Doc On The Run Podcast Episodes 2018 - DOC

Doc On The Run Podcast Episodes 2018

#123 5 Causes Of Big Toe Joint Pain In Runners

Photo credit: The Domer’s Domain

Today on the Doc On The Run podcast we’re talking about the 5 causes of big toe joint pain in runners.

If you are a runner and you have pain in the big toe joint, the first step in treating it is figuring out what is actually causing the problem. There are lots of different causes of pain in the big toe joint, but there are really five that affect runners most often. These are the most common that I see in runners, so I’m going to explain all 5 of the conditions to you.

But not all these conditions mean you have to stop running. There’s whole range of conditions in the big toe joint, but you have to figure out which one of these is most likely to be causing your pain, to decide whether or not you should stop running, or whether or not you can keep running and get it to calm down while you’re still running. You just have to make sure you know which is causing the problem to figure out if you can keep running.

#122 Collagen Healing- Is It Working For Or Against Your Running Injury

I know I talk about this a lot but collagen is one of the most critical things when you’re healing any running injury. If you have a tendon, ligament, fascia that’s injured. All that stuff is made of collagen.

If you get an ankle sprain, you get an Achilles tendon tissue, you get a peroneal tendon tissue, you get plantar fasciitis. Any of those things, it’s all an issue with collagen and all of those structures have to heal.

If you think all you need to do is form collagen, that’s not really the whole story. The fact is that when you get one of these injuries, the collagen and the formation of collagen in your body to try to heal that tissue can actually be working for or against you when you’re a runner.

Today on the Doc On The Run podcast we’re talking about Collagen- is it working for or against running injury.

#121 What’s The Difference Between A Doctor And A Librarian?

In an ideal world, we would have research that actually studies everything, every variable, every possible scenario and then helps you know conclusively what will work and what will definitely not work. The problem is that research studies really don’t work out that way. There’s almost never a study that shows that something is 100% effective for everybody, all of the time, given all of the variables that can go into a patient’s given circumstances.

When you’re a runner, that’s even way more complicated because you don’t just get injured and want to heal a specific injury like a metatarsal stress fracture or Achilles’s tendonitis. You want to run. You don’t want to just heal the thing, you want to run. You want to heal it as quickly as possible, so you can keep running. And you want to figure out why the injury happened in the first place so it doesn’t happen again.

Unfortunately, there are many doctors who hide behind their stack of research articles and they don’t really help you understand what the real possibilities are for you. When you’re a runner you have to look at every possibility.

In this podcast episode we’re talking about the difference between a doctor and a librarian.

#120 The One Small Shift You Need When You Aren’t Healing A Running Injury

You’re never staying the same. You’re never the same person. You’re not the same person you were a year ago, and you’re not the same person now. You’re certainly not the same person you were 10 years ago either. And what you’re doing professionally, you’re probably not the same sort of person you were a year ago or 10 years ago with that either. The truth is pretty much nothing stays the same in life. And running injuries, they have a life of their own. But they’re never staying the same either. And today we’re going to talk about that.

Now the other day somebody called me and they said, “You know, my injury just isn’t getting better. I have a metatarsal stress fracture and it’s pretty much just staying the same.” But the deal is is that, again, your injury is never the same. So you have to think about what’s changing, what’s getting better and what’s getting worse.

Today on the Doc On The Run podcast, we’re talking about how your running injury is never staying the same.

#119 Can I Run With A Split Peroneal Tendon?

Can I run with a split peroneal tendon? Well, yes. There are two cases in which you can run with a split peroneal tendon. Number one. If you’re certain running will not make the peroneal tendons worse or if you can accept that you may make the injury worse and it’s worth the risk to you, given your specific goals. Today, we’re going talk about what all that means if you’re a runner with a longitudinal tear or a split in the peroneal tendons.

This whole episode is basically based on a couple of questions that a runner sent to me on Twitter. The first question was, “Is surgery the only option for runners when they have a split peroneal tendon?” And second, “If it’s possible to run? What a runner must do after running?” And then third, “What kind of exercises are good? “

So, based on those questions, we’re going to put together this episode to help you understand split peroneal tendons and what that means for you as a runner.

#118 7 Steps When A Runner Is Not Healing

Today on the Doc On The Run Podcast, we’re talking about the seven steps a runner should take when you’re not healing.

You’re probably a runner and you’ve probably been injured for some time. You probably just didn’t get injured last week when you were running a race, but you probably got injured a while back, and then a lot of things happened. You probably took a little bit of time and kind of took care of yourself, took off a few days from running. Maybe you iced it. Maybe you changed your routine a little bit, tried to do a little bit shorter runs, tried to in some way kind of slow down your training, slow down the intensity, and see if you could just get back on track.

But, something didn’t work. You didn’t get better. You maybe started to improve, felt like you were getting all better. Maybe even got to the point you were pain free, but then you started running again and the pain ramped back up. And now you’re sitting here wondering why it is that you’re not better and trying to figure out what to do next, and you’re probably incredibly frustrated because all of your fitness has dwindled away over this whole course of really half training and not really doing what you need to be doing in order to maintain all your running fitness.

