#685 Advice for flat footed runner with plantar plate injury started on a treadmill - DOC

#685 Advice for flat footed runner with plantar plate injury started on a treadmill

Today on the Doc On The Run Podcast, we’re going to talk about my advice for a flat-footed runner who has a plantar plate injury that started from running on a treadmill.



I was on a call with a runner who has a plantar plate sprain and a plantar plate sprain is an injury to a very small ligament right at the base of the toe, usually the second toe, right where it attaches to the metatarsal and what we call the metatarsophalangeal joint at the ball of the foot. These are tough injuries to get better. I’ve had one myself, and when you get them, they’re really annoying because it seems like they get better very, very slowly, but you can make them worse very, very quickly. So it’s really important when you get one to identify the one thing that caused it so you stop doing it.

In this case, this was somebody who was flatfooted. He’d been running on a treadmill, and he got this plantar plate injury. And so we were talking about this during a phone call that we had, and it was a remote consultation where he had called me originally for a second opinion, and he was asking me about what to do. And so what I did was I actually explained to him during the call, and I actually recorded my portion of the call just to actually… My explanation recorded it for him, and I thought it might be useful for you because it really is, I think, good advice if you’re overpronator, if you have wide flat feet, and you have a plantar plate injury and you like to run on treadmills. In his case, it started when he is running on an incline treadmill with a angle up which, of course, makes it harder so it feels like you can do a better workout in a shorter amount of time. But it’s high risk, particularly when you have a plantar plate injury.

I’m going to play that for you now. You can listen to what I recorded for him as the explanation, and I think it may be really helpful for you. So we’re going to start that now.

Dr. Chris Segler:

So yeah, so first of all, I don’t ever put the treadmill on an incline. Never. I hate running on treadmills, but I’ve had times, like when I was doing Ironman training, that I would go to a medical conference or something, and I would go in Tahoe, for example, when I go to the conference, if it’s really nasty, it’s snowy, icy, whatever, it’s raining, too cold to run, I would go run for three or four hours on the treadmill. I know that I could cut that in half if I put it at a steep angle, but I’d never do that.

Yesterday, I ran about eight miles on a trail that’s close to where I live. I can run up Mount Tam and at least once a week, I run to the top of Mount Tam and back down on a trail that’s 16 miles, so it’s eight miles up and eight miles down. That doesn’t worry me, though, because it’s varied enough that it really spreads out the abuse. But man, to put in perspective, most people when I’m like, “Yeah, I ran to the top of East Peak today,” they’re like, “You did what?” And there are people who run, and they think it’s really crazy and really hard. But I would never get on a treadmill and run with it at an angle. I think it’s incredibly risky. And walking is the same. Walking’s almost worse because your heel is striking all the time, and that angle is really risky. And certainly in allbirds or anything not supportive is really going to be worse.

So that’s the first thing is don’t ever do that again. Don’t ever put the treadmill at an angle. Every time I run in the gym on a treadmill, the first thing I do, literally, is I get on the machine, and usually they’re different and I don’t keep up with them because I don’t like them. And I get on the treadmill and I basically turn it on, and I’ll look for the angle thing and make sure it’s at zero, that somebody didn’t leave it on some angle. So you have to be very cautious of that. And I also think just because the way the rubber hits your shoe and impacts it, that there’s just a much higher risk of getting plantar plate injuries and stuff because it was like a friction trauma kind of thing. But whatever, I’m not going to tell you don’t run on a treadmill. I just don’t like them personally.

Listen, I hope you found this helpful, and if you want to call like that, if you want to talk to me directly, you can call me, you can talk to me. You can also send me questions that you have during part of the Fast Track Challenge. But you can reach out to me, but you’ve got to think about what is really unique for you, just like in this case. So if you’re a runner and you have flat feet, if you have wide feet, you’ve got to think about the things that are causing your injuries and contributing to it getting aggravated, irritated, and not getting better.

That is the whole trick when you have a running injury. So you just don’t want to think that the advice for you is the same as the advice for somebody that has high arches. You do not want to think the advice for you as somebody with a wide foot is the same as somebody with a narrow foot. You’ve got to think about the variables, and if you do, you really can get back to running a whole lot faster.

If you like this episode, please like it, please share it, and I’ll see you in the next training.


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