Raynaud’s Phenomenon is an interesting condition in which spasms of small blood vessels cause changes in the skin color of the hands and feet. Raynaud’s phenomenon can also cause pain in the feet. Foot pain is also very common in runners. Raynauds is one of those conditions that isn’t typically diagnosed with a blood test or and x-ray. The diagnosis is typically made “clinically” meaning the doctor hears your story, listens to your history and decides you probably have the condition, because not...
Mar 07, 2021•8 min•Ep. 374
When you get any stage of Achilles injury and you're a runner, you're trying to figure out what you can do to get it to heal as quickly as possible. The biggest concern with runners when they have an Achilles tendon injury is that the tendon is going to continue to degenerate, turn into Achilles tendinosis, and then potentially even rupture. But the good news is that stress, when actually applied in the right way, can help your Achilles tendon recover faster, become stronger, so you can get back...
Mar 05, 2021•7 min•Ep. 373
There are the three forms of stress that can affect you and the injured tissue when you actually get back to running after you've been injured and you feel like you've recovered. I was just recently doing a telemedicine visit with someone who had an injury and was getting better. She was told to start running, but she wasn't really given any specific instructions. She was told, "You can go and just kind of run a little bit and see how it feels." If you're a runner and you haven't been running fo...
Mar 03, 2021•9 min•Ep. 372
Just a couple of days ago I was doing a telemedicine call with a runner who wanted to know what it meant to have “thinning of the plantar plate ligament on his MRI. He asked, "What does ‘thinning’ really mean? Do I really have a plantar plate tear? Is it a problem? Will I be able to continue to run?" “What is the issue with this idea of thinning of the plantar plate ligament, and why does it happen?” Today on the Doc On The Run Podcast we're talking about thinning of the plantar plate ligament o...
Mar 01, 2021•8 min•Ep. 371
When you break down the goal of running a marathon, it really only has 3 key elements. You are crystal clear on the distance, the starting point and the end point. All you have to do to compete the marathon successfully is break your training down into the daily and weekly stages of growth to establish the fitness required of your body on race day. Running injuries are difficult because they lack the clarity and simplicity of training for a marathon. But make no mistake. The process is just the ...
Feb 27, 2021•6 min•Ep. 370
Metatarsal stress fractures are one of the most common injuries in runners. Unfortunately for runners, 4 weeks to 6 weeks in a fracture walking it boot is the common recommendation from doctors. Part of the reason you get the boot for 4-6 weeks, is that you didn’t give your doctor enough information to recommend anything else. The doctor wants you to heal. The way you tell your stress fracture fracture story leaves the doctor imaging the worst possible scenario and you get the worst possible tre...
Feb 25, 2021•7 min•Ep. 369
This weekend, I was giving a lecture at a medical conference that was specific to running injuries. During the question and answer period, one of the physicians in the audience asked a completely valid question. She asked, "Why wouldn't you just begin with a prescription medication if you're 100% sure that medication had the highest probability of reducing the patient's symptoms?” The difference between the treatment options really lies in what is best for a runner long-term, versus what may bes...
Feb 23, 2021•7 min•Ep. 368
Think back to the last time you really remember getting a second wind. Maybe it was 2 miles into your fastest 5K. Maybe it was mile 18 or mile 22 of a marathon. Just when you felt you really couldn’t got on, just when you hit an all time low, your energy started to grow. You felt revived. Energized, you pressed on the the finish, thrilled with the boost of energy moving you forward. Every runner recovering from a running injury will have dark days. The energy vaporizes and is replaced by frustra...
Feb 21, 2021•5 min•Ep. 367
A few minutes ago I was on a second opinion telemedicine call with runner who was told he had an MRI showing an “osteochondral defect.” The doctor told him to stop running. If a joint surface gets damage, you may develop a little soft-spot called an “osteochondral defect.” Just because you have an osteochondral defect, it doesn't necessarily mean you have to stop running, but you do need to figure out whether or not it's actually a problem that could get worse if you don't address it. Today on t...
Feb 17, 2021•5 min•Ep. 366
I just got off a telemedicine call with a woman who was an elite runner in college. She has been having a difficult time getting back to an acceptable level of activity after recovering from her overtraining injury. When you have been doing a certain run at a certain pace, as a part of your training for years, you always fell like you can do that workout. But when you get a running injury and take time off, unfortunately, your sense of reality is off in that moment. What you sense about your fit...
