Doc On The Run Podcast - DOC

Doc On The Run Podcast

The #1 Podcast For Injured Runners

 

This podcast is for injured runners. Those who have been told (or worry) that running is at the root of their trouble.

If you are listening to this podcast you’re probably a runner. And you have probably been told by your friends, your family and maybe even your doctor that running is the cause of your trouble and that you need to run less.

But deep down inside you don’t just like running you feel like you have to run in order to be healthy, fit and sane. This podcast simply helps injured runners understand their condition better, and keep running.

 

 

LATEST EPISODES

 

 

 

#875 Your Goal Tells Me How Chronic Your Running Injury

The most important first step with any athlete who signs up for a webcam second opinion or series of coach coaching calls is to ask, “What is your goal?”

I was lecturing at a medical conference in Wisconsin where I was doing a whole morning session on running injury talks and diagnosis of subtle fracture patterns in athletes.

What I told those doctors is they have to ask the athlete, “What is your goal?”

Without understanding your timeline based on your running goal, you cannot make a useful recommendation on treatment on any running injury.

Sitting in that conference room I realized…

Your goal that you have right now could tell me how chronic your running injury really is.

Don’t believe me? Well, that is what we’re talking about today on the Doc On The Run Podcast.

#874 Are You Depressed Because Of A Running Injury?

Today, I had a final follow-up call with a runner who did a series of consultation calls with me to get advice every week. After the series of calls he had improved and was better, but disclosed to me that he felt like he had been depressed.

He thought he might have depression because he realized something had significantly changed in his goal setting.

He said, “I can’t even imagine myself doing races anymore.”

Are you depressed because of your running injury?

Well, maybe you are, maybe you are not. I am not a psychiatrist. I am not a psychologist, but that is what we’re talking about today on the Doc On The Run Podcast.

#873 Can Collateral Toe Ligaments Be Surgically Repaired?

This morning, I was on a second opinion call with a runner who had a couple of different injuries in his foot.

The main problem keeping him from running was an injury to the collateral ligaments in one of his toes.

“The toe feels weak and unstable.” He is understandably worried that the instability is going to cause a problem if he runs.

He was asking me:

“Well, can we surgically repair the ligaments?”

Should I have surgery to repair the collateral ligaments in my toe if I am a runner?

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

#872 Do I Keep Using Compression Socks Until Healed?

This morning, I had a conversation with a runner who had an injury. He has been getting a lot better and one of the things that really seemed to help the injury improve was wearing compression socks.

His question was a really good one. He said:

“I had so much improvement with wearing compression socks, but with the injury I have, every time I take the socks off and on, it feels like I am moving the injured tissue now. I am not really sure if I still need the compression.”

Do I need to keep using compression socks until my injury is really healed?

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

#871 2 Reasons For Morning Pain With A Fracture Boot

If you get an overtraining injury like a metatarsal stress fracture or a plantar plate sprain or Achilles tendonitis, or peroneal tendonitis, a doctor might prescribe a fracture walking boot.

Well, it is designed to hold you still so that you can hopefully walk on something like a fracture and still let it heal.

The reason for this episode is this morning I was on a call with someone who has been wearing a boot and he is curious why all of a sudden, he is starting to have some aching pain in the boot in the morning when he first gets up and steps on his foot while wearing the boot.

What are the two reasons you might get pain when you have been wearing a fracture walking boot for a running injury?

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

#870 First 3 Steps When Runners Feel A Lump In The Leg

I was doing a second opinion webcam consultation with a runner who noticed a lump in the calf muscle.

The knot in the leg wasn’t limiting his running. In fact, when he was running, this lump in the calf muscle felt better, not worse.

So, you have to wonder, could the knot “not” be a big deal?

There are really 3 things a runner can do immediately after noticing a bump in the leg.

Today on the Doc On The Run Podcast, we’re talking about the three steps you should do as the very first thing when you feel a weird lump in your calf muscle.

#869 3 Things You Should Not Tell Your New Doctor

Today I am about to drive to the airport, get on a plane, fly to Wisconsin to give five lectures on running injuries at a medical conference.

As I was finalizing that talk on medical imaging strategies for athletes, I was thinking about a conversation that I had yesterday with an athlete who had a very frustrating course and actually called me for a second opinion.

