Today's episode comes from an injured runner who saw a doctor, got x-rays and found what looked like bone fragments in the peroneal tendons. We were doing a telemedicine second opinion consultation, and she wanted to know whether or not she should have surgery to take the bone chips out of the peroneal tendon. That's a great question! How did bone chips get in my peroneal tendon? Well, that's what we're talking about today on the Doc On The Run Podcast.
Dec 13, 2021•4 min•Ep. 495
I was just on a second opinion telemedicine call with an injured runner. She had a recurring injury that was still keeping her from running. Unfortunately, that injury first started eight years ago. When you have an injury, and you get x-rays, an MRI or a CT scan, or any kind of medical imaging study that shows more detail than the x-rays, you should always get a copy of that disc. This runner's story is a great example of why you need those images. Today on the Doc On The Run podcast we're talk...
Dec 10, 2021•6 min•Ep. 494
Today's question comes from a telemedicine visit second opinion for a runner. She was asking if she should have surgery to remove bone fragments. I said, "Well, let's talk about what's going on with you first." Anytime we see something abnormal on an x-ray or an MRI, we often think that it's pathologic. We presume something is wrong, just because it doesn't look right. We think if something's wrong, we should go cut your foot open and fix it. Should a runner have surgery to remove bone fragments...
Dec 08, 2021•8 min•Ep. 493
The other day I was talking to a runner who had some abnormal findings on the x-rays. What we could see was calcification in the Achilles tendon that looked like bone chips. She wanted to know if she should have surgery to remove the calcification or little bony chips that were inside her Achilles tendon. Now, the interesting part of the story is that the Achilles calcification was discovered from an x-ray where she had a stress fracture in one of the metatarsals....in a completely different par...
Dec 06, 2021•6 min•Ep. 492
Today's episode comes from a runner who was having some weird aches and pains when running. One doctor suspected he might have a thing called a "tarsal coalition." A tarsal coalition is an abnormal union or connection between two bones. He was even told me might need surgery to remove the tarsal coalition. He asked me whether or not an injection, like a stem cell injection, might actually help a tarsal coalition. You have to think about the runner's goals, and we expect different injections will...
Dec 03, 2021•8 min•Ep. 491
A podcast listener sent in a great question for the Doc On The Run Podcast. Sandra asked, "Is there a best way to ascertain if a person has a leg length discrepancy? MRI, measuring, what is it?" "Limb length discrepancy" just means one leg is a little bit longer than the other. There are lots of different ways to figure out whether or not you have a limb length discrepancy. Figuring out how big that difference might be is really important if you want to fix it. Today on the Doc On The Run Podcas...
Dec 01, 2021•8 min•Ep. 490
Today's episode comes from a discussion in our Monday, Wednesday, Friday coaching group. This was someone who actually had a metatarsal fracture and had graduated from using crutches to using the boot and was transitioning out of the boot and she asked me a great question. She said that her foot was hurting a little bit as she was transitioning out of the boot. She wanted to know if that was normal. Or was the aching associated with walking in a normal shoe something to be concerned about. Today...
Nov 29, 2021•7 min•Ep. 489
Today's discussion actually comes from a question from a runner in the Monday, Wednesday, Friday Coaching Group. This is a runner who has a condition called "hallux rigidus." He wanted to understand the best way to assess your running shoes. He also wanted to know whether or not it was possible to identify hallux rigidus just by looking at the soles of a runner's running shoes. When you get hallux rigidus, your big toe doesn't actually "dorsiflex" or come up away from the ground enough to allow ...
Nov 26, 2021•8 min•Ep. 488
Today's episode comes from a discussion I had with a runner in person who had some foot pain, it was kind of weird. He's an elite runner and he started developing this symptom that he couldn't figure out and it was in a weird spot. He got an evaluation and part of his evaluation was X-rays of his foot. When we got the X-rays of his foot and we were looking at him, he had this thing that we call talar beaking and he wanted to know what that was. What is talar beaking on the X-ray of a runner? Wel...
Nov 24, 2021•6 min•Ep. 487
Every treatment in medicine has pluses and minuses. Applying ice is no different. Ice can make some things better, and some things worse. If you ice something, in general it will calm that inflammatory response, reduce the pain and make you more comfortable. But your goal is to get back to running as quickly as possible, not to just make you feel better. Today on the Doc on the Run podcast, we're talking about whether or not an injured runner should ice a broken toe.
