Thursday, August 28, 2008

Friends vs Patients

A long time friend whom i play football with came to see me at the beginning of the season complaining of shin pain (shin splints). Without hesitation I agreed to treat him.
Breifly, on assessment his left leg was worse than right, we had both significantly increased our training workload, most of which was running. He also over pronated on both feet.
I explained that i thought it was only shin splints at this stage and that if we address his compounding factors we could manage the issue. I also explained some red flags that he needs to be aware of and what could happen should he fail to manage the simple shin splints.
So i advised him to start wearing his orthotics again and strapped his feet for training and games also asked him to reduce his workload or switch to swimming to avoid running. His left leg responded well whilst his right actually deteriorated, I continually asked him how he was doing and he always responded i'm doing alright.
It wasn't till he had to come off half way through a game that he revealed he had been having significant pain with ambulation, hadn't reduced his training load and had pain at night. I immediatley sent him to our team physio who sent him straight to a sports doctor who had him scanned and diagnosed him with a stess fracture in his right tibia.
Well, I felt like an idiot because I was looking after him and his condition deteriorated. It sidelined him for 6 weeks and I felt really guilty. It was when he decided to play against doctors recommendations that i realised it wasn't my management it was just the way my freind was.
I have realised that dealing with freinds just isn't appropriate, they can't dissociate between freindship and professional relationship. Now i'll give advise but ultimately freinds should see an impartial professional for treatment and on going management.
anyone else expeiranced this with friends and family?

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