Doc On The Run Podcast

It’s not plantar fasciitis if you call for a ride instead of finishing your run

Today I was on a call with an injured runner who was told she had plantar fasciitis. She was confused and she started doing some research. She enrolled in the Runner's Heel Pain Course because she was trying to figure out why her "diagnosis" didn't seem to match her gut instinct. She suspected her diagnosis was wrong. If you have heel pain, and you call for a ride instead of finishing your run, it's not plantar fasciitis. And that's what we're talking about today on the Doc On The Run Podcast....

Doctors goal with fracture boot versus your goal with boot

Risks of PRP vs Cortisone injections for Hallux Rigidus

I was just on a call with a runner who has had this condition called "hallux rigidus." and it's where your big toe joint starts to get stiff, becomes rigid, and it doesn't move as much. Hallux rigidus is a progressive condition, especially if you continue to irritate the joint. You can damage the joint cartilage. The stiffer the big toe joint gets, the more pressure on the cartilage when the big toe is trying to fight that stiffness. Sometimes that movement hurts. He was asking me about the opti...

Running allergy and injury recovery

Have you ever been to the doctor and heard this, “You must be allergic to running because you get injured every time you go running.” A recovering runner and I were on a call talking about how she could get back to running and how to "just go for a run" without getting re-injured. We were talking about this approach of getting her running fitness back now, and returning to running faster without just sitting around waiting. She told me something I had never heard. Today on the Doc On The Run Pod...

Top 5 reasons Runner’s Heel Pain doesn’t get better

Plantar fasciitis is one of the most common conditions that affects runners. In fact, foot pain consistent with plantar fasciitis accounts for about 40% of all visits to the podiatrists in the United States each year. Unfortunately, just because you think that you have plantar fasciitis, and you started doing some simple things to treat it, it doesn't necessarily mean that it's going to get better. If you are a runner, and you think you have plantar fasciitis, you must realize there are some avo...

Logical vs. Psychological barrier to healing running injuries

I just had a discussion with a really interesting patient. He was a pro triathlete. He had some difficulty getting past a particular injury. We were talking about all of the ways that you can encounter barriers to healing. And how you can start making progress in spite of them. We were talking about two different things, logical and psychological barriers. What's the difference between logical versus psychological barriers to healing injuries in runners? Well, that's what we're talking about tod...

6 Stages of fracture healing in runners explained

Every runner with a stress fracture wants to know "when can I run?" How soon you can start running after a foot fracture really depends on when you have enough strength in the bone so that the healing fracture will withstand the forces applied during running without breaking the bone again. It all depends on what you do to speed up (or slow down) the bone healing process. The rate of fracture healing depends on your physiology, and it depends on stages of bone healing. But it does NOT depend ent...

3 ways runners lose fitness after an ankle sprain

The first thing any runner should do when you roll your ankle is protect the ankle from further injury. In fact, the algorithm doctors use to treat ankle sprains is P. R. I. C. E. P stands for Protection, meaning don’t roll it again. Don't make it worse. Then, Rest it. Ice it. Use Compression to keep it from swelling. Elevate it to get the fluid out if it's really swollen. So, what happens is, you're a runner, you're out on a trail and you roll your ankle. What happens if you don't follow the PR...

3 Best signs heel pain is NOT plantar fasciitis

There are three key indications that tell me that somebody may not have plantar fasciitis, but probably have something else. If you think you have plantar fasciitis, you may have a different form of runner's heel pain. Treating the wrong condition will not get you back to running. Understanding the ways plantar fasciitis shows up can help you make sure you don't have something else causing your heel pain. What are the three best signs that your heel pain is not Plantar fasciitis? Well, that's wh...

Does callus reduction decrease risk of plantar plate sprain?

I got a specific question about a recent episode on calluses in runners. The question was, “Well, if you have that pattern of callus, and reduce the thickness of the callus so the callus is going away, does that mean there is less pressure there?” You may have checked out the episode on the three callus patterns that I see in runners at high risk for getting a plantar plate injury. Does callus reduction reduce your risk or decrease the risk that you're going to get a plantar plate sprain? Well, ...

