I got an interesting question from a runner who had a plantar plate injury. This runner had a long course of sort of misdiagnosis, mistreatment and various plantar plate "misadventures." But when we started working together, he started to do some specific things to improve quickly, and he is doing great now. He asked: “Which comes first after my plantar plate sprain heals, will I be running, or will I be wearing dress shoes?” Well, that is a good question and that is what we're talking about tod...
Jun 10, 2024•3 min•Ep. 885
I had a call from a patient who wanted to know about surgical removal of Morton's neuroma. She said she went to the doctor. The doctor said, “Well, we can just take the nerve out. It is not a big deal. We do this all the time.” The reason she called me for a second opinion was because the doctor told her we have to cut a ligament to take the painful nerve out. She wanted to know if that was true, and whether or not that could cause a problem later. Do you have to cut a ligament in the foot to re...
Jun 07, 2024•5 min•Ep. 884
I got a comment from a runner who posted this question on one of the YouTube videos on the Doc On The Run YouTube channel. He says he had plantar fascia surgery just over 3 months ago. He said that following the operation, he followed all of the surgeons post-operative instructions "to a tee." He was feeling great, until he started developing a small pain at the back of the arch right where the heel starts. He said: “My whole arch is in pain. Do you think I could have a torn plantar fascia? It w...
Jun 05, 2024•6 min•Ep. 883
I was just on a call with a runner who had a plantar plate injury that has been bothering him for about a year and a half. We did a series of calls to talk about some changes in his treatment that could get him moving in the right direction. He asked me a great question when I was on a call with him this morning. He said: “Can I run in zero drop shoes once it is really healed? Not today, but like when it is really, really healed and it is stronger and all that kind of stuff.” I said, “You can do...
Jun 03, 2024•5 min•Ep. 882
When you have hallux rigidus, the problem is the big toe joint does not want to move. Many doctors will simply tell you that your big toe joint, or the "first metatarsal phalangeal joint" is getting progressively stiffer and developing arthritis. If you wear shoes that irritate the joint more, the condition will only gets worse. The question is what sandals won't make hallux rigidus worse? What sandals can I wear with hallux rigidus? Well, that is a great question and that is what we're talking ...
May 31, 2024•3 min•Ep. 881
Today's episode comes from a comment on one of the YouTube videos on peroneal tendinitis. A limping runner asked the question: “Can peroneal nerve tendinitis cause fifth metatarsal to be tender to the touch and when walking, I am not sure if I have a stress fracture.” When I read this comment, I became confused because I am not sure what is going on with this runner, but I am going to try to explain and answer the question as best I can in this episode. Can peroneal nerve tendinitis cause fifth ...
May 29, 2024•6 min•Ep. 880
I got a great question from a runner with a sesamoid fracture that turned into a "non-union." The sesamoid bones are two tiny little bones under the big toe joint. When you break one of the sesamoids, if two pieces of bone do not heal back together, we call a "sesamoid fracture non-union." In this runner's case, she used a bone stimulator. She wore a fracture boot. She used crutches. But after a year of treatment, the doctor looked at her X-ray and said, “You have a non-union, we should take it ...
May 27, 2024•6 min•Ep. 879
The primary way I help runners is through telemedicine second opinions. I help runners who are not running, who have not been getting better, who are frustrated, and help them figure out what they need to do to get past the injury and back to running. Once they are on track and have made lots of progress, they want to know “When should we check in for our next call?” I feel like I am on track with my running injury, should we book another consulting call or a series of calls to talk about it? We...
May 24, 2024•3 min•Ep. 878
I saw a runner today and I did a cortisone injection to treat her sinus tarsi syndrome. She asked me a great question. She said, “Is the cortizone injection something I am going to need to do every three to six months?” She had been reading up on corticosteroid injections and had found that some athletes with certain conditions may have injections scheduled every few months. Should I have serial injections for sinus tarsi syndrome? Well, that is a great question and that is what we are talking a...
May 22, 2024•5 min•Ep. 877
The most important first step with any athlete who signs up for a webcam second opinion or series of coach coaching calls is to ask, “What is your goal?” I was lecturing at a medical conference in Wisconsin where I was doing a whole morning session on running injury talks and diagnosis of subtle fracture patterns in athletes. What I told those doctors is they have to ask the athlete, “What is your goal?” Without understanding your timeline based on your running goal, you cannot make a useful rec...