He had an injury that hass been going on for a long time. In short, he is trying to get a second opinion from me specifically because I have worked with runners.

Today on the Doc On The Run Podcast we’re talking about three things you should not tell your new doctor.

#868 Is Plantar Fascia Really A Ligament?

This episode comes from a question posted by one of the Doc On The Run YouTube viewers as a comment on the video “Where to run with plantar fasciitis.”

In the video, I was trying to explain which surfaces can help you the most when you’re trying to run with plantar fasciitis. The only way to do that is to make sure you are decreasing the stress and strain on the plantar fascia ligament.

But the question was…

Is the plantar fascia really a ligament?

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

#867 3 Ways A Doctor Convinces You You Need Plantar Plate Surgery

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. 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? What are the things a doctor does, that might actually lead you to believe that it really is time to have 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.

#866 When Can You Resume Pushups With Hallux Rigidus?

Today’s episode comes from one of the YouTube videos and it was specifically a comment that someone posted on one of the videos that was called “Five worst exercises for hallux rigidus”.

This came from Matt and he asked:

“When can you start doing push-ups again, if you have hallux rigidus?”

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

 

#865 3 Mistakes Runners Make That Lead To Plantar Plate Surgery

I know. You don’t want plantar plate surgery.

But if your plantar plate ligament doesn’t repair itself, or your doctor doesn’t help it repair itself, you might get talked into surgery.

If you have plantar plate repair surgery, you may spend a lot less time running over the weeks following surgery…because you have to let it heal.

There are really three mistakes that I see runners make when they’ve had a plantar plate injury. This episode will help you avoid them.

What are 3 big mistakes runners make that lead to plantar plate surgery?

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

#864 The 3 Problems (Not 2) Solved By Boot And Crutches

I’m not going to tell you that any runner should want to use crutches. I’m also not going to tell you that you will enjoy wearing a fracture walking boot.

But there are reasons that you may want to do things a little differently if you’re a runner.

The critical issue is that runners must really try to speed up the healing process as much as possible, so that you can avoid losing your running fitness.

What are the three time-sensitive problems solved when you use a fracture walking boot and crutches at the same time?

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

#863 Plantar Plate Surgery Is A Failure To Act Quickly

Most of the runners I see who have pain in the ball of the foot from a plantar plate sprain rarely start out with a completely torn plantar plate tear.

More often, runners ignore the pain from the plantar plate sprain and it evolves into a full thickness plantar plate tear.

Surgery is only needed when the plantar plate is torn in such a way that the plantar plate ligament cannot be expected to heal without surgery.

But there are some mistakes that could lead a runner to the operating room.

Plantar plate surgery is a failure to act quickly.

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

#862 How Self Judgment May Be Slowing Your Injury Recovery

Sometimes when you get injured and have to stop running, you start to lose your identity.

One of the things that I notice most in runners who have gone weeks or months without running, is they are really bummed out.

These runners seem really grumpy. In some cases, they don’t even view themselves as a “runner” anymore…well, because they’re “not running.”

If you want to heal and get back to running as quickly as possible this can be a real problem.

How can self-judgment actually slow down your injury recovery when you have an overtraining injury as a runner?

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

#861 Chronic Stress Reaction Versus Acute On Chronic Stress Reaction In A Runner

I just had a consultation with a runner who had foot pain that she thought might be a stress fracture that had been coming and going for about a month.

She had been increasing her training volume and doing strength exercises that are supposed to build her running fitness.

The pain seemed to be volume related. The more training she did, the more she would notice the discomfort in her foot.

But when we x-rays of her foot, the radiologist suggested this could be an “acute on chronic” stress reaction.

What does that mean?

What is the difference between a chronic stress reaction, or an acute on chronic stress reaction in a runner?

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

#860 Radiologist And Orthopedic Doctor Disagree On My Stress Fracture Diagnosis

Just this morning, during the live Stress Fracture Masterclass I had an interesting question.

The story went like this. An athlete who is a State ranked high school cross country and track, had to suddenly stop running due to intense pain that started about 15 days ago.

He went and saw a doctor. He got x-rays. He got an MRI, had a physical exam where the orthopedic doctor poked around and tried to figure out what was going on. The Orthopedist gave on diagnosis, but the Radiologist suggested a different diagnosis.