Traumatic disappointment and delayed healing

I was just on a call with an interesting elite athlete, and he's been injured. He had one particular injury in his foot and then started having a completely different injury, as soon as that injury in his foot was starting to heal. We were talking about how disappointment can lead to more and more setbacks. The phrase he used struck me. He said, “I think it might be traumatic disappointment.” What is traumatic disappointment and what kind of effect can it have on delayed healing in an injured ru...

First step sit still and wait

Yesterday I called a recovering runner, just to check in and see how he was doing, because he had done the Fast Track Challenge 2 months ago. He's doing great. He has recovered and gotten past his injury. He said he learned a lot in the Challenge and has applied it to his training. He's on track for running ultra-marathons this year. He has a coach. Training is in full swing with no limitation from the injury and got him into the Fast Track challenge. Something he said on that call actually kind...

3 Callus patterns show risk for Plantar Plate Sprain in runners

If you are a runner and you get pain in the ball of the foot, particularly at the base of the second toe right. It could be a plantar plate sprain. Whenever I see a runner on webcam who has pain that sounds like a plantar plate sprain, the first thing I do is look for any callus pattern in the skin that suggests they have too much pressure and friction at that area that could injure the plantar plate ligament underneath the skin. This episode will help you understand how certain callus patterns ...

Most valuable stretches after a running injury

Everybody's short on time. This is true for runners in training, but it's also true for injured runners. If you're trying to make progress as fast as possible, you really have to do the things that will give you the most progress in the least amount of time. Many runners I talk to on a second opinion consultation webcam call really want to know which stretches will help them. Specifically, which two or three stretches will help the most. What are the most valuable stretches you can do after a ru...

3 reasons for Cheilectomy failure after Hallux Rigidus surgery

If you have a condition called "hallux rigidus" or "hallux limitus," the name tells you what's wrong. "Hallux" means big toe. "Rigidus" means the big toe joint doesn't move at all. "Limitus" just means the big toe joint movement is limited and stiff. There are three problems with hallux rigidus, which are: 1) damage to the cartilage, 2) bone spurs around the joint and 3) restriction of the soft tissues such that the toe doesn't move up and down the way it should. Those three reasons that cause t...

What is a tendon synovectomy surgery?

Let's say you have a nagging tendon injury that's really been painful. It's been bugging you a lot when you run. You have had persistent pain either on the side of the ankle that just won't seem to go away, even if you run less. You see the doctor and she says, “Look, we tried everything. We should do surgery. Your tendon is not really torn, but we should do this surgical procedure called a "synovectomy" to get it to calm down so it will finally stop hurting.” What is a tendon synovectomy surger...

Broken toes with an ankle sprain?

Let's say you're out on a trail run, you roll your ankle and sprain it. So what do you do? You limp home, you get back to the car, you ice it, you take some pressure off of it, you elevate it, you do all the right stuff. But, it's really painful and swollen the next few days. Then, maybe a day or two later, it's black, it's blue and swollen. But even worse, you look down and you're kind of dismayed because your toes are swollen like sausages. Believe it or not, I have had a number of patients wh...

Should I get a CT scan or test walking to see if fracture is healed?

Today's episode comes from a discussion I just had yesterday with an athlete. He had a metatarsal fracture non-union. A "fracture non-union" can develop when there is a crack in the bone that moving a little bit too much and doesn't completely heal. Non-unions can happen if you get a stress fracture, and you keep running on it and you're tough and you're strong and it doesn't really hurt that bad. If you keep running and repeatedly stress that crack, it can't heal. Should I get a CT scan or shou...

What is a bone callus in a metatarsal stress fracture

When you get an injury to a bone like a metatarsal stress fracture, you can develop a thing called a "bone callus." You might even see it as a lump visible on the x-ray in your doctors office. Whether the lump is made up of hard bone, fibrocartilage or something in between, it may help you to understand the significance of that lump in your foot. When the bone callous appears, and the size of the bone callous itself, can tell your whole lot about your progression of healing, and whether or not y...

Can running on the road cause Achilles tendinitis in one leg and calf strain on the other?

Achilles tendon injury on one leg and a calf muscle strain on the other leg? Talk about a bummer: 2-for-the-price-of-1 overtraining injuries! Yes, it is possible to get similar running injuries on opposite legs, at the same time. Today I had a conversation with a runner who has developed both of these injuries from running. These are actually just opposite ends of the same biomechanical spectrum at work. During the call I was explaining to him how it can happen, and how he could make some simple...

