Stress fractures are the most common overtraining injury I treat in runners. If you're a runner with a stress fracture, your first question is probably "When can I run?" Since the answer is always, "When it is healed enough to withstand running..." Your second question is likely “What can I do to heal a stress fracture as quickly as possible.” But if you heal it, get back to running and then get another stress fracture, a recurrent stress fracture, your number one question should be “why”. What ...
Nov 13, 2023•4 min•Ep. 795
If you are a runner struggling with a plantar plate sprain, it is probably going to be extremely frustrating trying to get it to heal so you can get back to running. The plantar plate a very small ligament. It does not have a great blood supply. Every time you take a step, you put pressure on the plantar plate. Every time your heel comes up off the ground when you walk, you stretch the plantar plate. Because it is so difficult to heal, runners typically have frustrating setbacks. That state of d...
Nov 10, 2023•5 min•Ep. 794
Just last week, I was giving a lecture at the International Foot and Ankle Foundation meeting in Hawaii. The lecture was on Conservative Management of Ankle Sprains in Runners Who Want to Run. One of the worst things that can happen to a runner with an ankle sprain is that you can lose what we call proprioceptive ability. But that is preventable. What would you do if I told you, you can reduce your risk of the number one most common musculoskeletal injury by 35%? Well, that's what we're talking ...
Nov 08, 2023•4 min•Ep. 793
In today’s podcast episode we're talking about fracture healing versus skin healing. This talk comes from a discussion I had at the International Foot and Ankle Foundation meeting in Hawaii where I was recently giving a lecture on Runner's Heel Pain to a whole roomful of doctors. A doctor asked me a question about how to get a runner back to running as quickly as possible after injury. What do injured runners do that makes about as much sense as picking at a healing skin incision? Well, that's w...
Nov 06, 2023•4 min•Ep. 792
If you get a fracture of one of the metatarsal bones in your foot, you are not going to be able to run until it heals. But as soon as it's healed, you will want to start running again. You may have recently seen the episode that I did where I was talking about how ultrasound may show signs of healing sooner than X-rays. How much earlier can ultrasound show healing of a fracture as compared to X-ray? Well, that's what we're talking about today on the Doc On The Run Podcast....
Nov 03, 2023•5 min•Ep. 791
I was just lecturing at the International Foot and Ankle Foundation meeting in Hawaii. One of the podiatrists came up to me and asked me a question after one of the sessions. He said that he was going to be working with a local high school cross-country team. He wanted to know what I thought would be the most important things to share with cross-country runners to try to reduce their risk of injuries amongst the team throughout their cross-country season. What information would I want to share w...
Nov 01, 2023•6 min•Ep. 790
If you're a trail runner or a marathon runner or an ultra-marathoner, well, the last thing you want to do is get a fracture. If you break something, you have to sit still until it heals, and that can take a long time. What is a common cause of fracture in a trail runner? Well, that's what we're talking about today on the Doc On The Run Podcast.
Oct 30, 2023•4 min•Ep. 789
Bruised toenails are extremely common in runners. Many consider black and blue toenails a rite of passage when training for your first marathon. However, if a bruise under the toenail appears without any trauma, it can be worrisome. A solitary dark linear streak is alarming to dermatologists and podiatrists. Because if you get a solitary linear bruise that doesn't drift out like a typical bruise under the nail usually does, your doctor might be concerned that you have something called acral-lent...
Oct 27, 2023•5 min•Ep. 788
If you get a fracture of the metatarsal, you have to make sure that it's healed before you start running on it. It doesn't matter if it's a stress fracture, or a traumatic fracture where you stepped in a hole, tripped or fell off a ladder. Deciding when it appears to be healed enough to withstand the forces of running is the key. The most common way doctors decide when the fracture is fully healed is by taking an X-ray. When can I start running after a metatarsal fracture if I have no healing on...
Oct 25, 2023•4 min•Ep. 787
Plantar plate injuries are one of the most difficult injuries for runners. The reason is that they can take a long time to get better. Every time you take a step, you're applying direct pressure to the plantar plate ligament. Every time your heel comes up off the ground, you bend the toes, and you're stretching the plantar plate ligament. The plantar plate ligament doesn't really have a great blood supply, and they can be extremely frustrating for runners. So the big question is: When can I star...
