Last week, I was in Hawaii lecturing at the International Foot & Ankle Foundation Medical Conference. meeting. I had been invited to give several lectures on running injuries. One of those was about stress fractures for physicians, podiatrists, foot and ankle surgeons. One of the objectives was to help them understand how they can look at stress induced injuries differently, with the intent of teaching the doctors that they really have to consider these timelines. Timelines, forced decisions...
Oct 28, 2024•5 min•Ep. 945
Plantar plate injuries in runners are a common topic at medical conferences because they cause a lot of pain in the ball of the foot. I just spoke to a runner who had an interesting question about plantar plate injuries, which was a question I never would have imagined. She wanted to know whether or not a "mallet toe" might lead to a plantar plate sprain. She didn't really understand the difference between a "mallet toe" and a "hammer toe." But she did understand that one or both are in some way...
Oct 25, 2024•4 min•Ep. 944
Today I was on the call with an injured runner who is trying to figure out how soon she can start running. She had been having pain and she was getting relief by taking over-the-counter medication. She asked me whether not that was good or bad. Whenever we have pain, we can simply take a pill, and the pain will go away. Non-steroidal anti-inflammatory drugs or NSAIDs are powerful readily available painkillers. I do not just get rid of inflammation they also control or reduce pain. So, when is it...
Oct 23, 2024•3 min•Ep. 943
Today I was doing a consultation with a runner who has a thing called an "accessory navicular." She thought that the bump was much more swollen than normal. She had basically rolled her ankle and banged that bone into a rock and then she was having some swelling there over the arch. She did a form of cryotherapy called the contrast bath routine to reduce the inflammation. It suddenly got much smaller. Like the bone shrank. How can that happen? If I have an accessory navicular bone in my foot and...
Oct 21, 2024•4 min•Ep. 942
Okay...I'm just gonna say it...lots of runners get funky toenails. Runners get bruised toenails, black toenails. But the worst thing is when the nail lifts up off the nail bed and you get fungal filaments that cause athlete's foot underneath the toenail. Then you get toenail fungus or onychomycosis. If your doctor recommends oral antifungal medications, you may get worried about the side-effects of the medication. Just today I saw a runner with toenail fungus. He wants it gone! So I was talking ...
Oct 18, 2024•5 min•Ep. 941
If you start getting pain in the ball of the foot, especially in the area between the metatarsals, it might be caused by a little fluid-filled sack (called a bursa) that sits between the metatarsals. Sometimes you get swelling of that little bursa, and it causes pain in the forefoot. This problem could be misdiagnosed or thought to be caused by a neuroma, an inflamed nerve that runs in that same area. What is intermetatarsal bursitis in the runner's foot? Well, that is a great question and that ...
Oct 16, 2024•5 min•Ep. 940
I have recently gotten a bunch of questions on one of the episodes I did where I mentioned somebody who had a stress fracture, and I had suggested that she should increase her cadence to try to decrease some of the impact forces through that particular bone when she was running and getting back to training now that she is really started to recover in a meaningful way. Specifically, what we are talking about here is your cadence. However, I think that since I have gotten so many questions about i...
Oct 14, 2024•5 min•Ep. 939
This episode comes from one of the YouTube viewers on the Doc On The Run YouTube channel and he posted a question as a comment on one of the videos, and he wanted to know, how can I tell if I broke the plate and screws on my calcaneal fracture. But number one, my number one question here is, what is it that this guy could have done that would have made him think that he applied enough force to the broken heel bone that he then could have broken the plate after the surgery? How can I tell if the ...
Oct 11, 2024•7 min•Ep. 938
Today's episode actually comes from a comment posted on one of the Doc On The Run YouTube videos. The viewer asked, and he said exactly, “I dropped a piano on my foot. Will I run again?” Well, that depends. If you drop a piano on your foot, maybe it would break your pinky toe. Maybe it would completely crush your foot. I dropped a piano on my foot. Will I run again? That is s a great question and that is what we're talking about today on the Doc On The Run Podcast....
Oct 09, 2024•6 min•Ep. 937
A runner who has been recovering from a plantar plate sprain was on a webcam call just to follow up and ask me some questions about her first runs now that she is returning to running. She wanted to know whether or not she should be running on a treadmill or running outside if there was any advantage or disadvantage to either. Which is better when you are returning to running after an injury, running on a treadmill or just running outside? Well, that is a great question and that is what we're ta...