So, there are always things you can do, but you have to really figure out what you can really do if you’re not healing. And today we’re going to talk about that.

#117 Top 10 Myths About Plantar Fasciitis In Runners

Today on the Doc On The Run podcast, we’re talking about the top 10 myths about plantar fasciitis in runners.

There are a lot of myths surrounding plantar fasciitis, and plantar fasciitis is common, but you have to understand when you’re a runner that not all the stuff you read is true.

You can check out the course on runner’s heel pain if you’re really worried about this or you really want to keep running, you really want to figure out how to take care of it, everything’s in there. We created this monster course, it’s like two and a half hours of videos and it walks you through every step of the process of self diagnosis and self treatment of runner’s heel pain.

#116 Is Running Risky?

I recently went to pick up my 10 year son Alex from an after school program. He and all his classmates were playing on the playground. The camp administrator that runs the program actually approached me as I was walking across the playground.

He said, “Alex doesn’t make good decisions for his safety.”

I looked over and Alex who was standing up on the tire swing. He was swinging so high that he was almost horizontal at the top of the arc.

I looked at the Camp instructor and said, “That may be true. But it looks to me like he makes awesome decisions in terms of adventure!”

I will openly admit that I may be defined or labeled as a “risk taker.”

I raced motorcycles professionally. I fly a paraglider. I’ve climbed mountains in Alaska. I have done lots of solo big rock climbs in Yosemite and Zion national Park. I’ve even free soloed routes, climbing over a thousand feet off the ground, alone, with no rope.

When Alex was little we used to ride motorcycles together. He would often ask me to ride wheelies while he was on the motorcycle with me. Does that seem risky to you?

A lot of people think that motorcycles in and of themselves are risky or dangerous. But is riding a motorcycle dangerous?

What about someone riding a motorcycle on a road, somewhere in the countryside with no other traffic or no cars around. Does that really seem risky to you?

Look, the point here is that some things are just more risky than others.

If you are a runner and you’ve been injured you have to think about risk. There is risk in everything!

In this podcast episode we’re talking about whether or not running is risky.

#115 Should A Runner Ice To Treat Soreness?

I recently got a great question from a runner in San Francisco.

“I just want to make sure that I’m not heading for an over training injury and want to make sure to reduce the inflammation. When I have soreness following a hard workout, should I apply ice?”

Overtraining injuries happen because you have too much tissue damage, and not enough healing of that injured tissue before your next workout.

If you want to make sure you never get an over training injury all you have to do is make sure that all of your soreness completely subsides before you do your next workout. Obviously that just makes sense. But it’s also an absolute impossibility for any training endurance athlete.

I would be willing to bet that almost all actively training and racing endurance athletes are almost always in some state of soreness. You’re going to be stiff. You’re going to be achy. That’s a normal consequence of the normal tissue damage sustained during a workout. You’re always going to be healing and recovering. That’s part of getting stronger.

Today on the Doc On The Run Podcast we’re talking about whether or not a runner should apply ice to treat soreness.

#114 Inflammation Management: Keys For Runners

Today we’re talking about how inflammation management can make you slower.

After giving my lecture in Las Vegas a couple of weeks ago I’ve had so many different questions about inflammation that I thought we should do an entire series of episodes about inflammation management in runners.

One of the things you have to understand first and foremost is that you don’t always have to prevent inflammation. Runners think that inflammation is bad. We hear all this stuff about inflammation, about how it causes chronic Achilles tendon problems and chronic disease. But inflammation is a normal consequence of training.

You run, you train and when you do, you get tissue damage. That’s part of the process. You damage the muscles, you get little micro-tears and then your body repairs them and you get stronger.

Inflammation is the very first step to repairing any tissue damage when you’re training and is the first step to getting stronger. So you have to have the inflammation as that initial response to the injury that you inflict on yourself when you’re training.

So today we’re going to talk about some basic guidelines about inflammation management.

#113 Inflammation In Runners- Sometimes It’s Good And Sometimes It’s Bad

Just about a week ago I was giving a lecture in Las Vegas at the 24th Annual Scientific Program of the International Foot and Ankle Foundation and this is a medical conference where podiatrists, foot and ankle surgeons, sports medicine doctors go to get their continuing medical education credits.

One of the lectures I was asked to give there was entitled “Inflammation in athletes – The good, the bad and ugly” and in that talk I was trying to go through and explain to doctors what really happens and why is inflammation such a big problem.

There’s lots of stuff written now and it’s been going on for a long time in way back in 20014 there was the cover of Time magazine. It was the secret killer and this link between inflammation and all these other chronic diseases that really cause trouble.

We think of inflammation as this inherently bad thing. In fact if you do a search and you’re looking up inflammation, you’re trying to learn about inflammation, you can actually find where doctors have written that inflammation is a pathology that has to be treated. And that may seem like its true because there’s so many different things related to inflammation and particularly in chronic inflammation.

