Doctor or Physio?

Started proper training for the DCM last week, figured I was a bit late so did 50 miles, pretty hard, and an all day hike. And for the first time in about 2 years of running I have a pain in my ankle in the past 48 hours. Don't remember any rolling on it, so presume it was just starting off so hard.

This might seem an obvious question, but do people go straight to a physio or to a doctor? I am a bit sceptical about physios (I come from that GAA school in the 80s where things were either rested or run off). Will they not just get me to raise and lower my foot and say it could be tendinitis or it could be a stress fracture or blah blah blah give us €50 and come back again each week for this programme of exercise? Course a doctor might say the exact same thing, but at least they can refer for xrays and they won't be looking for me to return weekly.

Oh and don't want to be a pessimist, but any refund on entries for the DCM?

Slydice

I'd say both because of recent experience I had.

I went to the Physio cos of knee pain after running. He did some work on the leg around the area and asked me to go to a doctor and see about getting an MRI.

I went to the Dr and she referred me for the MRI. Got the MRI results and the doctor gave me literature with advice.

Went to the physio and he gave me exercises he recommended to help the injury. I did the exercises (and still do) and I've been back running ever since.

ecoli

My first port of call is always physio to rule out muscular injuries which can be treated easily enough. After this would proceed for a scan.


There are some physio's who you will find are looking at you as a cash cow and will tell you you need to come back x amount of time but they are all not like that so my advice would be go to someone who is well recommended by people from your sport that have experience treating runners moreso than other sports not because they are more qualified but simply if you have someone treating common running injuries day in day out ther are getting plenty of hands on experience and work.

robinph

I went to the physio, they figured out the problem, gave me exercises to fix it but to be doubly sure wanted an xray. Went to get an xray, they sent me to the GP to get a letter saying "give this guy an xray", got an xray, xray said that you did have this problem but it's on the mend now.

Went back to the physio, they said "told you so", keep doing these exercises.

Robinph was then fixed, if with a little bit of a lighter wallet.


No correct answer, but depending on the issue and what caused it I'd be inclined towards the physio first as they are more likely to have experience with sports issues, whereas a GP is ... well "General".

spurscormac

Need some context here.

You went straight to 50 miles in one week from what baseline?
Also, what was the breakdown of those 50 miles, did you do 5 6-milers & 1 20 mile run ?

You'll find that the general consensus on here is to up your mileage by about 10% week on week, but you can't just go from 0 to 50 miles & not expect your body to complain.

You should be looking at a training plan that will suit your level and take it from there.

spurscormac

spurscormac wrote: »

Need some context here.

You went straight to 50 miles in one week from what baseline?
Also, what was the breakdown of those 50 miles, did you do 5 6-milers & 1 20 mile run ?

You'll find that the general consensus on here is to up your mileage by about 10% week on week, but you can't just go from 0 to 50 miles & not expect your body to complain.

You should be looking at a training plan that will suit your level and take it from there.

Went into 50 miles from a pretty low baseline...:o

I was doing one 12 mile run, one 8 mile jog and in the gym one speed session per week, so say just over 25 miles. After being way out of shape at both the Kilomarathon and the Clonmel Half Mar I decided that even if it killed me I was gonna have to go a bit hatchet one week and thereafter it might be easier. Like the opposite of cold turkey. So did about 35 miles in the 5 nights following Clonmel, 12 miles at 8 min miles, jog 8 miles, speed session in gym for another 8 miles, another jog, all day hike, 8 mile jog...

All over the place really. Think the extra nights on the road might not have helped. Plus changed runners. Hopefully, some sessions on grass and changing back to the old runners might see things settle down.

spurscormac

Deleted User wrote: »

Went into 50 miles from a pretty low baseline...:o

I was doing one 12 mile run, one 8 mile jog and in the gym one speed session per week, so say just over 25 miles. After being way out of shape at both the Kilomarathon and the Clonmel Half Mar I decided that even if it killed me I was gonna have to go a bit hatchet one week and thereafter it might be easier. Like the opposite of cold turkey. So did about 35 miles in the 5 nights following Clonmel, 12 miles at 8 min miles, jog 8 miles, speed session in gym for another 8 miles, another jog, all day hike, 8 mile jog...

All over the place really. Think the extra nights on the road might not have helped. Plus changed runners. Hopefully, some sessions on grass and changing back to the old runners might see things settle down.

A couple of points on your reply...

1. You've increased your mileage dramatically, so that is part of the problem. Seems from what you've said you've jumped from 25 to 35, with an extra hike thrown in for good measure (this took you up to 50 I guess?)
2. Pace of runs - you haven't given a huge amount of detail here, but it seems your longest run is at your fastest pace? This is not a good approach - your long run should be at a slower pace & your shorter runs should be a mix of different sessions. All of the paces of these runs should be based around your goal marathon pace.
3. New runners, were you fitted for them (i.e. gait analysis) or did you just pick them off the shelf? Are they the same brand and type as your old runners? My advice here would be to take it easy with new runners & do a few weeks of your current mileage, interchanging with your old runners for a while until you're happy with the new ones.

I'd advise having a look at some online training plans, see if you can fit them in between now & DCM and alter then to suit your needs & the time frame - maybe you can fit in partway along the schedule if you already have a base.

spurscormac

spurscormac wrote: »

A couple of points on your reply...

1. You've increased your mileage dramatically, so that is part of the problem. Seems from what you've said you've jumped from 25 to 35, with an extra hike thrown in for good measure (this took you up to 50 I guess?)
2. Pace of runs - you haven't given a huge amount of detail here, but it seems your longest run is at your fastest pace? This is not a good approach - your long run should be at a slower pace & your shorter runs should be a mix of different sessions. All of the paces of these runs should be based around your goal marathon pace.
3. New runners, were you fitted for them (i.e. gait analysis) or did you just pick them off the shelf? Are they the same brand and type as your old runners? My advice here would be to take it easy with new runners & do a few weeks of your current mileage, interchanging with your old runners for a while until you're happy with the new ones.

