Everyday I help runners who are stuck by giving them a different perspective during a second opinion call. When we get on the call, we do a couple of things to get focused in the right direction and get them unstuck. 1) We figure out what their real goal is with running, not with injury. What race did you sign up for? How fast do you want to run? What are your long term goals with running? 2) If those are the goals you really want to achieve, how is your present injury interfering with those goa...
Nov 28, 2022•5 min•Ep. 645
Ankle sprains are probably the most common musculoskeletal injury affecting runners. It is really easy to roll an ankle and find yourself limping, unable to run. You might have sprained your ankle tripping on a root or rock when you're out running on a trail. Maybe you were wearing some fancy shoes going out to dinner and you stepped on a little reflector on a crosswalk, twisting your ankle. No matter how you injure the ankle, if your ankle is painful and swollen it is definitely going to interf...
Nov 25, 2022•7 min•Ep. 644
In this episode, we're talking about three mistakes I see almost every runner make when they call me for help. Let's be clear, runners do not call me when they are on their run and first start getting foot pain. More often, aching runners go see a doctor, talk to a running buddy, or seek information online to get a rough idea of what's going on. When those steps don't help, it is my job to help them figure out which mistake they are making. What are the three steps every injured runner is missin...
Nov 23, 2022•5 min•Ep. 642
A couple of weeks ago, I was invited to give some lectures at the Heartland Podiatry Conference in Des Moines, Iowa. The conference organizers asked me to give an entire "Doc On The Run session" during which I presented five lectures back to back...all on how doctors could approach treatment of injured runners differently. During the attendee question and answer session, a doctor asked: "Do you use ankle braces for ankle sprains, and under what circumstances would you recommend braces for recove...
Nov 21, 2022•6 min•Ep. 643
If you have trouble with your Achilles tendon and a doctor told you that you might actually rupture it and tear completely if you continue to run, you should probably be worried. If you are anxious about your Achilles, stay with me. I have some good news and some bad news. A recovering runner in the Runners Aid Station asked me... “If I rupture my Achilles tendon, if I just ignore the tendinosis, if I just block out the pain, continue to run, continue to train, and then it does rupture, would I ...
Nov 18, 2022•6 min•Ep. 641
Today's episode comes from a question from one of the YouTube viewers. The specific question was, are calcified Achilles tendons more prone to tendon rupture in runners? That's a great question. I think if you ask most doctors, their answer is probably going to be yes. But since I got this very specific question, I actually wanted to see if there is any research that truly proves whether or not Achilles tendons that have calcification or ossification within them, whether or not they're actually ...
Nov 16, 2022•11 min•Ep. 640
What would happen if you did this? Walk into your doctor's office and say, "Hey, look, I'm a runner. My situation is complicated. I really want to train. I really want to get back to running. I would like you to take an hour, sit down with me and let's really work through this so that I can get back to training." Right now when you picture yourself going into your doctor's office and asking for a full hour, how does that make you feel? If you don't think you could walk in and ask the doctor dire...
Nov 14, 2022•6 min•Ep. 639
If you're a runner and you have pain in the ball of the foot, especially around your second toe joint where the toe attaches to the foot, you may be suffering from a plantar plate sprain. Many years ago, if you had this kind of pain, it would probably have just been called "capsulitis" by your doctor. But a plantar plate injury is something that has become more recognized as a distinct pathology in the last 10 or 20 years. Plantar plate injuries do not get misdiagnosed nor ignored as often as be...
Nov 11, 2022•8 min•Ep. 638
Every time a runner calls me who has a plantar plate sprain, they're trying to figure out how they can know for sure they actually do have a plantar plate sprain. They often also want to know how bad the plantar plate injury really is. When you're a runner, the problem with plantar plate sprains is that many doctors will offer a standardized cookie cutter approach. I most often help runners get better without surgery. That's not because I'm a better doctor. It is because I really put a lot of at...
Nov 09, 2022•7 min•Ep. 637
After years of doing the Doc On The Run Podcast and making YouTube videos to explain overtraining injuries that can interfere with running, I have gotten a lot of interesting questions. We've had over a million views on YouTube, and over 300,000 downloads of the podcast which all equal a lot of questions. Mostly overtraining injury questions center on a search for a shortcut. Many injured runners also think the solution is in only one action. Don't search for less than what is needed. That's wha...