This is where the trouble comes in.

So, the runner was told a couple of different things, 1) a stress reaction, or 2) stress fracture, possibly of A) the third metatarsal or B) intermediate cuneiform bone, at the base of the third metatarsal.

Confused yet?

So was this runner!

What do you do if you think you have a stress fracture, you see an orthopedic doctor and the radiologist who reads your images s disagrees about your diagnosis.

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

#859 Difference Between MRI Vs MRA In Runner With Ankle Injury

Let’s say you had an ankle injury a long time ago.

You sprained the ankle when you were out on a trail run, it got better , and you went right back to running.

But over time, you slowly got more and more pain in the ankle.

In that case, you doctor might order an MRI of your ankle, or a similar imaging study called an MRA (instead of MRI).

What’s the difference between MRI or MRA in a runner with an old nagging ankle injury?

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

#858 2 Ways Running Shoes Cause Shin Splints

I recently saw a runner who thought that he might have a tibial stress fracture. But it turns out, it was just shin splints, which of course is good news. Because you don’t really want a tibial stress fracture. Shin splints is much easier to treat.

One of the questions he asked me was about the best running shoes based on his foot type.

This runner really needed more stability than got from the running shoes that he was wearing.

What are two different ways shoes can actually cause shin splints in runners?

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

#857 2 Reasons Toe Drifts Sideways With Plantar Plate Injury

If you got pain on the ball of the foot, at the base on the 2nd, and you have been running in a minimalist shoe, running uphill, doing lots of calf raises, or running on steps, you could have an injury to a little bitty ligament called the plantar plate ligament.

If you get an injury to the plantar plate, sometimes your second toe will drift toward your big toe or away from your big toe. The toe drifting sideways can happen for two different reasons.

They are very different causes and so they are treated differently.

Why does the toe drift sideways when you have a plantar plate injury?

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

#856 3 Phases Of Ankle Sprain Recovery In Runners

If you roll your ankle on a trail run and it turns black and blue and swollen, you may think you just have to take a few days off.

In fact, if you research how long it will take to get back to running, you might find a study that says that if you do early range of motion after an ankle sprain, it only takes 4 days to get back to pre-injury levels of activity.

However, if you do that, you can wind up with a lot of trouble later.

When I lecture at medical conferences on how doctors should treat ankle sprains in runners, I teach 3 phases of ankle sprain injury recovery.

If you are a runner with an ankle sprain, and you understand them, it’ll help you get back to training and running without another ankle sprain.

What are the three phases of ankle sprain recovery in runners?

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

#855 Doctor Missed Fracture On My X-Rays

Last night, I was doing a consultation with an athlete who had a fracture when she accidentally kicked a piece of furniture.

Her foot was swollen, it was black and blue. The foot was really painful and she couldn’t walk on it.

She went to urgent care and they took x-rays. She was a little concerned that they told her that it wasn’t broken.

So, she called me for a second opinion.

My doctor missed a fracture on my x-rays. What should I do about that?

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

#854 Calcaneal Stress Fracture In Runners Good News Bad News

My doctor missed a fracture on my x-rays. What should I do about that? Well, th

If you’re out on a run, and you have heel pain that suddenly hurts a lot, you may have a calcaneal stress fracture, especially if you see bruising and swelling.

If you go see a doctor, they take an x-ray, and they don’t see anything at all but they squeeze your heel and it hurts. The suspicion goes up.

If your doctor gets an MRI that shows a calcaneal stress fracture, the doctor is probably going to tell you, “you can’t do anything until the stress fracture heels.”

Today on the Doc On The Run Podcast, we’re talking about calcaneal stress fractures in runners and I have some good news and some bad news.

#853 Broken Toe Can I Compete In 4 Weeks?

Last night, I was doing a consultation with an athlete who actually broke one of her toes and her main question was:

Can I compete in four weeks? I have a competition in four weeks, I want to compete. Do you think I’ll be ready?

Well, I actually told her, no joke, I actually said, “I’m very sorry, but my crystal ball is broken.”

However, I can tell you how to figure that out because that is what I teach athletes to figure out when they do the Fast Track challenge.