May 20, 2024•4 min•Ep. 876
Today, I had a final follow-up call with a runner who did a series of consultation calls with me to get advice every week. After the series of calls he had improved and was better, but disclosed to me that he felt like he had been depressed. He thought he might have depression because he realized something had significantly changed in his goal setting. He said, “I can't even imagine myself doing races anymore.” Are you depressed because of your running injury? Well, maybe you are, maybe you are ...
May 17, 2024•3 min•Ep. 875
This morning, I was on a second opinion call with a runner who had a couple of different injuries in his foot. The main problem keeping him from running was an injury to the collateral ligaments in one of his toes. "The toe feels weak and unstable." He is understandably worried that the instability is going to cause a problem if he runs. He was asking me: “Well, can we surgically repair the ligaments?” Should I have surgery to repair the collateral ligaments in my toe if I am a runner? Well, tha...
May 15, 2024•5 min•Ep. 874
This morning, I had a conversation with a runner who had an injury. He has been getting a lot better and one of the things that really seemed to help the injury improve was wearing compression socks. His question was a really good one. He said: “I had so much improvement with wearing compression socks, but with the injury I have, every time I take the socks off and on, it feels like I am moving the injured tissue now. I am not really sure if I still need the compression.” Do I need to keep using...
May 13, 2024•5 min•Ep. 873
If you get an overtraining injury like a metatarsal stress fracture or a plantar plate sprain or Achilles tendonitis, or peroneal tendonitis, a doctor might prescribe a fracture walking boot. Well, it is designed to hold you still so that you can hopefully walk on something like a fracture and still let it heal. The reason for this episode is this morning I was on a call with someone who has been wearing a boot and he is curious why all of a sudden, he is starting to have some aching pain in the...
May 10, 2024•4 min•Ep. 872
I was doing a second opinion webcam consultation with a runner who noticed a lump in the calf muscle. The knot in the leg wasn't limiting his running. In fact, when he was running, this lump in the calf muscle felt better, not worse. So, you have to wonder, could the knot "not" be a big deal? There are really 3 things a runner can do immediately after noticing a bump in the leg. Today on the Doc On The Run Podcast, we're talking about the three steps you should do as the very first thing when yo...
May 08, 2024•5 min•Ep. 871
Today I am about to drive to the airport, get on a plane, fly to Wisconsin to give five lectures on running injuries at a medical conference. As I was finalizing that talk on medical imaging strategies for athletes, I was thinking about a conversation that I had yesterday with an athlete who had a very frustrating course and actually called me for a second opinion. He had an injury that hass been going on for a long time. In short, he is trying to get a second opinion from me specifically becaus...
May 06, 2024•5 min•Ep. 870
I know. You don't want plantar plate surgery. But if your plantar plate ligament doesn't repair itself, or your doctor doesn't help it repair itself, you might get talked into surgery. If you have plantar plate repair surgery, you may spend a lot less time running over the weeks following surgery...because you have to let it heal. There are really three mistakes that I see runners make when they've had a plantar plate injury. This episode will help you avoid them. What are 3 big mistakes runners...
May 03, 2024•5 min•Ep. 869
This episode comes from a question posted by one of the Doc On The Run YouTube viewers as a comment on the video “Where to run with plantar fasciitis.” In the video, I was trying to explain which surfaces can help you the most when you're trying to run with plantar fasciitis. The only way to do that is to make sure you are decreasing the stress and strain on the plantar fascia ligament. But the question was... Is the plantar fascia really a ligament? Well, that's what we're talking about today o...
May 01, 2024•3 min•Ep. 868
There are three ways that a doctor might convince you that it's really time to have surgery and fix that plantar plate ligament that's been making you miserable when you've been trying to run. To you, it may not seem that bad. It kind of aches. It kind of swells. It kind of bugs you. But then the doctor suddenly says, “Look, it's not getting better, let's have surgery.” Well, how does the doctor convince you that it's time for surgery? What are the things a doctor does, that might actually lead ...
Apr 29, 2024•4 min•Ep. 867
Today's episode comes from one of the YouTube videos and it was specifically a comment that someone posted on one of the videos that was called “Five worst exercises for hallux rigidus”. This came from Matt and he asked: "When can you start doing push-ups again, if you have hallux rigidus?" Well, that's what we're talking about today on the Doc On The Run Podcast.