Oct 23, 2023•5 min•Ep. 786
I was on a call with a marathoner who had a cuboid fracture. He was getting better, and he was trying to figure out how he could start running. The cuboid bone is an irregular bone at the base of the metatarsals, and it's sandwiched in between the fourth and fifth metatarsal bones and the heel bone. It is a bad bone to break. So he had a valid question: Is it risky to run with a cuboid fracture? Well, that's a great question, and that's what we're talking about today on the Doc On The Run Podcas...
Oct 20, 2023•4 min•Ep. 785
I don't like it when I hear a doctor said, "Don't run." What the doctor should say is, "Let's figure out how you can run." And if you're injured, that's what you should be thinking about too. Not, "When can I run?" But, "How can I work out right now?" When can I run if my doctor says "don't run" because of an injury? That's a great question, and that's what we're talking about today on the Doc On The Run Podcast.
Oct 18, 2023•4 min•Ep. 784
Today I got a great question from a runner who had a 4th metatarsal stress fracture while training for a marathon. He wanted to know how likely it was to get a setback, or re-injury, if he is running while the stress fracture heals. How likely is a setback if I run while my stress fracture heals? Well, that's a great question and that's what we're talking about today on the Doc On The Run Podcast.
Oct 16, 2023•5 min•Ep. 783
Today's episode comes from the question-and-answer session at the International Foot & Ankle Foundation meeting in Las Vegas. I was lecturing on Medical Imaging Strategies in Runners to Avert Misdiagnosis. At the end of this talk that I was giving, one of the doctors, Dr. Brad Hayman, asked a great question, "A lot of us doctors who are not runners have a very difficult time relating to some of these runners because we don't necessarily get why it's so important that they're doing a particul...
Oct 13, 2023•5 min•Ep. 782
Today's episode comes from the question-and-answer period when I was lecturing at the International Foot & Ankle Foundation Medical Conference in Las Vegas. The talk was Conservative Management of Ankle Sprains in Runners Who Want to Run. During that talk, I explained to the doctors everything that I do with runners who have ankle sprains. Afterward I got a great question from Dr. Bryan Markinson, who is a prominent physician from New York. He said: "Okay. Is this stupid or is this not stupi...
Oct 11, 2023•5 min•Ep. 781
All injured runners realize it's a problem. You're not working out when they get an overtraining injury. You're told to sit still. But the problem is not that you're going stir crazy because you feel like you need to exercise. The problem you notice is that you're getting weaker, you're losing your fitness. And although I know that you're worried about losing your fitness, there is another problem you may not see. You should work out while you're waiting to heal. And that's what we're talking ab...
Oct 09, 2023•4 min•Ep. 780
I just got a great question from a runner with a cuboid fracture. He signed up for four weekly coaching calls as he was returning to running. He just wanted to make sure that he didn't make the fracture worse as he was actually getting back to activity. He asked, “Once I start running outside, can I use the Alter-G treadmill to add miles and speed while lowering overall tissue stress?” Can I use the Alter-G treadmill to add miles and speed while lowering overall tissue stress after recovering fr...
Oct 06, 2023•4 min•Ep. 778
I got a question on one of the Doc On The Run YouTube channel videos about insertional Achilles tendinitis. Kevin asked: “For a few weeks, I had insertional Achilles tendinitis. I have read that doing heel raises over a step could make the situation even worse. Some suggest doing it on barefoot in a flat zone. What do you think?” Can heel raises make insertional Achilles tendinitis worse? Well, that's what we're talking about today on the Doc On The Run Podcast
Oct 04, 2023•4 min•Ep. 777
When I see a runner who's had a sprain or a trip or a fall or something, the #1 concern is to make sure no bones are broken. Most of the time, what I do is I take a portable ultrasound unit with me so that I can look at the foot on the spot and try to figure out whether or not there is a fracture. I had a question about this as a comment on one of the Doc On The Run YouTube video episodes where I was talking about ultrasound imaging in the foot when you're a runner. The question was, “Can you ge...
Oct 02, 2023•5 min•Ep. 776
Today's episode comes from a question on the Doc On The Run YouTube channel. We were talking about how bone callus shows up as evidence of healing after a fracture in a runner. Her question was: “If there was no visible gap in between the bones where the fracture is, will the callus still be visible on the X-ray ? How will the callus show for non-displaced fractures on imaging? Thank you so much for creating this channel and for sharing all your expertise to the world.” How does callus show heal...