I have a broken toe and I want to compete in four weeks. Is it possible?

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

#852 Orthopedic Doctor Said Come Back 4 Weeks After Fracture

Yesterday, I went to an appointment with a friend who had an appointment with an orthopedist.

She had 3 fractures. She wanted to know what she could do in terms of activity while she’s healing and recovering from these different injuries.

I just went with her, not as her physician, but to serve as a friend and advocate for her at her appointment. This episode is going to explain why you really need to take an advocate with you to any doctor’s appointment.

I went to an orthopedic appointment yesterday and they told me to come back in four weeks. What do I do now?

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

#851 Can I Use A Bone Stimulator For A Broken Toe?

Yesterday, I was doing a consultation with an athlete who broke one of her toes when she accidentally kicked a piece of furniture.

If you fracture your toe, and you just run and ignore it, it can turn into a painful nonunion (non-healed fracture).

As a runner, you want to speed the healing as much as possible. One of the ways to stimulate fracture healing is with a thing called a bone stimulator.

This particular athlete actually happened to already have a bone stimulator. Her question was pretty obvious:

“Can I just use that bone stimulator for this broken toe since it’s a different kind of fracture?”

Well, that’s what we’re talking about today on the doc on the run podcast.

#850 Medial Calcaneal Neuritis Vs Baxter’s Neuritis In Runners With Heel Pain

If you’re a runner with heel pain you may think you have plantar fasciitis. But if it is not getting better, your heel pain may be caused by “neuritis.”

I was just giving a lecture to a group of physicians getting their continuing medical education credits at the International foot Medical Foundation medical conference in Lake Tahoe.

I was giving a lecture called “When Heel Pain is NOT Plantar Fasciitis in Runners.” One of the conditions I was talking about was “medial calcaneal neuritis.”

One of the doctors in the audience asked a really great question…

He said, “I see a lot of people that have Baxter’s neuritis, and it’s down on the bottom of the heel it’s plantar , it’s not on the side of the heel, it’s not medial neuritis, it’s different. What would you do to tell the difference between these two conditions in a runner, given the circumstances you just explained in the talk?”

Today on the Doc On The Run Podcast we’re talking about medial calcaneal neuritis versus Baxter’s neuritis in a runner.

#849 How Dress Shoes With Long Toe Box Act As A Lever To Stress Plantar Plate

I recently did a consultation with a runner who had gotten a plantar plate injury. He had been getting better by using some of the tricks I teach in the Plantar Plate Course For Runners.

He got better, he was protecting it, he reduced the stress and strain on the ligament, and he got back to running. He was doing great.

But then he had a setback when he went to the synagogue. He was dressed up and wearing some fancy dress shoes, and he started to get plantar plate pain again.

Today on the Doc On The Run Podcast, we’re talking about how dress shoes with a long toe box can actually work as a lever against your plantar plate.

#848 Can A Cortisone Injection As Stop Gap For Plantar Fasciitis In Runner

I was just at the International Foot & Ankle foundation meeting in Lake Tahoe listening to a lecture given by a Professor of Biomechanics and Podiatric Medicine at Barry University.

He said that a cortisone injection can be used as a “stop gap treatment” in heel pain caused by plantar fasciitis.

The idea is that some runners may need pain relief sooner than would normally be expected. It is true that corticosteroid injections can reduce the inflammation in and around the plantar fascia and quickly reduce pain.

When I had “normal practice” with “normal patients,” I used to treat plantar fasciitis with corticosteroid injections pretty much daily.

But I almost never do plantar fascia cortisone injections now.

Can a corticosteroid injection serve as a stop gap for runners with heel pain?

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

#847 Worse Exercise For Plantar Plate When Building Uphill Strength

I just had a conversation with a runner who has a plantar plate injury.

He got the plantar plate sprain trying to build his uphill running strength in preparation for a trail race.

This is no rookie mistake. He is a longtime ultra marathoner with lots of experience. But he made a common mistake determined runners can make.

Today on the Doc On The Run Podcast, we’re talking about one of the worst exercises you can do if you have a plantar plate sprain and you’ve been trying to build your uphill running strength for a trail race.

#846 How To Patch Test For Tape Allergy

Taping is one of the oldest and simplest ways to treat foot pain and injuries to the toes, feet and ankles.

