I was recently invited to give a lecture at a foot and ankle medical conference in Seattle. I was giving a talk called Conservative Treatment of Ankle Sprains in Runners Who Want To Run.
This was an attempt to teach physicians what I do with ankle sprains. Mostly I was trying to get them to think about what they need to do to get runners back to running as quickly as possible instead of just doing the standard ankle sprain protocols with their patients.
The Ottawa Ankle Rules are a set of rules that were created in Canada to reduce people from getting unnecessary ankle X-rays when they have an ankle sprain and go to the emergency room.
Today on the Doc On The Run podcast, we’re talking about a common fracture missed by the Ottawa Ankle Rules.
I was just lecturing at the International Foot and Ankle Foundation meeting in Seattle. I was giving talks on running injuries. A doctor in the audience asked me if “not running” was the safest way for runners to heal running injuries.
Keep in mind, this was a doctor asking the question.
Have you ever thought this makes sense?
After all, if a runner gets a running injury, and they stop running, that’s the safest way to get it to heal. Or is it?
Do you agree that not running is the safest way to heal a running injury?
Well, that’s what we’re talking about today on the Doc On The Run podcast.
I was listening to a podcast about the way that disagreements happen. He said, anytime there’s a disagreement, no matter what, there are two possibilities. If there are two people arguing about something, one person could be right, and the other could be wrong. That means roughly speaking, there’s a 50% chance that one person is wrong all the time. This is true of physicians as well. Let’s say, I come to your home to see you and help you with a metatarsal stress fracture. You’ve been told you have a neuroma. But it seems like you have a stress fracture, based on your x-rays or your story. What if there’s a 50% chance your doctor might be wrong? Well, that’s what we’re talking about today on The Doc on the Run Podcast.
One of the questions I got in the Runners Aid Station was:
“Do I really need a fracture walking boot?”
This is a runner who went to the doctor, and was told, “You have extensor tenosynovitis. The best way to get it to calm down is to remove the inflammation and stop aggravating the tendons.”
If you get aching pain on the top of your foot, it might be caused by an irritated extensor tendon sheath (which is the little tube around the extensor tendons as it goes out to the toes on the top of the foot). If so, you might be thinking you need something drastic to stop the tendons from moving so it can calm down.
Do I need a fracture walking boot for extensor tenosynovitis?
Well, that’s what we’re talking about today, on the Doc On The Run podcast.