Today on the Doc On The Run podcast we’re talking about inflammation, sometimes it’s good and sometimes it’s bad so you don’t always have to treat the inflammation.

#112 7 Healing Limiters That Slow Runners Down

Today I was out on a run and it was a great day. I was running in the sun and I was just trying to think about like what are the things that really slow runners down in terms of healing because the whole key with training efficiently is to avoid an overtraining injury and to really train as hard as possible, to do as much tissue damage as possible and then rebuild that tissue before you do your next hard workout so that you can actually increase your fitness, increase your strength, increase your speed and continue training.

All of that back fires when you get injured. So if you listen to this you may be one of those runners who is actually recovering from an actual overtraining injury. But if you’re not then you’re probably recovering from the last workout.

The whole point here is that there are really a bunch of things that we can do. I’m thinking about the really simple limiters. The things that we all do that we can easily capitalize on that. We can easily take into our training, into our daily routine and actually recover faster.

And that is true for you whether you have a true overtraining injury that sidelined you or if you’re actively in training and you’re trying to make sure that you avoid one of those overtraining injuries by making sure that you recover before your next key workout.

In this episode we’re talking about seven healing limiters that slow runners down.

#111 2 Reasons Runners Should NOT Get An MRI

An MRI is an interesting diagnostic tool and we often think that an MRI is the best thing to show you what’s going on inside your body when we suspect you have some kind of injury and your doctors have a difficult time making a diagnosis. But the truth is there are two really good reasons runners shouldn’t just jump to an MRI and try to get an answer when they’re injured we’re going to talk about that today.

The first reason is that MRI’s can lead you down the wrong path. The second problem with MRI is instead of showing you something that maybe is worrisome that you even know existed, it can actually falsely make you think that nothing is wrong at all.

Today we’re talking about 2 reasons you may not want to get an MRI if you’re a runner.

#110 Sub-Fibular Impingement Syndrome In Runners

In this podcast episode we’re talking about sub-fibular impingement syndrome.

Why do runners get sub-fibular impingement syndrome? How can you tell if you have sub-fibular impingement syndrome?

That may sound confusing to you but I am going to explain it. I’m going to talk about what this condition is, the signs and symptoms, what you can do about it.

We are going to talk about this in detail but the reason runners get sub-fibular impingement syndrome first of all is that you have a relatively flat foot type that’s unstable and can roll over and smack into the heel bone and into the fibula. That’s the first thing, so if you really have high arches probably do not have sub-fibular impingement syndrome.

#109 Sinus Tarsi Syndrome In Runners

What is sinus tarsi syndrome? I mean it sounds like a complicated name but it’s not really a complicated condition. The “sinus” means basically like a tube or a passageway and “tarsi” refers to the rear foot bones in your foot. So the tarsal bones are the big bone in your rear foot like the calcaneus heel bone or the talus that sits on top of the heel bone and sits underneath your tibia and your ankle joint. Those are the greater tarsal bones.

Sinus Tarsi is actually a tunnel that runs between the talus and the heel bone. Your subtalar joint, the joint under which is important and runs under the neck of the talus in your subtalar joint and it’s a little cavity that has some fat, it has some nerve endings and it has some fluid that lubricates the joint.

But sometimes you can get inflammation on the tissue that lines that joint and when you get inflammation of the lining of that joint and it hurts, that’s sinus tarsi syndrome.

Today on the Doc On The Run podcast were talking about Sinus Tarsi syndrome on runners.

#108 Extensor Tenosynovitis In Runners

Why runners get extensor tenosynovitis?

Basically what happens is that you get this problem from a number of things. The most common thing is overuse. When you get inflammation of the tendon sheath injury it’s usually because you work the tendons too hard. But with the extensor tendons, it really doesn’t happen that much unless you do a lot to hill repeats. But it’s not the tendons that get injured, it’s the inside of the tendon sheath that becomes inflamed and that’s what causes pain.

The first thing is what exactly does that mean? All these medical terms you hear like extensor tenosynovitis, they all sound very long and they sound very technical or important but I think that’s because most doctors just want to charge you by the syllables.

In this episode we’re talking about Extensor Tenosynovitis.

#107 Why Doctors Misdiagnose Runners

Today on the Doc On The Run podcast we’re talking about why doctors misdiagnose runners.

All I do is talk to runners who are injured and want to run and ninety nine percent of the time when a runner calls me for advice is because they aren’t getting better and they want a second opinion.

Well much of the time the runner has been misdiagnosed. If you don’t have the right diagnosis, you will be doing the right treatment for the wrong problem and you’re not going to get better.

In this session we’re going to talk about the top six reasons doctors come up with the wrong diagnosis when you’re injured.

#106 Bone Stimulators For Healing Metatarsal Fractures

I spend a lot of time talking to runners who have metatarsal stress fractures. Let’s face it, they’re common. And a metatarsal stress fracture may be one of the most disruptive injuries to you as a runner can encounter.

