I just got a great question from a runner with a tibial stress fracture that had been misdiagnosed with shin splints. She wanted to know how long to use the crutches. Is two weeks on crutches better than one week when I have a tibial stress fracture? Well, that's what we're talking about today on the Doc On The Run Podcast.
Today's episode applies to any injured running pondering surgery. I just spoke to a runner who was told she might need surgery to fix a non-union of a metatarsal fracture. I said, “Look, you have two choices. You can have surgery or not have surgery.” We talked about what it meant if she did have surgery in terms of her recovery. And we also talked about how she could potentially get it to heal without having all the risk associated with surgery. What is the very last option you can do as a runn...
If you are an injured runner, you are probably limiting your activity. Doctors who don't understand how important it is for you to get back to running tend to limit runner's workouts more than necessary. They're more restrictive than necessary. And it costs you. You lose more fitness, you get weaker, you get stiffer, you get neuromuscular changes that damage your running form, and disrupts your coordinated firing of muscle units that makes you efficient. All of that gets damaged over the weeks t...
Please change the podcast descriptions, Aweber email and Clickfunnels email to: I had an interesting question from an athlete who asked, “I had an injury, I went to see the doctor and got an X-ray. There was no crack on the X-ray, but my doctor called it a stress fracture. So, I'm confused.” “I thought that a stress fracture happens when you run too much, too far, too soon, it overloads the bone, and you get a little crack in it. I didn’t do that. It was trauma, a sudden injury, not a bunch of f...
I recently did a webcam consultation with an athlete who has had a lot of trouble for a long time. He was very, very athletic. He started having pain and a whole lot of trouble that ensued afterwards that severely changed his athletic picture in only a couple of years. After years of seeing experts and not getting any better, he asked me to help him to do a second opinion and help him reassess where he was and what he might be able to do. The way I think about this is really simple. Many of the ...
I saw a runner who had a traumatic fracture, but she had been told it was a stress fracture. This did not make sense to her, because her injury wasn't from training for a race. She was trying to understand the difference in healing between a stress fracture with a crack when compared to the healing time of a traumatic fracture with a similar crack. It's important to understand they were talking about similar cracks in similar bones that remain in a similar position. We're not talking about broke...
A metatarsal fracture "non-union" is what doctors call it when you broke the bone, it started to heal, but then the fracture kind of quit healing. Usually it means you got a bunch of scar tissue between the ends of the bone. Sometimes that happens without you or your doctor realizing it. The problem gets worse if you start running on it. The question is, "should I take non-steroidal anti-inflammatory drugs (or NSAIDs)? NSAID's are medications like ibuprofen and naproxen. These drugs are not ster...
If you get a metatarsal stress fracture, the first thing that you're going to notice is not that you have a broken bone in your foot. You are going to notice pain. Typically, the feeling starts as a little vague discomfort in your foot that progressively gets worse as you continue to train and run on it. The soreness gets worse the longer you run, feels worse when you walk barefoot on hard surfaces and becomes more notable going up and down wooden stairs. As I explained this to a runner in the I...
A stress fracture in your tibia, or shin bone, is a bad injury. You definitely don't want the crack to grow to the point where it could break. The big question is what will make a tibial stress fracture better, faster...crutches or a fracture walking boot? When is a fracture walking boot better than crutches for a tibial stress fracture if you're a runner? That's what we're talking about today on the Doc On The Run Podcast.
This episode comes from a discussion I called with a runner who called me for a second opinion. She had a stress fracture non-union and somebody had remained recommended that she have surgery. I was looking at her CT scan and she asked me an interesting question. She said, “Does it look stable?” And I said, “Can't tell.” It looks like a non-union. It looks like it’s broken and never healed. What are the three ways you could tell whether or not a metatarsal fracture non-union is stable without ge...
50% of your body weight goes through the big toe joint when you run. So, If you get a fracture in the big toe joint, it can be a serious problem. One type of fracture in the big toe joint is called an avulsion fracture. I was just doing a consultation with a runner who had a phalanx avulsion fracture in the big toe joint. I wanted to show you what it really is and so that you can understand it better and what it might actually mean in terms of your returning to running. What is a phalanx avulsio...
Non-steroidal anti-inflammatory drugs (or NSAIDs for short), like Ibuprofen and Naproxen, what we call are extremely popular with runners because they get rid of lots of aches and pains. We often think inflammation results from hard exercise, so it stands to reason a non-steroidal anti-inflammatory will actually help after a long run. I don't normally recommend runners take NSAIDs as a part of a training routine. But there are a couple of alternatives that I would recommend over non-steroidal an...
I had a call with a runner who asked me an interesting question about the difference between a mild stress fracture and a serious stress reaction in a runner. She wanted to know if the difference was based on the amount of tenderness or pain that she had. Although it stands to reason that the more tenderness, the more pain you have, the worse it must be. However, that is not really what differentiates a mild stress fracture from a serious stress reaction. What's the difference between a mild str...
If you get gout, it's going to be painful. It hurts because you get so much uric acid buildup in your bloodstream that it starts to crystallize, forming little bitty needle shaped crystals in the joint. They are pointed, they're sharp and they are poking the tissue on the synovial tissue inside of the joint, and it hurts. When is the worst time to check for gout with a blood test? Well, that's what we're talking about today on the Doc On The Run Podcast.
Every runner who has heel pain wants it fixed. A lot of us think about this in the way that we fix automobiles. The alternator goes out in your car, you go get a new one put in. Your battery dies, you go get a new battery. But your foot doesn't work this way. So unfortunately, when you have surgery, you're trading one problem for another. I have done endoscopic plantar fascia release surgeries, but not on any runners for more than a decade. Why do you think that is? Can an endoscopic plantar fas...
