what-do-you-do-when-nobody-can-diagnose-your-injury

18 months later no further forward

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07/08/2013 at 16:56

Hi all,

I am looking for some general advice / guidance here, not injury specific

I have had a pain in my quad for more than 18 months (Pain builds up after a few runs) and I have been to see 5 x physio's, 3 x different doctors , 1 x chiro, 1 x acupuncture guy, 3 x orthotics / podiatrists. I have had X Rays, MRI's, ultrasound, ESWT, Graston, ART, Dry needling, herbal med's, orthotics blah blah blah.

 

Every person I see without fail feels says "this is a nothing injury, do this and you will be back running in such and such a time"

 

The fact is they are wrong, all of them everytime.

 

I had only been running for 2 years up until this point and I guess I go the bug for it. After many years of being overweight, anxious and unhappy I had finally found something that fixed everything that is until I got injured.

 

What I would like some advise on is what do you do when this happens, surely this cant be the end of my running, I am only 35!!

 

What would you do, what do you do when you cant find anybody who can help or even listen to you when you turn up at their office!

 

Long shot I know but hopefully somebody can offer me some solid general advice and guidance.

 

Cheers

 

John

 

 

07/08/2013 at 17:02

where exactly is the pain, and what is it like?

07/08/2013 at 17:19

Hi Maxs Mum,

 

The pain is never awful, max 7/10 if I just keep running (it would get worse i am sure if i kept running) but generally lower on the pain scale.

 

Pain is just dull, on upper quad. If I dont run for a while it disappears entirely (8-10 weeks later) I have recently noticed that I cant feel ice pack on it as much on one side as the other so there is some reduction in sensitivity.

 

I'm not looking for a diagnosis as such , more like advice on what you would do in this situation.  I have seen so many different doctors / professionals that I am at a loss as to where to go now - nothing has worked.  Would you start the process again and visit a GP, or see a different specialist?  Is there somewhere that exists where they could do various diagnostic tests and advise me under the one roof so to speak?

08/08/2013 at 01:20

Am I right in thinking it is just in one quad/leg.


If so, working out why that is might be the best thing - both legs have run the same miles, so why is one suffering sooo much more?

Can't be the running - the other leg is fine - that leg can cope with the running mileage.

There is an imbalance somewhere.

There is something is your life - probably completely unrelated to running that is stressing one leg more than the other.

Like when Man U finally got to the root cause of Giggs's persistent left hamstring problems – the overly stiff clutch on his new Ferrari.

Most people’s jobs, or something else in their lifestyle, involve an unbalanced use of their muscles.

Usually this doesn’t matter – until that person starts over-stressing all those muscles with, for e.g., distance running.

I once treated a runner, whose one sided injuries we put down to the fact that he spent most of his working day kneeling – on one knee – and always the same knee - for years. This resulted in a (relatively) chronically shortened hip flexor and calf on the on the non-kneeling knee.

If you find there might be something like that out there – that might be the start to getting to the route of the problem.

 

I could be wrong though…

Edited: 08/08/2013 at 01:23
08/08/2013 at 08:47

Pain dull. But not sharp!

Classic repair machanism of a previously injured muscle. 

The area of injury was probably small, but not resolved. Scar tissue has formed around the site of injury and is now getting in the way. 

Areas around the scar tissue become strained due to it's lack of flexibility and multi directional make up.

The solution is to break up the scar tissue. 

08/08/2013 at 10:20

Hi Waylon Smithers

 

The imbalance thing is something that I would like to rule out, my sore leg is my dominant leg however the quad measures 1/2" less than the uninjured leg.  One physio told me to strengthen up the weak side but everytime I done any exercises to strengthen my quad it became sore just like it would do If i had started back running.

How can I strenghthen without doing anything to hurt it! I suspect my glutes are very weak too, I have no arse after losing about 4 stones!

 

 

08/08/2013 at 10:31

RICF,

 

My current treatment is to treat the scar tissue (break it up) I dont feel the sore quad much different from the other one but my physio says he can feel it.

 

He gave me about 6-7 treatments of ESWT (shockwave treatment) and said it was all cleared up and to start running again, I did and low and behold it came back after about 12 runs. When I went back with the pain he was surprised, he said he could feel the scar tissue had reappeared again.  

Now I am having another course of the same thing, he said this time he will give me more than the last time as he is concerened it wasnt fully away the last time.

I am also extremely cynical about ESWT being able to break up scar tissue, my brother in law is a doctor said I am being fleeced that there is absolutely no way this treatment can break it up, Searching on the web there is very little evidence that it does anything, seems like witch doctor medicine to me.

 

I am so desperate I will try anything so I just do as I am told!

 

I was in the USA recently and went to see a Chiro who gave me two courses of ART & Graston, the ART didnt feel like it was doing anything and the Graston was ridiculously painful. This guy said scar tissue was my problem too, infact he wrote these articles which I thought sounded very like my problem and this the reason that I went to see him.

