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

 

 

 

#620 Are You Hiding From Your Injury?

The #1 concern all injured runners face is time.

How long will I have to use crutches.

How long will it take the surgery to heal.

How long will I have to wear a fracture walking boot.

How long will I have to stop running.

How much running fitness will I lose in that time.

I feel like most of the runners who call me for a second opinion over webcam are making a critical mistake. They are hiding from the injury.

Are you an injured runner who’s hiding from your injury?

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

#619 Painful Calluses In Runners Fixed With The Strawberry Stem Technique

If you have ever run with a rock in your shoe, you know just how painful a little pebble can be.

Sometimes a callus forms in a way that it gets rock hard and starts to get embedded in the skin.

Painful calluses can literally feel like a rock taped to your foot. The problem is that callus removal pads don’t work.

Using a pumice stone to shave down the surface of the callus doesn’t really help much either.

But you can fix them the same way I do using what I call the Strawberry Stem Technique.

Let’s talk about how they form and how this technique works.

Today on the Doc On The Run podcast, we’re talking about how you can fix painful calluses in a runner with what I call the Strawberry Stem Technique.

#618 Injured Runners Must Proceed With Confidence

The whole key to rapid running injury recovery is to proceed with confidence.

If you are using a fracture walking boot or crutches, you must do so confident the boot is necessary…and not based on guesswork.

If you are starting range of motion exercises for a torn tendon, you must be confident you can work past pain, without worrying you might cause a re-injury.

You need to make sure that you know that the present action in your recovery is necessary.

You also need to understand how you can gain confidence in your next step in recovery.

Today on the Doc On The Run Podcast, we’re talking about how injured runners must proceed with confidence.

#617 How Can Pronation Cause Hallux Rigidus In A Runner?

One time at a medical conference, an expert lecturing on biomechanics said,

“When a runner develops Hallux Rigidus, he becomes a swimmer instead of a runner.”

Most of the doctors in the audience laughed.

I really didn’t think that was very funny. I actually have hallux rigidus myself, and it doesn’t disrupt my running.

It is true Hallux Rigidus can cause pain and swelling in the big toe joint. If you aren’t careful the joint can get destroyed.

If you understand a little bit about the mechanics of the joint, it may help you understand how to avoid the arthritis that can hamper your ability to run in the future.

How can pronation cause hallux rigidus in a runner?

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

#616 What Is A “Bone Bruise” At An Old Fracture Site?

I was just giving 3 lectures on running injuries at a medical conference in Las Vegas.

As is often the case, after one of my lectures one of the physicians in the audience approached me in the hallway to ask a question.

What do you do with activity level when somebody has an old fracture where the bone was broken long ago?

The runner recently had a re-injury at that spot. It has been painful, it’s been swelling, and he’s trying to figure out what to do.

What’s a bone bruise at an old fracture site? Is it a big problem or a little problem?

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

#615 Runner Has A Neuroma And Bursitis, Which Is Worse?

When you have two painful problems in different parts of the same foot, things can get complicated.

I recently had a call with an injured runner with a couple of different problems.

On the outside of his foot, between the third and fourth toes, he has a painful neuroma. The other problem is that he’s got bursitis. The inflamed bursa is in a completely different place, no where near the irritated nerve.

When a runner has two injuries, like a neuroma on one side of the foot and bursitis on the other side of the foot, which one is worse?

Which one should you pay attention to first?

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

#614 Got Clearance To Start Cycling, Should I Stop Icing?

I just got off a call with a runner who needed a second opinion with his running injury recovery.

He had a fracture and it has been improving. But because it was painful and swollen, he was still icing it daily.

At his last follow-up appointment, the doctor actually said, “I think you’re good enough to actually start cycling at this point, to get back a little of your running fitness.”

So, the question is, should I stop icing?

Do I need to keep doing that? If my injury is good enough to start cycling can I stop icing?

Does a release to cycle mean you’re good enough to stop icing your foot?

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

#613 When Is A Web-Cam Second Opinion Just As Good As In Person Doctor Visit?

Sometimes a doctor really needs to touch your foot to make the diagnosis. But not always with runners.

Since the pandemic pushed so many of us into Zoom meetings, we all know it’s pretty easy to get on a web-cam call when it’s really difficult to meet someone in person.

There are a couple of times when webcam second opinion visits can be almost as good as meeting in the doctor’s office.

There are lots of benefits to the webcam calls that do make them almost as valuable as in person visits.

When is a webcam second opinion just as good as an in-person doctor’s visit for runners?

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

#612 Dry Needling Vs PRP Injection In Runners

Today’s episode comes from a great question I got during one of the Runners Aid station calls.

This was someone who had a plantar plate sprain and had talked to a doctor about a couple of different procedures that might actually, potentially, speed up the healing.

He wanted to know about the difference between these two things called dry needling or a PRP injection.

Today on the Doc On The Run podcast, we’re talking about dry needling versus PRP in runners.

#611 What If Stress Fracture Still Swells And Hurts A Lot?

Ivan has a great question. After watching the watching the video “Can I Run After Wearing a Fracture Boot?” he wanted to know: “It still swells and has a lot of pain what do I do?”

Anytime a runner gets a stress fracture, the main goal is to confirm the foot is healed enough to withstand the forces and stresses applied to the injured bone.

In the episode we are going to talk about:

3 indicators of ongoing tissue damage when you have a stress fracture.
3 strategies used to decide when it’s safe to run after stress fracture.
Questions I would ask you if you called me for a stress fracture second opinion consultation.

Today on the Doc On The Run Podcast we’re talking about what to do if a stress fracture in the foot still swells and hurts a lot after wearing a fracture walking boot.

#610 Find Your Target When You Are Not Getting Better

Let’s say you’ve had an aching pain in the ball of the foot that’s been going on for several weeks.

You’ve tried lots of stuff. You tried icing it. You tried some over-the-counter inserts that you got.

Maybe you stopped running all together. Maybe even used a fracture walking boot.

But after weeks, you’re not getting anywhere.

Today on the Doc On The Run Podcast we’re talking about how you need to find your target when you’re not getting better.

#609 How Can A 2nd Metatarsal Stress Fracture Cause A 5th Metatarsal Stress Reaction?

I was just on a call with a cross-country runner who had had a second metatarsal stress reaction.

A stress reaction is basically like a mild stress fracture, but without any crack in the bone.

She was doing well and her foot had been getting better.

But then when she went for her first run, she had pain in her foot.

The pain during that first run was in a completely different bone. The new problem was not in the second metatarsal, it was in the fifth metatarsal on the outside of the foot.

