Last week, I organised the first London pelvis trauma course to give registrars and surgical fellows an introduction to pelvis surgery and encourage them to join the specialty.
Over 30 delegates attended from all over the UK at the London Transport museum depot which was one of the few places big enough for the huge Stryker teaching lab on the bag of a lorry.
We had 12 faculty members including the legendary Martin Bircher, Pete Bates, Paul Culpan and John Dwyer (President of AO UK, www.aouk.org) who all gave up their valuable time to teach. Orthopaedic Research UK (www.oruk.org), Stryker (gold sponsor, www.stryker.com), LEDA Orthopaedics (www.ledaortho.com) and Siemens all kindly donated to this educational event so that we could keep the costs down for delegates.
The registrars learnt the fundamentals of pelvis and acetabular trauma cases and tips and tricks to surgical approaches. We debunked to the teaching lab where 8 dry-bone stations allowed the students to practice fixing posterior wall fractures and open book pelvis fractures.
My personal favourite was getting the delegates to play with the the image intensifier C-arm where they could practise their wire and screw orientation using a Starr frame. This video which brings what we were practicing to life (www.youtube.com/watch?v=HXzsZr_mtA8).
There was great feedback and so the plan is to run the course every year.
A few weeks ago, I ran the London Marathon for the sixth time. Unfortunately for my pride, it was another failed attempt to break 3hrs after 6 months of training (should have tried to train up my sweat glands!) but one silver lining was successfully avoiding a tendinopathy.
In previous years, I’ve pushed my training too hard and too fast and ended up with a range of different tendinopathies including proximal hamstring injuries, piriformis hip tendonitis, achilles tendonitis and perineal braves (foot) tendinopathies. Each of these took over 4 weeks of virtually zero load training to settle down and ultimately affected my performance.
I see many patients with similar issues so I thought I would share a few thoughts on how to avoid and treat tendinopathies.
As a reminder, a tendon attaches a muscle to a bone and a tendinopathy occurs when the load being applied to the tendon is too great for the tendon to withstand. This means the tendon begins to become stressed and then inflamed. This can happen for a number of reasons - bad shoes, bad technique, running too fast, running too far - however the main cause is not factoring in a gradual build up in your training. I worked a lot this year on strengthening by hip abductors, my core muscles, good dynamic stretching, meticulous warm up and warm down. I also focused on adopting a more symmetrical running technique after a great running gait analysis at www.onebodyclinic.co.uk in Notting Hill by physiotherapist Sarah Morton.
All of these marginal gains meant that I avoided injury for the first time but for those who do have tendinopathies which don't get better through rest, the first thing to do is to get the right diagnosis by seeing a specialist. Once you have this, there are a variety of interventions which start with targeted physiotherapy programmes, shock wave therapy, ultrasound-guided injections. Only as a last resort (and only in some circumstances) is surgery advised.
For me, my next stop are the World Half Ironman Championships in Fynn (Denmark) in July 2018, fingers crossed I stay injury-free until then.