#830 What is the most important ingredient to a runner after a plantar plate sprain? - DOC

#830 What is the most important ingredient to a runner after a plantar plate sprain?

What is the most important ingredient to a runner after a plantar plate sprain? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



I get questions all the time from runners who are asking me about what is the most important ingredient in their diet when they have an injury that involves something made of collagen like the plantar plate ligament. I think this could also apply to plantar plate injuries as well as plantar fascia injuries like a partial rupture of the plantar fascia or a partial tear in the Achilles tendon. But what we’re talking about is tendons and ligaments and structures that are made primarily of collagen.

Collagen supplements are very popular right now. You can buy them online, I put them in my smoothie myself. I do use collagen but that doesn’t mean it’s necessarily the most important ingredient for you. But the plantar plate ligament is primarily made of collagen. So, it’s understandable why you think that if you just take collagen that will do it, it will help it repair faster.

Although it’s reasonable to believe that if you read the nutritional supplement information on a container of collagen, it will say it’s not supposed to treat any disease. This stuff’s not been evaluated by the FDA, there’s all these disclaimers on there. But I was just going to mention briefly a couple of the key ingredients that you actually need to repair collagen that are components of your diet and so if you’re missing these, you might have a slower repair process of something like the plantar plate when you have a little rupture or partial tear of the plantar plate ligament itself.

If you have one of those and you are a runner, you know it’s really difficult to keep it calm, to keep the pressure and strain off of it and get back to running quickly. So, you got to do everything you can to get it repaired as quickly as possible.

The first thing is that in response to the question what ingredients are most important, well, I’m not going to talk about all of them. I’m not a nutritionist or a molecular biologist, but I do know that there are some things that really matter when it comes to rebuilding collagen. The first one is vitamin C and vitamin C is essential for collagen synthesis. But Vitamin C is probably the most widely cited vitamin of something that you need in your body for repair of all kinds of tissues, cellular mechanisms, everything and you can read a lot about this at the Linus Pauling Institute, where Linus Pauling, he was Nobel Prize winner, but he talked at great length about why you should do high both doses of vitamin C. So can read more about it there. But a deficiency in vitamin C levels will actually have some changes in your epigenetic DNA, DNA hypermethylation that doesn’t really matter if you know what that means or not but basically, you need it for the transcription or the production of collagen synthesis in tissues like the plantar plate ligament. If you’re missing vitamin C in your diet, well that can be a problem.

Vitamin E is also something. If you look up like hair and nails and skin, there’s like Vitamin E is one of the most common nutritional supplements that people recommend for those things that are made of collagen. And vitamin E, if you have it in your diet, you have in your system, it does improve the production of collagen. Whether or not taking a pill of vitamin E is really necessary or not,  maybe you can have some investigation into that, but vitamin E is another thing. So, vitamin C, vitamin E and the other one is copper. Those are the big three that I really think of.

Copper, I remember very specifically from medical school, there are a number of different disorders involving copper metabolism where people get all kinds of collagen disorders. Some people are hyper flexible. There’s all kinds of really interesting things that can happen. But basically, collagen strands form together into five roles and collagen bundles and you have to have the sort of bundles of collagen for them to really become effective components of something like a tendon or ligament like the plantar plate ligament at the base of your second toe.

What it is with copper is that part of it is that there is a copper dependent enzyme that actually speeds up the production, the final step of the synthesis pathway and without it you have a real problem because with that enzyme you have the tropocollagen molecule which basically blend together and become connected to form the collagen fibrils that turned into fibers that can’t happen without copper.  If you’re missing copper and you’re you have a truly like a copper deficiency, then it can actually dramatically slow the repair process of any injured tissue that you got from an overtraining injury like a plantar plate sprain or Achilles tendonitis or a partial rupture of the plantar fascia.

But that doesn’t mean necessarily you should just take tons of copper, you should talk to your doctor and see if there might be a possibility these things would help you. But this isn’t a great detailed explanation on each of these things and how the steps and each of these pathways actually repairs the collagen. I’m just trying to make you aware that there are different things that can actually help or hurt your process of repairing the collagen in things that are made primarily of collagen like the plantar plate ligament.

If you haven’t checked it out, you want to go into deep dive about why the specifics about all these things with testing like MRIs and stuff with surgeries and PRP injections for plantar plate ligament, why I don’t think that stuff is the most important thing to do as a runner, you can check that out at the plantar plate masterclass. It’s free. It’s a deep dive, it’s about 90 minutes where I go into a detailed strategy of why it is that I think about repairing plantar plate ligaments in runners the way that I do, the process that I use, the framework you have to understand that is more important than any individual procedure or any individual supplement or anything else that might be applied to the plantar plate repair process when you have one of those and you are a runner. So, you can get it for free at www.docontherun.com/plantarplatemasterclass. Go check it out and I’ll see you in the training.