The reason metatarsal stress fractures are so worrisome to you is that most doctors will tell you it takes six weeks for bone to heal. And whether or not that’s actually true is entirely different episode.

I was recently in Reykjavik Iceland giving a talk on stress fracture healing strategies in runners. All of the people in the audience were physicians.

The main point of that lecture was to help doctors understand not everybody needs six weeks to heal a metatarsal stress fracture. And every single patient has the potential to significantly accelerate the healing process depending upon a number of factors.

What you eat, how much you sleep, what you’re doing to activate the recovery process can all influence the rate of healing when you have a stress fracture.

One of the super tools I recommend doctors consider for their patients is a bone stimulator. And in this episode I’m going to help you understand how a bone stimulator might help, if you get a metatarsal fracture.

#105 3 Keys To Less Time On Crutches 

Let’s Face it…Crutches Suck!

It’s still hard for me to believe that the same crutches, the same design that doctors hand out to patients today are more or less the same kind of crutches handed out to injured soldiers during the Civil War.

And although crutches are truly terrible, they can be a useful treatment to help any injured runner heal faster.

But you as a runner have to understand there’s a very high price to pay for using crutches. With one week of immobilization and non-weight-bearing on crutches you will have a 17% reduction in the muscle diameter size in that lower extremity. At six weeks, the damage is 60% and you actually can wind up with permanent atrophy as a result of being on the crutches too long.

That’s right. You can actually get permanent weakness as a consequence of using the crutches.

Today on the Doc On The Run podcast we’re talking about 3 keys to less time on crutches.

#104 Avoid Foot Fungus Around Swimming Pools

Yesterday I was talking to my sister, who is of course, also a marathon runner. She has been running marathons way longer than me and she is always fit.

She runs in the morning and then swims later in the day.

Swimming is a great way to cross train, supplement your aerobic fitness, strengthen your core fitness and frankly stay cool and relax in the summer.

But I got an email from a runner who had a bout of toenail fungus that was severe enough to need laser treatment to kill the fungus in the toenails.

After the treatment she said:

Now that I’m feeling “fungus free” – new mindset, a few days on the oral meds, new shoes, new yoga mat, flip-flops for the health club – I’m wondering: Is it OK to go back to swimming? This is one of my favorite leisure and workout activities at my health club (Club Sport). I take it that I should wear flip flops to and from the pool, etc. Any other advice or precautions?

Yes! You can swim. You just have to make sure you don’t pick up any more fungus.

The fungus doesn’t just jump up and attack your toenails. Runners and triathletes can get it, first in the form of athletes foot.

Today on the Doc On The Run Podcast, we’re talking about how to avoid getting infected with foot fungus from swimming pools.

#103 Why You Aren’t Healing Like A Professional Runner

I actually did some research recently in preparation for a presentation I was going to be giving on running injuries at the International Foot & Ankle Foundation medical conference in Seattle.

When I went to Medline, which is the search engine that catalogs medical research articles for the National Center for Biotechnology Information, I entered the search terms “running” and “injury.” That search produced 5,093 articles that were published in authoritative medical journals around the world. So not only do a lot of runners get injured, apparently a lot of researchers are writing scientific articles about running injuries.

The primary objective of that research study was to figure out the true incidence of lower extremity injuries among distance runners. Basically they wanted to figure out how often runners really get injuries like shin splints, stress fractures, Achilles tendinitis, and plantar fasciitis.

In this episode we’re talking about why you aren’t healing like a professional runner.

#102 Injury Recovery With Elite Triathlete Christiann Arbini

Today on the Doc On The Run podcast we’re talking with Christiann Arbini about injury, recovery and what it takes to bounce back to national championship racing after a doctor told her she was done.

For years I’ve been saying you should fire your doctor when they try to rob you of hope and Christiann was a great example of how are you can succeed even if the conventional medical wisdom is not really on your side.

Christiann qualified for the 2018 USA Olympic distance national championship triathlon race and that’s not really the awesome part. The best part is that she did that after she suffered a serious injury while skiing and was told she might have to hang up racing altogether. Not only is she racing but she also has a thriving coaching business for athletes.

Christiann Racing is both a wellness coaching business which is dared to be fit for life and through that Christiann encourages athletes to reach for big goals, inspires them to succeed and helps you to become the best version of yourself.

#101 How Can A Runner Heal A Plantar Plate Sprain?

A plantar plate sprain is an overstretched, possibly even partially ripped ligament on the bottom of one your little toe joints in the ball of the foot.

When you get a plantar plate sprain, there are really 3 issues:

  • Inflammation
  • Tissue damage
  • Stress preventing healing

You have to address all three if you really want to get better quickly and get back to running.

Today on the Doc On The Run podcast we’re talking about how a runner can heal a plantar plate sprain.

#100: 100% Recovery Means Free Speed

Are you recovering at 100% capacity?

