How well does the NHS look after runners? - Health + Injury

Tom Goom

04/04/2012 at 16:44

Hi,
I'm a Physio in the NHS and privately. I'm also a runner. Being on the forum a while has me wondering, does the NHS do enough to look after runners? I'm trying to persuade my NHS team that we need to develop a service for runners and so would appreciate any views, stories and feedback of your experience in the NHS and particularly relating to physiotherapy.
Did you get seen quickly enough? Was the GP reluctant to refer you to Physio?
Did the doctor or Physio seem knowledgeable when it came to running?
Overall did it help?
Do you feel the most likely thing the NHS will do is just say "stop running" and offer little alternative?
Did they advise you on techniques you could use? Stretches, taping self massage etc.
Did they help you plan a graded return to running or advice on strategies to reduce pain when running?

Any views very gratefully received, positive or negative.

Many thanks

Tom

Ian M

04/04/2012 at 16:50

Do you feel the most likely thing the NHS will do is just say "stop running" and offer little alternative?

Is my gut reaction, which is why I've never tried the NHS for sport related injuries.

Stuff like this on their websites doesn't help though

You should always land on your heels and push through on to your toes

http://www.nhs.uk/Livewell/c25k/Pages/C25K-tips-for-new-runners.aspx

Jiminey

04/04/2012 at 16:54

I know my boyfriend recently booked an appointment with his GP when he saw her she looked kind of perplexed that he had gone in because he was suffering knee pain, couldn't offer any help then said she would refer him to a physio. He hasn't yet heard anything and that was over three weeks ago. My Dad also found the same thing, there was over a months waiting list to see an NHS referred physio but when he went privately he had an appointment the next week.

Albertooo

04/04/2012 at 16:57

This is something I've also thought about.

As I understand it, there is a huge financial incentive for the government to emphasise preventing illness and disease by promoting healthy lifestyle choices. But I personally feel that the apparent implication of this -- that there should be tailored support for people who are pursuing healthy activities such as running -- is being ignored.

People shouldn't have to pay to see specialist physios to deal with running-related injuries/problems.

When I've been to my GP with running-related pains (2 occasions) her attitude has been pretty much: "Well if you will go running around like some loony you're going to end up hurting yourself". I have to say though that the "physio direct" phone service she's referred me to has been very good for a phone-based service, and their advice on stretches has been very helpful.

I do wonder, though, whether if I had something more serious than a bit of bursitis or shin splints I'd get any proper help with rehabilitation/prevention from the NHS.

Peter Collins

04/04/2012 at 16:57

Hi Tom. I've spent two years trying to persuade doctors that the pain I get in my upper thigh isn't simply a pulled muscle. A lot of visits, signings off and two MRI scans later, they've finally told me it's ischial tuberosity bursits, i've had a cortisone injection and have been put on antiinflammatories. I love the NHS and deplore private medicine, but I all too often get the feeling that any sports-related injuries are seen as somehow not worthy of spending resources on. If you ever do get physio, and you may have to wait a while, it's of necessity (they have lots and lots of people to deal with) not the most personal service. I would also say, however, that I saw three different private physios in that time and not one had any clue what it was either. I've eventually found a very good musculo-skeletal specialist in a hospital round the corner from me - this after being sent to a clinic much further away who seemed convinced it was a hip problem (it isn't). I DID get advice from all quarters on stretching, and that did help. I have never been offered advice by anyone on graded returns to running or on strategies to reduce pain when running.

Badly Drawn Bloke

04/04/2012 at 17:16

I saw a doctor at my GPs surgery when I had a reccurance of a thigh strain that initially took months to recover. Luckily, this guy also had a degree in sports science so was sympathetic, examined me, sent me for x-rays and referred me for physio which was local. I had 4 or 5 sessions where they assessed me and get me stretches and exercises some of which I still do and I have had a re-reoccurance. From referral to seeing the physio was probably a month so not too bad really.

The centre I went we're treating all sorts. I saw babes in arms and Octogenarians in the waiting room. I'm obviously lucky to have access to a decent PCT and I hope that this service can continue.

postie postie

04/04/2012 at 17:23

I live in Oxford

My GP, who runs a bit and pirates a bit, refered me to the sports clinic at the Nuffield, They were fab and understand about running.
If the service you're getting is no good, move to Oxford.

Edited: 04/04/2012 at 17:24

Gloryboy

04/04/2012 at 17:28

i recently had 3 month course of chemotherapy. both my surgeon and oncologist were runners and we often spent more of my appointments discussing races we had done than actually talking about my illness! however the only advice relating to my running during treatment was 'not to' and once they were happy for me to return to running the advice consisted of 'take things easy' and 'you'll be back to full fitness 6 months from now'. I'm not a great one for listening to advice anyway but my fitness was often given as a reason why my recovery would be expected to be full and speedy. My desire to get back running asap and wish to get my fitness back to marathon & half marathon levels was also known to everyone, it would have been great if this could have been incorporated into a recovery plan.

Joolska

04/04/2012 at 17:31

I've never bothered with NHS treatment for injuries because anecdotally the response is slow (when I'm injured I want to be fixed NOW!) and because I'm in the fortunate position of being able to self-fund private treatment. I guess the difficulty is that the financially-stretched NHS has to focus on life-threatening conditions and, frustrating as ITBS/shin-splints can be, they're simply never going to be the priority. But it does make running a rather middle-income occupation the minute you get injured, which seems unfair.

