I just got off a call with a runner who needed a second opinion with his running injury recovery. He had a fracture and it has been improving. But because it was painful and swollen, he was still icing it daily. At his last follow-up appointment, the doctor actually said, "I think you're good enough to actually start cycling at this point, to get back a little of your running fitness." So, the question is, should I stop icing? Do I need to keep doing that? If my injury is good enough to start cy...
Sep 19, 2022•5 min•Ep. 615
Sometimes a doctor really needs to touch your foot to make the diagnosis. But not always with runners. Since the pandemic pushed so many of us into Zoom meetings, we all know it's pretty easy to get on a web-cam call when it's really difficult to meet someone in person. There are a couple of times when webcam second opinion visits can be almost as good as meeting in the doctor's office. There are lots of benefits to the webcam calls that do make them almost as valuable as in person visits. When ...
Sep 16, 2022•6 min•Ep. 614
Today's episode comes from a great question I got during one of the Runners Aid station calls. This was someone who had a plantar plate sprain and had talked to a doctor about a couple of different procedures that might actually, potentially, speed up the healing. He wanted to know about the difference between these two things called dry needling or a PRP injection. Today on the Doc On The Run podcast, we're talking about dry needling versus PRP in runners.
Sep 14, 2022•7 min•Ep. 613
Ivan has a great question. After watching the watching the video "Can I Run After Wearing a Fracture Boot?” he wanted to know: “It still swells and has a lot of pain what do I do?” Anytime a runner gets a stress fracture, the main goal is to confirm the foot is healed enough to withstand the forces and stresses applied to the injured bone. In the episode we are going to talk about: 3 indicators of ongoing tissue damage when you have a stress fracture. 3 strategies used to decide when it’s safe t...
Sep 12, 2022•8 min•Ep. 612
Let's say you've had an aching pain in the ball of the foot that's been going on for several weeks. You've tried lots of stuff. You tried icing it. You tried some over-the-counter inserts that you got. Maybe you stopped running all together. Maybe even used a fracture walking boot. But after weeks, you're not getting anywhere. Today on the Doc On The Run Podcast we're talking about how you need to find your target when you're not getting better.
Sep 09, 2022•3 min•Ep. 611
I was just on a call with a cross-country runner who had had a second metatarsal stress reaction. A stress reaction is basically like a mild stress fracture, but without any crack in the bone. She was doing well and her foot had been getting better. But then when she went for her first run, she had pain in her foot. The pain during that first run was in a completely different bone. The new problem was not in the second metatarsal, it was in the fifth metatarsal on the outside of the foot. Let's ...
Sep 07, 2022•4 min•Ep. 610
The radiologist reading your MRI knows nothing about your problem. The only clues a radiologist gets about your injury are described in the clinical history section of the MRI order from your doctor. I just got off a call with a runner who had gotten an MRI order from his doctor. He had a long history of injury but the only description on the MRI order was "Concern for fracture." This runner had more than just a concern for a possible fracture. But because there was such a limited description fo...
Sep 05, 2022•5 min•Ep. 609
This episode has a whole bunch of complicated-sounding terms that you may have never heard before. One of them is sinus tarsi syndrome, and the other one is FHL tenosynovitis or flexor hallucis longus tenosynovitis. Sinus tarsi syndrome is often confused with ankle pain. FHL tenosynovitis is often confused with plantar fasciitis. These conditions affect opposite sides of the same foot. Yet, one can lead to the other. Today on the Doc on the Run podcast, we're talking about how sinus tarsi syndro...
Sep 02, 2022•6 min•Ep. 608
Imagine your doctor tells you that you have a metatarsal stress fracture and you should not run. Why would you come home from the doctor and call me asking, "Can I run in cleats with a stress fracture?" Believe it or not, that actually happened. In this case we are talking about an athlete who is actually getting better and who wanted to train on the track. He wanted to run in cleats. Aside from the uncertainty, he was doing okay. He was a little hesitant and wasn't sure if cleats would aggravat...
Aug 31, 2022•3 min•Ep. 607
A runner called me and said, "I got some new running shoes and they made my bunions worse overnight. I think I need surgery now." The problem is that bunions do not typically get worse quickly. Bunions get worse slowly because the bone is changing position. In this episode, we're going to talk about how it's possible bunions could get worse from a new pair of shoes. If you are a runner with bunions this is a situation you may want to understand. Today on the Doc on the Run podcast, we're talking...