If you have a tear in the plantar fascia, you probably know what a frustrating injury it can be. If you think it's better, and you're going to start running, one of your big questions is probably, “How do I avoid a second tear in the plantar fascia?” That's a great question and that's what we're talking about today in the Doc On The Run Podcast.
If your doctor said you have gout, you might have heard about a gout specific diet. A gout diet is not a specific diet in terms of a plan. It's avoiding foods that are high in purines that can contribute to high blood levels of uric acid. What is the most ignored part of a diet for somebody who's a runner and thinks they have gout? Well, that's what we're talking about today on the Doc On The Run Podcast.
Don't ever forget that when you get a running injury, the goal is not to heal the injury. The goal is to get back to running. If you heal the injury and you get so weak and so stiff, that you wind up getting another overtraining injury, that is a failure. The thing you have to really think about as you're returning to running isn't just about the possible other injuries you could get but incomplete healing. The goal is to always strengthen everything as much as possible without obviously causing...
Why would you want to add stress? We're not talking about psychological stress. We're not talking about the stress of a screaming baby or a boss yelling at you. We're talking about stress on the tissues that will actually stimulate a healing response that makes them stronger later, just like working out. If you're an injured runner who's getting back to running, you need to add stress systematically. And that's what we're talking about today on the Doc On The Run Podcast....
One of the problems with the plantar fascia is that you may think you have plantar fasciitis, but eventually you find out that it was not really fasciitis at all. It's actually a partially torn plantar fascia ligament. That can be a problem since it is the largest ligament in your foot. When somebody says: “Can I run with a small tear in the plantar fascia?” I say that depends. Is it a big deal if I run with a torn plantar fascia? Well, that's what we're talking about today on the Doc On The Run...
When you have a running injury and you know what your goal is you are halfway there. But if you're trying to get back to running, you've really got to do three things. You have to start moving, not make the injury anything worse, and you've got to get fit as fast as possible. Every day is a test run after you've healed a running injury. That's what we're talking about today on the Doc On The Run Podcast.
One of the problems with being a runner is that you have a higher pain threshold. If you have a minor attack of gout, it may not bother you as much as it would other people and what Gout is, is that you get painful crystals forming within a joint like the big toe joint. If you have what we call sub-acute gout, meaning it's not really killing you, it's just kind of a minor thing that's building up gradually, then the condition might actually sort of fly under the radar. You might be gradually bui...
A runner called me to follow up and asked: "I've been doing the routine that we discussed during our first call and I've got no pain, I’ve got no tenderness. How can I tell if I'm really ready to run now without hurting it?” You have to realize that if you run and you are weak and unstable, you are at higher risk. Those gaps in recovery create unnecessary risk. You have to figure the pieces you haven't really considered that could put you at risk of re-injury. Find the gaps between where you are...
Your doctor might recommend custom orthotics if you're an athlete, and you happen to be pregnant. When you get pregnant, you have lots of hormones going through your systems that can cause ligamentous laxity. The reason that's a problem if you're a runner is that you have rapid weight gain during pregnancy. That weight combined with additional relaxation in your feet can accentuate mild foot problems and even cause deformities that persist later after the pregnancy is over with. When does a preg...
Today we're talking about the Yasso 800's developed by a guy named Bart Yasso. I was lucky enough to meet him after he gave a talk before the Salt Lake City marathon back when I was in residency about 20 years ago. In any event, this workout is a useful way to analyze your fitness and determine your marathon pace. Yasso 800's can be really helpful to an injured runner who's returning to running when trying to figure out how fast you should run your post-injury marathon. Today on the Doc On The R...
Today's episode comes from one of the YouTube viewers who was watching a video called "Can I run with a split peroneal tendon?" I was trying to explain the circumstances when you can run with a split tendon, and when you really shouldn't. He wanted to know if his doctor could tell whether or not he needed surgery just by looking at his ankle. “The MRI tells me I have a split tear. So, presumably as a tear in the peroneal tendon, but I don't know which one." Can my doctor tell me if I need surger...
This episode comes from a consultation call on webcam with a runner with a sesamoid stress fracture. Interestingly, his doctor wasn't even sure what it was, if it was really a crack in the bone that wasn't healing, or if it was what I call a "sprain" of the bipartite sesamoid. Today on the Doc On The Run Podcast we're talking about how big toe positioning can actually help a medial tibial sesamoid stress fracture or bipartite sesamoid disruption.
Today's episode comes from Benda, who was watching a video called "12 steps to healing and running with a metatarsal stress fracture" on the Doc On The Run YouTube channel. She asked a question, “I'm so confused. I don't have a stress fracture. It was an acute injury. I have a half marathon in early December. Is there hope for me?” I got injured five weeks out from my half marathon. Is there hope? Well, that's what we're talking about today on the Doc On The Run Podcast....
I recently got a comment from Michael on a video on the Doc On The Run YouTube channel which was about how fracture walking boots are one of the worst treatments for an injured runner. He posted an interesting comment which is really a valid question. He said, “What is the boot for? Is it for protection? Is it for immobilization? Is it to keep weight off?" What does a fracture walking boot actually do? Well, that's what we're talking about today on the Doc On The Run Podcast....
I recently got a great question from someone who was watching one of the videos on sesamoid fractures. Underneath the big toe joint, you have two little bones called sesamoid bones. Sometimes you can get a fracture or crack in the bone that doesn't heal. Then it turns into what we call a non-union. Some people have sesamoids called "bi-partite" sesamoids. It looks like a fractured sesamoid. But its' normal. The two pieces are connected by soft tissue. But that soft tissue connection can become i...