Nov 22, 2021•5 min•Ep. 486
Every day I do telemedicine calls with injured runners. They often ask questions that remind me of things learned in the past, that help them understand what to do right now. It's interesting how many times I actually think of this guy that was my mentor when I was racing motorcycles. His name is Fred Provis. Everyone called him "Motorhead Fred." Fred and I raced together and won an endurance championship, and he taught me a ton of stuff about life (not just racing). Much of what Fred told me, I...
Nov 19, 2021•5 min•Ep. 485
Ankle sprains are incredibly common in runners. Sprained ankles account for about 10% of all musculoskeletal injuries that show up in the Emergency Room. But there is another injury that can seem sort of like an ankle sprain, but doesn't respond to treatment the same way. This sprain is not in the ankle. It is a sprain of the joint under the ankle...the subtalar joint. It's called a Subtalar Joint Sprain. What is a subtalar joint sprain in a runner? Well, that's what we're talking about today on...
Nov 17, 2021•4 min•Ep. 483
If you suffer a severe running injury, some doctors will give you crutches to speed up the recovery process. Healing any running injury is a race against time. All overtraining injuries will eventually heal. But if you take a long time to heal, you're going to lose a lot of running fitness. You will get weaker, stiffer and develop a loss of coordination. That loss of fitness will make it very difficult for you to achieve your running goals after you fully recover. The goal isn't to heal. The goa...
Nov 15, 2021•5 min•Ep. 484
This podcast episode comes from a telemedicine visit second opinion with a triathlete and runner who was having pain as he ramped up his mileage. It turns out he had what we call a limb length discrepancy, where you actually have one leg that is a little bit shorter than the other. This is something we see a lot in runners who are starting to get problems as they increase mileage during training. Today on the Doc On The Run podcast, we're talking about three signs of limb length discrepancies in...
Nov 12, 2021•6 min•Ep. 482
This is a great question from a runner I've been helping in the Monday, Wednesday, and Friday coaching group. She had a fifth metatarsal fracture and wanted to know if this could actually cause posterior tibial tendonitis. Since they're on the opposite sides of the foot, a lot of people think that it won't cause the same kind of problem, because you wouldn't expect to have problems on both the left and right sides of the same foot. Can a fifth metatarsal fracture cause posterior tibial tendoniti...
Nov 10, 2021•5 min•Ep. 481
A runner in the in the recovering runners coaching group asked a great question. She had just broken her toe and could barely walk on it. She was really worried that she was going to have to use a fracture walking boot for a month or month and a half to get the toe fracture to heal. She wanted to know specifically when she could start running. Today on the Doc On The Run Podcast, we're talking about what happens if you run on a fractured toe before it completely heals....
Nov 08, 2021•5 min•Ep. 480
I just got a great question from somebody who said he went rock climbing over the weekend, and he got a huge blister on his big toe from his climbing shoes. He didn't really complain that much about the blister, in fact, he'd even been running. But then he said he was getting peroneal tendonitis. He was having this pain on the outside of the ankle where the peroneal tendons go down around the back of the fibula bone. He wanted to know if it was somehow related to the blister on the big toe. Can ...
Nov 05, 2021•4 min•Ep. 479
I recently got a great question from a runner who was calling me for a second opinion during a telemedicine visit. She wanted to run but had a partial rupture in the plantar fascia. When we were talking about her history, she told me that she had had a couple of corticosteroid injections (or cortisone) injections for the plantar fascia when she had plantar fasciitis. Is a cortisone injection malpractice if it causes a plantar fascia rupture in a runner? Well, that's what we're talking about toda...
Nov 03, 2021•6 min•Ep. 478
I got a call from a runner who has a really interesting situation. He's been doing lots of running, but he's been getting pain in his ankle whenever he runs. He gets a little bit of swelling in the ankle at the end of the day. But when he wakes up, the swelling in the ankle is completely gone. The ankle swelling is completely resolved and he seems fine the next morning. So his question was, “Can I run with arthritis in my ankle?” Well, that's what we're talking about today on the Doc On The Run ...
Nov 01, 2021•5 min•Ep. 477
This is a great question I got from a runner during a recent telemedicine visit and this was a runner who actually called me for a second opinion because she had a tear in the plantar fascia. She felt like it was healing, and she wanted to get back to running. She was really hoping to get some kind of real positive affirmation or confirmation that she was okay to run and wanted to know whether or not she should get a repeat of the MRI that she had previously that actually discovered she had a pa...