Nov 07, 2022•4 min•Ep. 636
If you are a runner and you have an injury, my guess is that you are most worried about how long you will need to stop running. When people call me for a webcam consultation or an in-person second opinion evaluation, I see runners making the same mistakes over and over. If you've made one of these mistakes, don't beat yourself up too much. There is not that much you can do about the past. But you can take action today, change course and get focused on what you need to do right now to get back to...
Nov 04, 2022•10 min•Ep. 635
Last week I was lecturing at the International Foot & Ankle Foundation medical conference in Hawaii. Specifically, I had been asked to give a couple of talks on treating running injuries. During the day I was moderating the surgery and sports medicine session, Dr. Gary Labianco was giving a lecture on Metatarsal Fractures. He said something that led us to today's episode. It was genius! "If you want to heal a metatarsal fracture, you have to break bone faster than you break it down." What he...
Nov 02, 2022•8 min•Ep. 634
Growth happens outside of your comfort zone. This is true for both emotional growth and physical growth. Very few patients who call me for help with a stress fracture are not really upset. They all feel like they wasted months of time with treatments that either didn’t help, or made them worse. They are still not running. All of these runners seem to express the same concern, the fastest path back to running seems just as mysterious as that supposedly invisible crack in the bone. Is your doctor ...
Oct 31, 2022•8 min•Ep. 633
I just did a consultation call with an injured runner who had a really interesting history with his heel pain. There was some concern that he might actually have a calcaneal stress fracture and not a plantar fascia issue. In case you don't know, "calcaneal stress fracture" is just the medical term for a stress fracture in the heel bone. The heel bone is the largest bone in your foot, and runners can sometimes develop a stress fracture in the heel bone. They are relatively rare, but there are a c...
Oct 28, 2022•11 min•Ep. 632
If you have this pain on the outside of your foot near the cuboid bone, you might start worrying you have a cuboid stress fracture. Cuboid stress fractures are rare. In fact, cuboid stress fractures account for less than 1% of all the stress fractures that happen in the foot in athletes. But there is something more common that can feel like a cuboid stress fracture. Doctors call it "capsuloligamentous strain." How can a runner tell the difference between a cuboid stress fracture and this thing c...
Oct 26, 2022•12 min•Ep. 631
If you have been running with a nagging aching pain on the outside of your foot, just in front of your ankle, you might think you have a cuboid stress fracture. If you then get an x-ray of the foot and it shows a tiny little extra bone sitting just next to the cuboid, well that bone has a specific name and it is called an Os Peroneum. Sometimes you can get pain from the Os Peroneum, sometimes you can get pain from the cuboid bone that's right next to it. If you're a runner and you have Os Perone...
Oct 24, 2022•7 min•Ep. 630
If you call me and you tell me, I think I have a cuboid stress fracture, the first thing I'd say is...pretty unlikely. In fact, cuboid stress fractures are less than 1% of all the stress fractures that happen in the foot in athletes. So they really are very rare. One thing you can get that's actually much more common is arthritis within the joint. That's also pretty rare, but you can tell the difference. How can a runner tell the difference between a cuboid stress fracture or calcaneocuboid join...
Oct 21, 2022•12 min•Ep. 629
"Subluxed Cuboid" is just a cuboid sitting slightly out of position. Stress fracture of the cuboid is very different from a subluxed cuboid. If you have this aching pain on the side of your foot, and you've been told maybe it's "cuboid syndrome" or a "subluxed cuboid," but it's not getting better, you could have a thing called a cuboid stress fracture. The reason you probably weren't told it was a cuboid stress fracture is that, first of all, those are really rare. Cuboid stress fracture is less...
Oct 19, 2022•9 min•Ep. 628
If you are a runner and you've had pain on the outside of your ankle or the outside of your foot, kind of near the heel you may have been told that you have peroneus longus tendinitis. Sometimes peroneus longus tendinitis is the wrong diagnosis. You might actually have a cuboid stress fracture. Which one's worse? Well, I'll tell you that in terms of really destroying your ability to run, definitely an ignored cuboid stress fracture is worse. How can you tell the difference between a cuboid stres...
Oct 17, 2022•11 min•Ep. 627
If you're a runner who has been told that you have a cuboid stress fracture, you might be worried that there's an actual crack in the bone. A visible crack on x-ray is what I think of when I picture a truly fractured cuboid bone. There is a huge difference between a cuboid bone with a crack, vs. without a crack. The cuboid bone is an irregular bone. It's small, but it's important. It sits right in between your heel bone and the fourth and fifth metatarsal bones. When you roll your ankle and your...
