I was just lecturing at the International Foot and Ankle Foundation meeting in Seattle. I was giving talks on running injuries. A doctor in the audience asked me if "not running" was the safest way for runners to heal running injuries. Keep in mind, this was a doctor asking the question. Have you ever thought this makes sense? After all, if a runner gets a running injury, and they stop running, that's the safest way to get it to heal. Or is it? Do you agree that not running is the safest way to ...
Jul 11, 2022•5 min•Ep. 585
Let's consider you are a runner with a painful neuroma. The more you run, the more painful the foot becomes. But it only started with some weird little sensations. Eventually it starts to get more numb. You notice more tingling, then more burning pain. Now your doctor wants to talk you into surgery. You just want the problem fixed. So you go to the operating room and then you're shocked to find out that you still have pain later. By the way...that's not malpractice. It just means you had a bad o...
Jul 08, 2022•8 min•Ep. 584
I was listening to a podcast about the way that disagreements happen. He said, anytime there's a disagreement, no matter what, there are two possibilities. If there are two people arguing about something, one person could be right, and the other could be wrong. That means roughly speaking, there's a 50% chance that one person is wrong all the time. This is true of physicians as well. Let's say, I come to your home to see you and help you with a metatarsal stress fracture. You've been told you ha...
Jul 06, 2022•4 min•Ep. 583
One of the questions I got in the Runners Aid Station was: “Do I really need a fracture walking boot?” This is a runner who went to the doctor, and was told, "You have extensor tenosynovitis. The best way to get it to calm down is to remove the inflammation and stop aggravating the tendons." If you get aching pain on the top of your foot, it might be caused by an irritated extensor tendon sheath (which is the little tube around the extensor tendons as it goes out to the toes on the top of the fo...
Jul 04, 2022•5 min•Ep. 582
Maybe you have been taking some time off because you have been injured. Maybe you took some time off because you spent way too much time in a fracture walking boot. Maybe all of your training just took a backseat to all the chaos and confusion of the pandemic. But none of that would be as bad as having a doctor tell you that your hip was injured because you are just way too fat to run! Irrespective of why, if you are a runner, and you feel like you are running just a little bit too slow, I can p...
Jul 01, 2022•32 min•Ep. 581
If you're reading this, it's probably not because you love toenail fungus. It it also probably not because you think black toenails are pretty. In fact, you probably think both are pretty gross and you would be right. But this bruised black toenails and toenail fungus joining the party is mostly preventable. All runners should understand the circumstances that can put you at risk of getting a fungus infection in the nail which runners call "toenail fungus," or which doctors call "onychomycosis."...
Jun 29, 2022•6 min•Ep. 580
If you get a plantar plate sprain, the first thing you may notice is pain and irritation at the ball of the foot, right where the second toe attaches to the foot. If the foot feels swollen, puffy or sore in that spot, it could be a plantar plate sprain. A one common injection performed for plantar plate ligament sprains is a corticosteroid injection. I just spoke with a runner who thought the doctor did the injection in the wrong part of the foot. She saw a podiatrist, and the doctor did a corti...
Jun 27, 2022•7 min•Ep. 579
This morning I was on a call answering injury questions live in the Injured Runners Aid Station. This runner actually said, "Well, my doctor said that since I got a running injury, the solution is to stop running." When I think about this, there are really only two approaches to the questions of whether or not you have to stop running entirely to heal an overtraining running injury. Do I have to stop running and lose my running fitness entirely just to heal? Well, that's a great question and tha...
Jun 24, 2022•6 min•Ep. 578
I was just speaking with a woman who has a suspected mild plantar plate sprain. What was interesting is the fact that she doesn't really have a whole lot of pain. I was explaining how important it is that she actually figures out her baseline "pain" numbers. I was explaining that even if you don't call it "pain" you have to rate the level of discomfort so you can track it. How bad is it when walking with or without running shoes, or simple things like walking up and downstairs. Now, the problem ...
Jun 22, 2022•5 min•Ep. 577
I just got off a webcam call in the Injured Runners Aid Station. The runner who called me, had some down with a cold. He had been sick for a few days. He wasn't running. He was curious about whether or not his injury was going to actually get worse while he was ill. Because he knows that when he's sick, his immune system is working really hard to try to fight the infection. And your immune system can't do everything all at once. If you have an injury, it is widely accepted that the illness is go...
