Doc On The Run Podcast

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 not. I am not a psychiatrist. I am not a psychologist, but that is what we're talking about today on the Doc On The Run Podcast.

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, that is a great question and that is what we're talking about today on the Doc On The Run Podcast.

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 compression socks until my injury is really healed? Well, that is what we're talking about today on the Doc On The Run Podcast.

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 boot in the morning when he first gets up and steps on his foot while wearing the boot. What are the two reasons you might get pain when you have been wearing a fracture walking boot for a running injury? Well, that is what we're talking about today on the Doc On The Run Podcast.

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 you feel a weird lump in your calf muscle.

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 because I have worked with runners. Today on the Doc On The Run Podcast we're talking about three things you should not tell your new doctor.

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 make that lead to plantar plate surgery? Well, that's what we're talking about today on the Doc On The Run Podcast.

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 on the Doc On The Run Podcast.

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 you to believe that it really is time to have surgery? What are the three ways that a doctor might convince you that you need surgery if you're a runner with a plantar plate injury? Well, that's what we're talking about today on the Doc On The Run Podcast.

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.

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 crutches at the same time? Well, that's what we're talking about today on the Doc On The Run Podcast!

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. Plantar plate surgery is a failure to act quickly. That's what we're talking about today on the Doc On The Run Podcast.

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 injury recovery when you have an overtraining injury as a runner? Well, that's what we're talking about today on the Doc On The Run Podcast.

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 reaction. What does that mean? What is the difference between a chronic stress reaction, or an acute on chronic stress reaction in a runner? Well, that's what we're talking about today on the Doc On The Run Podcast.

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 different diagnosis. This is where the trouble comes in. So, the runner was told a couple of different things, 1) a stress reaction, or 2) stress fracture, possibly of A) the third metatarsal or B) intermediate cuneiform bone, at the base of the third metatarsal. Confused yet? So was this runner! What do you do if you think you have a stress fracture, you see an orthopedic doctor and the radiologist who reads your images s disagrees about your diagnosis. Well, that's what we're talking about today on the Doc On The Run Podcast.

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.

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 in runners? That's what we're talking about today on the Doc On The Run Podcast.

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 are treated differently. Why does the toe drift sideways when you have a plantar plate injury? Well, that's what we're talking about today on the Doc On The Run Podcast.

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 ankle sprains in runners, I teach 3 phases of ankle sprain injury recovery. If you are a runner with an ankle sprain, and you understand them, it'll help you get back to training and running without another ankle sprain. What are the three phases of ankle sprain recovery in runners? Well, that's what we're talking about today on the Doc On The Run Podcast.

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 we're talking about today on the Doc On The Run Podcast.