Thursday, 14 January 2016

Inspirational Patients - Al Churcher

My husband and I were innocently promenading down Ecclesall Road one day, minding our own business, when we were distracted by shouting from the terrace at Nonnas. Al Churcher was celebrating his 70th birthday. And as usual with Al, he was doing it in some style - having just come from performing a gig in his own honour the champagne was flowing. Our reporter made her excuses and left. Since then Al has become the European Silver Medalist at Triathlon in the 70 year old age category. In the last few months he’s also recorded the age-group record at all six Sheffield Park runs, including a time of 22.18 at Sheffield Hallam Park Run.

I first met Al when he was recovering from a knee injury which had stopped him running for four months. He then injured his other knee requiring arthroscopic surgery. Overall he was out for a year.

"When I first saw Kim I was, to say the least, pretty depressed. For the first time ever I'd injured my "good" knee - the left one. The right has an unreconstructed anterior cruciate ligament and there is no cartilage on the inside of the knee so I'm used to that giving me a bit of trouble. The left knee pain had started after one hard 5km run. Two other professionals had been unable to diagnose the source of the problem. Not knowing what the problem was made it even worse and I was struggling to face up to a future that would not include triathlon..

"... realising this might be my last chance I was determined not to blow it again."

"It took only a few minutes for Kim to be fairly sure that I'd torn the cartilage - a referral to a specialist soon confirmed this. Following the arthroscopy I put myself completely in Kim's hands - realising this might be my last chance I was determined not to blow it again. Runners & triathletes are their own worse enemies and I'm a perfect example. We love what we do, we're addicted to it and as a result we over-train, ignore warning signals and when we do get injured we think we can immediately bounce back to our pre-injury level."

Some people are motivated by goals and it is said that we must set our goals beyond what we really want to achieve. Al’s goal was to win a medal at the European Championships, after a year of no running at all, at the age of 70.

As a physiotherapist who deals with many runners one can understand how challenging that goal really was. It takes self-belief, patience, objectivity and a willingness to take the setbacks and pick yourself up - most importantly a willingness to keep focusing on that goal.
Add to that the perception of many in the general population, and in the medical profession, of how a seventy year old should be and should behave.

Many runners I know struggle to race 5km: firstly, if you are racing then it's painful, and pain isn’t pleasant. Secondly, your speed when racing such a short distance places more load on your body and, unless you have trained for it, it is easy to get injured. Particularly as you get older ...

Al started just running a few minutes at a time. He built up slowly over the year in a very methodical and disciplined way. The results speak for themselves and I find his achievements inspirational.
"I've finally learnt a little patience and to listen to my body"
"One of Kim's great strengths is her positive attitude and the way she transmits her belief that if you do the right things it will come right again. She is also pretty strict with me. This time I stuck religiously to her recovery plan and guess what - it worked - so much so that I've started Duathlon again and won my class at Carsington in October. That was TWO hard 5km runs separated by a 30km bike. Thanks to Kim I've finally learnt a little patience and to listen to my body - well most of the time - and now I'm targeting this year's world Duathlon champs in Spain, hoping to finally land that elusive Gold medal."

I should have mentioned - that gig he played - was one of his first ever after a life long passion for music and guitars. He is now a regular on stage at the Yellow Arch.

Monday, 11 January 2016

Inspirational Patients - Alison Hilton

Lots of people run marathons these days. So why should I find it inspiring when an experienced runner manages to run one?

Well, most of us who are runners are familiar with being too injured to run properly. Sometimes for weeks, sometimes for months - but thankfully relatively few of us become so injured that we can't run properly for several years. How many times would we think we would have to give up? How many of us would believe we can recover? And how many of us do?

I first saw Alison in 2013 when she had been suffering painful achilles problems for nearly three years. Prior to this she had been regularly running 20 to 25 miles per week, but had reduced this to one long Monday run with her running club.

Regular readers of these missives won’t be surprised that I felt that pattern had to change - from the one weekly long run to several much shorter runs of 20 to 30 minutes. Of course this is very frustrating to someone who is used to and enjoys running further. But her achilles needed both the right levels of loading and time to adapt.

After four months of gradual build up she was back to running 8 to 9 miles but with only a minimal reaction. Through the next six months she slowly built up her running load. There were a few setbacks, but she backed off and stayed sensible.

Steady progress? Time for a marathon then!

