Today's episode actually comes from a question sent in by Shay. She said, "I have a plantar plate complete tear and I had surgery on my left foot in October 2019. So that was a couple years ago. I'm running with some new issues in the right calf, but the main thing I want to learn is how this injury occurs. I'm really afraid of it happening to my right foot." I talk to injured runners all the time. I lecture at medical conferences, teaching doctors what I do with runners who have these plantar p...
Feb 21, 2022•9 min•Ep. 525
This weekend I was lecturing at the International Foot & Ankle Foundation meeting in lake Tahoe, and I was lecturing on running injuries. At the beginning of that lecture, I was asking the group of doctors there and I said, "Well, if you had a runner with a fourth metatarsal stress fracture and they had this level of pain and this level of disability and this level of complaint about it, how long would you expect to have them in a fracture walking boot?" There was a doctor from Flagstaff, Ar...
Feb 18, 2022•4 min•Ep. 524
I just got off the phone with a runner who had a plantar plate sprain. He was out on a run, he got a plantar plate sprain. I saw him, I helped him understand what to do and what I showed him to do was exactly the same stuff I show you in the plantar plate sprain course. He was doing much better, but he had a great question. His question was, "When is my plantar plate sprain really healed enough that I don't have to worry about it anymore?" Well, that's a great question and that's what we're talk...
Feb 16, 2022•5 min•Ep. 523
Yesterday I was giving a lecture at the International Foot & Ankle Foundation meeting in Lake Tahoe. The topic was on protocols for return to running after recovering from over training injuries. One of the most important points I was trying to make to the doctors in that session was that fitness is transient. Fitness is only present in the presence of growth. If you're an injured runner this is terrible news. Today on the Doc On The Run podcast, we’re talking about why running fitness is tr...
Feb 14, 2022•4 min•Ep. 522
One of the worst injuries you can actually get if you're a runner is a plantar plate ligament sprain. The plantar plate ligament is a very small ligament on the bottom of the foot, where the toe attaches to the metatarsal phalangeal joint, right at the ball of the foot. These can happen for lots of different reasons but it's a very small structure and the unfortunate reality is, is that every single time that you stand, you're stepping on the ligament. Why do plantar plate sprains take so long t...
Feb 11, 2022•4 min•Ep. 521
I talk to injured runners all the time, and what I see is there are some runners who are kind of over the hump. They've started figuring out that they're injured and they're going to have to do a whole lot of work to actually get back to running quickly. Then there are other runners I see who are basically just demoralized and depressed because they're stuck in a rut. Are you an injured runner or a recovering runner? There is a difference, and that's what we're talking about today on the Doc On ...
Feb 09, 2022•4 min•Ep. 520
I got a question from a runner who's had a metatarsal stress fracture who's very frustrated, who's trying to figure out how to get back to running. He went and saw a doctor and he was told that he had a stress fracture and the doctor told him to take some time off of running. Then he started watching some YouTube videos, started listening to some podcasts, and then asked me a very serious question: How long do I have to wait to run with a metatarsal stress fracture? Well, that's what we're talki...
Feb 07, 2022•4 min•Ep. 519
I just got off a consultation call with a runner who called me for a second opinion, and she had an injury. She actually said that a doctor told her she wasn't built to be a runner. I'm not built to be a runner. Is that true? What does a runner look like? Well, that's what we're talking about today on the Doc On The Run podcast.
Feb 04, 2022•5 min•Ep. 518
In this podcast episode we’re talking about one of my favorite false beliefs. It's that rest equals recovery. This sort of makes sense to most people, but then runners get confused and wind up calling me for second opinions because they're still a little confused when they hear this. Rest equals recovery. That's what we're talking about today on the Doc On The Run podcast.
Feb 02, 2022•6 min•Ep. 517
In this episode we're talking about whether or not you can't run just because you got a running injury and this is a thing I hear all the time from injured runners. They call me because they're frustrated because they're runners, they got a metatarsal stress fracture, or a plantar fasciitis, or a plantar plate ligament sprain, or Achilles tendonitis. They say, “My doctor said I can't run because I got a running injury. Does that make sense to you?” Well, that's what we're talking about today on ...
