I was just speaking with a runner who scheduled a second opinion consultation. He asked, "what is the best way to tell if my foot is broken." I said, "Well, there's the fast and easy way and then there's the fast and cheap way.” Today on the Doc On The Run Podcast, we're talking about fast and easy versus fast and cheap ways to tell if your foot is broken.
Today's episode comes from a comment on Doc On The Run YouTube channel. Colin watched the video explaining: “Bone bruise vs stress reaction in a runner.” He posted a question asking what he should do after a frustrating 10 months off from running, without improvement. I've had a bone bruise for 10 months and I'm still not running. What does that mean? Well, that's what we're talking about today on the Doc On The Run Podcast.
I just had a conversation with a runner who signed up for one of the self-help courses. She booked a short call just to get a jumpstart, prioritize and figure out what she really needed to do first, so she could get better as quickly as possible. She asked me a really interesting question at the end of our call and she said, “Okay, based on what we talked about, are you sure that my ligament is not going to just rip apart if I start running?” I said, “No, I'm not sure of that at all. In fact, we...
Perhaps the most nagging injury, and most difficult to deal with if you're a runner, is something called a "plantar plate sprain." The plantar plate ligament is on the bottom of the foot, usually at the base of the second toe. I got a question from a runner who actually had a plantar plate injury. She also happened to have bunions. So, she asked: "Do bunions cause plantar plate sprains in runners?" That's a great question and that's what we're talking about today on the Doc On The Run Podcast....
Today's episode comes from Janet ,who posted a comment and question on the Doc On The Run YouTube channel. She said, “I got a healed stress fracture, returned to running. I got into cross country and it started to flare up and hurt around the tibia again, is this normal or should I be concerned?” Is returning pain normal when returning to running after a healed stress fracture? Well, that's what we're talking about today on the Doc On The Run Podcast.
The peroneal tendons help stabilize your foot. They're kind of your landing gear when you run. They keep you from wobbling or swaying out of control. When you start to roll your ankle, the peroneal tendons pull your foot back under you. If you ignore irritation and aggravation of those tendons, they can get weaker, tear or split apart. The sudden trauma of suddenly rolling your ankle can cause them to split as well. If you see a doctor when you suspect a split peroneal tendon, one of the first t...
Today's episode comes from a discussion I had with a runner who is only five weeks out from a marathon. She has been injured and super-aware that she could lose her fitness fast! Her main goal on our call was to make sure that she is ready for the starting line, but more importantly, make it to the finish line fast enough to qualify for Boston. Maintaining your running fitness when you're injured is a delicate dance. And that's what we're talking about today on the Doc On The Run Podcast....
There really are three basic steps that doctors use when you have a broken toe. The medical term for this procedure is called "closed reduction." We don't cut the broken toe open, look at the bones and put them in place. Instead, we leave the skin closed and manipulate the toe to pop the fracture back in place. This is a very common procedure doctors do. I even have done it many times in people's homes, most often with a runner who has a broken toe that really hurts. I am going to explain the ba...
One of the questions I get most often from runners with stress fractures is... "How can I get it to heal better? How do I get back to running faster?" The best way is to remove the stress so that the stress fracture can actually heal as fast as possible. That sounds obvious, but most runners aren't doing that. I talked to a runner just a couple of days ago who was not running on it, but she was walking on it...a lot. She told me, “Well, I have a fracture walking boot, but I'm walking in it and m...
Plantar plate injuries are very common, and they are extremely annoying. I get lots of questions and comments both from the podcast and from the Doc On The Run YouTube channel about plantar plate sprains. Today's episode comes from a question posted by Jason on the Doc On The Run YouTube channel. He asked... "Can MRI miss a plantar plate strain?” The short answer is yes, and I'm going to try to explain why. Can an MRI miss a plantar plate strain? Well, that's a great question and that's what we'...
Almost all runners who call me for a consultation have one thing in common. The number one thing they want to get out of their discussion with me is “How can I start running sooner? I want to get back to running so I don't lose all my running fitness.” There is one free and highly effective tool you can use as an injured runner, but most of the runners I talked to seem to be completely neglecting and ignoring it. What is the single most effective but most often neglected tool injured runners can...
If you have ankle pain and you push around on that lump of bone on the outside of your ankle, you may realize that you have pain on the bone specifically. If so, you might become worried that you have a thing called a fibular stress fracture. If you start trying to figure out what to do, one of the first things you may find is a lot of discussion about something called a "stress reaction" instead of just a "stress fracture". What's the difference between a fibular stress reaction and a stress fr...
This may seem like a strange episode, but I just had a conversation with a runner who is not just a forefoot runner, but she is really a forefoot runner. Like running-on-your-tiptoes kind of forefoot runner. One of the things that I brought up in our discussion were some research studies that have actually calculated the amount of pressure in the forefoot when a woman is wearing high heels. What does an elephant, a woman in high heels and a forefoot runner have in common? Well, that's what we're...
If you've been running, training for a marathon or an ultra-marathon and you start to get pain on the outside of your ankle, you do have a reason to be concerned. There are really four things that seem to cause pain on the outside of the ankle the most. We're going to talk about those today. What are the four main causes of lateral ankle pain in runners? Well, that's what we're talking about today on the Doc On The Run Podcast.
If you have been told you have a plantar plate sprain, you're probably already really frustrated. Even minor plantar plate tears can be nagging injuries that are very difficult to get better while you're running on them. The bottom line is, you've got to make sure that the plantar plate ligament improves because (in general) plantar plate sprains are either getting worse or they're getting better. One of the questions I get all the time from runners is what is really the best study for a plantar...