Let’s talk about how that happens.

Today on the Doc on the Run podcast we’re talking about how a second metatarsal stress fracture might cause a fifth metatarsal stress reaction.

#608 The Benefit Of Your Radiologist Being Clueless

The radiologist reading your MRI knows nothing about your problem.

The only clues a radiologist gets about your injury are described in the clinical history section of the MRI order from your doctor.

I just got off a call with a runner who had gotten an MRI order from his doctor. He had a long history of injury but the only description on the MRI order was “Concern for fracture.”

This runner had more than just a concern for a possible fracture.

But because there was such a limited description for the radiologist, the injured runner was understandably irritated and frustrated that the radiologist didn’t have the full information.

I will admit that I also get very upset about this when I’m looking for something obscure that the radiologist is likely to miss, unless it’s on their radar.

But there is an up-side to everything!

Today on the Doc On The Run podcast, we’re talking about the benefit of your radiologist being clueless.

#607 How Can Sinus Tarsi Syndrome Cause FHL Tenosynovitis

This episode has a whole bunch of complicated-sounding terms that you may have never heard before.

One of them is sinus tarsi syndrome, and the other one is FHL tenosynovitis or flexor hallucis longus tenosynovitis.

Sinus tarsi syndrome is often confused with ankle pain.

FHL tenosynovitis is often confused with plantar fasciitis.

These conditions affect opposite sides of the same foot. Yet, one can lead to the other.

Today on the Doc on the Run podcast, we’re talking about how sinus tarsi syndrome can cause flexor hallucis longus tenosynovitis.

#606 Can I Run In Cleats With A Stress Fracture?

Imagine your doctor tells you that you have a metatarsal stress fracture and you should not run.

Why would you come home from the doctor and call me asking, “Can I run in cleats with a stress fracture?”

Believe it or not, that actually happened.

In this case we are talking about an athlete who is actually getting better and who wanted to train on the track.

He wanted to run in cleats.

Aside from the uncertainty, he was doing okay. He was a little hesitant and wasn’t sure if cleats would aggravate the injury right or not.

Can I run in cleats with a stress fracture?

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

#605 New Running Shoes Made My Bunion Bigger

A runner called me and said, “I got some new running shoes and they made my bunions worse overnight. I think I need surgery now.”

The problem is that bunions do not typically get worse quickly.

Bunions get worse slowly because the bone is changing position.

In this episode, we’re going to talk about how it’s possible bunions could get worse from a new pair of shoes.

If you are a runner with bunions this is a situation you may want to understand.

Today on the Doc on the Run podcast, we’re talking about how new running shoes might have made your bunion bigger.

#604 Time Is The Enemy When You Have A Running Injury

We’ve all heard the saying that time heals all wounds.

While that may be true, time also kills your running fitness when you’re not training.

You have to remember that the enemy of your running fitness is not the fracture walking boot.

The enemy of your running fitness is not the crutches.

The enemy of your running fitness is not your doctor.

The enemy of your running fitness is time!

Today on the Doc On The Run podcast we’re talking about how time is the enemy when you have a running injury.

#603 5 Choices With Split Tear In The Peroneus Brevis Tendon

Today I was talking with a runner who has been diagnosed with a longitudinal split of the peroneus brevis tendon.

The concern with this kind of tear in the peroneal tendon is that if you can’t get it to calm down, it can only get worse.

Continually moving, irritating and producing inflammation in and around injured peroneal tendons just causes them to get weaker over time.

Many surgeons are quick to offer surgery to correct the problem.

This runner wanted to know the details of all the different treatment options when a runner gets diagnosed with a longitudinal split of the peroneus brevis tendon.

Today on the Doc on the Run podcast, we’re talking about the 5 choices runners have when there is a split or tear in the peroneus brevis tendon.

#602 How Do You Stay Motivated When Injured?

It really seems incredible that we now have over 600 episodes of the Doc On The Run Podcast!

Today’s episode is a little different in that I actually want to ask you a question.

How do you stay motivated when you have been injured?

I’m really interested to know because this is one of the most important things you can do as an athlete when you’re recovering from an over training injury.

Much of what I’ve learned that helps injured runners is not stuff I learned in medical school.

Much of the strategies and techniques that seem to work best, I’ve learned in large part from seeing how creative injured runners can be.

Today on the Doc on the Run podcast, we’re asking a question, how do you stay motivated when you are injured?

#601 5 Changes On X-Rays With Hallux Rigidus

Today we’re talking about some of the x-ray changes that happen when you get hallux rigidus or hallux limitus.

If your doctor tells you the x-rays show hallux limitus…what does it mean?

We’re going to talk about these five things that you can see commonly on the x-rays when you have hallux rigidus.

Today on the Doc On The Run podcast, we’re talking about five changes on x-rays when you get hallux rigidus.

#600 Stretching Is Like A Recovery Day. Finite Pain That Pays Off.

I know a lot of people are not even going to listen to this episode because I’m talking about stretching.

Many runners seem to recoil from the topic of stretching.

But if you get injured and you go to a physical therapist, you can take it to the bank that they are going to give you some stretching exercises to do.

Why?

Because stretching helps when you have tissue that is predisposed to injury because it’s too tight.

When you have that issue, you need to stretch that tissue.

Today on the Doc On The Run Podcast, we’re talking about how stretching is like a rest day, finite pain that pays off.

#599 Broken Sesamoid Vs Bipartite Sesamoid What Is The Difference?

If you have pain in your foot under the big toe joint, the doctor might tell you that you have an issue with one of these two little bones called sesamoids.

Interestingly, some people have a sesamoid bone that is not broken, but looks like it broke apart.

If you understand how that happens, it may help you understand your x-rays and the doctor’s description of your condition.

Today on the Doc on the Run podcast, we’re talking about a broken sesamoid versus a bipartite sesamoid. What’s the difference?

#598 How To Overcome Friends Telling You Not To Run After A Traumatic Accident

Today’s topic comes from a longtime listener named Jenny. She wrote a really nice review that I wanted to share with you.

She said, “If you are a runner, you need to listen. What I love about Doc On The Run Podcasts is that each one covers one topic, is short, sharp, full of useful practical information that you can apply right away without having to go and do more reading or research.”

She also asked, “Would you consider doing an episode on return to running after an accident and how to overcome the fact that everyone tells you that you should not run, even when your surgeons and physios have said that it is safe for you to run and really good for you to exercise?”

Thank you Jenny! And yes, that is a great idea for a topic!

