INJURY: Enter the Professionals

Today I went to see dr. Paddy Duggan of the Carysfort Clinic in Blackrock.

Dr. Duggan is a doctor with a diploma in sports medicine and he was not impressed. While, after thorough investigation, he could concur my original diagnosis off Plantar Fasciitis, he was not impressed with me not having seen a single doctor with proper education in sports medicine (I've only seen physios and a normal GP without this diploma).

He explained that Plantar, as all tendon injuries, did not respond well to most conventional treatments (because they are "white tissue injuries", meaning they get little blood supply) and had left the market open to "quacks" and multiple non-proven solutions (most of which I have probably tried).

Plantar, he explained, is a form of tendinosis (not actually tendoniitis) which means its a "rotting joint". It's also a Mickey Mouse joint (we don't need it), and he said, should I tear it completely, a clever fitted orthotic would allow me to compete just as well as I had before.

He then went on to examine in depth the causes, as he said, "any physio and most GPs can make the diagnosis of Plantar Fasciitis, but that's not what's interesting". He gave me a new program taking 6 minutes that I have to do 4 times a day. It has similarities to the others but is more focused on regaining plantar flexibility than increasing the eccentric strength of the achilleus and calf area.

Next he ordered an MRI, so we can determine the length of the tear in the fascias and the state of the scar tissue and other necrotic tissue in the foot. There were differences between my two feet (he ruled out that the old knee injury had a part to play as this had fully healed), so an orthotic needs to be professionally made for me.

He set me up for a Monday appointment with his in-house physiological specialist who will do a further biomechanical assessment of me as he had worries about my feet, very tight ankles, and hip. Also, he described my hamstrings as "shockingly tight" but said this was normal in runners and is probably not a direct cause of the injury.

My right foot is currently less flexible than the left due to the after-effects of the three bad sprains.

Following up on both these, I'll meet him again in three weeks and we'll see where we go. He told me to avoid anything "painful" in the meantime, but assured me that if he and his in-house physio couldn't sort me out, I'd be in real trouble.

Nerve damage could not be ruled out, but it would be unlikely and will show on the eventual MRI scan. From his conclusions, I take it that should treatment fail to work, the next logical step would be separating the fascias from my heel. If I can establish that there is indeed no loss from this, performance wise, it's worth considering, but for the moment, I hope this good doctor and his specialists will sort me out.

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