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Where to turn to for medical help?

RuijgRock

New Member
Camino(s) past & future
sept/oct 2017
#1
I have a question concerning medical help. Where does one turn to?

I went to the medical centre in Sarria to ask if they could check my heels (since a month they become painful everyday; the next morning it usually is okay but it starts again after about 10 km of walking). Seems reasonable to me to have them checked but the medicals didn't think so. They send me away telling me to take a few days rest without having a look or even listen to the problem. What is the right place to turn to to have my feet checked?
 
Camino(s) past & future
Camino Frances (2012, 2014, 2015, 2016). Seville-Astorga (Mar 2017). Mozarabe (Apr-May 2018)
#2
I have a question concerning medical help. Where does one turn to?
I went to the medical centre in Sarria to ask if they could check my heels (since a month they become painful everyday; the next morning it usually is okay but it starts again after about 10 km of walking). Seems reasonable to me to have them checked but the medicals didn't think so. They send me away telling me to take a few days rest without having a look or even listen to the problem. What is the right place to turn to to have my feet checked?
All of this will be my personal opinion, as I have no medical qualifications at all!

I think you have done the right thing, in going to a medical centre for a consultation. You are walking a long distance and have sore feet after 10 km, so the obvious first treatment is to stop walking so far. The clinic in Sarria probably sees so many people with sore feet that they only treat the cases that are acute. Some medical problems are very difficult to diagnose, and it is necessary for the patient and doctor to work together to try to understand the cause and the appropriate treatment. This can't happen very well when you walk into a clinic or hospital for a single visit. They can check for obvious injuries and treat them, or do an x-ray to determine if bones are broken. However, when you have an overuse injury, there is not much they can do in the short term except tell you to stop the overuse.

Maybe they didn't ask a lot of questions about your feet because they know that an acute problem would not allow you to walk for 10 km each day, they know that the treatment for other problems always starts with rest, and they know that you are just passing through town for a short period. Are you thinking that they should do an x-ray or other scan to investigate the problem? Are you prepared to spend the time and money to investigate the problem thoroughly? Perhaps this will be necessary, but it makes more sense to do it at home with your own doctor. These procedures can be very expensive and may still not yield clear information. For example, stress fractures are often not clear even with modern imaging. It you have a stress fracture you may need 6 weeks of no walking at all, to let it heal.

Maybe the advice to rest for a few days is the best advice available. The outcome after a few days rest will be important information to help with a future diagnosis, but that is better done at home.
 

RuijgRock

New Member
Camino(s) past & future
sept/oct 2017
#3
Thanks so much for your extensive reply; sounds very sensible. Don't actually know what I was expecting and I guess you're right by sorting this out in my hometown. Tomorrow a day of rest and then very slowly to Santiago
 

Kanga

Moderator
Staff member
Camino(s) past & future
Francés x 5, Le Puy x 2, Arles, Tours, Norte, Madrid, Via de la Plata.
#5
@RuijgRock I'm not medically qualified at all - but have walked a lot. I used to think I had 14km feet until I changed my shoes (from boots to lightweight joggers). If your feet are good for 10 km, then it might be a shoe problem. Have you tried different shoes or gel inserts?

Pain is an indication that something is wrong, but that might only be that your body needs rest, time to recuperate, and shorter distances.
 

RuijgRock

New Member
Camino(s) past & future
sept/oct 2017
#6
@RuijgRock I'm not medically qualified at all - but have walked a lot. I used to think I had 14km feet until I changed my shoes (from boots to lightweight joggers). If your feet are good for 10 km, then it might be a shoe problem. Have you tried different shoes or gel inserts?

Pain is an indication that something is wrong, but that might only be that your body needs rest, time to recuperate, and shorter distances.
Yes, I threw away my boots and bought Keens sandals (no heels) on which I have been walking almost the whole trail (boots only first 2 weeks until the problem started). They gave me a few more km's a day at the beginning but I seem to be back at 10-12 a day. I am averaging 15, thought that is not a lot for a healthy 46 year old... apparantly my feet think otherwise :-( See what happens after a day of rest and even shorter distances.
 
Camino(s) past & future
Northern Way (2017)
#8
I did not seek medical attention - I wish I had because there were a few simple things I discovered at the end of the walk that were incredibly helpful for reducing pain. I would say a podiatrist or physiotherapist are better options - if it is something that can be mitigated through stretching or a little spacer between your toes, or... they are more likely to be able point it out compared to a doctor.