Foot pain that is truly a pain in the butt

What would be worse than not being able to run because you had foot pain that didn't get better for a year or two? I know one thing that would be worse... Having foot surgery to treat a problem that was not actually even located in the foot. Think about that. You had pain in your foot for two years. Then some doctor convinces you to have surgery, only to find out there was no problem with the tendon. You stop running. You have surgery. You wait for your stitches to heal. You have to stay off you...

Methodical testing is the key to running after injury

If you just got injured, your number one goal is to not lose your running fitness as your running injury heals. If you were diagnosed with a running injury a while ago, you stopped running and now you’re just getting back to running after taking some time off, in that case your primary goal is to resume running without sustaining another overtraining injury. Especially right when you start running again. What I teach runners in the Fast Track Challenge is how to find their unique fastest path ba...

Scared of re-injury after trying to build strength

This morning, I was on a call with a recovering runner who signed up for a series of coaching calls to get back to running after a long-standing injury. This is an elite athlete who had multiple setbacks, and encountered difficulty getting over the hump a number of times. If you're going to get back your fitness, and if you're going to get back to training as fast as possible, you're going to have to endure some discomfort, some risk, and frankly, a little bit of anxiety every time you bump up a...

After healing a stress fracture should I use Alter-G after I start running outside?

Let's say you have been injured. You've been a good little patient. You waited around, you have done nothing. You have endured a frustrating period of boredom. And you finally started running again. That’s great! Today's episode came from a webcam call I did with a recovering runner. She has a stress fracture but her foot was good enough to run outside. The question was about whether or not an injured runner should keep using something like an AlterG treadmill to maintain running fitness while c...

Are you using a treadmill for returning to running after an injury?

Today I was out on a run and I was thinking about treadmills versus running outside. To be fair, I was actually running outside during this run. It seems like most of the runners who sign up for the Fast Track challenge, or who call me for a second opinion, the majority of them like to run outside. I have a question for you. If you got an overtraining injury like a metatarsal stress fracture, calcaneal stress fracture, or a tibial stress fracture, plantar plate sprain, the question is... Are you...

When are x-rays useful for runners with Morton’s neuroma?

Let's say you're out on a run and you start getting some aching pain in the ball of the foot. It persists for a while. It's not really that bad. Your foot is not killing you. But it starts to bother you more and more over the course of a few weeks. Being proactive, you see a podiatrist. The podiatrist tells you that he thinks you have something called a Morton's neuroma. So he does an x-ray of your foot and what do you see? Well, nothing. Why is that? When are x-rays useful for a runner with a M...

Best way to file toenails for marathon runners

Have you ever had black toenails after a long run? Have you ever lost a toenail after a marathon? Have you tried using goopy skin lubricants, or worn bigger shoes that make you feel like you're wearing clown shoes? If you have, but you're still having problems beating up your toenails in your running shoes when run, I've got a simple solution that may actually help. Today on the Doc On The Run Podcast we're talking about the best way to file your toenails if you're a marathon runner....

When is plantar fascia surgery necessary for runners?

If you're a runner with plantar fasciitis, you probably have heel pain when you get up and step out of bed. If that's gone on for months, you tried icing, you've tried stretching, and you've become frustrated, it starts to become pretty easy for your doctor to talk you into surgery. If you've had plantar fasciitis for a long time and your doctor is trying to convince you need surgery, you should listen up! When is plantar fascia surgery really necessary for runners? Well, that's what we're talki...

Ankle pain vs sinus tarsi impingement when running

If you get aching pain in your ankles when you're running, and it seems to lag and doesn't just go away, you might not have ankle pain at all. There's a thing that I see often in runners complaining of ankle pain, but when I actually look at the runner's feet, it's a different condition altogether. That condition is something called "sinus tarsi impingement." Today on the Doc On The Run Podcast, we're talking about ankle pain versus sinus tarsi impingement when running....

Does the plantar plate need to “heal” on MRI before I can run?

Plantar plate ligament sprains are a tough injury for runners. Plantar plate tears can cause a lot of pain in the ball of the foot. Unless you treat them correctly, that pain can persist for a long time. As a result plantar plate injuries can be super frustrating. Unfortunately, plantar plate tears are often diagnosed when you get an MRI of the foot. I often get questions from runners asking me whether or not they have to wait for another MRI before they can run. Does the plantar plate ligament ...