Jan 31, 2022•5 min•Ep. 516
A running injury is always bad. No runner is ever happy to have a stress fracture or to have plantar fasciitis or Achilles tendonitis...or something worse. If you get an overtraining injury and you're trying to recover, but you're not getting better fast, you need to stop and evaluate. The biggest problem I see with most injured runners is that they half do the recovery. You stop running. You stop working out. All you do is sit around. You are waiting and waiting and waiting to heal. But all of ...
Jan 28, 2022•5 min•Ep. 515
If you are a runner with a plantar plate injury, it is pretty easy for a doctor to make a convincing sales pitch on surgery. There are a couple of reasons that you should consider surgery for a plantar plate sprain. The first reason surgery makes sense is you tried everything else and nothing non-surgical will work. But you have to be honest about your non-surgical attempts. Here are some examples I often hear from injured runners. "I used the fracture boot a little bit, but had to take it off t...
Jan 26, 2022•6 min•Ep. 514
I was recently doing a webcam call with an injured runner who wanted to know whether or not he should try to work on his running form. He got injured and he started to get better. But the injury kept coming back. He was in a cycle of yo-yo healing. Better, then worse, then better again. After a big race he got a lot worse. His question was whether or not working on his running form might help halt the recurring running injury cycle. Should an injured runner work on running form? Well, that depen...
Jan 24, 2022•7 min•Ep. 513
One thing that's really demoralizing if you get a stress fracture is to spend a bunch of time in a fracture walking boot and then go get something like an MRI and be shocked and horrified when the doctor says, "Well, not only do you have a stress fracture in that bone, it looks like you've got a stress fracture in another bone as well." If you think this stress fracture might have spread well, it could. But not the way an infection would spread. There is a way that stress related inflammation in...
Jan 21, 2022•6 min•Ep. 512
I was just on a call with an injured runner who's been having trouble for a couple of months. He wanted to know what to do next. The very next step in most cases is getting baseline numbers so you can figure out where you really are with your fitness, your injury, and your recovery...or lack thereof. You've got to take an honest inventory! The whole key to getting recovered as quickly as possible is letting the injury heal...while you work to maintain your running fitness so that you can get bac...
Jan 19, 2022•7 min•Ep. 511
If you're a runner with running pain on the top of the foot, it could be lots of different things. The actual diagnosis depends on what happened, what you did, and what it feels like now. There are a couple of really common things causing pain in the top of the foot in runners. Let's talk about two common causes. It may be either a tendon or a nerve on the top of your foot. Today on the Doc On The Run Podcast, we're talking about how a runner can tell tenosynovitis from neuritis in the top of th...
Jan 17, 2022•8 min•Ep. 510
If you've got an overtraining injury, but you're trying to figure out how to stay fit, a lot of people are going to think that you're not normal. But if you ran 50 miles you are not normal. If you signed up for a marathon, you're not normal. If you are a runner, you are not normal. Don't think you will be told you're normal when you are injured, in pain, but still working out. But that's exactly what all the rapidly recovering injured runners do. I call them injury hackers. Today on the Doc On T...
Jan 14, 2022•3 min•Ep. 509
I just saw a comment on our YouTube videos from a runner named Mary. She viewed the video on permanent calf atrophy, and how that can happen if you spend way too long in a fracture walking boot or a cast. Mary replied and basically said, "Great. Now you depressed the crap out of me. Thanks. Ugh." Realizing that you have lost fitness to the point of atrophy can be really upsetting for any runner. Well, I've got some good news and some bad news for you, and that's what we're talking about today on...
Jan 12, 2022•4 min•Ep. 508
If you've been running and you started having pain on the outside of your foot and then you went to see a doctor who diagnosed you with a thing called a Jones fracture, you're probably really worried right now and that would be reasonable because most of the time when you get a Jones fracture you might wind up in surgery. I think it's important, if you're considering whether or not you could run with a Jones fracture, you really have to think about what a Jones fracture is, where it's located, w...
Jan 10, 2022•6 min•Ep. 507
This may seem like a crazy question when you first think about it, because skiing seems like a high stress activity. But I have had lots of runners who have asked me this question, and usually when they do, they have thought about it, and they point out that a ski boot is a very stiff and very protective piece of equipment. The question though is not really, if it's safe for you to wear the boot, the problem is, is it safe for you to ski with the boot and that leads to several questions that you...