Apr 26, 2024•4 min•Ep. 866
I'm not going to tell you that any runner should want to use crutches. I'm also not going to tell you that you will enjoy wearing a fracture walking boot. But there are reasons that you may want to do things a little differently if you're a runner. The critical issue is that runners must really try to speed up the healing process as much as possible, so that you can avoid losing your running fitness. What are the three time-sensitive problems solved when you use a fracture walking boot and crutc...
Apr 24, 2024•6 min•Ep. 865
Most of the runners I see who have pain in the ball of the foot from a plantar plate sprain rarely start out with a completely torn plantar plate tear. More often, runners ignore the pain from the plantar plate sprain and it evolves into a full thickness plantar plate tear. Surgery is only needed when the plantar plate is torn in such a way that the plantar plate ligament cannot be expected to heal without surgery. But there are some mistakes that could lead a runner to the operating room. Plant...
Apr 22, 2024•3 min•Ep. 864
Sometimes when you get injured and have to stop running, you start to lose your identity. One of the things that I notice most in runners who have gone weeks or months without running, is they are really bummed out. These runners seem really grumpy. In some cases, they don't even view themselves as a "runner" anymore...well, because they're "not running." If you want to heal and get back to running as quickly as possible this can be a real problem. How can self-judgment actually slow down your i...
Apr 19, 2024•3 min•Ep. 863
I just had a consultation with a runner who had foot pain that she thought might be a stress fracture that had been coming and going for about a month. She had been increasing her training volume and doing strength exercises that are supposed to build her running fitness. The pain seemed to be volume related. The more training she did, the more she would notice the discomfort in her foot. But when we x-rays of her foot, the radiologist suggested this could be an "acute on chronic" stress reactio...
Apr 17, 2024•6 min•Ep. 862
Just this morning, during the live Stress Fracture Masterclass I had an interesting question. The story went like this. An athlete who is a State ranked high school cross country and track, had to suddenly stop running due to intense pain that started about 15 days ago. He went and saw a doctor. He got x-rays. He got an MRI, had a physical exam where the orthopedic doctor poked around and tried to figure out what was going on. The Orthopedist gave on diagnosis, but the Radiologist suggested a di...
Apr 15, 2024•5 min•Ep. 861
Let's say you had an ankle injury a long time ago. You sprained the ankle when you were out on a trail run, it got better , and you went right back to running. But over time, you slowly got more and more pain in the ankle. In that case, you doctor might order an MRI of your ankle, or a similar imaging study called an MRA (instead of MRI). What's the difference between MRI or MRA in a runner with an old nagging ankle injury? That's what we're talking about today on the Doc On The Run Podcast....
Apr 12, 2024•4 min•Ep. 860
I recently saw a runner who thought that he might have a tibial stress fracture. But it turns out, it was just shin splints, which of course is good news. Because you don't really want a tibial stress fracture. Shin splints is much easier to treat. One of the questions he asked me was about the best running shoes based on his foot type. This runner really needed more stability than got from the running shoes that he was wearing. What are two different ways shoes can actually cause shin splints i...
Apr 10, 2024•3 min•Ep. 859
If you got pain on the ball of the foot, at the base on the 2nd, and you have been running in a minimalist shoe, running uphill, doing lots of calf raises, or running on steps, you could have an injury to a little bitty ligament called the plantar plate ligament. If you get an injury to the plantar plate, sometimes your second toe will drift toward your big toe or away from your big toe. The toe drifting sideways can happen for two different reasons. They are very different causes and so they ar...
Apr 08, 2024•3 min•Ep. 858
If you roll your ankle on a trail run and it turns black and blue and swollen, you may think you just have to take a few days off. In fact, if you research how long it will take to get back to running, you might find a study that says that if you do early range of motion after an ankle sprain, it only takes 4 days to get back to pre-injury levels of activity. However, if you do that, you can wind up with a lot of trouble later. When I lecture at medical conferences on how doctors should treat an...
Apr 05, 2024•4 min•Ep. 857
Last night, I was doing a consultation with an athlete who had a fracture when she accidentally kicked a piece of furniture. Her foot was swollen, it was black and blue. The foot was really painful and she couldn’t walk on it. She went to urgent care and they took x-rays. She was a little concerned that they told her that it wasn't broken. So, she called me for a second opinion. My doctor missed a fracture on my x-rays. What should I do about that? Well, that's a great question and that's what w...
Apr 03, 2024•4 min•Ep. 856