Aug 29, 2022•5 min•Ep. 606
We've all heard the saying that time heals all wounds. While that may be true, time also kills your running fitness when you're not training. You have to remember that the enemy of your running fitness is not the fracture walking boot. The enemy of your running fitness is not the crutches. The enemy of your running fitness is not your doctor. The enemy of your running fitness is time! Today on the Doc On The Run podcast we're talking about how time is the enemy when you have a running injury....
Aug 26, 2022•3 min•Ep. 605
Today I was talking with a runner who has been diagnosed with a longitudinal split of the peroneus brevis tendon. The concern with this kind of tear in the peroneal tendon is that if you can't get it to calm down, it can only get worse. Continually moving, irritating and producing inflammation in and around injured peroneal tendons just causes them to get weaker over time. Many surgeons are quick to offer surgery to correct the problem. This runner wanted to know the details of all the different...
Aug 24, 2022•6 min•Ep. 604
It really seems incredible that we now have over 600 episodes of the Doc On The Run Podcast! Today's episode is a little different in that I actually want to ask you a question. How do you stay motivated when you have been injured? I'm really interested to know because this is one of the most important things you can do as an athlete when you're recovering from an over training injury. Much of what I've learned that helps injured runners is not stuff I learned in medical school. Much of the stra...
Aug 22, 2022•3 min•Ep. 603
Today we're talking about some of the x-ray changes that happen when you get hallux rigidus or hallux limitus. If your doctor tells you the x-rays show hallux limitus...what does it mean? We're going to talk about these five things that you can see commonly on the x-rays when you have hallux rigidus. Today on the Doc On The Run podcast, we're talking about five changes on x-rays when you get hallux rigidus.
Aug 19, 2022•8 min•Ep. 602
I know a lot of people are not even going to listen to this episode because I'm talking about stretching. Many runners seem to recoil from the topic of stretching. But if you get injured and you go to a physical therapist, you can take it to the bank that they are going to give you some stretching exercises to do. Why? Because stretching helps when you have tissue that is predisposed to injury because it's too tight. When you have that issue, you need to stretch that tissue. Today on the Doc On ...
Aug 17, 2022•4 min•Ep. 601
If you have pain in your foot under the big toe joint, the doctor might tell you that you have an issue with one of these two little bones called sesamoids. Interestingly, some people have a sesamoid bone that is not broken, but looks like it broke apart. If you understand how that happens, it may help you understand your x-rays and the doctor's description of your condition. Today on the Doc on the Run podcast, we're talking about a broken sesamoid versus a bipartite sesamoid. What's the differ...
Aug 15, 2022•7 min•Ep. 600
Today's topic comes from a longtime listener named Jenny. She wrote a really nice review that I wanted to share with you. She said, "If you are a runner, you need to listen. What I love about Doc On The Run Podcasts is that each one covers one topic, is short, sharp, full of useful practical information that you can apply right away without having to go and do more reading or research.” She also asked, "Would you consider doing an episode on return to running after an accident and how to overcom...
Aug 12, 2022•6 min•Ep. 599
If you get pain and swelling and discomfort particularly in and around the big toe joint, you may have a condition called hallux limitus or hallux rigidus. Hallux limitus and hallux rigidus are both conditions that affect the big toe joint. It causes pain right where your big toe attaches to your foot. Many runners with this condition don't even understand the difference between hallux limitus and hallux rigidus. There are really a few things that define the difference between these two conditio...
Aug 10, 2022•11 min•Ep. 598
The problem is not that you have a stress fracture. The problem is not that you have an Achilles tendonitis issue that is bugging you. The problem is that you have been given advice that freaks you out and convinces you to do absolutely nothing while you wait to recover. How do I know? Because I don't help people get better from running injuries. Instead, I help injured runners figure out how to run. That's what I really do. Today on the Doc On The Run podcast, we're talking about why you need t...
Aug 08, 2022•6 min•Ep. 597
Yesterday, I saw a runner who has plantar fasciitis. Plantar fasciitis is the most common condition affecting the foot in runners. When a runner gets plantar fasciitis, it is often because the plantar fascia ligament is too tight. The tight ligament becomes overstretched and strained. Heel pain is the result. Since it is safe to assume that the plantar fascia ligament on the bottom of the foot is just way too tight, you may want to stretch it. But with every potential treatment comes risk. Stret...
