Injury. Not a topic us runners or athletes like to think about, but unfortunately for some it’s an inevitable part of training. My husband Glen has had more than his fair share of injury, after spending most of last year unable to run. He is back on form now, and after his amazing comeback at the Brighton Half Marathon, a few people asked me about his treatment and how he overcame his knee injury.
Glen hurt his knee last June. We were running along the Lee Valley canal and after 12 miles he had to stop with an agonising pain in his knee. He had suffered with niggles in his knee before, but this time the pain was much more intense. He decided to take a few days off from training to rest and ice the area.
The pain did not subside after rest. His knee and thigh ached constantly for the next three weeks and he used strong painkillers to manage the pain. After a few sports massages and acupuncture, there was still no improvement and Glen decided it was time to see a physio.
I was told about Oxford Circus Physio after asking the Team Naturally Run girls for recommendations. Glen made an appointment at the clinic for an initial assessment, which cost £65 for 45 minutes. His physiotherapist Alice Prescott advised him to stop running and cycling. He could keep active by swimming (front crawl only) and using the elliptical trainer. Basically, he was to avoid any activity involving bending his knee to a 45 degree angle.
Alice also gave him stretches and strength building exercises to complete daily. He also was advised to continue icing the area and take more rest. He had appointments at Oxford Circus Physio for the next 6 weeks, which involved sports massage, acupuncture and taping around the knee. Each session cost £50 for 30 minutes.
There was still no improvement after the course of physio, the ache in his knee still persisted and he couldn’t run for longer than 5 minutes without intense pain. As any injured runner knows, it can be incredibly frustrating and depressing to have to stop the sport you love. Glen carried on swimming and using the elliptical trainer, but found it boring and repetitive. He worried about losing fitness and gaining weight, and wondered if he would ever be able to run again. He also found it difficult to spectate at my races and was envious of other runners. Cycle Rhythm opened in July and Glen was keen to support my new venture, but was still unable to cycle. We moved an elliptical trainer into the studio, so that he could take part in the class without having to ride a bike.
Alice wrote Glen a referral to take to his GP for further more specialised treatment. After approval from his medical insurance company, Glen was given an appointment with Dr Nikolaos Malliaropoulos, aka ‘Dr Nick’.
Not to be confused with Dr Nick from The Simpsons…
Dr Nick is a consultant in Sports and Exercise Medicine at the London Independent Hospital. During Glen’s first consultation, he was asked to draw on his knee where the pain was. The doctor thoroughly examined it and performed an ultrasound scan. Glen was also sent for an MRI scan at the European Scanning Centre to diagnose the cause of the pain. The results of the MRI scan were unremarkable, but did show up some cysts behind the knee which would require further investigation and another ultrasound scan. The second ultrasound was not covered under his medial insurance, so Dr Nick was able to negotiate a discounted rate to £280 (ouch- almost as painful as the injury itself!).
Thankfully the cysts were not a serious problem, and were caused by joint fluid leaking into the space behind his knee. Apparently, he was lucky as when these occur further down the leg nearer the calf, they can become aggravated and cause symptoms similar to Deep Vein Thrombosis.
Glen was diagnosed with left Iliotibial Band insertional tendinopathy, ie: IT Band syndrome. Dr Nick outlined the treatment he wanted to carry out- it would consist of 8 sessions of Radial Extra Shock Wave Therapy which would increase in impact and pressure. Shock Wave Therapy is a safe non-invasive treatment method for tendinopathy. It is a relatively new procedure which works by sending strong, specialized shock waves towards the area of pain, thereby stimulating healing of painful tissues. Dr Nick is a pioneer in this type of therapy- he has used Shock Wave therapy on elite and non-elite sportsmen and women for 15 years, with excellent results. He has submitted 2 papers for publication on his findings.
The treatment started in October, alongside a regular stretching routine and muscle building exercises. The Shock Wave machine looks like some sort of sex toy!
Glen was still not able to run at this point, and was forced to give up his ballot place in the Royal Park’s Half Marathon, which was massively disappointing. I also suffered a knee injury around this time and pulled out of the race, so we spent that Sunday in October sulking together!
Shock Wave Therapy continued until mid-December, and Dr Nick gave him a 6 week running rehab plan along with more strength building exercises. Glen began the running plan on a treadmill on New Year’s Eve, it consisted of:
Week 2- 2x 15 minute runs
Week 3- 2x 20 minute runs
Week 4- 2x 30 minute runs
Week 5- 2x 40 minute runs
Week 6- 2x 50 minute runs
It was a slow and gradual return to running. Glen was frustrated to take the pace so slowly, and was tempted to skip ahead and increase the distance and speed more rapidly.
He still had a slight niggle in his knee on these initial runs, but no where near as bad as the pain from the past 6 months. It seemed that the Shock Wave treatment had worked!
By early February, Glen was able to run 10 miles pain-free and the Brighton Half-Marathon looked promising. I was still concerned that running a half-marathon so soon after rehab would cause the injury to flare up again. But the race went well and Glen smashed it in an official chip time of 1:35:36…
It was a long, painful and expensive journey to get back on form after last summer. The injury basically came about through overuse, so Glen’s wary of overdoing it again. He’s got into triathlon now, so hopefully mixing up the three sports will take the pressure off his knee. He still stretches and tapes his knee on a daily basis, as well as keeping up with the strength building programme.
Have you had an injury? How was the recovery?