October 28, 2013 (Specialist)

About two months ago I went to my doctor with pain in my ankles, as I mentioned here.  At that time, her office made an appointment for me with a specialist in New Westminster.  Knowing how difficult it can be to see a specialist in a short time frame, I figured I would get in to see him months down the road – after my problem was gone.

I would see the specialist at the end of October.  I ran the CMR and did two runs in early-mid October in Palm Springs.  Felt much better than I had at the end of August.  Was worried I’d be wasting the specialist’s time to go in now.

But {Diwali} thought I should go anyways; she thought {DrCaps79-82} would have some good ideas and insights.  And this being Canada and all, it’s free.  I looked up his clinic online, learned where it was and that there was a sports medicine clinic as well, and so figured it would be helpful.

Monday October 28th.  Early appointment.  Wore shorts as requested when I confirmed my appointment, brought my VFF Bikilas with me, was ready to find out what was up.

I really don’t like going to see a doctor or a dentist when there is nothing consistently wrong, in the same way I don’t like to take my car to a mechanic when it misbehaves at random.  I always feel like I’m trying to convince them that (a) there’s actually something amiss even though it’s not obvious; and (b) I am totally not wasting their time right now, because (a).

This appointment, though, should give me some insights into the mechanics of my running.  My doctor thought there might be a biomechanical flaw; knee- or hip-joint deviation, posture, muscle bias.  I imagined that {DrCaps79-82} and his clinic would do a bunch of awesomely high-tech tests like in “Rocky IV”, plus high-speed cameras and motion-capture and sensors hooked into computers and such.

So I thought.  None of which was the case.

I’ll start by saying that {DrCaps79-82} was exceptionally generous to see me, given that I had no disabling injury; that I am not a professional or even competition-grade athlete; and that I am there based on casual discomfort from an entirely recreational, optional hobby.  He knows his stuff and has considerable experience and knowledge in the field, and I’m lucky to have had access to him.  Also he reminds me a LOT of my Uncle {BoSox-9}.  The resemblance was eerie.

In terms of outcome for me, however, this appointment was a massive waste of time.

We spoke for half an hour, perhaps 45 minutes.  He did a very superficial exam; perhaps a couple minutes’ worth of range-of-movement and direct observation of posture, and that was it.  His practise is not affiliated with the sports-med clinic elsewhere in the building; the exam room is his office and an exam table.

I gave him the background on my running, when and how far and how often, and problems I’d had since the start of the year.  I was describing the Learn to Run program when he stopped me and informed me that his mentor *wrote* the Sun Run Learn To Run 10k, so he was familiar with it.  That was pretty impressive.

On the topic of shoes I showed him the Bikilas I brought with me.  If the appointment so far was showing the barest sliver of promise, that was gone now.  While not directly hostile to VFF’s and barefoot/minimalist running, {DrCaps79-82}’s contempt for subcultures outside of “normal running” turned this potentially informative session into a lecture.

Not to say that I am a stalwart defender of minimalist running, or that I know better, or that I “have to” run this way.  None of those are true.  It is the case that I have chosen to run the way I have chosen to run – perhaps inasmuch as someone chooses to drive a BMW instead of a Mercedes.  Fundamentally they are the same way of getting around; both have their advantages and disadvantages, ardent supporters and critical detractors.  Comes down to preference.

{DrCaps79-82} was of the mind that I should (quite literally) throw away the Vibrams, get a pair of “neutral running shoes” from the Running Room, and follow a slower progression.

Now, this opinion was not based on any physical evidence.  He did not check my stride in the VFF’s, nor did he watch me run, nor did he get any sense of my actual biomechanics.  Coming back to the car analogy, it was as if I took a BMW to a mechanic complaining of a grinding noise under the hood, and without looking at the engine the mechanic tells me that I should be driving a Mercedes, and that would solve a lot of my problems.  {DrCaps79-82} jumped to a very generic conclusion as soon as he saw my chosen footwear.

His suggested running progression was a huge step back from what I’d been doing.  {DrCaps79-82} proposed a 2-3 times a week, 0:30 run / 4:30 walk (five intervals), adding 30-seconds of running and reducing the walking portion by the same, keeping the total interval at 5 minutes.  He suggested avoiding all hills (up and down), running on a circular track if at all possible.  This contradicted advice from Physio, which had warned against track running because of the “turning bias” from always running into left- or right-hand curves.

I was cordial, and as open-minded as I could be (or as open-minded as I could appear to be).  I heard him out, took his notes, accepted his proposal to try things his way and come back in six weeks to see how it was going.  Thanked him for his time and left off in a friendly fashion.  Gave the receptionist a line about needing to check my calendar at home before scheduling the follow-up…and left equally as conflicted and depressed as I had been triumphant after the CMR.

On one hand I’m a scientist and free-thinker and amateur philosopher (but with a day-job, ha ha).  I know the value of setting aside emotional response and assessing the information at hand based on logic and fact and evidence.  I’d just received advice from one of BC’s leading sports-medicine specialists, a professional athlete in his day and an expert in the field.  There is truth in a lot of his words.  That it conflicts with my world-view does not make it incorrect.

On the other hand, the advice I was given was based on shockingly incomplete physical evidence, and was based more on a dismissive attitude towards what {DrCaps79-82} himself even said was inconclusive medical opinion for-or-against minimalist running theory.  His wasn’t specific advice for me; it was generic, almost cliché’d platitudes said at me.

To follow his advice would mean basically abandoning everything I have done to this point; effectively admitting minimalist running as a “failure”; and shelling out $150 for new shoes when I’m in just a fraction of the lifespan of the ~$90 VFF Bikilas.  Despite my free use of luxury European cars in my analogies, I’m not swimming in money.

I struggled with this situation for a week.  Dismayed, conflicted, doubting which way to go or what to do.  Professional advice against what I’m doing, yet advice derived from faulty or under-informed conclusions.  Try a two-month detour and go normal-shoes (also re-building my stride and cadence, mind you) or keep on with minimalism ?

In the end, I toyed with the question and the longer I went without answering it, the easier it became to decide what I wanted to do.

I was not out anything but time for having gone to see {DrCaps79-82}.  But I’m not going back to see him again.  I appreciate his time, I think I considered his advice on its merits based on his experience, but I can only conclude that his assessment of my situation critically ignored too many specific, biometric factors to be considered reliable in my case.

The crew at my Physio clinic spent as much hands-on time assessing my movement, range of motion, flexibility, and physical condition, as {DrCaps79-82} spent talking his opinions at me.  If I have problems in the future, I will go back to their clinic, 100% for sure.  They took the time and made the effort to learn how my body works, and advised me based on that.

I would not dissuade anyone from seeing {DrCaps79-82}.  I just found the appointment and experience a complete disappointment.




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