Are you doing truly everything you can to maximize your capacity for healing after your workouts? If you’re not, you’re wasting a lot of time when you’re training.

On Friday I was lecturing at the International Foot and Ankle Foundation meeting in Seattle. This is a medical conference where foot and ankle surgeons, podiatrists and sports medicine physicians go to get their continuing medical education. One of the lectures I was giving was on recidivism in runners and what doctors can and should be doing differently to help reduce the risk of re-injury.

One of the concepts I was trying to explain to doctors is the idea that there is no overtraining, there is only under-recovering.

#99 How Can A Runner Heal A Stress Fracture

Today on the Doc On The Run podcast we are talking about how a runner can heal a stress fracture.

When you get a metatarsal stress fracture, there are really 3 issues:

  • Inflammation within the bone
  • Tissue damage to the bone
  • Too much stress preventing healing

You have to address all three if you really want to get better quickly and get back to running!

#98 Can I Run With A Stress Fracture In The Heel Bone?

Today on the Doc On The Run podcast we’re talking about whether or not you should run when you have a stress fracture in the heel bone.

The heel bone is an irregular bone. It’s an odd shape. It’s not tubular. It’s not square. It’s very thin on the outside and squishy on the inside. It’s really kind of like a hard boiled egg.

A hard boiled has a hard shell on the outside and if you drop it cracks, but it does not really deform. That’s usually what happens with heel bone when it actually fractures. But if you drop it hard enough, it will completely explode. The shell bursts outward in a bunch of little pieces and then we have to go and try to put it back together.

In this session I’m going to explain to you about whether or not it’s a good idea and how you might be able to run with a stress fracture in the heel bone.

#97 Can I Run With A Partial Rupture Of The Plantar Fascia?

Today on the Doc On The Run podcast, we’re going to talk about whether or not you can run with a partial rupture of the plantar fascia.

Can I run my race if I have a partial rupture of the plantar fascia? Well that’s a question I’ve got in a number of times from runners who’ve been to the doctor, they thought they have plantar fasciitis, they were told they had a partial rupture or a tear in the plantar fascia and then they want to know if they can do their race.

In this session we’re going to explain how you can decide whether or not you really can or should run when you have a partial rupture in the plantar fascia.

#96 How 2 Days In A Fracture Walking Boot Can Help You Decide If You Can Run A 100 Mile Race

That may seem like a silly thing like you think if you’re wearing a fracture walking boot, there’s no way you’re going to run a hundred miles. But there is a patient I just had a consultation with yesterday on the phone and we were talking about this because she’s actually signed up for a one hundred miles trail race, she wants to do this ultramarathon and she’s having a problem.

The task is to figure out really is it safe for her to do this run which is a hundred miles basically a month away or not. So we have a long talk about this and it was really interesting because she’s very smart. She’s had a couple of injuries over the years. She totally understands running. She’s a multiple sort of level endurance athlete. She has had a number different races, she has done lots a races and all kinds of races, strictly running, triathlon, all kinds of events and so she knows a lot about the process.

In this lesson we’re talking about how a couple of days in a fracture walking boot can actually help you decide whether or not you might be able to run a hundred miles.

#95 Can I Run With A Metatarsal Stress Fracture?

Stress fractures are extremely common. But first thing is that if you’re going to figure out how to run the race, if you should run the race, whether or not it’s a good idea to run a race, you have to really understand what really is metatarsal stress fracture.

Doctors want to put everybody in the same little bucket of “You have a metatarsal stress fracture. You can’t run.” That’s not true at all. In fact I have had lots of patients who have actually had not only done an Ironman but I had one that actually had her fastest Ironman ever, four weeks after she was diagnosed with a metatarsal stress fracture and she was told to wear a boot for six weeks.

Today on the Doc On The Run podcast we’re talking about whether or not you can run your race if you have a metatarsal stress fracture.

#94 Can I Run With Plantar Fasciitis?

Can I run my race if I think I have plantar fasciitis? That’s a good question. In this session what we are going to talk about is whether or not you can or should run if you think you have plantar fasciitis.

A lot of doctors tell you stop running if you have plantar fasciitis. Well, the idea is that you’re stressing the plantar fascia when you’re walking on it and of course when you’re running.

Today on the Doc On The Run podcast we’re talking about whether or not you should run when you think you have plantar fasciitis.

#93 How A Runner Got His Physical Therapy Aimed At His Running Goals

Today on the doc on the run podcast we’re talking with Patrick about how to stay on track when you see a doctor or physical therapist and make sure that they focus on your running goals.

The main reason I wanted to have him on the podcast today is he actually had this experience with physical therapy that can help people understand how to better get your physical therapists and doctors more on track with your goals instead of just focused on the injury.


#92 Can I Run With Peroneal Tendonitis?

One of the million dollar questions I get from runners is whether or not you can run when you have this specific injury. Just today I was on a remote consultation call on Skype with a runner who is an ultramarathoner. He is training for a huge trail race in the Dolomites and he wants to be able to run.