After 12 months she was running at the level she had been four years earlier - it can be a long road. Then, in August 2014, Alison mentioned she wanted to run a marathon, twice the distance she had raced previously, within a year. Ambitious maybe?

As is often the way in life, she was coming back from a setback - chickenpox. Often innocuous in children it is almost always serious for adults. She had been wiped out for a while and needed to build up carefully.

She chose as her goal the Loch Ness Marathon in September 2015, appropriate perhaps as it is sponsored by Baxters. I thought a year should be enough time to prepare - but it might be a good idea not to aggravate the old injuries along the way. So we worked together on a plan that built up her mileage slowly at a level I thought her body could manage.

Another setback occurred in spring with an ITB injury which led to several weeks of no running. As Alison understates “there were one or two points along the road with my little setbacks that I genuinely thought I was going to have to give up running and find something else. I do tend to catastrophise and setbacks can become big mental hurdles for me. However Kim’s confidence in the approach we discussed and her general positivity made a huge difference and really did encourage me to stick at it.“

What I find particularly inspirational as a runner myself is the way she followed the plan, sensibly choosing to back off when she received the early warnings, not when it was already too late. This marathon was a real challenge for her but she approached it with both determination and common sense. Had either one of those been missing she probably wouldn’t have succeeded - something I’m still learning myself.

"My achilles feel better than they have in years."

“Looking back, I can absolutely see that the steady build of load was the way to go...having run hundreds of training miles and the marathon itself in a controlled and sensible way my achilles feel better than they have in years. Oh, and the cold baths were a revelation!”

As a runner who works with injured runners almost every day I am trying hard to follow my own advice, training consistently without breaks and building up the volume slowly year on year. This means having the good sense to back off when I have to - which is tough. I get doubts all the time.

I constantly have to fight the desire to push on too quickly and need to keep reminding myself the longer-term goals are usually more important than the immediate ones: this or that unimportant race, this or that non-critical session, this or that mileage total etc. Alison's recovery from years of injury and her sensible approach to setting and achieving her goals are a big source of inspiration for me.

Thursday, 7 January 2016

Inspirational Patients - Susan X

Chronic pain can be life destroying. Chronic is from chronos, meaning time. For Susan, this started four years before retirement, and in the two years since, she has morphed from being a full time professional teacher into a full time professional 'patient'. Numbness in two regions of the body after operations and immense, increasing pain have become an intrinsic part of her life.

So what does medical science have to say?

Susan started with a hip replacement at the age of 56, followed by a knee arthroscopy almost immediately after. Numbness in her feet followed swiftly on, and eventually another hip replacement upon retirement, further numbness in another area of the body and the chronic pain. There has followed numerous X-rays, MRI scans, Ct scans, nerve conduction tests, blood tests, a lumbar puncture, thermal threshold tests and bone density scans.

Nothing. No diagnosis. Nothing.

She’s seen four consultants with a referral to the fifth on the way, all flavours of physiotherapist - NHS, NHS HLP (High Level Professional), Private, Pet Detective, Saga NorĂ©n etc.

She’s been prescribed drugs, lots of drugs. Injections. And exercises. Oh how we Physios love to dish out the exercises. More exercises. Exercise classes. Then more exercises. 

Nothing. No change. Nothing. 

At this point many people would give up. That would be understandable. Logical almost. Susan hasn’t.

The pain persists. No explanation is forthcoming. And for the last nine months it has been getting worse.

“What have I done to cause this pain? Will I be like this for ever?”

“My before-sleep mantra for the last two years has been obsessive and negative, like a record that never moves from a certain groove: ‘What is wrong? What has gone wrong? What have I done to cause this pain? Will I be like this for ever ?”

“I was living everyday with a sense of helplessness and hopelessness.  Recently, in desperation, I joined the gym to start regular swimming as walking, gardening and any other form of exercise, which put pressure on my back and leg was unbearable. It was a chance meeting at the gym with another of Kim’s patients, which led me to make the phone call which has connected us.“

My ego isn’t sufficient that I can believe all these other professionals have missed something. Perhaps they have but I think it’s unlikely. So Susan and I are going on a journey. A journey that starts with respect for her as an individual. 

Necessarily our explorations must be empirical - a repeated cycle of testing and evaluation - guided by my experience and knowledge but led by Susan’s open mind, willingness to listen to new ideas and her ability to adapt and innovate. 

