Why should you always compare the right foot to the left foot when you have a running injury? Well, that is a great question and that is what we’re talking about today on the Doc On The Run Podcast.
Just this morning, I was on a second opinion call with a runner who had an issue and he said, “It is only going to take a few minutes. I would not even use the entire time because I have a simple problem.”
Every time I do a consultation, I try to see if I can compare the right foot versus the left foot. I wanted to see both of his feet and he just showed me the one that was hurting. I told him I needed to see the other one and he said it did not hurt and it did not matter, but it does matter. It is super important.
One of the things doctors will do if you go in to see a podiatrist and you have a running injury, that seems a little bit weird, like maybe it is a sesamoid injury, then one of the first things they’ll do is they’ll get comparison views. If anything looks unusual, they will take an x-ray of your painful foot, then they will take a comparison view of your non-painful foot to see if something that looks weird happens to be present on both your painful and non-painful foot.
When you have a running injury, you have comparison views right in front of you. All you have to do is closely compare the right and left foot in the same light to see if you have something that might indicate a serious problem like swelling. When you look at the back of your hand, you can see that you have extensor tendons, these little lines on the back of your hand. Well, you have those on your feet too and if you pull your toes up, you’ll see them.
When you have bad swelling, you have so much tension in the tissues that you can’t see those lines at all, but you can see them on the other foot. When it is very subtle, the wrinkles in the skin that we call relaxed skin tension lines, they start to disappear. So, if you look at your right foot and your left foot and you see that you have all these wrinkles on the top of your foot, on your injured foot, and on your non-injured foot, they’re more prominent, you can see them easier, then that tells you that you have very subtle swelling.
You also have veins, you have this thing called the dorsal venous arch on the top of your feet. If you cannot see that on one foot that hurts, it means you have swelling that is sort of pulling up the tissue, pushing the tissue out, so you can’t even see that vein. You can’t tell if you don’t compare the right versus the left. The thing is, is that the one thing that allows you to get back to running and do more activity faster is to see improvement.
That is why I have people track their pain. I have them track their swelling. I have them figure out how to confirm that you’re getting better so that you can increase your activity, so that you can maintain your running fitness and get back to running a lot faster. Waiting is not a plan. Monitoring, tracking, and paying attention to these things that are signifying improvement, like a reduction in swelling in one foot versus the other, are critically important.
The other thing is that most of the time when people call me, number one, they don’t call me right when they have problems, they call me when they’re not getting better after they’ve seen another doctor. They also call me after they tried a whole bunch of stuff and still haven’t improved because they’re missing some piece. The information that you have today is right in front of you.
The amount of swelling you have today is right in front of you. And if you take a picture of it with your phone and you have it for reference later, it will be really helpful and you can’t go back and get it later. And so much of the time, like today when I was on this call, I asked this guy if he had pictures from when it first started hurting and he did not.
He did not have any pictures at all. But this is critical information you’re missing when you don’t keep these comparison views of right versus left. The other thing I’ll tell you is that when you do it, make sure your feet are in even light. If you take a picture in front of a window and the light’s coming from the left, shining down on both of your feet, it is going to look different. The way that it hits the extensor tendons and your feet kind of slope this way. So, you’ve got to do it where the light is coming straight toward the feet or straight down on your feet like taking a picture in the bathroom where you can tell that the shadows are even, that is a better way to do it.
Don’t do it in front of a window and take one picture in the morning and then take another picture in front of that same window in the afternoon. The light’s going to be different. Make sure that you take it in a reproducible place that you keep them for comparison views and you’re really comparing the right foot versus the left foot to see whether or not that injured foot is really improving. That will help you get back to running a lot faster.
If you like this episode or you know an injured runner who needs to hear it, please send it to them. Let them know about the podcast. Let them know about the videos that we make to help runners figure out how to do these things on their own. Like it, subscribe, and I’ll see you in the next training.
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