Jan 07, 2022•6 min•Ep. 506
If you rest long enough any overtraining injury will eventually calm down. But if you rest too long, you will lose all of your running fitness. The difference between elite athletes who get better fast, and average runners who take forever to recover are the daily activities they focus on while recovering. Today, on the Doc on the Run podcast, we're talking about the two most important questions for recovering runners.
Jan 05, 2022•6 min•Ep. 505
Let's say you're out on a run and you start noticing this weird aching pain in your foot and so you suspect you have a metatarsal stress fracture. I often get consultation calls and webcam visits, and I even do house calls for athletes who have metatarsal stress fractures. The good news is that a lot of the times, if you actually do something, when you first notice that aching pain in your foot, when you're running, it may not actually be a true stress fracture. Today on the Doc On The Run podca...
Jan 03, 2022•6 min•Ep. 504
I often get questions from runners and this is actually a common one that I get from runners when they have either enrolled in the plantar plate sprain treatment course for runners, or if they've signed up to do an individual webcam consultation. Everybody seems to think that an MRI will give you a crystal clear image of what's going on inside your body and in some sense, that's true. It is amazing, the amount of detail you can get when you get an MRI. However, you have to remember that the plan...
Dec 31, 2021•7 min•Ep. 503
I lecture at medical conferences about stress fractures, trying to teach physicians the difference between a stress response, a stress reaction, which is basically an irritated and inflamed metatarsal bone, and a stress fracture where there's actually a crack that can cause real trouble. One of the questions doctors ask me is what's the best way and the worst way to tell a stress reaction from a stress fracture, because it does make a difference. What is the worst way to tell a stress reaction f...
Dec 29, 2021•5 min•Ep. 502
If you only get one thing from this episode, let it be this…Thank you! From the bottom of my heart I am grateful for you as a listener of the show! More than 10 years ago I started writing a blog talking about running injuries, and the various treatments that we as physicians offer. A few years later, at which point I had actually only listened to a few podcasts myself, I thought it might be useful to start recording a podcast to talk about foot and ankle injuries in injured runners. Well, its h...
Dec 27, 2021•5 min•Ep. 501
Every time I do a second opinion consultation with a runner who has a plantar plate injury, I hate to tell you this, but I hear the same story over and over and over. Basically they call me and they say, "Well, I have a plantar plate sprain. I know I have a plantar plate sprain. I went through the plantar plate sprain course and I've been doing some of those things to actually try to get it better and it's starting to improve, but I was misdiagnosed with another condition." And we're going to ta...
Dec 24, 2021•10 min•Ep. 500
Metatarsal stress fractures are one of the most common overtraining injuries afflicting runners. Much of the time the stress fracture is preceded by what we as doctors call a “stress reaction.” If you ignore the warning signs of a stress reaction and keep on running in the same way, applying the same stress, the stress reaction will advance to a full on stress fracture they can keep you out of training for months. Most people think and X-ray of the foot is the best way to tell the difference bet...
Dec 22, 2021•11 min•Ep. 499
This question came up from somebody in the coaching groups who wanted to make sure that she wasn't going to get re-injured. She wanted to know which running shoes she should use to reassess her pattern, and make sure that she's working her way out of this compensation pattern, where she's essentially limping because of this prior injury and that's a really useful thing to do. Today on the Doc On The Run podcast, we're talking about which running shoes show running form wear patterns best....
Dec 20, 2021•4 min•Ep. 498
An MRI can be very helpful when you have a strange injury that doesn't seem to fit in any of the common running injury boxes. I just had a call from a runner in that very situation. He is someone who has an injury and has something kind of strange going on. He actually had an abnormal finding on an MRI from a little more than three years ago. At the time that he had that previous MRI that thing that was a little weird on his MRI wasn't really causing a problem, but now his pain is in exactly tha...
Dec 17, 2021•5 min•Ep. 497
Today's episode actually comes from a second opinion telemedicine visit with a runner who wanted to know more about a tarsal coalition. He had an X-ray and the doctor found this thing called a "C-sign." The "C-sign" is an abnormal appearance on an x-ray that suggests a tarsal coalition. When you look at the lateral view of the foot X-ray, a bridge of bone can form, partially encircling the talus bone and the calcaneus or the heel bone. It creates a bridging bright white thing that looks like the...
Dec 15, 2021•5 min•Ep. 496