“At the first consultation, Kim explained with a drawing and clear explanation what had been happening to cause my chronic pain.  It was refreshing to meet a practitioner who sat at my side and talked rather than check me out and provide me with a list of exercises, which I knew would cause even more pain.” 

 “The Todd Hargrove book she recommended has been revelatory. It has turned all my thinking upside down.  “Pain is a real feeling, but that does not necessarily reflect real (tissue) damage in the body”. This was just one of many statements which opened my eyes wide to future possibilities. This book, together with Kim’s support has changed my thinking and outlook.”

I wanted Susan to play at moving her body within its pain free range. Susan chooses to do exercises whilst listening to music and she lets her body become the conductor of the orchestra. Perfect.

We are having some success. Susan can now move pain free whilst lying down and has recently walked more than a mile with minimal discomfort. This is great news as Susan can now slowly start to build up by sharing enjoyable walks with friends. 
“It is as though I have given my body permission to work towards change.“
“Knowledge and understanding of the cause of my pain has enabled me to take control.  I feel empowered. It is as though I have given my body permission to work towards change. I have joined yoga classes and have started relaxing and putting my body into positions last experienced over 6 years ago.  I had no idea that my body still had this level of flexibility.“

“The pain in my lower back and part of my hip and leg is easing, but I know it is still a long journey to gradually re-train the neural pathways and mend the nerve pain mechanisms. This will require regular practice and some considerable discipline, but I do know that Kim will be there explaining and cajoling me along my road to recovery in at least some of my complex issues.”

Susan has had a really tough six years but she is still determined to live life and enjoy it. She’s an inspiration to me and it is an honour to be able to support her. 

Monday, 4 January 2016

Inspirational Patients - Cat Taylor

Happy New Year … although it often doesn’t feel like it in gloomy January. With that in mind I thought I would use the next four blogs to highlight some patients from 2015 that I personally found inspirational. Although their challenges and achievements are very different there is a common theme of working towards their goals in a logical long-term manner and dealing sensibly with all the setbacks they face along the way. I wish them all the best for 2016.

Cat Taylor

“The amazing Catherine Taylor”, to quote the commentators at the 2015 World Cup Final, needs no introduction to orienteers around the world. But as a junior, despite possessing outstanding raw talent, she was relatively unknown. Because she was injured. Cat first showed her international potential with a Long Distance Bronze medal at the European Championships in 2014. A good season in 2015 saw her place an excellent 5th in the Middle and 6th in the Long at the World Orienteering Championships in Scotland and pick up the title of Swedish Champion for club OK Linne in the Relays. But at the season’s finale in Switzerland we watched in awe as she destroyed the World’s best by a huge margin - the prize for all that effort being a rather large, rather solid, wooden bench that had to somehow make it’s way back to Sweden. Who said orienteering wasn’t like the Krypton Factor? It wasn’t always this way. I first met Cat when she came to the clinic back in February 2007. After finishing her A-Levels the previous year she had just returned from an abortive attempt to live her dream as an orienteer in Sweden. She had been unable to run for months due to injuries. Cat and I have worked together since that day. Whilst her results are amazing, it is her fortitude that is an inspiration to me. The last eight years has been a long journey full of injuries, frustrations and some dark times …

“Working to compete at the top level in orienteering has meant a lot of focused hard work over many years. It's been quite a journey from when I was 18, injured and hardly able to run, to training long hours each week and challenging for great results in international races. It's meant moving country and shaping my lifestyle around sport but I love what I do and feel really lucky to be able to spend a few years of my life chasing my goals in the forest.” Through all this Cat has never given up and has always been ready to learn - to learn more about the art of orienteering, the art of consistent hard training and the art of listening to and understanding her body - aiding her in managing niggles, aches, pains and serious injuries: “Working with Kim for the first time marked a turning point in my recovery from injury and the start of my learning to understand and manage my own body's reactions to training, which has been vital to the process. Today, Kim is still the first port of call when I have any problems or questions - she's both very knowledgeable and very helpful!” It has been a real privilege to see her move from an athlete who was perpetually struggling with injuries to putting together four years of consistent training at a high level - in the last week alone she has done fourteen hours running, seven of those orienteering in the cold and often dark forests of Sweden. Well done Cat, you deserve it.

Photos courtesy of, still older than Google.