I did stop frequently, usually every hour or two. I experienced acute pain in the balls of my feet, and that was my cue to sit down, take off the shoes, and give every part of my foot a good rubbing. It really helped. If there was a pressure point that really ached, I would GENTLY apply pressure in that spot and slowly massage out the ache. If nothing else, the warm greetings of other pilgrims walking past felt pretty nice too.

I did carry a foot massage ball (a tennis ball works too) for the first 600km and it felt absolutely delightful at the end of the day. Alas, it rolled into the dark under a bed and was forgotten.
 
Camino(s) past & future
C/F: 2013, 2014
C/M: 2016
C/P: 2015, 2017
C/I: 2018
Voluntario: 2014 to 2018
#11
In 2013, I had very serious problems with calluses on both heels. Knowing that I needed medical attention, I made an advance reservation at a 4-star hotel in Burgos. I did so because, in my 40 years of global travel, I knew there would be English speaking staff at the desk.

On check in, I explained my problem and suggested I needed either: (a) the world's best pedicure, (b) a foot doctor [podiatrist], or (c) a taxi to take me to the emergency room of the hospital. On arrival, my feet were actually squishing in blood.

Within 20 minutes of checking me in, the staff located a podiatrist who would see me at his office on Saturday, his day off. I hobbled over to his office and was treated. IN-office surgery was needed to remove the thick calluses and address the blood-filled blisters underneath. Told to NOT continue for two days, I returned on Monday for a follow-up exam and clearance to walk the next day.

Sometimes, you need to think outside the box, and be creative. I knew I needed medical attention. I also knew that the Centros de Salud (health clinics) would not help me, pretty much for the reasons mentioned above).

As an option, you could go to a farmacia, ask if the pharmacist speaks some English then try to get them to refer you to someone who can help. In Spain, farmacias are almost a one-stop diagnostic clinic and information resource for pilgrim ailments.

Another alternative, if you are truly lucky is to happen upon an albergue with a hospitalero who is expert at treating pilgrim feet. These people exist, but they are rare and far between.

I hope this helps.
 
Last edited:
Camino(s) past & future
Caminos Frances (x4), Finisterre, Aragon, Via de la Plata, Portuguese 2011 -2015. Hospitalero 2015
#12
I suggest you see a podiatrist (podistra in Spanish). The fee of possibly 30 euros will be worth every cent if he/she can fix the problem. Surely it's worth a try as they are medical professionals for feet problems. Ask at a 'Farmcia' for a 'podistra'. No doubt you have seen the green cross above a shop signifying a pharmacy. These shops are in every town, usually on the Camino itself (they know where the business is!)
 
Camino(s) past & future
April 9 - May 3 2018 on regular bicycle.
#13
All of this will be my personal opinion, as I have no medical qualifications at all!

I think you have done the right thing, in going to a medical centre for a consultation. You are walking a long distance and have sore feet after 10 km, so the obvious first treatment is to stop walking so far. The clinic in Sarria probably sees so many people with sore feet that they only treat the cases that are acute. Some medical problems are very difficult to diagnose, and it is necessary for the patient and doctor to work together to try to understand the cause and the appropriate treatment. This can't happen very well when you walk into a clinic or hospital for a single visit. They can check for obvious injuries and treat them, or do an x-ray to determine if bones are broken. However, when you have an overuse injury, there is not much they can do in the short term except tell you to stop the overuse.

Maybe they didn't ask a lot of questions about your feet because they know that an acute problem would not allow you to walk for 10 km each day, they know that the treatment for other problems always starts with rest, and they know that you are just passing through town for a short period. Are you thinking that they should do an x-ray or other scan to investigate the problem? Are you prepared to spend the time and money to investigate the problem thoroughly? Perhaps this will be necessary, but it makes more sense to do it at home with your own doctor. These procedures can be very expensive and may still not yield clear information. For example, stress fractures are often not clear even with modern imaging. It you have a stress fracture you may need 6 weeks of no walking at all, to let it heal.
Maybe the advice to rest for a few days is the best advice available. The outcome after a few days rest will be important information to help with a future diagnosis, but that is better done at home.
I got very sick in Sarria, I had bronchitus so bad from cycling in snow, rain, hail and -4 C temps that I couldn't stop coughing. My diaphragm hurt from so much coughing that I didn't sleep for two days. I went to the hospital in Sarria and he gave me oxygen with albuterol for half an hour to open up my bronchioles and 5 prescriptions. I felt better within hours. There was no charge. Now having said all that when I return I will definitely bring antibiotics and buy a european temporary health insurance plan from AAA.
 

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