Well it turns out that he got a little bit peroneal tendonitis, he got some pain and swelling around the ankle and it was starting to bug in. So his big question is “Can I do the race if I have peroneal tendonitis?”

Today on the Doc On The Run podcast we are going to talk about whether or not you should run with peroneal tendonitis.

#91 Why Doctors Tell You To Stop Running

I think when a doctor tells a runner to quit running it doesn’t make any more sense than telling an accountant to quit working with numbers. Running is what we do. And running should be the goal. You have to work with a doctor who will help you get back to running. And no matter where you are, you should be able to find a doctor who will help you heal AND get back to running.

I talk to runners all over the world. Of course most of them are injured runners. The main reason injured runners call me when they want to get answers to all of their questions is they are frustrated by doctors who tell them to quit running.

In this Podcast we’re talking about the five main reasons doctors tell you to stop running.

#90 4 Types Of Injured Runners Who Won’t Get Back To Running Quickly

Healing takes time. The longer you take to recover the more fitness you’re going to lose. But when you’re an injured runner the less time you spend healing the sooner you are going back to running. So we all want to heal as quickly as possible.

When doing virtual doctor visit consultations with patients over the phone or via webcam, just about every patient who comes to me for running injury advice is trying to figure out how to get better faster.

After many years of working with runners I have identified a few types of runners who seem to take a lot longer to get better. So it may help you to think about each of these different types of runners who don’t get back to running as quickly as possible and see if you have any these characteristics yourself.

In this episode we are talking about 4 types of injured runners who won’t get back to running quickly.

#89 5 Plantar Fasciitis Treatments Your Doctor Is Selling That Runners DON’T Need

If you are a runner with plantar fasciitis, you don’t need to watch hundreds of different videos to get better. You just have to do some simple things at home consistently and your heel pain will go away. If you do the right things, but you’re not getting better, then the chances are good you probably don’t have plantar fasciitis and have been misdiagnosed.

Runners are so frequently misdiagnosed with plantar fasciitis that I even wrote an entire book on Runners Heel Pain that you can get on Amazon. Even after I wrote the book on heel pain, runners kept calling to schedule virtual doctor visit consultations on Skype where they can actually talk to me and ask me questions. I pretty quickly realized they were all asking the same questions about what I do to diagnose and treat runners when I see them in person.

In this podcast episode we’re talking about 5 Plantar Fasciitis Treatments Your Doctor is Selling that Runners DON’T Need!

#88 The Only 3 Steps Runners Need To Heal Plantar Fasciitis

Today on the Doc On The Run Podcast we’re talking about the only three steps runners need to heal plantar fasciitis.

You don’t need to watch a hundred of different videos to get better. If you do these three things and you really have plantar fasciitis you should start getting better. In this episode we’re going to talk about the only three treatments needed to heal plantar fasciitis in almost every runner. If you’re not getting better, then the chances are good that you probably don’t have plantar fasciitis and have been misdiagnosed.

This problem is so common that I even wrote an entire book on Runners Heel Pain and you can get it on Amazon. Even after I wrote the book on heel pain, runners kept calling to schedule Virtual Doctor Visit consultations on Skype where they can actually talk to me and ask me questions. I pretty quickly realized they were all asking the same questions about what I do to diagnose and treat runners when I see them in person.

So then, we even created an online course on Runner’s Heel Pain that teaches runners like you how to do their own self-diagnosis and make sure your are doing the correct treatment once you know which condition is really causing your heel pain. We’ve put links to the book and the course at the bottom of the show notes for this episode. Check those out if you’re confused about whether or not you actually have plantar fasciitis.

But you don’t really need the book on Heel Pain or the course on Heel Pain if you just have plantar fasciitis. Let’s talk about what plantar fasciitis is, and what you as a runner have to do to get rid of plantar fasciitis.

#87 Top 3 Mistakes Runners Make When Getting A Second Opinion

Today on the Doc On the Run Podcast were talking about how runners can get the very best second opinion.

The other day I had an interesting conversation with a runner who has had a really difficult time recovering. The bottom line is that she had a couple of surgeries that didn’t work out exactly the way she expected and now she is still having trouble.

So we were having a conversation about how she can make sure that her current treatment plan is the best plan to get her back to running. We talked about all different kinds of surgical options, different approaches and how the doctor’s decision making process works. And through the course of that conversation I realized that many runners just don’t understand how they should approach a doctor when they’re getting a second opinion.

Your goal when you are getting a second opinion is to make sure you are getting an unbiased perspective on where you are right now and where you want to end up.

#86 Hope… An Invaluable Commodity

Have you ever had a race that you really only made it through just because you believe you can do it?

Sometimes you get to a place where it seems like all you have left is hope and when you get to that place it seems like hope is really all that you need.

Today I was doing a remote consultation call with a frustrated runner in Texas. We worked through her problem and came up with some options that should help her figure out what’s really going on and get her back on track.

