Well, that seems to be that - and a general point about 'evidence based' medicine.

The good news is that I am not going to have to worry about finding a replacement for my very comfortable, but outrageously short lived La Sportiva C-Lite 2s.  The anti inflammatory treatment I had recently has brought me no discernible benefit.  In fact, none of the treatment I have had to date has brought me any discernible benefit.

The story of my injury over the last two and a half years is one of decline, despite treatment and the optimism of medical professionals.  What I have experienced is some improvement after long rests (up to six months) followed by much greater declines.  At first I sometimes experienced discomfort after running.  Now I can only walk two or three miles on easy terrain before my knee starts to complain.  It usually takes at least a week's rest before symptoms subside.  To pursue treatment further, at my own expense, would have to be a matter of faith rather than reason. 

So that, where running is concerned, seems to be that.

While I do understand that I have just been unlucky so far as the efficacy of treatment is concerned, one aspect of the care I have received has annoyed me a great deal.

So what has annoyed me?

Let me explain that I do not make the distinction, that many do, between 'conventional' and 'alternative' medicine/therapy.  Frankly, why should I care about such a distinction?  I do however distinguish between 'evidence based' and 'non evidence based' medicine/therapy.

If I am going to risk my health, physical and financial, I want to see some evidence that treatment will work.  I require that this evidence is well documented, reputable, disprovable and has an adequate sample size.  Medicine that claims to be evidence based needs to constantly monitor and re-assess new evidence to support that claim.  This is especially true where evidence for the treatment is not unequivocal, as in the present instance ¹.

So why is it that, despite multi page feedback forms that ask me what I thought about everything from the décor of the hospital room to the courtesy of the desk staff and the quality of the food, no one has bothered to enquire whether I have benefited from treatment?


¹  "...unlike knee replacement surgery, which is supported by population based patient reported outcomes (PROMs) data and the National Joint Registry, healthcare commissioners lack the necessary data to allow informed decision making for knee arthroscopy" - BMJ 2014;348:g2382