There is a specific way to take your ankles after an ankle sprain so you can start running earlier.

If you have a plantar plate sprain you might try taping the toe to decrease some of the stress and strain on the plantar plate ligament when you run.

If you have a broken toe, buddy-splinting with tape can really help hold the broken bone still so it can hurt less and heal faster.

But if your skin gets irritated, and you are forced to stop using it, the tape can’t help you at all.

Today on the Doc On The Run Podcast, we’re talking about how to patch test for tape allergy.

#845 What Is Hyperemia In Medical Imaging Of Shin Splints?

I recently saw an elite runner who had what he thought was shin splints. One of the findings on the MRI report was something called “hyperemia.”

He asked me:

“What does that mean? Does that mean I have a stress fracture? Does that mean I have shin splints?”

What does hyperemia mean when you see it on an MRI report or an ultrasound report and you have something like shin splints or a tibial stress reaction?

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

#844 When Is Fracture Boot Really Needed With Metatarsal Stress Fracture?

I believe the most commonly prescribed and most overprescribed treatment for injured runners is probably a fracture walking boot.

The big question for your doctor is…

Is the fracture walking boot really necessary or not, given my stage of injury recovery?

When is a fracture walking boot really necessary for a metatarsal stress fracture?

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

#843 Overtraining Injuries Are Caused By Weakness

When you get an overtraining injury from running, it’s not because you did too much, because you were too strong or too motivated.

You got injured because you were too weak.

You were too weak to sustain the stress applied to that piece of tissue, that one injured piece of tissue that got injured when you did one workout.

That’s what really happened.

If you get injured, you have to understand how to correct that specific weakness.

Understanding this is crucial.

Overtraining injuries in runners are actually caused by weakness.

And that’s what we’re talking about today in the Doc On The Run Podcast.

#842 What Is Cortical Thickening That Precedes A Stress Fracture?

There are a lot of confusing things you can see on an MRI report, on an x-ray report or an ultrasound report when you’re a runner with pain that you think might be a stress fracture.

One of those findings that may be reported on your medical imaging study is a thing called “cortical thickening.”

I want to explain what that is so you can better understand it in case you happen to see it on an MRI report, x-ray report or in your doctor’s notes.

What is cortical thickening that precedes a stress fracture?

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

#841 Why Stress Fracture Grading Is BS For Runners

I just had an interesting call with an elite runner, who’s a high school cross country runner.

He developed a tibial stress fracture, or stress reaction.

But he thought it was shin splints.

When I looked at it with ultrasound, I saw some stuff that made me really worried about it. So, I got an MRI to confirm.

The first question he had was, what’s the grade?

Grading scales cause confusion.

Today on the Doc On The Run Podcast we’re talking about why stress fracture grading is BS for runners.

#840 What Is Periosteal Elevation In Tibial Stress Reaction?

When you get a stress fracture, one of the earliest visible indications on an X-ray or an MRI or a CT scan is a thing called periosteal elevation. Your doctor might see it on ultrasound, x-rays or MRI studies….way before your ever see a crack in the bone.

Since it’s one of the earliest changes in the bone when you start to get a stress fracture, I thought it might be useful to talk about the term “periosteal elevation” really means.

What is periosteal elevation in a stress fracture in a runner?

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

#839 Why Variety Makes You Stronger As A Runner

I got an interesting question in the Injured Runners Aid Station, “Should I run without my custom orthotics to strengthen my feet?”

It seems logical that stronger runners are less prone to injury. The premise behind this question is whether or not orthotics may cause weakness in your feet or legs.

Never ignore your doctor’s advice. But you have to ask your doctor the right questions about treatments like custom orthotics. You also have to understand when a little variety might help you become a stronger runner.

Why variety makes you stronger as a runner?

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

#838 My Stress Fracture Framework Simplified

If you’re a runner and you get a stress fracture, the number one most important thing that you do is get it to calm down while you maintain your running fitness.

Based on those ideas, I built a framework that I’ve been using for years with injured runners who want to heal and want to get back to running.

In this episode we will go through my stepwise process of how I do it.

Today on the Doc On The Run Podcast we’re talking about my stress fracture framework simplified.