Today on the Doc On The Run Podcast, we’re talking about how to overcome friends, telling you not to run after a traumatic accident.

#597 Hallux Rigidus Vs Hallux Limitus, What Is The Difference?

If you get pain and swelling and discomfort particularly in and around the big toe joint, you may have a condition called hallux limitus or hallux rigidus.

Hallux limitus and hallux rigidus are both conditions that affect the big toe joint. It causes pain right where your big toe attaches to your foot.

Many runners with this condition don’t even understand the difference between hallux limitus and hallux rigidus.

There are really a few things that define the difference between these two conditions.

Understanding the differences may help you get clarity after a doctor visit.

Today on the Doc On The Run Podcast, we’re talking about hallux rigidus versus hallux limitus. What’s the difference?

#596 Focus On Possibilities NOT Limits Or Obstacles When Injured

The problem is not that you have a stress fracture.

The problem is not that you have an Achilles tendonitis issue that is bugging you.

The problem is that you have been given advice that freaks you out and convinces you to do absolutely nothing while you wait to recover.

How do I know? Because I don’t help people get better from running injuries. Instead, I help injured runners figure out how to run.

That’s what I really do.

Today on the Doc On The Run podcast, we’re talking about why you need to focus on possibilities and not limits or obstacles when you’re an injured runner.

#595 2 Reasons Stretching The Plantar Fascia Is Bad For Runners

Yesterday, I saw a runner who has plantar fasciitis. Plantar fasciitis is the most common condition affecting the foot in runners.

When a runner gets plantar fasciitis, it is often because the plantar fascia ligament is too tight. The tight ligament becomes overstretched and strained. Heel pain is the result.

Since it is safe to assume that the plantar fascia ligament on the bottom of the foot is just way too tight, you may want to stretch it. But with every potential treatment comes risk.

Stretching the plantar fascia can be risky and has the potential to cause more trouble for a couple of reasons.

Today, on the Doc on the Run Podcast, we’re talking about two reasons that stretching the plantar fascia can be bad for runners.

#594 Which Decision Is Missing In Running Injury Recovery?

I want you to really think about which decision might be missing in your process of running injury recovery right now.

Is it the decision to just go for it?

Is it the decision to start exercising today?

Is it the decision to sign up for some specific event that can get you motivated?

Is it the decision to get a second opinion?

Which decision is missing in your running injury recovery? That’s what we’re going to talk about today on the Doc on the Run Podcast.

#593 Is Inflammation Good Or Bad For Plantar Plate Sprain

I was just on a call with a runner suffering from a plantar plate sprain.

He had a great question:

Is inflammation really bad or is it good when you have a plantar plate sprain?

Physicians commonly prescribe anti-inflammatories. There are many approaches used by injured runners to manage inflammation, reduce inflammation, and hopefully make your foot feel better.

If inflammation is bad for the plantar plate ligament, part of your recovery plan should include some sort of anti-inflammatory treatment.

But if the inflammation is good for the plantar plate, you should not try to interfere with the inflammatory response.

Is inflammation good or bad for a plantar plate sprain?

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

#592 Doubt Does The Most Damage To Recovering Runners

Doubt comes from confusion. Confusion leads to paralysis when you’ve been injured and you don’t know what to do to maintain your running fitness.

Doctors tell you to sit still.

Pill pushers tell you to take medicine.

Gizmo peddlers tell you to buy expensive devices.

Many runners don’t really even know what they can do, other than rest.

If you are going to doubt anything when it comes to your running injury recovery, what you should doubt is the validity of sitting around doing nothing while waiting for healing.

Today on the Doc On The Run podcast, we’re talking about how doubt does the most damage to a recovering runner.

#591 Sesamoid Pain Misdiagnosed As 4th And 5th Metatarsal Stress Reaction

If you are reading this, maybe you have sesamoiditis, a sesamoid stress reaction or a metatarsal stress fracture.

This is a real example from a real patient. This story really illustrates how MRIs can show misleading clues leading to a potential misdiagnosed leading your doctor astray.

It is crucial that you focus more on your running goals, your injury progress and what it really means precisely where you have pain in your foot. Then and only then can the MRI findings be put in the proper perspective.

Too much emphasis on MRI findings can make you think you have a different injury.

Today on the Doc On The Run podcast we’re talking about how sesamoid pain got misdiagnosed as fourth and fifth metatarsal stress reactions.

#590 2 Ways Runners Can Tell An Injury Is Improving

How do you know your injury is improving? How do you know that you got the green light to start running? How do you know it is healed?

Well, when I talk to runners, most of them say something like:

“Well, my x-ray shows this. Does that mean that I can run?”

“My blood test showed that, does that mean I can run?”

“My doctor said this, but I heard that on some other podcast, so does that mean I can run?”

There is lots of confusion around how you can tell when you are getting better as you start regaining running fitness after an injury starts to heal.

Timing is the crucial piece of information if you really want to run.

Today on the Doc On The Run podcast, we’re talking about two ways an injured runner can tell the injury is actually improving.

#589 Common Fracture Missed By Ottawa Ankle Rules

I was recently invited to give a lecture at a foot and ankle medical conference in Seattle. I was giving a talk called Conservative Treatment of Ankle Sprains in Runners Who Want To Run.

This was an attempt to teach physicians what I do with ankle sprains. Mostly I was trying to get them to think about what they need to do to get runners back to running as quickly as possible instead of just doing the standard ankle sprain protocols with their patients.

The Ottawa Ankle Rules are a set of rules that were created in Canada to reduce people from getting unnecessary ankle X-rays when they have an ankle sprain and go to the emergency room.

Today on the Doc On The Run podcast, we’re talking about a common fracture missed by the Ottawa Ankle Rules.

#588 Always Ask For A Copy Of Your X-Rays

I was just on a call with a runner who called me for a consultation of an ankle injury.

He had some funny looking stuff on his ankle x-rays. That was why he was scheduling a second opinion.

The bummer in this whole thing was that he actually told me that maybe 10 years ago or so, he’d had a similar ankle injury.

He’s pretty sure it was on the same side, but he wasn’t really sure because he didn’t have a copy of the x-rays.

Today on the Doc on the Run Podcast, we’re talking about why you should always ask for copies of your x-rays.

#587 Easy Home Test For Achilles Tendon Rupture

I just got a call from a runner who I have seen before. He had swelling in his Achilles tendon, and he was worried about it.

He was worried that he could have a ruptured or completely torn Achilles tendon.

If you are a runner and you get a complete rupture of the Achilles tendon, this is one of the worst things that could possibly happen to you.

