 weeks! My NHS physio wanted me to cycle so that my muscles wouldn't atrophy, but the system builds in at least a 13 week period before you can even see a physio. So if you're injured you either waste away or you try and train, often making the problem worse, causing the injury to spread elsewhere. If you have the money you can go private, but what if you can't?

The reality is, if you're a runner and you get injured, there's nothing you can do if you cannot afford to go private. Write off your season, potentially even the next, as the NHS is unfortunately not for runners.

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Tuesday, 7 January 2014

Hell runner down south

Six years on from my first hell runner and the event promised to add a few surprises to their standard 10-12 mile loop and boy they weren't kidding. 

Hell runner was one of the original mass participation mudstacle races and has built up a strong following with thousands of entrants each year, but with the escalation in the number and variety of competitor events, numbers have dropped and it definitely needed a reboot. 

Firstly the organisers moved the date from mid November to the beginning of January, which potentially could have a huge impact on the temperature of the race. Tough guy for example isn't hard because of the obstacles, it's slicing your legs on the ice and repeatedly being submerged in freezing water - the cold will sap you like no hill can.

Thankfully the temperature was fairly mild, but the local area had flooded over Christmas and the previous two days it had been pissing it down turning the car park into a swimming pool. As we lined up at the start I briefed my friend Ross, the potential winner, to go hard for the first two miles as the course is flat (when the sun is shining - fucking hey), but the organiser said the start have a twist.

Ross and I at the start

Loud music and devil chanting done, we were off and a front group was emerging, with Ross positioned at its head. I nestled in behind, taking a while to work my way through the chasers and within half a mile we veered from the track through the woods and through a small pond. We weren't following a path; this was an obvious effort to up the ante, a little bit of a token, but then it didn't stop. Every opportunity to deviate up an extra hill or run off trail beside a path they were taking. The climbs were not that long, but it was proving hard to find a rhythm.

The water had dramatically changed the course. The hills were sandy and therefore the paths were covered in pot holes. Puddles were everywhere, but combined with the potholes, every step could be into an inch of water or a foot. You had to decide how far extra you were prepared to run to avoid the Russian roulette puddles with every stride. The raised middle of the paths were rutted and overgrown, so they were'n't a great alternative and I came a cropper a couple of times, once wiping out down a pot hole, another losing my shoe completely.

By the mid way point I was up to fifth - Joe Dale had stormed past me, having started thirty seconds after the gun (and only came second by less than a second) and I'd switched places with a couple of other runners and that's when it went nuts.

My legs already felt tired from training, I glanced at my watch at five miles and was happy to still be pushing at near to the half way point, but then the hills and terrain moved up a gear. We were running through a forest, searching for the arrows and having to pick a path to get from one to the next, as there was no set route. The hills were getting steeper, doubling back on themselves constantly and at times were really dangerous. I pride myself on my descents, but there were meter drops, slippery leaves on top of sodden topsoil and the odd boulder thrown in. It was hard not to pick up speed, but a huge risk to go too fast, as even trail shoes weren't gripping and you'd unexpectedly need to jump, vault or come to a sudden halt to avoid turning an ankle. They sent us down gulleys or just off the side of a tree covered hill and the next two miles took me almost 20 minutes. You had to concentrate throughout and it felt great; it's so rare to run such challenging terrain, especially down south.

Craziness over, well part conquered, we headed for the bog of doom - a thirty meter bog of neck high rain water, which this year should have been rechristened the ocean of the occult. I had long considered my entrance and was opting for the dive, when I decided to switch for a bomb at the last moment and thank goodness I did, the bog that I bombed into turned out to be a three inch puddle leading up the the bog, I looked a bit foolish, but it possibly saved my life. Second attempt, bombs away, crowd soaked and the long cold swim/walk underway with the baying crowd mocking you all the way. The extra water extended the bog and increased it's depth, my friend Jackie at 3'6" or so had to swim the entire way, but I found myself a nice stick to use as a shepherd's staff.

I was closing in on fourth and by now he was walking large sections of the hills. I was warming up and it spurned me on to push on the hills. Half a mile later and we were met by six blondes, dressed as angels, offering jelly babies to the sound of Eye of the tiger. I hugged and kissed each one in turn to their delight and even got a hug from the medic, before finally hitting some flat trail through the woods, over the sands, picking up forth on the way and running in to the finish to hear the announcer say 'and here comes David Hellard our first vetera .... err, the oldest person to finish the race so far.' His slight awkwardness made me chuckle and it appeared that the veteran prizes had been scrapped this year.

Ahead of me Ross had raced off to build a comfortable lead, before slicing his knee open and cramping as he entered the bog and having to be dragged out by an elite team of SAB divers. Joe had caught up with a runner called flash Gordon, before losing a sprint for the line, but little did they know that a gentleman called Guy Matthews, storming to the finish in 2.39 proclaimed himself the winner upon crossing the line to the approval of the crowd. Stewards enquiry all round.

Sprint finish

So Hell Down South was relaunched and boy have they done a good job. They managed to add 10 minutes to my time without changing the distance. The course was far harder, partly due to the water, but imagine this 3 degrees below, covered in snow; we might have got off lightly. The total ascent of the course is still roughly the same, but the course now deviates from well worn trails to across brush, through woods and slippery, rocky descents. It's unpredictable, it's dangerous (only if you make it so) and it's blooming marvelous.

Well done to trail plus, it was a great event before, but they've upped it from fun race for all, to a course that can challenge even the best of trail runners and reminded us that even though there are plenty of assault course races out there, if you plan a course well, mother nature can be just as cruel. See you next year.

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