Jun 20, 2022•6 min•Ep. 576
The plantar plate ligament is a little ligament on the bottom of the ball of the foot, right where the toe attaches to the foot. The function of the plantar plate ligament is to reinforce the joint and support the toe by helping to hold it down against the ground. Anatomically, the plantar plate ligament resists the motion doctors call "dorsiflexion," where the toe gets pulled up away from the ground. Even though the plantar plate ligament is really small, its funcion is vital. Doing exercises t...
Jun 17, 2022•7 min•Ep. 575
If you recently started getting some aching pain on the outside of your ankle every time you run, you might have a condition called peroneal tendonitis. Peroneal tendonitis is a problem often encountered by runners with high arches. It can often be exacerbated by running in ultralight unstable shoes or running on trails when you're feeling too tired to maintain good form. The two peroneal tendons are both on the outside of the ankle. But they do different things. The way you position your foot t...
Jun 15, 2022•8 min•Ep. 574
If you get pain on the top of the foot when you're running you might discover you have a painful condition called extensor tenosynovitis. "Tenosynovitis" just means you have irritation and inflammation within the tendon sheath, or the little tube that surrounds the extensor tendons that fan out toward the toes on the top of the foot. There are really 2 keys to calming the tendon sheath. You have to decrease the inflammation with the tendon sheath. But you also have to stop irritating the swollen...
Jun 13, 2022•5 min•Ep. 573
The other day in the Recovering Runner's Aid Station, I got a great question: “If I get stress and strain on my foot, because I'm overweight, should losing weight be part of the strategy to actually get my foot to recover as fast as possible?” There are lots of ways to reduce the stress and strain on one injured part of your foot. Obviously, the more your body weight, the more pressure on your foot when you stand, walk or run. Sometimes doctors will tell patients, "If you weighed 20 pounds less ...
Jun 10, 2022•5 min•Ep. 572
Yesterday I saw a runner with a plantar plate sprain. She wanted to know if stretching the toe would help the plantar plate ligament heal faster. Plantar plate sprains happen because the plantar plate ligament gets overstretched, and strained. When you get a plantar plate injury, the fastest way to allow healing is to reduce the stress and strain on that injured ligament. If you're thinking about whether or not to stretch the toe or do something to try to help the condition improve faster, you r...
Jun 08, 2022•6 min•Ep. 571
Think about what happens when you start running. You decide you want to run. You make a decision, then you go out and you actually run. You start working on your running form. Maybe you hire a coach You add a little speed work. You also start doing some strength training to supplement your running fitness. Eventually you even start working on your pacing strategies for your races. These are all things that are important pieces of running. But thinking about your pacing strategy when you haven't ...
Jun 06, 2022•6 min•Ep. 570
Overtraining injuries only happen when you ignore a problem. No runner wants to be injured. Most runners who call me for web-cam visits have been tuning out the signs of impending injury...long before they actually got injured. You get an overtraining injury because you did feel something, but you ignored it. Don't forget...you could not become an accomplished runner if you were not capable of tuning out discomfort and putting in the work to become a strong runner. But that works against you whe...
Jun 03, 2022•6 min•Ep. 569
I just did a web-cam call with a runner who had a thing called a "mallet toe" deformity. He had pain in the ball of the foot when running. He said he was reading about plantar plate sprains, and thought, "Maybe I have a plantar plate sprain because I got this funky toe." He wanted to know if a mallet toe could cause a plantar plate injury. Can a mallet toe cause a plantar plate injury? Well, that's what we're talking about today on the Doc On The Run podcast.
Jun 01, 2022•5 min•Ep. 568
When we think about training for endurance events like marathons, we expect the payoff to feel good. We are patient with the process, yet in the progression of building fitness, we always expect that when we have a breakthrough run, it's going to feel great. It is just not true. When you do a run that is a lot longer, or a lot faster, you know you've made a breakthrough. Breakthrough runs do not always feel great and that's what we're talking about today on the Doc On The Run podcast....
May 30, 2022•5 min•Ep. 567
I was just watching an injured runner walk. We were trying to pin down her diagnosis and figure out why she was getting injured. She asked me what I actually saw when analyzing her gait. One of the things I saw was that she had this thing called extensor substitution. She wanted to know how it contributed to the issues she has been having when she was running. Today on the Doc On The Run podcast, we're talking about extensor substitution in runners.