Feb 15, 2021•3 min•Ep. 365
If you over-stretch any nerve it can become inflamed and painful. If you roll your ankle on a trail you can get a condition called traction neuritis. Most of the time when I am on a telemedicine or second opinion call with a runner with traction neuritis, they have been misdiagnosed with some other condition. If you understand how to tell the difference, you can understand how to get back to running sooner. Today on the Doc On The Run Podcast we're talking about traction neuritis in a runner and...
Feb 12, 2021•5 min•Ep. 364
If you hire a running coach, your coach is going to design a program that is going to actually test you physically and mentally, and push you to your physiologic limits on a regular basis to make you stronger. Any running coach will give you a series of workouts to execute. And when you do runs correctly then what happens is that you do the maximum amount of tissue damage that your body can sustain and rebuild before your next workout. Today on the Doc On The Run Podcast we're talking about why ...
Feb 10, 2021•6 min•Ep. 363
Osteophytosis is a common finding on foot and ankle x-rays of runners. Bone spurs can form anywhere bone is irritated or otherwise aggravated by jamming, jarring motion. Most often, osteophytosis is found in the heel, big toe joint and ankle joint. The real is question is whether or not the osteophytosis a problem that needs to be removed, treated, or even prevented. Today on the Doc On The Run Podcast we're talking about osteophytosis in the foot and ankle in a runner....
Feb 08, 2021•7 min•Ep. 362
The biggest mistake any runner can make when seeing a doctor for a running injury is leaving the office without a clear picture or how bad the injury actually may be. If you don’t have a clear idea of your state of injury, you (or your doctor) are only guessing at how long it will take to get better and return to running. Part of the lack of clarity is your fault. You have to communicate what really happened when you got injured, what happened between the injury and the day you show up in the do...
Feb 05, 2021•6 min•Ep. 361
The chances are good a lot of your friends secretly admire your ability to run. Unfortunately it seems a lot of people who want to start running, but don't think of themselves as runners find it very difficult to start. Sooner or later one of your friends is going to call you or talk to you and ask for some advice. The real challenge and helping one of your friends begin running is to get them to go for the initial run, and be proud of themselves for doing it. I really believe that we as runners...
Feb 03, 2021•9 min•Ep. 360
I am sure that you have heard your running buddies use an analogy: "We just banked another long run.” “We got another hard workout in the bank.” All these efforts and investments in our training add up. They create this great store of energy for us. The accumulation of fitness is what prepares us for a marathon an Ironman, or an ultramarathon. Today on the Doc On The Run Podcast we're talking about how running injuries are a lot like a savings account.
Feb 01, 2021•5 min•Ep. 359
Snowboarder’s fracture is a small fracture in your foot that is often misdiagnosed as an ankle sprain. The injury occurs when you break a portion of the talus bone called the lateral process. The lateral process of the talus sits at the outside of your foot and ankle. You can break it when you roll your ankle running on a trail or stepping in a pothole while running on the road. These fractures are much more common that previously taught. Not surprisingly, if you think you have an ankle sprain, ...
Jan 29, 2021•9 min•Ep. 358
Many times doctors look at you cross-eyed when you tell them how much you run, how far you run and how much you want to run now. They tell you that you ran “too much” and got injured. The snap recommendation is to stop running. Doctors want you to heal your running injury. Many times doctors recommend the “safest” path…stop running. Be patient. Wait for healing. Slower treatment is not always better, and isn’t even always safer. The goal for most injured runners is not to just heal the injury. T...
Jan 27, 2021•5 min•Ep. 357
A runner with a stress fracture called me for a telemedicine visit because she was confused. The doctor told her that she has a stress fracture. But there was no crack on the x-ray. The doctor said she only had a “periosteal reaction” which suggested she had a metatarsal stress fracture. She wanted to know if a periosteal reaction meant the foot was really broken, or not. The periosteal reaction is one of the earliest findings that you can see on your x-ray when you have a stress fracture in one...
Jan 25, 2021•8 min•Ep. 356
If you're not actually healing as fast as you want to it is just not a priority. I talked to a runner the other day who said that he was trying to lose some weight, but he already felt like he was off track, yet it's only a couple weeks into the new year. The fact is that if you can't get to run and exercise, if you can't take the time to prepare meals and eat food that is healthy, it's just not a priority for you. That's not a judgment, it's just a fact. If we are not really taking the time to ...