#837 The Most Important Ingredient For Healing A Stress Fracture

The most common medical advice for a runner with a stress fracture, is to stop running, rest, let it heal and then wait to start training after it heals.

But as a runner, you need the stress fracture to heal as quickly as possible so you can get back to running as quickly as possible.

In the Injured Runners Aid Station, I got a question from a runner who asked me about the “most important ingredient for healing a stress fracture.”

What is the most important ingredient for healing a stress fracture?

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

#836 Is The Pain From Injury Or Inflammation?

Pain is the most useful and likely most underutilized tool available to any runner who is tired of waiting for doctors to give them permission to run.

How you track your pain is important.

One of the critical components in the running injury secrets framework that I discussed in the first episode of the members only podcast in the Injured Runners Aid Station is about pain caused from damage in the tissue versus pain caused by inflammation around the tissue.

You cannot run without understanding the difference, at least not safely.

Is the pain from injury or just inflammation?

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

#835 2 Ways Capsulitis Can Lead To Plantar Plate Rupture

If you get a plantar plate sprain, it can take a long time to heal, particularly if you’re not paying close attention.

And because of that, many runners get frustrated.

I see 2 responses to that frustration:

1) go to the doctor and hope for some kind of quick fix.

2) just ignore it and run on it because it doesn’t really hurt that bad.

Both of those are bad ideas with plantar plate injuries in runners.

What are two ways capsulitis can actually lead to a plantar plate rupture?

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

#834 Osteoblast Vs Osteoclast Battle Rebuilding Bone After Stress Fracture

When you get a stress fracture, you need the little bitty crack in the bone to heal.

How do you do that?

First, you have to stop bending or torquing or twisting the bone in a way that led to the crack in the first place.

Second, you have to let the healing process take place.

After the inflammation goes away, and after you get some collagen sealing up the healing crack, you start to get “ossification” of the bone where it turns into hard solid bone that you can run on.

That happens through a combination of two different types of cells in the bone called osteoblasts and osteoclasts.

Osteoblast versus osteoclast, the battle that’s rebuilding bone after a stress fracture.

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

#833 How Long Will It Take My Overtraining Injury To Heal?

How long does it take you to get fit enough to run a 3 hour marathon?

Well, that depends on what? It depends on what you would actually do. Not how long you wait.

How long it takes for you to heal your overtraining injury all depends on what you do, and which variables you choose to control. Not how long you wait.

Believe it or not, every injured runner who calls me for a consultation has control over far more of these variables than they think.

How long will it take my overtraining injury to heal?

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

#832 3 Running Drills That Can Cause Plantar Plate Sprain

If you’re a runner with a plantar plate sprain, I can understand why you’re frustrated.

You have some minor vague aching pain in the ball of the foot, and you’re trying to get back to running, but you’re getting lots of conflicting advice.

In my experience, it’s very rare that a runner gets a plantar plate injury from what I call “overtraining.”

Plantar plate ligaments don’t get sprained because you ran way too much, or ran too many miles. It doesn’t really happen that way. But they do get injured by workouts designed to support your running fitness.

What are three running drills that might lead to a plantar plate sprain?

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

#831 Who’s Fault If A Runner Is Not Getting Better?

If you’re trying to improve and you don’t improve, whose fault is it?

Before we talk about running injuries, let’s talk about when you’re not injured. You hire a coach. You know the coach is qualified, You know your coach has given you a valid training plan, and you know that you can execute.

But then something goes sideways. Your baby gets sick. You get an additional work project. You are sent away out of town on work. Something happens, and you miss some workouts.

If you don’t communicate that to your coach, and you just skip workouts, or inadvertently stack workouts together to make up for missed workouts, and then you get injured, whose fault is that?

Whose fault is it if an injured runner is not getting better?

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

#830 What Is The Most Important Ingredient To A Runner After A Plantar Plate Sprain?

I often get nutrition questions from runners who have overtraining injuries involving tissues made of collagen like the plantar plate ligament.

At the heart of these questions is what is the most important ingredient to add in their diet to speed recovery.

In this episode we are briefly discussing the key ingredients your body needs to repair collagen. If you are missing these, you might have a slower repair process if you have a partial tear of the plantar plate ligament itself.