May 27, 2022•7 min•Ep. 566
What happens when you look down at your feet as you run? Many injured runners start looking down toward the injury, even as they run. What do I mean by that? We start to hunch over, our running form falls apart, and we do all the things that are completely counter to everything that we know about good running form. If you're running after an overtraining injury, you really need to keep your head up. That's what we're going to talk about today on the Doc On The Run podcast....
May 25, 2022•4 min•Ep. 565
If you are reading this because you are researching Achilles tendinosis, I'm sorry. Achilles tendinosis is one of the worst injuries a runner can get. Tendinosis is a serious problem and must be treated aggressively. It is helpful to understand what you really need to do. You also need to understand Achilles tendinosis treatments doctors often recommend, which you might want to avoid. Today on the Doc On The Run podcast, we're talking about Achilles tendon calcification in runners with tendinosi...
May 23, 2022•8 min•Ep. 564
One of the things that's really important is that you really have to think about what it takes to ramp up without getting injured, and that requires tracking and paying attention to everything. I'm going to let you listen in on a recording from an actual live session in the Injured Runner's Aid Station explaining these keys to ramping up and running without getting reinjured, while using the advantages that you already have with your runner's mindset. Today, on the Doc On The Run podcast, we're ...
May 20, 2022•6 min•Ep. 563
The reality is, there are only two kinds of runners that I think really need a fracture walking boot for plantar fasciitis. The runners who don't mind losing all their running fitness and the other group of runners who really need a fracture walking boot for plantar fasciitis are those that basically assume they have the wrong diagnosis. Which kind of runners really do need a fracture walking boot for plantar fasciitis? Is it somebody with mild plantar fasciitis? Moderate plantar fasciitis? Seve...
May 18, 2022•4 min•Ep. 562
One of the worst things when you're an injured runner is to stop taking action. Think about what would happen if you did this with a marathon. If you were to sign up for a race and you didn't do anything to actually gain fitness in preparation for that event, would you expecto to do well? It blows me away when I see injured runners who have spent years in disciplined training, yet then when they get injured, they just sit in a puddle of inaction that keeps them stagnant and prevents them getting...
May 16, 2022•4 min•Ep. 561
A great question I got from someone recently who had a plantar plate injury and the toe was a little bit crooked. His question was, "Do I really need to have surgery if my toe is crooked? Is that a good indicator of whether or not I need plantar plate surgery just because the toe is sitting out of position a little bit?" I thought it might be helpful to explain when it might actually be necessary to have surgery and when it might not be necessary to have surgery. Does a crooked toe mean you have...
May 13, 2022•9 min•Ep. 560
Plantar fasciitis is one of the most common causes of heel pain and it's also one of the most common reasons people actually go to the podiatrist. The fastest way to get it to calm down is to reduce the stress and strain to the plantar fascia ligament so that it'll actually heal. So if you're going to try to run, you have to do something to reduce the stress and strain to the plantar fascia ligament, while you're running. Today on the Doc On The Run podcast, we're talking about where to run when...
May 11, 2022•6 min•Ep. 559
I do lots of running injury second opinions and I do most of those over webcam. Sometimes I do them over phone, but webcam's way better because I can see you, we can talk, I can show you some stuff on screen, share if I need to, and I can look at stuff that you have that might be really useful for me to help you figure out what's going on. Whether you're seeing me for a webcam visit or if you're seeing your doctor in your neighborhood, there are four things that you really should make sure that ...
May 09, 2022•9 min•Ep. 558
If you are a runner with a plantar plate sprain, you may be really frustrated. Unfortunately, plantar plate sprains are difficult injuries to get better quickly. One key is to make sure it doesn't come back once you're running. When I do second opinions for runners with plantar plate sprains, they ask...Should I have a cortisone injection? The short answer is there are only two times when it makes sense to get a cortizone injection around the plantar plate. Today on the Doc On The Run podcast, w...
May 06, 2022•8 min•Ep. 557
Faith and doubt are both beliefs. If you're taking action to maintain your running fitness, you have faith you're going to get better. If you're doing nothing to maintain your running fitness it's because you have doubt. But don't let this example convince you that there is only one way to decide whether or not you can do something to maintain your running fitness. No matter what the specific injury, there is always some action, some step you can take to gain confidence, move from Doubt to Faith...
May 04, 2022•8 min•Ep. 556