Oct 07, 2024•4 min•Ep. 936
This episode is a really good example of the confusion that comes from Jones fractures, and this was hosted as a comment on the Doc On The Run YouTube channel on a video that was entitled, “What is a displaced versus a non-displaced fracture?” The viewer who posted the comment said, “My daughter's a D1 athlete in soccer. She fractured her foot on September 1st, so that would have been just over a couple of weeks ago. It was a non-displaced Jones fracture. What does that mean?“ “She's gotten thre...
Oct 04, 2024•9 min•Ep. 935
I was recently on a follow-up call with a runner who is recovering from a calcaneal stress fracture. She was doing really well, the stress fracture was healing, and her heel pain had completely resolved. So it was time to start ramping up her running. Since she wanted strategies to decrease stress on the stress fracture, we talked about increasing her running cadence. She asked me specifically about the difference between pace and cadence, as she wanted to be absolutely clear on what they were. ...
Oct 02, 2024•5 min•Ep. 934
If you get a metatarsal stress reaction, you might be confused for a number of reasons. First You are probably trying to figure out whether or not it is really just a subtle stress fracture or, if it is something more ominous? Second, you are also probably trying to figure out how to make the pain go away as fast as possible so you can get back to running. Last night I was talking to a physician who referred a runner who had a fourth metatarsal stress reaction. She wanted to know if it really wa...
Sep 30, 2024•6 min•Ep. 933
I just got a really obscure question from a runner suffering from chronic stress fractures. She was asking about a surgical procedure called a tibialis anterior tendon lengthening in order to address a situation where she had the same kind of 5th metatarsal stress fracture, again. Today on the Doc on the Run podcast, we're talking about tibialis anterior tendon lengthening for chronic fifth metatarsal stress fractures.
Sep 27, 2024•8 min•Ep. 932
If you sprain your ankle, you know that you need to protect it. The old treatment algorithm used to be R.I.C.E.: rest, ice, compression and elevation. The newer protocol is P.R.I.C.E.: protection, rest, ice, compression and elevation. Compression is one of the main things you need to do when you get an ankle sprain. When you sprain the ankle, it swells a lot and it's not going to get better, and you are not going to get back to running until sometime after that swelling goes away. The point of t...
Sep 25, 2024•5 min•Ep. 931
Sometimes runners have to do a whole lot of digging trying to figure out the difference between a couple of different surgical solutions for a recurring injury. Pain under the big toe joint can be because you are getting a stress reaction or a stress fracture in one of the two little sesamoid bones. It is pressure to that bone that is causing all the trouble. How can a doctor surgically reduce that pressure? What is the difference between a sesamoidectomy and a first metatarsal osteotomy for pai...
Sep 23, 2024•6 min•Ep. 930
I got a call from a worried runner who had a stress fracture. The fracture was not healing so he called for a second opinion. One of the things that he did not understand was this x-ray report that he got. The x-ray report and it said that he had "two millimeters of displacement of the fractured metatarsal bone without angulation." So, in this episode, I am going to try to explain to you (the same way I explained to him) what "fracture displacement" really means and how it shows up on the x-ray ...
Sep 20, 2024•4 min•Ep. 929
The plantar plate ligament that gets injured in runners is typically located on the bottom of the foot, at the base of the second toe. It gets inflamed, it gets irritated, it may feel weird at first. The plantar plate may not even feel sprained, or sore, or injured. It might just feel like this weird sort of fullness sensation. I got a question from a runner who had those same strange symptoms. He was trying to figure out what treatment would best address the "fullness" sensation in and around t...
Sep 18, 2024•5 min•Ep. 928
I got a call from a runner who had a stress fracture that was not healing, who needed a second opinion. When we were on the webcam call, one of the things that he did not understand was the specific medical terms on his MRI report. The MRI report said that he had "troughing" of the fractured metatarsal bone. I just thought that it might be helpful to explain to you what metatarsal troughing really means and how it shows up on an MRI. Today on the Doc On The Run podcast, we’re talking about what ...
Sep 16, 2024•4 min•Ep. 927
I was on a call with an active athlete who is recovering from a couple of different injuries and her main goal is to get back to running at high intensity. But while she has been injured and she cannot really run, what she has been doing is cycling, swimming, and doing a number of different strength training workouts to supplement her running fitness. She asked me an interesting question and she wanted to know whether or not swimming was really helpful in terms of her cardiovascular fitness more...