If you're out on a run and you roll your ankle, you need to know how you can test the ankle to figure out what is wrong. More importantly, what tests can tell you how likely it is that you're actually going to get back to running and not have an ankle sprain again. There are several tests doctors use in evaluating injured ankles. Some are more important than others. What is the single most important test for a runner with an ankle sprain? Well, that's what we're talking about today on the Doc On...
There are times when you might have a suspected stress fracture in your foot. If so, your doctor may order an X-ray. There are other times when it's extremely unlikely that you have a broken bone at all, but it is almost certainly just a soft tissue injury. One of the questions I get a lot from runners with plantar plate sprains is how to make sure the pain is not from a stress fracture. I have only seen one case where somebody had fracture pain in the exact same spot you would have pain when yo...
If you are running with foot or ankle pain, and you're trying to figure out what's wrong, the first step is deciding if it is a bone injury or soft tissue injury. It might be useful to talk about the thought process I use when trying to figure out whether or not you have bone versus soft tissue injury. How do you rule out soft tissue versus a bone injury when you're a runner and you've rolled your ankle? Well, that's what we're talking about today on the Doc On The Run Podcast....
I recently did an episode where I was talking about Lister’s corns. If you missed it, a "Lister's corn" is really just a callus or thick skin that looks like the pinky toenail or the little toenail has a split in it. That edge of the nail that looks like a completely separate piece of nail. But it's not a nail at all, it's callus. I just saw a runner who had this problem where his Lister's corn was really painful. It hurt so much he thought the nail might be ingrown. He asked, Why does a lister’...
All overtraining injuries are difficult. The problem is that you're trying to not lose your running fitness while giving the injured part enough of a rest so it can actually heal. A runner asked me an interesting question the other day, he actually said, “Okay, if I have bruising and swelling, does that mean I'm more likely to have a bone injury or a soft tissue injury?” What are the key differences between a soft tissue injury and a bone injury in a runner? Well, that's what we're talking about...
I was recently doing a second opinion consultation with a runner over a webcam to review the MRI of his foot. What we found was that he had what looked to be attenuation and a partial tear in the plantar plate ligament on his MRI. There was a lot of inflammation in the foot around the ligament, not just within the ligament itself. He asked me was really good question: “Could my plantar plate ligament been have injured long before I ever got an MRI?” Well, that's what we're talking about today on...
Every runner who gets injured is in a race against time. It is a race to not lose your running fitness. You know you are going to get weaker. You know you're going to get stiffer. You're probably really concerned that you're going to lose all that aerobic fitness that took months or years building up. Running injuries are like compound interest but in reverse. That's what we're going to talk about today on the Doc On The Run Podcast.
I just saw a runner who sprained her ankle. It's been about a month and she's still having pain. Pain and swelling persisting a month later, are not good. There are a couple of reasons that that can happen. Anytime doctors see persistent swelling and pain after an ankle injury, they become concerned there might be a fracture. When should a runner who rolled an ankle be concerned that there might be a fracture like a lateral process fracture? Well, that's what we're talking about today on the Doc...
If you are a runner with pain in the ball of the foot at the base of the second toe and start researching online, you may become concerned you have a thing called a plantar plate injury. If so, you may be wondering whether X-rays or MRI imaging may be needed to tell what is wrong. Before seeing a doctor, it may be helpful to understand which are helpful, and which imaging studies are a waste of time. What is the worst possible medical imaging study you could get if you're a runner with a suspect...
Just this week, I got a call from an injured runner about a new problem. I've seen him before for some other issues, but in this case. He said that he thought maybe he actually had an ingrown toenail on his pinky or that the toenail itself had split in half and it was bugging him a little bit. I said “Well, send me a picture. I'll take a look and see.” My pinky toenail split in half. Is that a problem? Well, that's what we're going to talk about today on the Doc On The Run Podcast....
Today's episode comes from a YouTube viewer who posted a question, “I have a low risk grade stress reaction in my posterior tibia. Interestingly, there is some research discussing the benefits of weight bearing bone building exercise once tolerated pain free, like hops jumps and step ups. Do you have any advice on when and how to integrate these types of exercises into a rehabilitation program?” When is it okay to add weight bearing exercises when you've had a bone injury like a stress reaction?...
Today's episode comes from a YouTube viewer named John, who wrote in with a question about nerve pain vs. peroneal tendon pain. He said ”I'm experiencing discomfort in my fifth metatarsal/peroneal tendon below the ankle. There is no swelling. However, upon hamstring stretch, especially in a downward dog position, this area feels like it's on fire. The fact that I cannot do downward dog right now, with my right heel down. I'm starting to think this may be a nerve. It's been hurting for about 10 d...
Today's question comes from one of the YouTube viewers. Tasnim, wrote in and wanted to know whether or not "stress reaction" is the same terminology that is used in the UK for the term "metatarsalgia". This question points out how confusing these two terms can be when you have forefoot pain that might be a stress fracture, might be a plantar plate sprain, or could even be a neuroma. Are stress "reaction" and "metatarsalgia" the same terms? Well, that's what we're talking about today on the Doc O...
You're out on a run, and you suddenly start having extremely sharp heel pain. You think it's plantar fasciitis. But when you look at your foot, you see a huge bruise. That's not plantar fasciitis. That's where you ripped something. Is there always bruising with a partial rupture or a tear in the plantar fascia? Well, that's what we're talking about today on the Doc On The Run Podcast.
One of the most powerful ways to reduce stress and strain on any piece of injured tissue is to get completely off of your feet. Bedrest can do that. I was talking with a runner recently who asked a great question, “Should I just do bed rest?” I answered, “Bed rest is like chemo for runners.” With chemotherapy, we're basically giving you a powerful drug. But is it going to kill the tumor first, or is it going to kill the patient first? Bed rest is like chemotherapy for runners, and that's what we...