A torn Achilles is way worse than a broken bone. The worst thing you could do is ignore a torn Achilles. You do not want to ignore it!

Today on the Doc On The Run podcast, we’re talking about an easy at home test you can do if you think you have a complete rupture of the Achilles tendon.

#586 3 Unfair Advantages In Healing Running Injuries

Every time I am in the Recovering Runner’s Aid Station where I answer questions for injured runners, I get questions about how to get an advantage.

Everybody wants an advantage.

I don’t think most people cheat.

There are some people who cheat, but certainly not everyone.

But I think it is okay to look for an unfair advantage when you’re injured and you’re trying to get back to running.

The truth is, getting an unfair advantage when you are injured is actually really easy to do.

Today on the Doc On The Run podcast, we’re talking about three unfair advantages in healing running injuries.

#585 How Can A Diagnostic Injection Help Heal An Ankle Sprain?

Let’s say you are out running on a trail and you catch a root and you roll your ankle.

You limp back home and you realize that your ankle is all swollen. It is bruised, it hurts and you’re really bummed out.

You are trying to figure out what you can do to get this thing to calm down faster and get back to running. Well, there are lots of different options.

How can a diagnostic injection help an ankle sprain?

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

#584 Do You Agree Not Running Is The Safest Way To Heal A Running Injury?

I was just lecturing at the International Foot and Ankle Foundation meeting in Seattle. I was giving talks on running injuries. A doctor in the audience asked me if “not running” was the safest way for runners to heal running injuries.

Keep in mind, this was a doctor asking the question.

Have you ever thought this makes sense?

After all, if a runner gets a running injury, and they stop running, that’s the safest way to get it to heal. Or is it?

Do you agree that not running is the safest way to heal a running injury?

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

#583 2 Types Of Injections After Failed Neuroma Surgery

Let’s consider you are a runner with a painful neuroma.

The more you run, the more painful the foot becomes.

But it only started with some weird little sensations.

Eventually it starts to get more numb. You notice more tingling, then more burning pain. Now your doctor wants to talk you into surgery.

You just want the problem fixed. So you go to the operating room and then you’re shocked to find out that you still have pain later.

By the way…that’s not malpractice. It just means you had a bad outcome.

But if you’re the runner, you’ve got to figure out what to do.

Today on the Doc On The Run podcast we’re talking about two different types of injections your doctor might offer you after a failed neuroma surgery.

#582 What If There Is A 50% Chance Your Doctor Is Wrong?

I was listening to a podcast about the way that disagreements happen.

He said, anytime there’s a disagreement, no matter what, there are two possibilities.

If there are two people arguing about something, one person could be right, and the other could be wrong. That means roughly speaking, there’s a 50% chance that one person is wrong all the time.

This is true of physicians as well.

Let’s say, I come to your home to see you and help you with a metatarsal stress fracture. You’ve been told you have a neuroma. But it seems like you have a stress fracture, based on your x-rays or your story.

What if there’s a 50% chance your doctor might be wrong?

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

#581 Do I Need A Fracture Walking Boot For Extensor Tenosynovitis?

One of the questions I got in the Runners Aid Station was:

“Do I really need a fracture walking boot?”

This is a runner who went to the doctor, and was told, “You have extensor tenosynovitis. The best way to get it to calm down is to remove the inflammation and stop aggravating the tendons.”

If you get aching pain on the top of your foot, it might be caused by an irritated extensor tendon sheath (which is the little tube around the extensor tendons as it goes out to the toes on the top of the foot). If so, you might be thinking you need something drastic to stop the tendons from moving so it can calm down.

Do I need a fracture walking boot for extensor tenosynovitis?

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

#580 300 Pounds And Running With Slow AF Run Club Founder Martinus Evans


Maybe you have been taking some time off because you have been injured.

Maybe you took some time off because you spent way too much time in a fracture walking boot.

Maybe all of your training just took a backseat to all the chaos and confusion of the pandemic.

But none of that would be as bad as having a doctor tell you that your hip was injured because you are just way too fat to run!

Irrespective of why, if you are a runner, and you feel like you are running just a little bit too slow, I can promise this discussion is going to help you today!

We are going to talk about why it’s not really so bad to be in the slow zone.

You’re getting to hear from Martinus Evans, host of the The 300 Pounds and Running Podcast Network, who runs the “Slow AF Run Club” and who is also the author of the “Zero to Running” guide.

Today on the Doc On the Run Podcast, we’re talking about 300 Pounds and Running!

#579 How Can A Bruised Toenail From Running Cause Toenail Fungus?


If you’re reading this, it’s probably not because you love toenail fungus. It it also probably not because you think black toenails are pretty. In fact, you probably think both are pretty gross and you would be right.

But this bruised black toenails and toenail fungus joining the party is mostly preventable.

All runners should understand the circumstances that can put you at risk of getting a fungus infection in the nail which runners call “toenail fungus,” or which doctors call “onychomycosis.”

It is often the fungus that actually causes the skin infection called athlete’s foot.

It’s very, very common. Fungus is all over the place! Don’t freak out, but it’s probably in your shoes right now!

Whether or not the fungal spores and fungal filaments will cause an infection on your feet, just depends upon the circumstances that you set up as a runner that actually allow it to get in and cause real trouble.

How can a bruised toenail from running cause toenail fungus?

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

#578 Did My Doctor Do The Wrong Plantar Plate Injection?

If you get a plantar plate sprain, the first thing you may notice is pain and irritation at the ball of the foot, right where the second toe attaches to the foot. If the foot feels swollen, puffy or sore in that spot, it could be a plantar plate sprain.

A one common injection performed for plantar plate ligament sprains is a corticosteroid injection.

I just spoke with a runner who thought the doctor did the injection in the wrong part of the foot.

She saw a podiatrist, and the doctor did a corticosteroid injection for the plantar plate sprain. She was confused afterward and asked me if the doctor did the injection with the right or wrong technique. I’ll explain why she was confused.

I think my doctor did the wrong injection for the plantar plate ligament.

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

#577 Do I Have To Stop Running And Lose My Fitness Entirely To Heal?

This morning I was on a call answering injury questions live in the Injured Runners Aid Station.

This runner actually said,

“Well, my doctor said that since I got a running injury, the solution is to stop running.”

When I think about this, there are really only two approaches to the questions of whether or not you have to stop running entirely to heal an overtraining running injury.

Do I have to stop running and lose my running fitness entirely just to heal?

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

#576 Does A Mild Plantar Plate Sprain Always Hurt?