Sep 13, 2024•4 min•Ep. 926
When you have a plantar plate injury, it can be frustrating. The whole problem stems from a tiny little ligament right at the base of the second toe that is getting irritated, stretched, and strained. If its really bad, you might even have some tiny little tears in the plantar plate ligament. I was just talking to a runner who asked me about other exercises. Because, she had been told... "stop running, do other exercises to get stronger." So, she signed up for a boot camp training class. Althoug...
Sep 11, 2024•4 min•Ep. 925
I get lots of calls from runners who need a second opinion for running injuries like metatarsal stress fractures. Many times they are confused by medical terminology in their imaging reports. In this particular case, the runner wanted to know what it meant when her radiology report said that there was "5 millimeters of shortening of the second metatarsal bone," the bone that had the stress fracture. In this episode, I am going to explain what fracture "shortening" really means and how it shows u...
Sep 09, 2024•5 min•Ep. 924
I was just on a call with a trail runner who is recovering from both a sesamoid bone injury as well as a peroneal tendon injury. Right now she is focusing on working toward running on long technical trail runs in the mountains. To that end she is doing a lot of different forms of activity to supplement her running fitness. During our call, she asked a great question... "Should I be adding a lot more time or a lot more intensity to rebuild her running fitness." Which is more important to increase...
Sep 06, 2024•5 min•Ep. 923
If you are a runner and you got diagnosed with a plantar plate sprain, you probably already figured that out plantar plate sprains can be frustrating. The plantar plate ligament is on the bottom of the foot, at the base of the second toe and it helps hold the toe down against the ground. What is crossover toe deformity? Well, if you look at the foot from the top, typically crossover toe deformity means the big toe tilts this way and the second toe forms a hammer toe and tilts that way and goes o...
Sep 04, 2024•4 min•Ep. 922
Today's episode comes from a question that I got during a second opinion webcam call with a recovering runner. She is running, she is doing fantastic, and she wanted to know if she should hire a running coach. By the way, this is a very experienced, very fast marathon runner. After injury recovery, do I need to hire a running coach? Well, that is what we're talking about today on the Doc On The Run Podcast.
Sep 02, 2024•3 min•Ep. 921
Today's episode comes from a question posted in the comments section of one of the Doc On The Run YouTube channel videos. Specifically, it came after a viewer watched the video entitled Top Three Clues of a Plantar Fascia Rupture and Davis posted a question. He wanted to know, does a full or partial plantar fascia rupture greatly increase your risk for a re-tear. Does a full or partial plantar fascia rupture increase your risk of a plantar fascia tear later? Well, that is a great question and th...
Aug 30, 2024•5 min•Ep. 920
I was just on a follow-up webcam call with a runner who has chronic ankle instability but wants to get back to running on trails. She is trying to decide when it is safe for her to make the transition from running on a smooth, flat surface like asphalt to running on uneven technical trails. Since she had a long time off of running for a long time and she does not want to get re-injured. She asked me a great question on a recent call. “Should I be doing this proprioceptive retraining on both ankl...
Aug 28, 2024•5 min•Ep. 919
If you are a runner, and you have pain in the ball of the foot, and you have been diagnosed with a plantar plate sprain, you probably already realize you are in for a lot of trouble. It is very difficult to get the plantar plate ligament to heal while you are still running. If you caused a plantar plate injury by hyperextending the toe, then obviously, you need to stop hyperextending the plantar plate by stretching it and pulling on it. At least, if you want to get back to running faster. Today ...
Aug 26, 2024•4 min•Ep. 918
What if I told you that you could skip two days and avoid an overtraining injury altogether? Well, if you are injured, you would probably go back and skip any two days I picked on your calendar, right? Overtraining injuries are preventable. You do not get overtraining injuries because you ran too much. You get overtraining injuries because you did not recover enough before the workout that you were not actually strong enough to withstand. What are the two most important days you should skip to a...
Aug 24, 2024•3 min•Ep. 917
Today's episode comes from a question that was posted as a comment on one of the videos on the Doc On The Run YouTube channel about the difference between a stress reaction and stress fracture in the fibula in runners. He said: “Hey, I really appreciate the video, I go to the gym a lot and I was doing the treadmill at maximum speed and one day my fibula started hurting a lot after the gym in the lower leg on the outside and I found out it was my fibula. I took a day of rest and went back to the ...
Aug 21, 2024•5 min•Ep. 916