Sep 29, 2023•5 min•Ep. 779
I was just on a webcam call with a runner who signed up for an initial consultation and then decided to get a few weeks of additional coaching where we just check in every week to make sure that he's not making any big mistakes that are going to cause a re-injury. We were talking about how the whole goal is to keep running without slowing down the healing. The way you do that is that you stay below your threshold for re-injury or re-fracture of the bone. Today on the Doc On The Run Podcast, we'r...
Sep 27, 2023•4 min•Ep. 775
Plantar fasciitis is the most common cause of foot pain that might keep you from running. But some treatments that help "normal" patients may cause lingering trouble in runners. It seems like most of the runners who call me for help have made at least one, if not two of the three biggest mistakes runners can make with plantar fasciits. Today on the Doc On The Run Podcast we're talking about the top three mistakes runners make with plantar fasciitis.
Sep 25, 2023•6 min•Ep. 774
Today's episode comes from Olivia who asked a question on the Doc On The Run YouTube channel: “I believe I'm dealing with an interstitial tear. Would supplementing collagen help the healing process?” An interstitial tear just means you have little bitty tear on the inside of a tendon or ligament. You can get these types of injuries in the plantar plate ligament, the plantar fascia, or any tendon. All of those tendons and ligaments are made of collagen. So, it seems reasonable that collagen suppl...
Sep 22, 2023•5 min•Ep. 773
Compression socks are a useful tool when recovering from a running injury. Just a little compression can gently squeeze all that inflammatory fluid out of your foot, your ankle and your leg. I was talking to a runner yesterday who asked me about the best compression sock sizing. She was worried that if the socks were too tight, they could hurt her fracture when she was pulling the socks on. That is a totally valid concern! If it hurts when you're pulling on compression socks, you might actually ...
Sep 20, 2023•4 min•Ep. 772
If you got injured, but you're trying to get back to running, one of the most important decisions you can make is which doctor you choose to see. And it is entirely your choice. I just got off a call with a runner who had a really serious issue. She rolled her ankle. She treated it like a normal ankle sprain. But about six weeks later, it was still a little bit puffy. It still hurts. It was still bugging her, and she wanted to get a second opinion. She did the right thing. She went and saw an or...
Sep 18, 2023•4 min•Ep. 771
Today's episode comes from one of the Doc On The Run YouTube viewers. Casey wrote in and he said, “This year I suffered from this problem after switching to zero drop running shoes and I was finally running pain free. The zero drop running shoes made me into a forefoot runner instead of a heel striker. I was doing great but then I started having pain in the ball of my foot from a callus. I then started having this pain and I did exactly what you said to do in this video and it worked great and s...
Sep 15, 2023•4 min•Ep. 770
I get lots of questions about "sinus tarsi syndrome" in runners. It seems like most runners who call me don't even really know what it is. The sinus tarsi is not a structure, so much as a space. That space contains some structures that can cause pain after an ankle sprain. The sinus tarsi may also ache in flatfooted runners as well. The sinus tarsi confuses many runners because it is kind of in the ankle, but kind of in the foot as well. What is the sinus tarsi? Well, that's what we're talking a...
Sep 13, 2023•4 min•Ep. 769
I had a question on one of my YouTube videos in which I was trying to explain the procedure for broken toes called "closed reduction." That's the fancy term for popping the broken bone back in place or "re-setting the fracture." You may have heard someone say, “Well, I had a fracture and the doctor had to "set it" or the doctor had "put the broken bone back in place.” There is a risk and a benefit to everything. Even with non-surgical fracture treatment. Putting a fractured piece of bone (in a b...
Sep 11, 2023•4 min•Ep. 768
Today's episode comes from a second opinion discussion with a runner suffering with a nagging plantar plate ligament injury. She was considering surgery for a plantar plate sprain. Truth is, her plantar plate sprain was not really that bad. It's pretty common when runners have trouble healing a plantar plate sprain, the doctor may recommend a number of different surgeries. One of those surgeries is where we actually shorten a bone in an attempt to decrease the tension and pressure on the plantar...
Sep 08, 2023•6 min•Ep. 767
Today's episode comes from a question from one of the Doc On The Run YouTube channel viewers about fibular stress fractures. There are only tow bones between your knee and your foot: The Tibia (or shin bone) and the fibula bone, which is much smaller. The fibula bone supports very little of your weight when you run. Your knee is at the top of the tibia bone, and the other end of the tibia sits on top of the talus bone at the top of your foot. The tibia is the bone that really takes the pressure ...
Sep 06, 2023•4 min•Ep. 766