I was just speaking with a woman who has a suspected mild plantar plate sprain. What was interesting is the fact that she doesn’t really have a whole lot of pain.

I was explaining how important it is that she actually figures out her baseline “pain” numbers. I was explaining that even if you don’t call it “pain” you have to rate the level of discomfort so you can track it.

How bad is it when walking with or without running shoes, or simple things like walking up and downstairs.

Now, the problem is that she said, “well, it’s not really painful so I can’t put a pain number on it.”

I understand it may not really be painful. Particularly if you’re an athlete with a high pain tolerance.

When you have a mild plantar plate sprain you must figure out what it is that you call discomfort or pain. You have to track it.

Does a mild plantar plate sprain always hurt?

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

#575 Can My Foot Injury Heal While I Am Sick?

I just got off a webcam call in the Injured Runners Aid Station. The runner who called me, had some down with a cold.

He had been sick for a few days. He wasn’t running. He was curious about whether or not his injury was going to actually get worse while he was ill. Because he knows that when he’s sick, his immune system is working really hard to try to fight the infection. And your immune system can’t do everything all at once.

If you have an injury, it is widely accepted that the illness is going to slow down your potential ability to rebuild tissue and repair damaged tissue, whether a metatarsal stress fracture or an Achilles tendon injury.

Can my foot injury heal while I’m sick?

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

#574 Best Exercise For Plantar Plate Sprain In Runners

The plantar plate ligament is a little ligament on the bottom of the ball of the foot, right where the toe attaches to the foot. The function of the plantar plate ligament is to reinforce the joint and support the toe by helping to hold it down against the ground.

Anatomically, the plantar plate ligament resists the motion doctors call “dorsiflexion,” where the toe gets pulled up away from the ground.

Even though the plantar plate ligament is really small, its function is vital.

Doing exercises to help support the plantar plate, can help to decrease some load on the ligament.

Today on the Doc On The Run Podcast, we’re talking about the single most effective exercise to support the plantar plate in runners.

#573 How To Tell Peroneus Longus From Peroneus Brevis

If you recently started getting some aching pain on the outside of your ankle every time you run, you might have a condition called peroneal tendonitis.

Peroneal tendonitis is a problem often encountered by runners with high arches. It can often be exacerbated by running in ultralight unstable shoes or running on trails when you’re feeling too tired to maintain good form.

The two peroneal tendons are both on the outside of the ankle. But they do different things. The way you position your foot to reduce the stress and strain on the one injured tendon, will have to be different because they each do different things.

Today on the Doc On The Run podcast, we’re talking about how to tell the difference between the peroneus longus and the peroneus tendon when you’re a runner.

#572 How To Lace Running Shoes With Extensor Tenosynovitis

If you get pain on the top of the foot when you’re running you might discover you have a painful condition called extensor tenosynovitis.

“Tenosynovitis” just means you have irritation and inflammation within the tendon sheath, or the little tube that surrounds the extensor tendons that fan out toward the toes on the top of the foot.

There are really 2 keys to calming the tendon sheath. You have to decrease the inflammation with the tendon sheath. But you also have to stop irritating the swollen tissue inside the tendon sheath.

The easiest way to stop that irritation when you run is to stop putting pressure right on that irritated spot.

Today on the Doc On The Run podcast, we’re talking about how to lace your running shoes when you have extensor tenosynovitis.

#571 Is Weight Loss Important For Running Injury Recovery?

The other day in the Recovering Runner’s Aid Station, I got a great question:

“If I get stress and strain on my foot, because I’m overweight, should losing weight be part of the strategy to actually get my foot to recover as fast as possible?”

There are lots of ways to reduce the stress and strain on one injured part of your foot.

Obviously, the more your body weight, the more pressure on your foot when you stand, walk or run.

Sometimes doctors will tell patients, “If you weighed 20 pounds less or 40 pounds less, well, there’d be less stress and strain on your foot…and you would heal faster.”

But it’s an unrealistic strategy for several reasons.

Should weight loss be a part of your running injury recovery strategy?

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

#570 Should I Stretch The Toe With Plantar Plate Sprain?

Yesterday I saw a runner with a plantar plate sprain. She wanted to know if stretching the toe would help the plantar plate ligament heal faster.

Plantar plate sprains happen because the plantar plate ligament gets overstretched, and strained.

When you get a plantar plate injury, the fastest way to allow healing is to reduce the stress and strain on that injured ligament.

If you’re thinking about whether or not to stretch the toe or do something to try to help the condition improve faster, you really need to think about the mechanics that are actually involved when you have a plantar plate injury.

Should you stretch the toe that has a plantar plate sprain?

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

#569 Find Your #1 Missing Piece In Running Injury Recovery

Think about what happens when you start running.

You decide you want to run. You make a decision, then you go out and you actually run.

You start working on your running form. Maybe you hire a coach You add a little speed work. You also start doing some strength training to supplement your running fitness. Eventually you even start working on your pacing strategies for your races.

These are all things that are important pieces of running. But thinking about your pacing strategy when you haven’t even started running is a really bad idea. It doesn’t matter what you think about pacing if you can’t actually run the whole distance.

There is a most important piece, at each point in the process. This is especially true in running injury recovery as well.

Today on the Doc On The Run podcast, we’re talking about finding your number one missing piece in your running injury recovery.

#568 Tuning Out Running Injury, Tuning In For Recovery

Overtraining injuries only happen when you ignore a problem.

No runner wants to be injured.

Most runners who call me for web-cam visits have been tuning out the signs of impending injury…long before they actually got injured. You get an overtraining injury because you did feel something, but you ignored it.

Don’t forget…you could not become an accomplished runner if you were not capable of tuning out discomfort and putting in the work to become a strong runner.

But that works against you when you get injured.

Tuning out injury, tuning in for recovery and that’s what we’re talking about today on the Doc on the Run podcast.

#567 Can A Mallet Toe Cause A Plantar Plate Injury?

I just did a web-cam call with a runner who had a thing called a “mallet toe” deformity. He had pain in the ball of the foot when running.

He said he was reading about plantar plate sprains, and thought, “Maybe I have a plantar plate sprain because I got this funky toe.”

He wanted to know if a mallet toe could cause a plantar plate injury.

Can a mallet toe cause a plantar plate injury?

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

#566 Breakthrough Runs Do Not Always Feel Great

When we think about training for endurance events like marathons, we expect the payoff to feel good.

We are patient with the process, yet in the progression of building fitness, we always expect that when we have a breakthrough run, it’s going to feel great.

It is just not true.

When you do a run that is a lot longer, or a lot faster, you know you’ve made a breakthrough.