Oct 29, 2021•6 min•Ep. 476
I was just doing a call with a runner who started running before his fracture was healed on the x-ray. In fact his regular doctor said he couldn’t run on it until the x-rays showed healing. I let him start running on it, in a very structured way. Now he is back to full running. If the bone is always getting stronger while it is healing, do you really need to wait until the x-ray finally proves it has fully healed? Today on the Doc On The Run Podcast, we're talking about whether or not you can ru...
Oct 28, 2021•6 min•Ep. 475
This episode actually comes from a question I got during the live question and answer period at the end of a talk I was giving at the International Foot and Ankle Foundation meeting in Hawaii. The question was about one of the conditions that can often be misdiagnosed as plantar fasciitis, and that's a condition called medial calcaneal neuritis. With this condition a nerve on the inside of the heel becomes inflamed and painful. In short, the patient had alcohol injection under ultrasound guidanc...
Oct 25, 2021•10 min•Ep. 474
A doctor at a medical conference asked me a great question! I was giving a lecture at the International Foot and Ankle Foundation meeting in Hawaii on runners heel pain, specifically about the, what we call the differential diagnosis or the things that can cause runners heel pain. In that talk I was also teaching about the differences in treatments between runners like us, and non-runner patients with heel pain. At the end of that lecture a doctor wanted to know which kind of imaging study was b...
Oct 23, 2021•7 min•Ep. 473
Today I got a question from a doctor who wanted to know what I would do with a runner after surgery to remove non-healing sesamoid fractures in both feet. You have two sesamoid bones under the big toe joint in each foot. When one of them develops a stress fracture, it can break. If it breaks into two pieces, it can be very difficult to get the broken sesamoid to heal completely. If it doesn’t heal, becomes arthritic and turns into what we as doctors call a “sesamoid fracture non-union” your doct...
Oct 22, 2021•7 min•Ep. 472
I was just given a talk at the International Foot and Ankle Foundation's 40th Annual Hawaii Seminar. And at the end of the session, we got a couple of questions from the audience during the live Q&A for the doctors. A doctor in the audience she had a runner who is one of her patients. This runner had been basically running on a mild stress fracture, which I would really consider a stress reaction, for a period of about two months but wanted to do a race. Today on the Doc on the Run Podcast, ...
Oct 20, 2021•7 min•Ep. 471
This episode comes from a question from a runner I saw in person during a second opinion house call. She had a metatarsal stress fracture and felt like it was more comfortable when she was barefoot. The more you can reduce the stress and strain to the injured metatarsal bone and the healing stress fracture the faster it will heal. The types of shoes you wear during the recovery can change those stresses for better or worse depending upon which shoes you are wearing. You need to focus on protecti...
Oct 17, 2021•5 min•Ep. 470
If you want to get back to running faster after a foot fracture (or any overtraining injury), the whole key is make sure that you are increasing your activity to get stronger, instead of just sitting around and waiting, while you get weaker. But the only way you can do that is with constant readjustment based on how you feel and what happens in response to that activity during that recovery process. This episode is about runner with a healing fracture who was told by a doctor, “don’t run.” Inste...
Oct 13, 2021•6 min•Ep. 469
A podcast listeners wrote in and she asked, "How long do I need to stop running or take it easy after taking five doses, meaning two and a half days, of Cipro? I told my doctor I was a runner, so I didn't trust their opinion on when or how I should run. I haven't run since finding out the side effects two weeks ago, and the Achilles feels weak and a little thicker than the other side." This is a great question, and she is right to be concerned because the FDA issued a black box warning because o...
Oct 11, 2021•7 min•Ep. 468
A couple of weeks ago, I was working on my motorcycle, and I accidentally cut myself open. Long story short…I let a middle school kid put the stitches in the wound. In this episode we talk about how that turned out. We also talk about how that story applies to running injury recovery. Which is more important when you have surgery to heal a running injury? Is the actual procedure done by the surgeon the most important? Or is the process of injury recovery after the surgery more important? Today o...
Oct 08, 2021•6 min•Ep. 467
A new runner was having some aching in pain in the shins and he asked, "I just started running. I started having shin splints. Some people told me I have to stop. Some people, say I don't. What do I have to do?" Obviously, if you started running, you're starting to develop some fitness and you're finally getting to the place where you can run consistently, the last thing you want to do is give up your running routine. The good news is that in some cases you don’t have to stop running just becaus...
Oct 06, 2021•5 min•Ep. 466
