#766 Should a runner have surgery to shorten a long second metatarsal bone?

Today’s episode comes from a second opinion discussion with a runner suffering with a nagging plantar plate ligament injury.

She was considering surgery for a plantar plate sprain.

Truth is, her plantar plate sprain was not really that bad.

It’s pretty common when runners have trouble healing a plantar plate sprain, the doctor may recommend a number of different surgeries.

One of those surgeries is where we actually shorten a bone in an attempt to decrease the tension and pressure on the plantar plate ligament.

Should a runner have surgery to shorten a long second metatarsal bone?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#761 Do bunions cause plantar plate sprain in runners?

Perhaps the most nagging injury, and most difficult to deal with if you’re a runner, is something called a “plantar plate sprain.”

The plantar plate ligament is on the bottom of the foot, usually at the base of the second toe.

I got a question from a runner who actually had a plantar plate injury. She also happened to have bunions. So, she asked:

“Do bunions cause plantar plate sprains in runners?”

That’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.

#750 Best imaging study for plantar plate injury in runners

If you have been told you have a plantar plate sprain, you’re probably already really frustrated.

Even minor plantar plate tears can be nagging injuries that are very difficult to get better while you’re running on them.

The bottom line is, you’ve got to make sure that the plantar plate ligament improves because (in general) plantar plate sprains are either getting worse or they’re getting better.

One of the questions I get all the time from runners is what is really the best study for a plantar plate injury.

What’s the best imaging study for a runner who is suspected of having a plantar plate injury?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#748 Fracture that seemed like a plantar plate sprain

There are times when you might have a suspected stress fracture in your foot. If so, your doctor may order an X-ray.

There are other times when it’s extremely unlikely that you have a broken bone at all, but it is almost certainly just a soft tissue injury.

One of the questions I get a lot from runners with plantar plate sprains is how to make sure the pain is not from a stress fracture.

I have only seen one case where somebody had fracture pain in the exact same spot you would have pain when you had a plantar plate injury.

Can a fracture in the metatarsal seem like a plantar plate sprain?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#744 Was the plantar plate ligament injured before my MRI?

I was recently doing a second opinion consultation with a runner over a webcam to review the MRI of his foot.

What we found was that he had what looked to be attenuation and a partial tear in the plantar plate ligament on his MRI.

There was a lot of inflammation in the foot around the ligament, not just within the ligament itself.

He asked me was really good question:

“Could my plantar plate ligament been have injured long before I ever got an MRI?”

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#741 Worst imaging study for plantar plate injury in runners

If you are a runner with pain in the ball of the foot at the base of the second toe and start researching online, you may become concerned you have a thing called a plantar plate injury.

If so, you may be wondering whether X-rays or MRI imaging may be needed to tell what is wrong. Before seeing a doctor, it may be helpful to understand which are helpful, and which imaging studies are a waste of time.

What is the worst possible medical imaging study you could get if you’re a runner with a suspected plantar plate injury?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#736 Is there always bruising with a plantar fascia partial rupture in a runner?

You’re out on a run, and you suddenly start having extremely sharp heel pain.

You think it’s plantar fasciitis.

But when you look at your foot, you see a huge bruise.

That’s not plantar fasciitis. That’s where you ripped something.

Is there always bruising with a partial rupture or a tear in the plantar fascia?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#705 Does the plantar plate need to “heal” on MRI before I can run?

Plantar plate ligament sprains are a tough injury for runners. Plantar plate tears can cause a lot of pain in the ball of the foot. Unless you treat them correctly, that pain can persist for a long time. As a result plantar plate injuries can be super frustrating.

Unfortunately, plantar plate tears are often diagnosed when you get an MRI of the foot. I often get questions from runners asking me whether or not they have to wait for another MRI before they can run.

Does the plantar plate ligament need to heal on an MRI before I can run?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#549 What is primary repair plantar plate ligament surgery?

What exactly is primary repair of the planter plate? Well, that’s a surgery where we actually go in and sew it back together. We fix it. We repair it. We do something to actually make it strong and hopefully heal again, so you can get back to running. But we’re going to talk about three different methods for actually doing that and some of them are kind of similar. They’re different approaches and they have different risks and benefits. Today on the Doc On The Run podcast, we’re talking about three different techniques for primary repair plantar plate ligament surgery.

#547 Why bone surgery for Plantar Plate Repair

I have talked about this before in other episodes where you basically have four kinds of structures that you could consider having surgery on. You could have bone surgery, you could have ligament surgery, tendon surgery, or joint surgery and of course, when you have an injury to only the ligament, the plantar plate ligament, you might be wondering why in the world would the doctor want to do surgery on the bone as well? Today on the Doc On The Run podcast, we’re talking about why you might need bone surgery for a plantar plate ligament repair.