Breakthrough runs do not always feel great and that’s what we’re talking about today on the Doc On The Run podcast.

#565 Extensor Substitution In Runners What Is It?

I was just watching an injured runner walk. We were trying to pin down her diagnosis and figure out why she was getting injured.

She asked me what I actually saw when analyzing her gait.

One of the things I saw was that she had this thing called extensor substitution.

She wanted to know how it contributed to the issues she has been having when she was running.

Today on the Doc On The Run podcast, we’re talking about extensor substitution in runners.

#564 Running After Injury Keep Your Head Up

What happens when you look down at your feet as you run?

Many injured runners start looking down toward the injury, even as they run.

What do I mean by that?

We start to hunch over, our running form falls apart, and we do all the things that are completely counter to everything that we know about good running form.

If you’re running after an overtraining injury, you really need to keep your head up.

That’s what we’re going to talk about today on the Doc On The Run podcast.

#563 Achilles Tendon Calcification In Runners With Tendinosis

If you are reading this because you are researching Achilles tendinosis, I’m sorry.

Achilles tendinosis is one of the worst injuries a runner can get.

Tendinosis is a serious problem and must be treated aggressively.

It is helpful to understand what you really need to do.

You also need to understand Achilles tendinosis treatments doctors often recommend, which you might want to avoid.

Today on the Doc On The Run podcast, we’re talking about Achilles tendon calcification in runners with tendinosis.

 

#562 Injured Runners Cannot Find A Solution When Refusing To Look At The Problem

Let’s imagine you got injured. You are recovering. But you want to get your running fitness back.

One of the things that’s really important to think about…is what it takes to ramp up without getting re-injured.

Most runners ignore the weakness that predisposes them to injury in the return-to-running period.

To avoid that common trap, you must track your progress and pay attention to everything.

In this episode, I’m going to let you listen in on a recording from an actual live session in the Injured Runner’s Aid Station explaining the keys to ramping up and running without getting reinjured, while using the advantages that you already have with your runner’s mindset.

Today, on the Doc On The Run podcast, we’re talking about how injured runners cannot find a solution when refusing to even look at the problem.

#561 Which Runners Need A Fracture Walking Boot For Plantar Fasciitis?

In my experience, there are only two types of runners who really need a fracture walking boot to treat plantar fasciitis.

1. Runners who don’t mind losing all their running fitness.

2. Runners who were told they have plantar fasciitis, but actually have been given the wrong diagnosis.

Are you in one of those two groups? Then ask yourself…

Which kind of runners really do need a fracture walking boot for plantar fasciitis?

Is it somebody with mild plantar fasciitis, moderate plantar fasciitis, severe plantar fasciitis?

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

 

#560 Anxiety Robs Injured Runners Of Action

One of the worst things when you’re an injured runner is to stop taking action.

Think about what would happen if you did this with a marathon. If you were to sign up for a race and you didn’t do anything to actually gain fitness in preparation for that event, would you expect to do well?

It blows me away when I see injured runners who have spent years in disciplined training, yet then when they get injured, they just sit in a puddle of inaction that keeps them stagnant and prevents them getting back to running.

Anxiety robs injured runners of action, and that’s what we’re talking about today on the Doc On The Run podcast.

#559 Does A Crooked Toe Mean Plantar Plate Surgery In A Runner?

I got a great question from someone who had a plantar plate injury. His toe was a little bit crooked.

He was wondering whether or not the position of the toe could determine whether or not plantar plate surgery would be necessary.

His question was,

“Do I really need to have surgery if my toe is crooked? Is that a good indicator of whether or not I need plantar plate surgery just because the toe is sitting out of position a little bit?”

I thought it might be helpful to explain when it might actually be necessary to have surgery, and when it might not be necessary to have surgery.

Does a crooked toe mean you have to have surgery for a plantar plate injury?

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

#558 Where To Run With Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain and it’s also one of the most common reasons people actually go to the podiatrist.

The fastest way to get plantar fasciitis to calm down is to reduce the stress and strain to the plantar fascia ligament so that it’ll actually begin to heal.

So if you’re going to try to run, you have to do something to reduce the stress and strain to the plantar fascia ligament, while you’re running to make sure you aren’t over-stressing the fascia.

Today on the Doc On The Run podcast, we’re talking about where to run when you have plantar fasciitis.

#557 4 Things You Need For A Running Injury Second Opinion

Nothing will destroy your running fitness faster than wasting time on the wrong treatment. Second opinions are one of the most effective ways to ensure you are not wasting time monkeying around with the wrong diagnosis, or the wrong treatment.

That’s why I do lots of running injury second opinions over webcam.

Whether you’re seeing me for a webcam visit or if you’re seeing your doctor in your neighborhood, there are four things that you really should make sure that you have together and that you take to get your most valuable running injury second opinion.

Today on the Doc On The Run podcast, we’re talking about the four things you need for a running injury second opinion.

#556 ONLY 2 Times Cortizone Make Sense For Plantar Plate Sprain In Runners

If you are a runner with a plantar plate sprain, you may be really frustrated.

Unfortunately, plantar plate sprains are difficult injuries to get better quickly. One key is to make sure it doesn’t come back once you’re running.

When I do second opinions for runners with plantar plate sprains, they ask…Should I have a cortisone injection?

The short answer is there are only two times when it makes sense to get a cortizone injection around the plantar plate.

Today on the Doc On The Run podcast, we’re talking about the only two times a cortisone injection makes sense for an injured runner with a plantar plate sprain.

#555 Which Belief Is Running Your Injury Recovery?

Faith and doubt are both beliefs.

If you’re taking action to maintain your running fitness, you have Faith you’re going to get better.

If you’re doing nothing to maintain your running fitness it’s because you have Doubt.

No matter what the specific injury, there is always some action, some step you can take to gain confidence, move from Doubt to Faith and start getting back on the right track.

Which belief is running your injury recovery? That’s what we’re talking about today on the Doc On The Run podcast.

#554 Is Resting Overrated For Runners?

Is resting overrated for runners?

The short answer is yes, but I want you to think about something.

If it’s true in training, then it must be true in over-training injury recovery.

Whenever I am speaking at a medical conference and I say this, doctors in the audience tend to cross their arms and glare at me.

It seems even some runners scratch their heads when I say it. But it is true. And I want you to really think about this.

If it is true in your training, then it should be true in your over-training injury recovery. That’s what we’re talking about today on the Doc On The Run Podcast.