What is the most important ingredient to a runner after a plantar plate sprain?

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

#829 Do Not Ask Me If You Do Not Know Your Pain Numbers

In the Injured Runners Aid Station, I get questions from injured runners that stop me in my tracks.

“I got this injury while running. I had a stress fracture. It was grade two stress fracture. It’s been six weeks. How much longer will it be before I can run?”

Every injured runner wants to know when it will be safe to run. But, I cannot make that decision based on that information. It seems crazy, but “how long until you can run” is never just about “how long since the injury started.”

Do not ask me if you don’t know your pain numbers.

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

#828 Tall Fracture Boot Vs Short Fracture Boot, Which Is Better For Runners?

It’s no secret that I truly believe fracture walking boots are overprescribed, overused and used for way too long for many injured runners with many different kinds of overtraining injuries.

But sometimes I recommend runners use a fracture walking boot for a short period of time. Then teh question becomes which kind? Short boot or Tall boot?

A tall fracture walking boot versus a short fracture walking boot. Which one is better if you’re an injured runner?

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

#827 Do I Have To Wait For A Callus To Go Away Before I Can Run?

I just saw a woman with an extremely painful callus on the bottom of her foot. She got a type of callus doctors call an “intractable plantar keratosis.” When you get one of these calluses, it turns into a tiny rock hard callus embedded deep in the skin on the bottom of the foot.

It hurts. It’s like having a little rock taped to your foot. In theory, you can start running as soon as the callus is removed.

But the real question is whether or not running right away will increase the probability of getting the same callus again.

Do I have to wait for my callus to go away before I can run?

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

#826 How Can I Tell If I Should Have Surgery To Remove A Big Toe Fracture Fragment?

If you get a fracture in your big toe joint it can be easy to get talked into surgery. Especially if you see fragments on an X-ray.

Your doctor may call old broken bone pieces by a number of terms:
“Osteophytes”
“Fracture fragments”
“Loose bodies”
“Surgical targets”

If your doctor points them out and starts talking about surgery, the chances are good that you’re going to want to have them removed. But there are times when surgery is totally unnecessary.

How can I tell if I really need to have surgery to remove a fracture fragment in my big toe joint?

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

#825 Best Imaging Study To Assess Non-Union Stability

If you get a metatarsal fracture and it does not heal, doctors call it a “non-union.”

Sometimes, even if you have a non-union you can still run. Maybe without surgery.

The single most important consideration with a non-union is stability.

The more stable the bone is, the more likely the fracture will heal.
The more stable the bone is, the less likely it will cause pain.
The more stable the bone is, the sooner you can start running.
The more stable the bone is, the less likely you will need surgery.

One of the keys to deciding when it’s actually healed enough has to do with that stability. When it comes to assessing it, everybody wants an imaging study.

What’s the best imaging study to assess non-union stability when you have a fracture?

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

#824 Is 2 Weeks On Crutches Better Than One Week With A Tibial Stress Fracture?

I just got a great question from a runner with a tibial stress fracture that had been misdiagnosed with shin splints.

She wanted to know how long to use the crutches.

Is two weeks on crutches better than one week when I have a tibial stress fracture?

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

 

 

#823 Last Chance Option To Avoid Non-Union Surgery In A Runner

Today’s episode applies to any injured running pondering surgery.

I just spoke to a runner who was told she might need surgery to fix a non-union of a metatarsal fracture.

I said, “Look, you have two choices. You can have surgery or not have surgery.”

We talked about what it meant if she did have surgery in terms of her recovery. And we also talked about how she could potentially get it to heal without having all the risk associated with surgery.

What is the very last option you can do as a runner to avoid surgery?

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

#822 Minimal Restrictive Intervention Is The Goal With Runners

If you are an injured runner, you are probably limiting your activity.

Doctors who don’t understand how important it is for you to get back to running tend to limit runner’s workouts more than necessary. They’re more restrictive than necessary. And it costs you.

You lose more fitness, you get weaker, you get stiffer, you get neuromuscular changes that damage your running form, and disrupts your coordinated firing of muscle units that makes you efficient.

All of that gets damaged over the weeks that you’re not running. So, it’s really important that you maintain your fitness.