After the call, she sent a really nice email to me in which she said,

“Thank you also for the understanding and hope… an under-appreciated but invaluable commodity.”

That was a really nice thing to say but it really brought up a lot of things for me because I realized a lot of doctors do not offer hope. In fact, they do quite the opposite.

Today on the Doc On The Run podcast were talking about hope an underappreciated, but invaluable commodity.

#85 The Power Of Meditation To Relax And Heal With Jason Stephenson

Today on the Doc On The Run podcast we are talking about how you can use the power of meditation to relax and heal.

Jason Stephenson has been involved in the meditation and relaxation field for over fifteen years and he even has a YouTube meditation sleep music channel that has over 700,00 subscribers with over 90 million views.

For whatever reason when runners become injured they don’t really seem to recognize the value of meditation. Maybe it’s just that they’ve lost their focus and they kind of forgot about it. Maybe they’re distracted because they’re kind of upset that they signed up for race they don’t think they’re going to get to run it. But in this episode Jason’s going to help us all understand a little bit more about meditation, living in the moment and how meditation has helped him and how it maybe can help us runners as well.

#84 Not Running Is Optional

Every day I talk to runners who tell me their doctor said they have to stop running. Just stop and think about that for a minute. A runner is told to stop running.

A runner has pain in her foot. Maybe it’s a metatarsal stress fracture. Maybe it’s a plantar plate sprain. Maybe it’s plantar fasciitis. But the runner wants to run and not have foot pain.

So the runner makes an appointment with a supposed expert (a doctor), sits in a waiting room, then sits in a second waiting room waiting for the doctor to actually come in to do something.

Finally, the door swings open and you tell the doctor that you have this pain in your foot when you’re running. And then the doctor tells you to stop running.

So what just happened? Did the doctor not understand that you’re a runner? Did the doctor not understand you actually want to keep running? Does the doctor think running is not important to you? Or does the doctor really think you showed up to have somebody in a white coat tell you you should trade your running shoes for a bike helmet or a pair of swim goggles.

That doesn’t really sound like much of a solution to you, does it?

In this episode we are talking about how not running is optional.

#83 There Is No Key To Healing. It’s A Combination.

Today I was on a 15 minute Virtual Doctor Visit call with a runner who has been trying to get over a nagging case of Achilles tendinitis and still wants to do well in the Boston Marathon.

It may not surprise you to hear that he is worried about how skipping long runs to protect the Achilles tendon will make it very difficult for him to have a good run in Boston.

He’s been doing all the right stuff. He has taken the right steps to remove the inflammatory fluid around the Achilles tendon. He’s been doing the right supplementation routine to help rebuild the collagen. He’s been doing the right workouts to help break up cross-linking and reorganize the collagen alignment in the Achilles tendon.

He has been improving but, he had very mild setback, got a little swelling and it made him worried. So, he just wanted to have a quick call to talk about his progress and figure out whether or not he needed to stop running or shift to some different activity.

In 15 minutes we were actually able to come up with several different ways he could augment his training to add some longer workouts that wouldn’t put as much stress on the Achilles tendon.

#82 Can You Fix The Plantar Fascia After Surgery? Question From A Runner

This episode is based on a question sent in from one of our listeners and she actually wrote in and said “I mistakenly had “plantar release” done to my right foot 16 years ago. I am no longer able to run because my arch has collapsed and my foot now rolls inward significantly with every step. I’m in constant pain in both of my knees (because of the change in my gait) as well as my foot as a result. A Mayo Clinic orthopedic surgeon recommended fusing the first and second metatarsals above my arch to reduce pain affected by the release but who knows if I’ll ever run again, which is what truly breaks my heart. My main questions are could stem cell therapy help me run again and can it decrease pain in the long term? Long shot question- is it remotely possible to “replace” (using that term very loosely) the cut ligament or it’s role in the foot, also allowing me to run again? (which is most important to me honestly).”

Today on the Doc On The Run Podcast we’re talking about what a runner can do to help the plantar fascia after plantar fascia surgery.

#81 From 400 Pounds To Running 100 Miles

Today on the Doc On the Run Podcast we’re talking about the special considerations overweight runners need to think about when they want to get to their goals without getting injured.

I am really excited to have Gary Stotler on the show today and Gary is a guy who is truly inspirational.

He actually went from 400 pounds to running 100 miles.

#80 Stress Related Eating And The Consequences For Injured Runners With Stephan Guyenet, PhD

I’m really excited to have Dr. Stephan Guyenet as a guest expert today. Dr. Guyenet spent 12 years at the University of Washington as a neuroscience and obesity researcher. Much of that time he was studying the role of the brain in eating behavior and body fatness. His publications have been cited more than 1,400 times by other scientists and in peer-reviewed scientific publications. He is the author an intriguing book entitled “The Hungry Brain” which explores the neuroscience of overeating, focusing on the following perplexing question: Why do we overeat, even though we don’t want to?