#553 Dancer’s 5th Metatarsal Shaft Fracture Training For Boston Marathon

This episode actually comes from Eryn and she’s somebody who was listening to the Doc On The Run podcast and then sent in a question. She said that she was 10 weeks out after getting a dancer’s fracture in the fifth metatarsal while she was trying to qualify for Boston and getting ready.

What she said is, “I’m one week in using my EXOGEN bone stimulator one time a day for 20 minutes. I heard you say that you had a runner who healed after two weeks using the device.”

She also wanted to know about, “What else was your patient doing? Did they follow the standard protocol? Was he taking any supplements or other treatment to help the bone?”

Today on the Doc On The Run podcast, we’re talking about a dancer’s fifth metatarsal fracture in a runner who was training for Boston.

#552 4 Strategies For Running Injury Recovery

All day long I talk to injured runners and help them figure out what they could be doing differently to get back to running as quickly as possible.

I have realized is that the majority of injured runners are choosing, or have been told by a doctor, to follow one of four different running injury recovery strategies.

Today on the Doc On The Run podcast, we’re talking about the 4 strategies for running injury recovery.

#551 Running Is NOT An Effective Weight Loss Strategy With Patrick McGilvray

In today’s podcast we have Patrick from the Running Lean Podcast here on the show, and you’re going to love this episode.

Patrick McGilvray is a podcast host, Licensed Primary Sports Nutritionist, NASN Certified Personal Trainer, UESCA Certified Running Coach, Master Life & Success Coach, experienced marathoner and ultrarunner, and The Weight Loss Coach for Runners.

Patrick helps runners properly fuel their bodies and their minds so they can achieve peak performance and optimal health and fitness.

Today on the Doc On The Run Podcast we’re talking about how “Running is NOT an effective weight loss strategy.”

#550 Leg Soreness From Balance Training For Runners

I was just on a call with a guy who signed up for the Runner’s Aid Station and one of the things we were talking about is he had noticed that while he was doing some specific exercise I gave him to restore some of the balance to actually make him a little more stable and more efficient.

He noticed he was getting a lot of soreness in his leg.

He was actually explaining what he was getting in terms of muscle soreness and we discussed whether or not it was really a problem and something you really need to pay attention to.

Today on the Doc On The Run podcast, we’re talking about soreness in your leg when you’re working on your balance and you’re trying to get back to running after an injury.

#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.

 

#548 Get Back To Running In 30 Days With Jill Angie Not Your Average Runner

When other doctors ask me what I do, I tell them rather simply I help runners figure out how to stay fit, hang onto their running fitness and get back to running as quickly as possible.

The other day I was talking to a woman, who wanted my help and wanted to schedule a consultation, and she committed what I call the cardinal sin of runner-self-criticism.

She said, “I know you only work with runners. I only ran 2.65 miles yesterday, and so I am not really a runner.”

When she said that, I not only immediately thought of Jill Angie from the Not Your Average Runner Podcast…but I found myself quoting her!!!

The very next day I asked Jill if she would come back on the show to share some of her insight, wisdom and glowing energy with all of you today.

Today on the Doc On the Run Podcast, we’re talking about how you can get back to running in 30 days.

 

#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.

#546 Waiting For X-Ray Of Stress Fracture Miss The Window

The worst runner to call me for a second opinion is someone who has been in a fracture walking boot or not running for 12 weeks or so.

Why is that so bad?

Well, they’re extremely aggravated. They’ve seen at least one doctor, probably a bunch of times. They’ve probably had several x-rays.

They’ve been waiting and waiting but they’re not getting better and they’re very upset about that.

Today on the Doc On The Run podcast, we’re talking about how waiting for an x-ray can cause you to miss your window with a stress fracture.

#545 Tendon Surgery For Plantar Plate Repair

If you are a runner and you’re thinking about surgery, you’re probably maybe thinking about a second opinion, but maybe just doing your initial research, but some doctor has probably already suggested the idea of surgery to you.

This is one of the four categories is tendon surgery and we’re going to talk a little bit about that, about what it means, what tendon is actually operated on and what the procedures really entail so that you can understand that a little bit better.

Today on the Doc on The Run podcast, we’re talking about tendon surgery for plantar plate repairs.

#544 Stress Fracture Wishes As Fodder For Facts

In this episode we’re talking about stress fractures and we’re talking about what happens when you as a runner, wished something to be true and it’s not a fact.

It’s really important that you understand this.

Some of the wishes are things like, well, I want to run. The second one is I don’t want there to be a crack on my x-ray. Some facts are, well, my podiatrist took an x-ray and there was no crack.

So what does that do?

Today on the Doc On The Run podcast, we’re talking about stress fracture wishes as fodder for facts.

#543 2 Joint Surgeries For Plantar Plate Repair

In today’s episode we’re talking about two different joint surgeries that are commonly performed as a component of plantar plate repair in injured runners.

This is a really important thing to understand. There’s two different kind of procedures. They both have different risks and benefits, and we’re going to talk briefly about them so you at least know what they are.

So if your doctor tries to sell you one of these procedures, you can at least know what you’re buying.

Today, on the Doc On The Run podcast, we’re talking about two different joint surgeries for plantar plate repair.

#542 How To Avoid Bias During Running Injury Second Opinion

In today’s episode we’re talking about bias and bias, of course, is where somebody is already kind of made up their mind about what should be going on with you.

They’re biased, they’ve got a slanted opinion and that opinion is based on something other are than exactly what is going on with you.

When you get a second opinion, bias is the worst possible thing, because it’s very difficult for a doctor to change their mind once they think they know what’s going on.

Today on the Doc On The Run podcast, we’re talking about bias in second opinions for runners and how you can avoid it.

#541 4 Surgical Procedures For Torn Plantar Plate Ligament

In today’s episode we’re talking about the four classes of procedures that affect four different anatomic structures in your foot when you have a plantar plate injury.

I think t’s really helpful if you’re really frustrated, you’re really demoralized and you’re in this very vulnerable place where it’d be easy for a doctor to talk you into surgery without you really understanding what’s going on.

That’s what we’re going to talk about today is give you a basic understanding of the four different kinds of surgeries that are offered to patients with these injuries so that you can make a better decision when you talk to your doctor.

Today on the Doc On The Run podcast, we’re talking about the four types of procedures you might get offered as surgical correction for a plantar plate sprain.

#540 No Proof No Permission To Run

I get questions all the time, daily almost, where somebody will send me a message and they’ll say, “Well, I saw a doctor and they said I had this injury, and they said that I couldn’t run for six weeks. Would you let me run?”

Well, the answer is no.