I'd advise having a look at some online training plans, see if you can fit them in between now & DCM and alter then to suit your needs & the time frame - maybe you can fit in partway along the schedule if you already have a base.

The 50 was including the half in Clonmel, did that on a Sunday, then into training to take it to 50 by the Friday, then the hike Saturday. So it was more of a jump from 25 to 50...plus the hike thrown in in addition - though would do a fair bit of hiking anyway.

Do 1 x 12 miler per week at about 8 min pace. This is because I do it with a couple of others who like to push it slightly. Did get new runners recently and got a little analysis, nothing too hectic, so got Asics in the outlet store in Kildare. However, the night I noticed the ankle sore after running it was a bit mucky and wet so ran on new trail runners, which may not have helped. So by going back, I will be going back to the new asics...it's all a bit complicated with me.

Thanks for all your suggestions. Think I will certainly look up one of the more standard training plans instead of just saying "this week I will flog myself". The ankle seems a good bit better today mind you, so maybe it was just protesting after the excess of last week. If it continues to improve might try a run in next 24 hours and see how that fares.

boredatwork82

In opinion with any sports injury, the first port of call should be to a good chartered physio who has experience with sports injuries. Its not a GPs area of expertise.
Qualified physios will refer you onto other professionals if the need be.GPs will just tell you to rest and put deep heat on it.

boredatwork82

boredatwork82 wrote: »

Qualified physios will refer you onto other professionals if the need be.GPs will just tell you to rest and put deep heat on it.

Ah. Had forgotten the deep heat. Think I have a tube somewhere. Though the "out of date" might be interesting...remember fellows howling in GAA dressing rooms in the 80s cos out of date deep heat can irritate and water doesn't cool it down!

dna_leri

Deleted User wrote: »

Started proper training for the DCM last week, figured I was a bit late so did 50 miles, pretty hard, and an all day hike. And for the first time in about 2 years of running I have a pain in my ankle in the past 48 hours. Don't remember any rolling on it, so presume it was just starting off so hard.

This might seem an obvious question, but do people go straight to a physio or to a doctor? I am a bit sceptical about physios (I come from that GAA school in the 80s where things were either rested or run off). Will they not just get me to raise and lower my foot and say it could be tendinitis or it could be a stress fracture or blah blah blah give us €50 and come back again each week for this programme of exercise? Course a doctor might say the exact same thing, but at least they can refer for xrays and they won't be looking for me to return weekly.

Oh and don't want to be a pessimist, but any refund on entries for the DCM?

To answer the question, NO.

Assuming I am not in extreme pain and can do my other daily activities, before I would pay money to a doctor or a physio, I would try RICE - Rest, Ice, Compression, Elevation. The old GAA school of rest the injury was not totally wrong.

Then I would go to a physio who regularly treats runners.

From the brief history you have given here, you seem like a great case study for how to get injured. Sometimes the hardest thing to do is back off or stop for a few days and give your body time to heal.

Now I'm off to the track to see how my bad knee, sore foot, tight calf and stiff back are healing.:)

EauRouge79

Am I right in saying your in Cork Conor?
If you are going down the physio route, I can recommend mine without reservation. PM me if you like.

ger664

This is a pretty good guide here. Have a look at the chart halfway down the page which is pretty general but its is a very good common sense approach.

Timmaay

Deleted User wrote: »

This might seem an obvious question, but do people go straight to a physio or to a doctor?

Focusing in on this question also, As Dna_leri said, no is often the answer. As well as Rest/Ice etc, I usually go straight to my local Physical therapist. He happens to be a runner also, and really knows his stuff on any running injures, but would be certainly be cheaper then most proper physios. In my view anyways he would be equally as good because he is an expert in his area (athletes). If he thinks there is anything serious, he will have no problems sending me on to a physio or doctor to get checked out further! Thankfully that's never happened me, prevention is better then a cure, and going to a good athletics physical therapist every so often is an utter must for anyone running constantly, to catch any possible injures before they knock you out of action totally!

Also, going once step further with the prevention is better then the cure, are you in an athletics club? Just by training, and talking to other runners you will quickly get upto speed with what sort of training you should or shouldn't be doing, such as ramping up the miles too quick. Athletics clubs don't suit everyone, but you should consider it at least.

rom

Normally there will be a recommended person that the club use that gives a club discount also. Another reason to join.

Thought as a matter of courtesy I should come back and give an update as people were so kind as to give me a lot of pointers, here and in PMs.

As indicated in no 8 above, I tried it out last Thursday. Went 40-45 mins at jogging pace with the odd wave of pain that would come and go. Generally going uphill seemed okay, but the jarring going downhill was bad. Eventually it all got too much and had to give up and hobble home. Left it go a couple of days, no exercise, went out for a short hike last Sunday and it wasn't great. Seems to be slowly improving so gonna give it another few days and then see. If I think I'm going to be able to get back to training, I'll go to a physio first - a few suggested physios in Cork but in Kerry so that could mean time off work and that would take a lot of juggling around. But will see how things go first.

At the moment, think my hopes for the DCM are fading. Not devastated, had a lot on over the next few weekends and was finding it hard to see when I could do lsrs - had left it late to start training. Think I will have to take this all as a lesson in why not leaving it late and then going ott on it is such a good idea. It really is hard to take a short cut on training plans.

Tommytwotimes

Physio first, doctors are the champions of referrals.