Jeepers

04/04/2012 at 18:06

In my experience, I've never come across a GP with sufficient knowledge to be able advise appropriately. My main complaints would be:

lack of appropriate knowledge (but fair enough, sports injuries are quite specialised and GPs are generalists rather than specialists)
hence
lack of appropriate referral (the only NHS physio I saw didn't know what to do)
slow response for appropriate treatment
lack of understanding of psychological impact of not being able to run

But as Joolska says, emphasis in the NHS is on chronic / life-threatening illness, not "minor running injuries" so with the cutbacks, I can't see how they could afford it.

Maybe in an ideal world. . .

seren nos

pirate

04/04/2012 at 19:02

i delayed going to the GP when i had my Achilles problem because people would say there was a very long waiting list.....delayed it for a month whilst i rested and say a sports guy who wanted me to get orthotics......

finally went to the gp and although he knew nothing of running referred me to a physio straight away and i was seen locally within 3 weeks....was seen every few weeks for a few months and after 3/4 months off finally returned to running and cycling and fitness did return quickly.....

went again a year or so later with knee problems.....had a quick appointment and was given advice and exercises and as they knew i would do them i was left to go away with them and just return if it didn't improve

so no complaints here.....

Muttley

04/04/2012 at 19:34

My GP is a runner and on the rare occasions I go to see him we spend more time nattering about events than my ailment. But I've never gone to him with a running injury, pretty much for the reasons that Joolska gives. I too am fortunate in that I can afford to see a private sports physio if needed.

Yes, it does irk me that the NHS seems to be more attentive to chips-munching diabetes-ridden morbidly obese chain-smoking porkers than to those who take some responsibility for their health and wellbeing (I probably exaggerate a bit here for effect), but the diseases the porker sofa potatoes suffer are more dangerous than those I am likely to present with. In an ideal world it would be different but hey ho.

All in all, I won't complain about the NHS. I think it's a truly wonderful invention.

Pipes

04/04/2012 at 20:14

I second Postie Postie about the NHS sports clinic at Nuffield.

I'd had hip pain for 2 months and had seen a private physio/ backed off training. I went to my local doctor, expecting him to tell me to keep doing those things, but he took my problem seriously straight away. I had an x-ray the same day and appointment in the Nuffield within a month. My MRI was a month after that and, although I moaned and groaned about delays, I was happy enough to get surgery (for hip impingement) a year after I first went to the doctor. I also had physio sessions while waiting for surgery and have now been put straight back into the system for the other hip, without needing to go back to the doctor.

So no complaints here...although I know that not everyone with my problem has been treated as well as I have (bit of a postcode lottery - some PCTs aren't offering the surgery on NHS).

Stephen E Forde

04/04/2012 at 20:26

I don't really expect my doctor to be an expert on running injuries. He is a GP after all.

His job is to deal with medicine in well a general way, and then refer me to a specialist if they cant help.

Thats as true of running injuries, a broken foot or cancer

I would go to a sports injuries specialist if I felt everything was going pearshaped.

If I went to my doctor and he knew about taping muscles to aid blood flow during races, I would think he was wasting his time.

Slowkoala

04/04/2012 at 21:41

Had to see a GP twice last year before getting referred to physio last year with knee problems. The first time I was just given a leaflet with knee exercises which was a standard one that they give to elderly patients (I am 40!) Luckily I didn't have to wait 3 months for the physio as have insurance through work. Otherwise something that could have been sorted by a physio in 6 weeks or so would have taken more like 7 months (from seeing the GP twice and resting each time for 3 weeks as instructed to waiting and getting physio).

Does annoy me that there are obese people out there being prescribed free swimming, free exercise classes, etc. The NHS should offer more to people who want to stay fit and healthy.

Tom Goom

04/04/2012 at 23:07

Thank you for your messages, really good to hear people's views.

It seems a mixed experience for people, some positive and some negative.
I agree too that it is frustrating that runners, who as a group take great care of themselves, seem to be offered less support than others who maybe don't.

I see a huge variety of patients, some who need help to walk, others who get pain 18 miles into a marathon. Both are surely equally entitled to treatment even though their needs are very different. Unfortunately the NHS budget is such that at the mo, if you're healthy enough to run your needs are rarely seen as a priority.

Wilkie

05/04/2012 at 09:24

I've never tried going to my GP with running-related problems, I've assumed that the advice will be "stop running".

As others have said, I'm in a position to pay for the (fortunately rare) treatment that I've needed, but maybe I will try my GP next time!

Nam

05/04/2012 at 10:03

I've given up with my GP for anything more complex than asking for the pill.

- biomechanics knowledge is zilch
- interest to treat or prioritise is zilch (usual 'stop what you're doing and the problem goes away' routine)
- when I asked to be referred (once for podiatry, once for physio) - a bored response with a reply of "waiting list of 3 months plus"

Needless to say it's near impossible to get an appointment with the GP in the first place... You have to ring before 8am with places allocated on a first come first served basis, so it's constantly engaged from 7am onwards...

Of course the surgery is rammed with patients with preventable chronic illnesses, and some interest in 'prevention' and 'wellbeing' wouldn't go amiss, but I guess there isn't the capacity.

Pay private and you can often see someone the next day.

Jeepers

05/04/2012 at 11:55

Nam wrote (see)

Pay private and you can often see someone the next day.

And when it's a referral, it's often the same person that you would have to wait months to see on the NHS.

Screamapillar

05/04/2012 at 12:13

My GP is pretty good but she seems fixated on the fact that I'm A 46 year old female and is always trying to link any condition I have to my age without knowing the first thing about my lifestyle - she has never even asked apart from the usual drinking/smoking questions. If I told her I was running the VLM in a couple of weeks she would fall off her chair.

I would no more go to her with a running injury that I would my local vet.