Jan 22, 2021•4 min•Ep. 355
The sesamoid bones, these two little bones and they sit under the big toe joint and interestingly when I show X-rays to someone like somebody who has a stress fracture almost always the first thing they say is “what are those two things” and they're pointing to the sesamoid bones. They are also very small and they don't have a great blood supply. So if you get a problem with the sesamoids and you get sesamoiditis, it gets flared up and gets worse and worse and worse. A lot of times it'll turn in...
Jan 20, 2021•4 min•Ep. 354
The only thing worse than a running injury is a re-injury. Most of the runners who call me for a telemedicine visit are demoralized. You get inured. A doctor tells you to stop running so you can heal. You wait. You heal. You go for a run. And you get injured again. The cycle of running injury and re-inury is a result of being de-conditioned during the “healing” period. Going for your first run in that untrained state is risky and completely unnecessary. Today on the Doc On The Run Podcast we're ...
Jan 18, 2021•5 min•Ep. 353
I recently got a great question from a runner... Why are flat feet less stable when you run? Pronation of the foot happens as your arch collapses and the foot elongates. You do that every time you land as you run. You need pronation to absorb impact and decrease forces. Supination is the opposite of pronation. Supination transforms your foot from a flexible, force-absorbing adapter to a rigid lever to propel you forward as you run and push off. Today on the Doc On The Run Podcast, we’re talking ...
Jan 15, 2021•8 min•Ep. 352
One of my best friends has pain and swelling in his Achilles tendon, right in the watershed region that we know develops Achilles tendinosis and can even rupture. He was understandably worried. He asked me, “Does my Achilles tendon need a PRP injection or Stem Cell injection?” I explained to him that he was asking the wrong question. I said, the right question is, “Do I need an injection at all.” Next I gave him access to the Achilles Tendon Course where he could go through the 5 step process I ...
Jan 13, 2021•7 min•Ep. 351
----more----When you get any kind of over-training injury, something also incredible happens. You limp. You compensate to remove all of the pressures and forces and friction that goes through that injured structure by “compensating.” But the reason compensation is a problem is that if you think about holding your foot in an uncomfortable and natural position, what you're doing is you are strengthening one thing and you're stretching and weakening something else. Today on the Doc On The Run Podca...
Jan 11, 2021•7 min•Ep. 350
I was recently doing a call with an athlete who has a sprain of the plantar plate ligament. One of the things that happens with runners is we get an MRI, sometimes just for what we suspect is a plantar plate sprain. He went and got an MRI. In fact, he got a couple of MRIs. The MRIs were different. It is reasonable to want reassurance that your foot is healing before you start running. But an MRI doesn't always provide the reassurance you seek. Today on the Doc On The Run podcast we are talking a...
Jan 08, 2021•8 min•Ep. 349
We always want obvious signs when we are healing form something like a metatarsal stress fracture, Achilles tendinitis or peroneal tendinitis or any injury that is keeping his from training as much as we would like. But the results aren’t always obvious. Think about your pace, what it feels like. Think about how those feelings of pace, perceived exertion and heart rate keep you on track. These are are performance clues when training and racing. We also have to look for performance clues when rec...
Jan 06, 2021•8 min•Ep. 348
I was just talking to a runner in one of the sessions where people call in who are taking the One Run Away challenge . In that challenge course, I'm helping you try to figure out what is the step that you're not taking that is holding you back from recovering as quickly as possible. So this is the thing that goes on and every few days I do calls and let people ask questions directly to me over webcam. I got an interesting question and this was about how to actually do something that Dr. Schreide...
Jan 04, 2021•6 min•Ep. 347
I was just doing a telemedicine visit with a runner who has had an injury to the plantar plate ligament with pain for months. He's been getting better slowly, but he was trying to figure out how bad it really is. And one of his first questions he asked me was what I see on the x-rays. Can you see anything about the plantar plate where it's torn, where it's injured or anything else? Most of what doctors see on a foot x-rays are changes that imply ligament damage. But there is really only one thin...
Jan 01, 2021•11 min•Ep. 346
I just got off a telemedicine call with a runner and she asked me an interesting question, she said, "I just want to know, am I on the right track?” When a runner calls me for a telemedicine visit, after they've seen two or three or four other doctors, I do something differently. What I do differently is something you can do on your own right now, you don't even have to talk to me. Just look at your results. If you track those results, you look at those results, you will know what's going on and...
Dec 31, 2020•5 min•Ep. 345