 

http://www.activerecoveryboston.com/links_articles_scar_tissue_art.html

http://www.activerecoveryboston.com/links_articles_scar_tissue_art.html

 

the second article described my issue very well actually 

 

08/08/2013 at 10:33

I had persistent calf muscle problems that physio etc just couldn't get rid of and was considering giving up running, as a last resort I decided to splash out & go to Stride UK near Brighton for a (Gold) bio mechanical assessment. I left armed with a new foam roller & exercises & stretches to rectify imbalances almost everywhere, also shoe recommendations as I wasn't wearing suitable ones, despite a shop assistant selling me some after a treadmill run. I was a little sceptical that I had spent well as it seemed like a simple remedy but I have to say that after a couple of weeks of doing the exercises, I started to run again & it has worked for me. I have had no reoccurrence at all thus far, which is about 3 months later. If you are near the south coast it could be worth a try. ATB!

08/08/2013 at 10:43

Hi Andy X,

 

Thanks for your advice, I have done that too although it was a bit of a joke, the woman couldnt get me out quick enough just prescribed me orthotics and said I would be fine in 6 weeks........i wasnt.  

 

I might need to re-look at that, Thanks

08/08/2013 at 10:51

Interesting to hear that Mabawzargowpin, I was prescribed orthotics at a clinic in London, when I went to Stride Uk I saw videos of me running barefoot, with my orthotics in my shoes & also in shoes without any insoles at all. Strangely enough the (expensive) orthotics prescribed for me were no better for me than standard shoe insoles, despite being much heavier & harder. They are now in the bin!

08/08/2013 at 12:43

Stuff orthotics. They simply jam your feet in a direction that isn't natural. All that does is transfere the forces elsewhere. 

Best thing is a rubberised arch support insole from a running shop.

08/08/2013 at 13:28

How do you break up scar tissue inside a muscle? what is the best way

08/08/2013 at 15:19

The only thing that I have found that is generally accepted is deep massage, beyond that I dont know of anything else. People have scar tissue surgically removed but that causes more scar tissue in the majority of cases. I think removing seems unlikely, i think mobilising and possibly even reshaping is more likely but thats just what I have read.

08/08/2013 at 18:38

I tend to imagine good muscle as having nice straight fibres. Scar tissue I imagine as a lump of gristle buried within.

So the problem is breaking up the scar tissue without wrecking the good muscle.

One way is massage followed by a sustrained stretch of the affected area. By that I mean holding the stretch for as long as 3 minutes.

With 'hands on' , there's a limit to how much you can do before the treatment becomes counter productive.

 

 

08/08/2013 at 22:36

I realise this isn't really an answer to the problem in terms of fixing your injury but just wondering if there is another solution.  (I have a similar pain pattern in my hamstring, physio says scar from previous tear, which I believe as I remember the sharp pain of the tear - 2 years on, with foam rolling etc pain still there but bearable)

 

Can you cycle or swim, row or 'run' on an elliptical without pain.  i.e. could you substitute a couple of your running sessions with another form of cardio that still works your legs (only in a different way) - and then do one run or maybe two a week.  This way, perhaps, you may be able to find a balance where you can get enough runs in to be happy, enough exercise to keep fit, but keep the pain to a minimum.

09/08/2013 at 05:02

Gymaddict,

Cycyling and eliptical hurt my leg also, I cant swim, very frustrating!

09/08/2013 at 11:21

Oh man that is awful.  Sorry to hear that - I can only imagine how frustrating this must be. 

 

Swimming lessons??  Front crawl doesn't engage the quads much and you can get a hell of a workout once you get some decent tecnique going.  I realise a lot of grown men don't like going for lessons but it's amazing how quickly you come on once you get a good teacher.

09/08/2013 at 12:16

As a grown man who didnt like the idea of swimming lessons i would have to agree with Gymaddict.  Had injured my knees a few months ago but didnt want to scrap the training completely as i had been enjoying it.  After much badgering finally plucked up the courage for some 1 to 1 lessons and went from 10m at a push to my current best of 50m in around 3 weeks.

I know this doesnt necessarily answer your initial point but i do find my knees prefer it when i can swap a run for a swim

09/08/2013 at 13:22

All I can say is persevere with badgering the doctors etc - there has to be a solution/diagnosis.  Unfortunately in today's NHS it seems like the person who shouts the loudest gets what they need.......How I wish I could afford Bupa!!!!!!!

09/08/2013 at 18:37

Hi Beth,

 

A point that I left out of my initial post just so that I could keep it simple is tha fac that I am currently living in the UAE. There is no NHS so on the upside I Can go see whoever I want as long as I pay them, the downside is thay I have become a victim of private medicine. Evert person I see treats me me the only way they know how, so the orthotics guy gives me orthotics, the chiro cracks my back, the physio uses whatever equipment he can charge the most money for and so on.  

 

I have came back to the UK once already to see a specialst who didnt help, I have seen somoene in the USA recently and I am probably going to have to come back again in October if the current treatment of ESWT doesnt work out (it didnt the first course)  I cannot afford it but what else do I do, be a fat depressed whinger again!!!!

 

I would love to go somewhere that had every specialty under one roof, and for once they listened to me, even I had to pay a small fortune it would be cheaper than seeing dozens of different people who dont help.

 

God I am so frustrated...

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