Tuesday, 23 September 2014

Why your Doctor Google self-diagnosis is wrong….

Working within the health industry you would think I would have known better. I have always been an advocate for listening to your body and reading the signs it’s telling you.  The body is truly an amazing thing and it does often give hints to let you know what needs some attention. To ignore these warning signs can lead to disappointment, including injuries and time away from what you love doing.

The body will tell you that you’re dehydrated by giving you a headache, it will tell you that you’re cold by making you shiver, it will even manifest pain in areas that are injured and require some attention, whether that be rest, rehab, taping, Myotherapy or stretching etc.

Last year I ran my third marathonyes I’m crazy, I run 42.2km for fun and I’ve done it more than once so lock me up, I’m a looney!! During my training for this event it was the first time running caused a debilitating injury for me.  I made some very common mistakes that I see every day in the clinic and the result was a forced 5months off running.  As I said earlier I should have known better.

Now I’m the first to tell anyone one that running hurts, you’re short of breath and the body pulls out every trick to try and make you stop.  There is always a little niggle here and some tightness there that reminds you that you’re running and then you start to questions WHY you are doing such a silly activity. Now there is a big difference between these sensations and pain.  Pain is a warning sign! It’s your body’s way of telling you, that something isn’t right. I ran through pain while training for this marathon. Why?? Well given my background of three years at University I self-diagnosed my symptoms to be classic plantar fasciitis. I had seen it a million times on my treatment table, how could it be anything different?

There was more pain upon waking in the mornings and it was present in my heal region. I have flat feet that pronate (roll in) and I would limb after prolonged periods of standing or sitting.  It was extremely painful to weight bear on the area and even worse after exercise.  Plus my painful area was in my plantar fascia muscle.  So I ran through it, call it the plumbers shoddy pipes or the builders unfinished home self-renovation.  I knew this “self-diagnosed planta fasciitis” was only going to get better with complete rest and I could do that after the marathon. So I pushed through.

I would run week in, week out clocking up the kms all the while the foot kept deteriorating, even though I was self-treating. This self-treatment included icing the area, self-massaging through my calf (gastrocnemius and soleus) and always making sure I was wearing correct supportive footwear. Anyone who has ran a marathon knows that they are mentally challenging and once you’ve run one you know what’s required for the next. In short it’s what you put in before the start line that dictates how your race will pan out on the day. So I was mentally aware my foot hurt and would continue to cause me grief until I decreased my running.

I ran my marathon, finished and clocked a PB but ran the whole distance in pain. Ecstatic and caught up in the hype of completing such an achievement I continued to run.  I was on a runners high, but still had a sore foot. Decreasing the amount of runs and kms I was doing had made no difference. I was still hobbling around like a 90 year old grandma that had misplace her walking frame.  Time to get a second opinion…

Heading to a local podiatrists describing my symptoms and being examinated he too came to the same conclusion as me, plantar fasciitis. He sent me off for an ultrasound to see how bad it was. How much extra damage had I caused myself by not stopping running? In the meantime we upgraded my orthotics and he advised me to keep running as normal. So with this green light I did, albeit decreased distance and frequency but still in pain!

Results day…  On reading my results I was shocked to find out that in fact didn’t have planta fasciitis but a very rare condition called fibromatosisWhat is this? It’s when a fibrous growth develops that results from repetitive microtrauma and overuse. It leads to chronic inflammation with the development of adhesions in muscle fibers and the fascia. The more stress that area experiences the more fibrous growth is laid down. My ultrasound showed the fibromatosis to be 14mm long by 6mm wide by 4mm deep, significantly big in comparison to the space available in your foot.  Treatment is immediate rest, trial of steroid and local anaesthetic to the area and possible surgery. The foot is a complex structure with many nerve endings, which would make surgery very difficult and possibly not solve anything. Also the steroid injection could also flare the fibromatosis as well. I opted not to head down either of these paths.

My treatment plan consisted of numerous taping trials before we decided a doughnut pad, attached to my orthotic, around the effect area was best action to stop the day to day load bearing. My first rehabilitation goal was to get through a day pain free.  To achieve thisnot only was my orthotic adjusted but I completely stopped running and iced like a mad woman. How long did this take? Not two weeks, not one month or two but five long (running free) months…..  

I couldn’t believe it took five months for me to have one pain free day, talk about frustrating! During these months of not being able to run I was encourage to try cycling by my boyfriend and it did help short term but it all came to an abrupt stop. A leisurely mountain bike ride turned into an emergency room trip with a couple of broken ribs, numerous grazes and a hematoma the size of a Sherrin footy on my thigh (but that’s another blog).  So I could now add not being able to cycling, swim or in fact do anything physical, including walking the dog, while all my war wounds healed.

I’d gone from being a long distance social runner, too craving being able to just run 5kms! After my first pain free day I gave it another 2 pain free weeks before pulling the joggers on. I still remember that run the breathlessness, the freedom and the endorphins.  On finishing the run the foot was soreWould I ever be able to run again? The symptoms were back but not to the same extent, so after another two weeks rest I again tried my hand at running.  It was very much a slowlyslowly approach back into running. I now have such a greater appreciation of the frustration clients feel while they are recovering from injuries. For the next three months I only ran once a week anymore and the foot would flare. It is only now over 12months since symptoms first appeared that I am running more than once a week.

What have I learned from all of this? No matter what your background is DO NOT self-diagnose. Getting a second opinion and reading the warning signs that your body is screaming at you can save a lot of heartache down the track. Every day I have patients that come in and ‘doctor google’ has given them a prognosis and I can tell you now that the majority of these clients have it wrong.  We live in an age where resources are at our fingertips but this information caneasily be misused and presented incorrectly.  My advice is seek guidance and information from your local experts within that fieldas its money well spent and their advice is directed particularly at your condition and circumstances.


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