Today on the Doc On The Run Podcast, we’re talking about how the minimum restrictive intervention should always be the goal with injured runners.

#821 I Had A Sudden Injury But My Doctor Called It A Stress Fracture

I had an interesting question from an athlete who asked,

“I had an injury, I went to see the doctor and got an X-ray. There was no crack on the X-ray, but my doctor called it a stress fracture. So, I’m confused.”

“I thought that a stress fracture happens when you run too much, too far, too soon, it overloads the bone, and you get a little crack in it. I didn’t do that. It was trauma, a sudden injury, not a bunch of force applied over a long period of time. I wasn’t training for anything. I don’t get it. Why is my doctor calling this a stress fracture?”

I had a sudden injury, but my doctor called it a stress fracture.

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

#820 Fix The Original Pain First

I recently did a webcam consultation with an athlete who has had a lot of trouble for a long time. He was very, very athletic. He started having pain and a whole lot of trouble that ensued afterwards that severely changed his athletic picture in only a couple of years.

After years of seeing experts and not getting any better, he asked me to help him to do a second opinion and help him reassess where he was and what he might be able to do.

The way I think about this is really simple. Many of the bad things that happen after the original injury are because of compensation or your body trying to keep pressure off of that worst injury that happened first.

So, I always tried to address that first injury, first!

Today on the Doc On The Run Podcast we’re talking about why you need to fix the original pain first.

#819 Is There Any Difference Healing A Stress Fracture Vs. Traumatic Fracture?

It’s important to understand they were talking about similar cracks in similar bones that remain in a similar position. We’re not talking about broken bones that are displaced.

If you jump off a ladder, you break the bone and it’s moved out of position, that is a completely different story. Stress fractures don’t generally get displaced as much as traumatic fractures.

If there’s a crack in the bone because of a stress fracture, the bone is not displaced. But how does that compare to similar (non-displaced )traumatic fracture?

Is there any difference in healing between a stress fracture versus a traumatic fracture?

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

#818 Should I Take NSAIDs For A Non-Union In A Runner?

A metatarsal fracture “non-union” is what doctors call it when you broke the bone, it started to heal, but then the fracture kind of quit healing. Usually it means you got a bunch of scar tissue between the ends of the bone.

Sometimes that happens without you or your doctor realizing it. The problem gets worse if you start running on it.

The question is, “should I take non-steroidal anti-inflammatory drugs (or NSAIDs)?

NSAID’s are medications like ibuprofen and naproxen. These drugs are not steroids, but they stop inflammation.

Many runners take them for all kinds of aches and pains after training. The question is, is it a good idea or not when you may have a metatarsal fracture non-union?

Should a runner take non-steroidal anti-inflammatory medications for a non-union?

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

#817 What Causes Most Of The Pain When I Have A Stress Reaction?

If you get a metatarsal stress fracture, the first thing that you’re going to notice is not that you have a broken bone in your foot.

You are going to notice pain.

Typically, the feeling starts as a little vague discomfort in your foot that progressively gets worse as you continue to train and run on it.

The soreness gets worse the longer you run, feels worse when you walk barefoot on hard surfaces and becomes more notable going up and down wooden stairs.

As I explained this to a runner in the Injured Runners Aid Station, she asked “What really causes the pain?”

What causes most of the pain when you have a metatarsal stress fracture?

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

#816 When Is A Boot Better Than Crutches For Tibial Stress Fracture In A Runner?

A stress fracture in your tibia, or shin bone, is a bad injury. You definitely don’t want the crack to grow to the point where it could break.

The big question is what will make a tibial stress fracture better, faster…crutches or a fracture walking boot?

When is a fracture walking boot better than crutches for a tibial stress fracture if you’re a runner?

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

 

#815 3 Ways To Tell If A Fracture Non-Union Is Stable Without Imaging

This episode comes from a discussion I called with a runner who called me for a second opinion. She had a stress fracture non-union and somebody had remained recommended that she have surgery.

I was looking at her CT scan and she asked me an interesting question.

She said,

“Does it look stable?”

And I said, “Can’t tell.”

It looks like a non-union. It looks like it’s broken and never healed.

What are the three ways you could tell whether or not a metatarsal fracture non-union is stable without getting an imaging study?

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

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