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Unsuspected Diagnosis to Sarah Haskins' Foot Pain

Olympic triathlete Sarah Haskins feared her career might be over after twisting her ankle running across a wooden bridge in Portugal during a race. The injury refused to heal no matter how much Sarah tried to rest or strengthen her leg. No doctor could tell her why. Then she met DISC’s Dr. Robert Bray who examined her leg, properly diagnosed Sarah and performed minimally invasive surgery to correct her problem. The result? In a few months, Sarah has gone from being completely out of the race to reclaiming her place as one of the world’s top contenders.

Sarah Haskins was competing in a triathlon in Lisbon, Portugal when she heard the sound no professional athlete ever wants to hear: a snap.

“It was on a wooden bridge, with wooden boards, wide cracks between them,” Sarah recalls. “My foot went inside the board and my ankle just snapped.” Sarah toughed it out and pushed through the pain. The triathlon is a grueling sport that requires endurance and speed in a variety of activities: swimming, biking and running. Sarah competes in the Olympic distance triathlon.

With the 2008 Olympic games only months away, Sarah needed to keep racing and continue her training. Unfortunately, what was originally diagnosed as a “sprained ankle” never managed to heal.

Despite her injury, Sarah competed at the 2008 Olympics in Beijing, finishing in 11th place; although it wasn’t the outcome she wished for. “My run didn’t feel right,” she explains. “I didn’t know what was going on. I was frustrated and very upset.” Sarah was experiencing severe calf pain and losing sensation in her left foot.

Then fate intervened. Sarah, who lives in Colorado Springs, was at the U.S. Olympic training center (OTC) at the same time as Dr. Robert S. Bray, Jr., a neurological spine surgeon. Dr Bray was visiting the OTC from DISC Sports & Spine Center in California, completing a rotation required as part of a credentialing process of the USOC when he examined Sarah.

“I could no longer feel my big toe or move it,” Sarah recalls. “I’d been asking doctors: ‘Is it a big deal?’ And they would tell me: ‘No, it’s probably not a big deal that you can’t move your big toe.’” But when Sarah asked Dr. Bray the same question, he said, “Of course it was a big deal. To a runner, the ability to move your toe is a huge function in running performance.”

“Every time Sarah ran, her foot would drop,” Dr. Bray explains. “She had a weak ankle and pain in her calf. Her leg would go lame underneath her and she’d keep re-spraining her ankle,” he says. “She was working hard doing exercises to strengthen her muscles for five hours a day, but her leg wasn’t getting stronger and she wasn’t getting better.”

Sarah accepted Dr. Bray’s personal invitation to fly out to southern California to consult with his team at DISC When she arrived he put her through a series of tests. An electrical study on her leg measured the output of her nerve and how it was functioning, but surprisingly, Sarah’s test showed basically normal results.

Remembering that Sarah complained that her leg hurt more after she ran, Dr. Bray asked Sarah to take a run around Beverly Hills, and then repeated the same electrical test.

“It was amazing, because this time the study showed a 60% drop in function immediately after her run,” Dr. Bray says, “but after a brief rest, her leg would return to normal.” Further testing revealed that Sarah had a cyst in her left knee, between the tibia and the fibula, which was causing a trapped nerve. Finally able to give the Olympian a proper diagnosis, Dr. Bray says, “She couldn’t get any better, because the nerve wasn’t working,”

Dr. Bray partnered with Dr. Eric Millstein to perform a microscopic peroneal nerve release on Sarah’s leg, an operation that combined orthopedic and neurologic surgery. “We scoped the knee and cleaned the cyst out, and then released the nerve as it came around the side of the leg,” Dr. Bray explains. “Sarah instantly felt the difference.”

“I could finally move my big toe! I was so excited,” Sarah exclaims. “I knew from that moment on that my surgery was a success. It was great to finally have answers, and Dr. Bray understood how important it was to me to have my leg fixed.”

“I never had surgery before,” Sarah says. “One of the most amazing things about D.I.S.C. is that it’s like your own private hospital. Everyone was so welcoming and kind. You don’t have the feeling of being stressed or rushed. I definitely felt comfortable, and any questions that I had were answered. Dr. Bray is the best in the country. I could not have been in better hands.”

“Sarah’s injury was totally missed, and it took a unique understanding of elite athlete mechanics as well as a combination of experts to find it and correct it,” Dr. Bray says. “These Olympic athletes really need to have the top quality health care available for diagnostic, for work-up, for treatment, for rehab, the best physicians available for modern surgery using minimally invasive techniques,” he insists. “If we want to keep these athletes healthy and moving forward, we need to provide the best care possible for them; that’s what DISC is about.”

“We were looking for answers,” Sarah says. “I was so lucky to find Dr. Bray and DISC, because they have the same mindset that elite athletes have. They treat everyone like they’re an Olympic athlete.”

DISC is now an official medical services provider for the U.S. Olympic teams, a pool of some 1000 Olympic athletes. Exceptionally proud of the grit and determination that Sarah displayed throughout her medical trials, DISC decided to sponsor Sarah personally as an athlete so she could continue to succeed. “Since the surgery, Sarah has gradually been coming back and winning more and more events,” Dr. Bray says. “She’s on a great path to the London Olympics now, so she can go take the Women’s Triathlon in 2012.”

The summer of 2010 saw Sarah Haskins globe-trotting to five different continents to compete in races. “Right now, from here on out, my sole focus is on 2012 and my goal is to earn a medal in the London Olympics,” she enthuses.

Sarah cherishes the memory of representing her country in Beijing, walking out to the starting line and seeing her family there. “I was really nervous,” she admits. “Next time around I’m not going to be.”

“Injuries do occur,” Sarah says. “That’s part of sports and having access to the right doctors and medical facility is what we need. Now that DISC is part of the USOC, they can help athletes all over the country to achieve their dreams.”

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About the author

discmdgroup DISC Sports and Spine Center (DISC) is one of America’s foremost providers of minimally invasive spine procedures and advanced arthroscopic techniques. Our individually picked, highly specialized physicians apply both established and innovative solutions to diagnose, treat, and rehabilitate their patients in a one-stop, multi-disciplinary setting. With a wide range of specialists under one roof, the result is an unmatched continuity of care with more efficiency, less stress for the patient, and a zero MRSA infection rate. Read more articles by discmdgroup.