Oct 14, 2022•10 min•Ep. 626
If you are a runner and you get an aching pain on the top of the foot, and it's not getting better, you might have this weird thing called a cuboid stress fracture. Cuboid stress fractures are often misdiagnosed as an "ankle sprain" or "foot sprain." The cuboid bone is positioned in a way that it can get squished in between the other foot bones. Cuboid stress fractures can cause a lot of trouble if you ignore it, because it can get worse and turn into an actual fracture. Even worse, the weakened...
Oct 12, 2022•18 min•Ep. 625
Just today I was seeing a runner during a house call and he had a neuroma. So, understandably, he put a neuroma pad in his shoes. When he was running, his neuroma suddenly got way worse! I asked him what happened. He said, "I moved it a little bit. I moved it from where you put it before and I thought it would take more pressure off, but I think it actually made it worse and it really flared it up." What happens if you run with a neuroma pad in the wrong place? Well, that's what we're talking ab...
Oct 10, 2022•4 min•Ep. 624
I was just speaking at a medical conference in Las Vegas, and of course I flew on a plane to get there. To me, as a podiatrist, the most dangerous two spots in the airport are in the security screening line. I don't like standing on those yellow footprints in the security scanner spots because I think it's a little gross to stand without shoes, where thousands of people a day step barefoot. I see people in airports with fungal toenails and with athlete's foot infections. I can see the skin on th...
Oct 07, 2022•6 min•Ep. 623
If you are a runner with a painful tendon or ligament issue like chronic plantar fasciitis, Achilles tendonitis or plantar plate sprain that just won't get better, you might have done some research into injections and found a thing called a PRP or "platelet-rich plasma injection." The way that PRP injections are marketed by some doctors, you might think that it's mostly unicorns and fairy dust, but there is some actual science behind platelet-rich plasma. and the effect that it can have on these...
Oct 05, 2022•11 min•Ep. 622
The #1 concern all injured runners face is time. How long will I have to use crutches. How long will it take the surgery to heal. How long will I have to wear a fracture walking boot. How long will I have to stop running. How much running fitness will I lose in that time. I feel like most of the runners who call me for a second opinion over webcam are making a critical mistake. They are hiding from the injury. Are you an injured runner who's hiding from your injury? Well, that's what we're talki...
Oct 03, 2022•5 min•Ep. 621
If you have ever run with a rock in your shoe, you know just how painful a little pebble can be. Sometimes a callus forms in a way that it gets rock hard and starts to get embedded in the skin. Painful calluses can literally feel like a rock taped to your foot. The problem is that callus removal pads don’t work. Using a pumice stone to shave down the surface of the callus doesn’t really help much either. But you can fix them the same way I do using what I call the Strawberry Stem Technique. Let’...
Sep 30, 2022•6 min•Ep. 620
The whole key to rapid running injury recovery is to proceed with confidence. If you are using a fracture walking boot or crutches, you must do so confident the boot is necessary...and not based on guesswork. If you are starting range of motion exercises for a torn tendon, you must be confident you can work past pain, without worrying you might cause a re-injury. You need to make sure that you know that the present action in your recovery is necessary. You also need to understand how you can gai...
Sep 28, 2022•5 min•Ep. 619
One time at a medical conference, an expert lecturing on biomechanics said, “When a runner develops Hallux Rigidus, he becomes a swimmer instead of a runner.” Most of the doctors in the audience laughed. I really didn't think that was very funny. I actually have hallux rigidus myself, and it doesn't disrupt my running. It is true Hallux Rigidus can cause pain and swelling in the big toe joint. If you aren't careful the joint can get destroyed. If you understand a little bit about the mechanics o...
Sep 26, 2022•5 min•Ep. 618
I was just giving 3 lectures on running injuries at a medical conference in Las Vegas. As is often the case, after one of my lectures one of the physicians in the audience approached me in the hallway to ask a question. What do you do with activity level when somebody has an old fracture where the bone was broken long ago? The runner recently had a re-injury at that spot. It has been painful, it's been swelling, and he's trying to figure out what to do. What's a bone bruise at an old fracture si...
Sep 23, 2022•5 min•Ep. 617
When you have two painful problems in different parts of the same foot, things can get complicated. I recently had a call with an injured runner with a couple of different problems. On the outside of his foot, between the third and fourth toes, he has a painful neuroma. The other problem is that he's got bursitis. The inflamed bursa is in a completely different place, no where near the irritated nerve. When a runner has two injuries, like a neuroma on one side of the foot and bursitis on the oth...
Sep 21, 2022•6 min•Ep. 616