One of the reasons I wanted to have him on the show is that I have noticed many injured runners and triathletes let their diets slide a little bit when they get hurt. When we talk about this it quickly becomes apparent that these athletes understand nutrition. They understand the value of quality ingredients going into their system. They know what they need to eat to recover from hard workouts.

Today on the Doc On The Run Podcast we’re talking about Stress Related Eating and the Consequences for Injured Runners.

#79 Mindfulness For Runners With Linda Hall

Today on the Doc On The Run podcast we’re talking with Linda Hall about meditation and how to focus on the mind-body connection and stress management as a tool that runners can use to recover faster, decrease the risk of running injury and hopefully even recover from overtraining injuries.



#78 What Is Synovitis In Runners?

This week I got a couple of calls from runners who had various different forms of foot pain and they both said the doctor they saw said they had a condition called synovitis. They were both understandably confused because neither one of them really understood what “synovitis” really means.

Synovial tissue is the tissue that makes the fluid that lubricates your joints. The fluid on the inside of your joints is called “synovial fluid.”

This is the stuff that lubricates and nourishes the cartilage on the inside of your knee joint, your ankle joint and all the other joints in your body. This fluid not only helps to lubricate the joint it also nourishes and keeps the cartilage healthy.

On the inside of the joint you have this soft squishy tissue, called synovial tissue, that makes that lubricating fluid. Sometimes you may hear it called synovium. Synovium and synovial tissue are synonymous. They’re both the same thing but they are different terms your doctor may use interchangeably to further confuse you.

Today on the Doc On The Run Podcast we’re talking about synovitis in runners.

#77 Muscle Atrophy After Recovering In A Fracture Walking Boot

Today on the Doc On The Run Podcast we’re talking about muscle atrophy after recovering in a fracture walking boot, and what runners can do to prevent it.”

I recently met Kim and she was explaining to me that she had an Achilles tendon rupture and then developed this same kind of muscle atrophy we all become concerned about. Fortunately for all of us, she was willing enough to come on the show and share her experience.

We are also going to talk about some strategies for avoiding all of the weakness if you ever have to wear fracture walking boot.

#76 Sleep: The Recovering Runner’s Secret Weapon

Sleep may be the most valuable, most abundant, least expensive, and yet most underutilized resource available to a recovering or injured runner.

If you are a runner, you are always recovering. You do tissue damage every time you run. If you run a little too much, or you run a little too far, you might get an over training injury. That overtraining injury is really nothing more than an exaggerated version of the intentional injury you are attempting induce when you are training.

Sleep Helps You Heal, Running Doesn’t Help You Heal.

Sleep is crucial for proper immune function, tissue healing and consequently healing after any hard workout or running injury. Sleep disturbances reportedly occur in one third of the U.S. population. Problems with sleep are so pervasive and detrimental that the Centers for Disease Control has declared insufficient sleep as a public health problem.

Interestingly, elite athletes have actually been cited as a group having poor sleep quality and reduced quantity of sleep in comparison to the general population. Why is that?

Today on the Doc On the Run Podcast we’re talking about how sleep is the recovering runner’s secret weapon.

#75 Communication Is The Key

The problem with running injuries is that they are easy to ignore. A little tightness here or little achiness there is nothing compared to the pain you feel in those final few miles of a marathon. Runners are used to ignoring pain. One of the most important elements of training for endurance sports is learning how to endure. After all, enduring is the name of the game. You have to learn how to keep running when your quads tell you to quit. You learn to ignore the burn, tune out the noise and keep going. You have to learn how to suffer.

It is just not surprising that runners ignore the early sensations they can signify the start of a running injury. What we have here, is failure to communicate. Your running injury didn’t start the day you called a doctor for help. Your running injury started weeks or months before you told anybody about it.

But I would be willing to bet that you knew it was there. Deep down inside, you knew something was wrong. Maybe you didn’t want to see it. Maybe you didn’t want to feel it. Maybe you didn’t want to acknowledge it. But I’ll bet you had some subtle clue trouble was brewing.

Today on the Doc On The Run podcast we’re talking about how communication can help prevent running injuries and help running injuries heal faster.

#74 How Injured Runners Should Focus On The Goal

A goal is not a fantasy. A goal is not a dream. It’s a place you clearly want to end up. If that goal is important to you, I believe you can get there. No matter how far-fetched, outlandish, or seemingly difficult to achieve, there is always a way to get there.They set all kinds of goals for themselves, their families, their finances, and of course, their athletic goals as well.

For most people the process of goal setting includes some analysis of the past. Maybe your just look at how fast you have run historically. Maybe you look at how much money you made last year. Maybe you look at how much time you spent with your family. In all likelihood your goals are partly based upon your past performance.

Part of the reason we base or future upon our past achievements is that we want to make sure that our goals are achievable. After all, no one enjoys failure.

Today on the Doc On the Run Podcast we’re talking about how injured runners should focus on the goal.

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