#867 3 ways a doctor convinces you you need plantar plate surgery - DOC

#867 3 ways a doctor convinces you you need plantar plate 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.



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. It kind of hurts a little bit. It kind of feels full and weird when you’re walking around barefoot on hardwood floors. 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? And what are the things a doctor does, that might actually lead you to believe that it really is time to have surgery?

The first thing is that the doctor might be wrong is that the doctor may just let you run on it and tell you, “You know, if it doesn’t bother you that much, go right ahead, do it. Go run, I don’t really care. It’s your foot, go run all you want. If it bothers you enough later, we’ll do surgery.”

Basically, you run, continue to run, continue to aggravate it, continue to get little micro tears and then continue to have swelling that that causes degradation of the collagen in the plantar plate ligament. And then eventually, it gets worse, you finally have had enough of running short, slow runs and it seems like you can really get back to running, real running if you have surgery. So, the doctor says, “Well, you tried running, that didn’t work, let’s have surgery.”

The second one is that the doctor may tell you, “Well, the thing that usually fixes this is six weeks in a fracture walking boot. So, I’m going to fit you with this fancy boot. I’m going to charge your insurance a few $100. You’re going to wear it for about a month or month and a half. And then if it’s not better, we’ll know you need surgery.”

So, basically they say that you failed conservative care, meaning that you failed to get better wearing the boot, which is a non-surgical thing, which is what certain conservative care means. And so, they say, “Well, you didn’t get better with the boot, therefore, you’re probably not going to get better. So, let’s just do surgery and fix it.” That’s reason number two.

Reason number three is the most expensive one, this is a failed PRP injection or platelet rich plasma. They say, “Okay, you’ve got this thing, it’s not getting better with you just not running. You did a boot for a little bit, it didn’t really improve much. Let’s do a PRP injection.” Right, a platelet rich plasma injection right into the plantar plate and if anything’s going to help, that’ll do it.

They sell you on this idea, your insurance doesn’t pay for it, you pay for it out of pocket, they take some blood out of your arm, they spin it down in a centrifuge, and then they take the platelet rich plasma that has all the cofactors for healing and all this fancy stuff that’s supposed to make it heal and injected it into there. And then you maybe walk on it and maybe wear a boot, maybe you don’t, you know depends on protocol. But I’ve seen lots of runners that have had PRP injections, they have all different kinds of protocols.

Someone was told you can just walk on it, it should work. It’s magical stuff. Well, that’s not really true. So, you’ve got to protect it, let it heal and if you have a PRP injection, and then you’re not better, they just say, “Well, that was the only other thing we could try aside from surgery. So, let’s just go do surgery.”

But you really need to think hard about this, and you need to make sure that you’re actually doing everything in your power to decrease the stress and strain to the plantar plate ligament even if you have a PRP injection, even if you’re going to wear fracture walking boot, or even if you’re going to try to run on it. And if you don’t, it’s easier for a doctor to explain to you or convince you that you need surgery to repair the plantar plate ligament.

If you liked this episode, please like it, please subscribe. And if you haven’t checked out the plantar plate masterclass, come join me there. It’s a deep dive into all the strategies that I actually use when I help runners who are getting back to running after plantar plate injuries without surgery. So, come check it out and I’ll see you in the training.