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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  1. Agreed, Having worked a while ago now in the NHS and privately as a physio, it makes me damned sad that physios no longer have the time to treat people. You keep fit and save the NHS a fortune and they cannot help you when this happens.

  2. Heartbreaking. My friend had an operation on his shoulder and nearly one year on, he has not recovered. He had the same procedure done on his other shoulder a year before that, it then had to be repeated. After it was done the second time, recovery was quick. However, the whole process is just not right. With sports injuries, there should be regular appointments for rehab, not once a month. Problem also arises, that there are very few top quality specialists, who can properly diagnose what is wrong.
    Hope you are back and running soon.

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