Aug 05, 2022•4 min•Ep. 596
I want you to really think about which decision might be missing in your process of running injury recovery right now. Is it the decision to just go for it? Is it the decision to start exercising today? Is it the decision to sign up for some specific event that can get you motivated? Is it the decision to get a second opinion? Which decision is missing in your running injury recovery? That's what we're going to talk about today on the Doc on the Run Podcast....
Aug 03, 2022•4 min•Ep. 595
I was just on a call with a runner suffering from a plantar plate sprain. He had a great question: Is inflammation really bad or is it good when you have a plantar plate sprain? Physicians commonly prescribe anti-inflammatories. There are many approaches used by injured runners to manage inflammation, reduce inflammation, and hopefully make your foot feel better. If inflammation is bad for the plantar plate ligament, part of your recovery plan should include some sort of anti-inflammatory treatm...
Aug 01, 2022•10 min•Ep. 594
Doubt comes from confusion. Confusion leads to paralysis when you've been injured and you don't know what to do to maintain your running fitness. Doctors tell you to sit still. Pill pushers tell you to take medicine. Gizmo peddlers tell you to buy expensive devices. Many runners don't really even know what they can do, other than rest. If you are going to doubt anything when it comes to your running injury recovery, what you should doubt is the validity of sitting around doing nothing while wait...
Jul 29, 2022•4 min•Ep. 593
If you are reading this, maybe you have sesamoiditis, a sesamoid stress reaction or a metatarsal stress fracture. This is a real example from a real patient. This story really illustrates how MRIs can show misleading clues leading to a potential misdiagnosed leading your doctor astray. It is crucial that you focus more on your running goals, your injury progress and what it really means precisely where you have pain in your foot. Then and only then can the MRI findings be put in the proper persp...
Jul 27, 2022•7 min•Ep. 592
How do you know your injury is improving? How do you know that you got the green light to start running? How do you know it is healed? Well, when I talk to runners, most of them say something like: "Well, my x-ray shows this. Does that mean that I can run?" "My blood test showed that, does that mean I can run?" "My doctor said this, but I heard that on some other podcast, so does that mean I can run?" There is lots of confusion around how you can tell when you are getting better as you start reg...
Jul 25, 2022•6 min•Ep. 591
I was recently invited to give a lecture at a foot and ankle medical conference in Seattle. I was giving a talk called Conservative Treatment of Ankle Sprains in Runners Who Want To Run. This was an attempt to teach physicians what I do with ankle sprains. Mostly I was trying to get them to think about what they need to do to get runners back to running as quickly as possible instead of just doing the standard ankle sprain protocols with their patients. The Ottawa Ankle Rules are a set of rules ...
Jul 22, 2022•4 min•Ep. 590
I was just on a call with a runner who called me for a consultation of an ankle injury. He had some funny looking stuff on his ankle x-rays. That was why he was scheduling a second opinion. The bummer in this whole thing was that he actually told me that maybe 10 years ago or so, he'd had a similar ankle injury. He's pretty sure it was on the same side, but he wasn't really sure because he didn't have a copy of the x-rays. Today on the Doc on the Run Podcast, we're talking about why you should a...
Jul 20, 2022•5 min•Ep. 589
I just got a call from a runner who I have seen before. He had swelling in his Achilles tendon, and he was worried about it. He was worried that he could have a ruptured or completely torn Achilles tendon. If you are a runner and you get a complete rupture of the Achilles tendon, this is one of the worst things that could possibly happen to you. A torn Achilles is way worse than a broken bone. The worst thing you could do is ignore a torn Achilles. You do not want to ignore it! Today on the Doc ...
Jul 18, 2022•6 min•Ep. 588
Every time I am in the Recovering Runner's Aid Station where I answer questions for injured runners, I get questions about how to get an advantage. Everybody wants an advantage. I don't think most people cheat. There are some people who cheat, but certainly not everyone. But I think it is okay to look for an unfair advantage when you're injured and you're trying to get back to running. The truth is, getting an unfair advantage when you are injured is actually really easy to do. Today on the Doc ...
Jul 15, 2022•6 min•Ep. 587
Let's say you are out running on a trail and you catch a root and you roll your ankle. You limp back home and you realize that your ankle is all swollen. It is bruised, it hurts and you're really bummed out. You are trying to figure out what you can do to get this thing to calm down faster and get back to running. Well, there are lots of different options. How can a diagnostic injection help an ankle sprain? Well, that's what we're talking about today on the Doc on the Run podcast....
Jul 13, 2022•7 min•Ep. 586