There’s a reason doctors don’t give you permission to run, and there are really four ways that you can tell, ways you can get permission. I think it’s important to talk about these four ways that you can actually get permission to run.

No proof, no permission to run. That’s what we’re talking about today on the Doc On The Run podcast.


#539 Restarting And Running Again After Surgery With Martha Runs The World

A couple of years ago Martha was on the podcast talking about how hip arthritis has impacted her running and how she has been able to gain a different perspective on her running goals.

She is the host of the Martha Runs The World Podcast.

In this episode we are talking about some basic principles and strategies for resuming running after surgery or a major over-training injury.

Today on the Doc On the Run Podcast we’re talking about restarting and running again after surgery with Martha Runs The World.

#538 Marathon Method Of Running Injury Recovery

This is the thing I came up with when I actually was thinking about what I do differently with runners now that I’ve been for about a decade, basically focusing just on injured runners, what do I do differently than when I had a normal practice where I saw everybody with any kind of foot problem?

Let’s think about what happens when you decide to run a marathon. Nobody just wakes up and says, I think I’m going to run a marathon today, it doesn’t work that way. What usually happens is you have something that triggers your desire to actually run a marathon.

We all know it’s really a big goal, we know it’s inspirational, and you decide that you want to do a marathon.

So, what do you do?

Today, on the Doc On The Run podcast, we’re talking about the Marathon Method of Running Injury Recovery.

#537 Runner’s Heel Pain That Might Be Plantar Fasciitis Or Insertional Achilles Tendinitis

Today’s episode actually comes from something I read in one of the running forums where someone actually was saying that they were confused.

They had been to see a couple of different doctors and had a couple of different recommendations because they had heel pain.

The heel pain was in a little bit of an unusual area, the heel pain wasn’t exactly on the bottom, the heel pain wasn’t exactly on the back and it was sort of in the middle, right at the back of the heel where it curves around and they wanted to know what to do.

Is it plantar fasciitis or insertional Achilles tendonitis? That’s what we’re talking about today on the Doc On The Run podcast.

#536 Success Is Spelled ACTION With Gary Stotler

Several years ago I had the honor of speaking with Gary and interviewing him for an episode of the Doc On The Run Podcast, called From 400 Pounds To Running 100 Miles.

At one point in his life Gary, was seriously overweight and weighed about 400 pounds. But he was able to not only lose that weight, he became a 100 mile ultramarathon finisher and even did Leadville.

Gary’s not just an incredible athlete but he’s also a personal development expert. Today were really fortunate to have him back on the show to share his wisdom, experience and inspiration
with you today.

“Success Is Spelled Action” and that’s what we’re talking about today on the Doc On The Run podcast.

#535 Plantar Plate Sprain Misdiagnosed As A Neuroma?

Let’s say you have this aching pain in the ball of your foot. You’ve been running and when you run, you get some sort of weird aching soreness in the ball of the foot.

You just know it’s in the middle of the ball of the foot and it hurts more when you run and it hurts kind of after you run.

Well, you go see a doctor. They look at you, they poke around, and they say, “I think you have a Morton’s neuroma.”

Then later you figure out either because you got a second opinion, either or you sign up for the Plantar Plate Masterclass and went through those things and started self-diagnosing you figure out that you actually have a plantar plate sprain.

You get really confused about why it is that someone would misdiagnose you with a neuroma.

Can a plantar plate sprain be misdiagnosed as a Morton’s neuroma? Well, that’s a great question, and that’s what we’re talking about today on the Doc On The Run podcast.

#534 Best Protocol For Runners Is A Customized Recovery Plan!

I was just giving a talk recently at the IFAF where I was talking about protocols that I use with injured runners to help them get back to activity after common foot and ankle injuries that happen to runners.

The thing is, and what I was telling them is there are a few things that I use as protocols. When I say my protocol or a doctor says protocol for a stress fracture is six weeks in a boot or two weeks on crutches, that is their protocol and that is a cookie-cutter treatment plan.

So in many ways, those decisions are made before you even show up and see the doctor.

But what you really need is a customized treatment plan.

The best protocol for injured runners is a customized recovery plan and that’s what we’re talking about today on the Doc On The Run podcast.

#533 What Is A Grade 5 Metatarsal Stress Fracture?

If you’re a runner and you think you have a grade five stress fracture because your radiology report said that or some doctor told you that, well, I have some good news and some bad news.

The good news is, is that you don’t even have a stress fracture if you have a grade five stress fracture. It’s not a stress fracture at all.

The bad news is, is a grade five stress fracture, is what we call a non-union, where you had a stress fracture, but that stress fracture actually failed to heal.

You have basically an unhealed, and probably not going to heal, stress fracture, unless you do something.

What is a grade five metatarsal stress fracture? Well, that’s what we’re talking about today on the Doc On The Run podcast.

#532 3 Best Methods Of Diagnosing Extensor Tenosynovitis In Runners

What are the three best ways to diagnose extensor tenosynovitis in runners?

Well, it’s pretty simple. They’re really three ways that I think are effective and they can work, all of them.

It’s not necessarily true that one is better than another, but they all three can work.

Today on the Doc On The Run podcast, we’re talking about something really simple, it’s the three best methods for diagnosing extensor tenosynovitis in runners.

#531 If You Are Recovering From Injury…Don’t Focus On Plan B!

The way that I thought about this episode today is that I just got off the phone, I was on a consultation with a runner and he has a plantar plate injury and he was planning on getting an injection to help the plantar plate sprain heal a little bit faster.

He asked me a question that really stopped me in my tracks. He said, “How long should I give it before I throw in the towel?”

I thought, well, are you planning for this to not work? I actually literally asked him that, I said “If you’re thinking about when you’re going to decide that this hasn’t worked, that means you have to be planning for it to not work.”

Today on the Doc On The Run podcast, we’re talking about why you should not focus on plan B.


#530 2 Ways To Modify A Fracture Walking Boot For A Plantar Plate Sprain

This is a great question that I got from somebody on a call who actually signed up and enrolled in the plantar plate class for runners.

He was going through the plantar plate course and he was actually trying to figure out what to do, and he was going to jumpstart the healing process by using a fracture walking boot.

He tried it on and he noticed that he was feeling some pressure because the inside of the fracture walking boot is basically flat.

Today on the Doc on the Run podcast, we’re talking about two ways you can modify a fracture walking boot if you have a plantar plate injury.

#529 The Best Free Advice For An Injured Runner

I recently got a call from someone who had a son who was in cross country and he’s been having some trouble. He’s had several weeks of not running, and she wanted to get some advice on what to do.

I got an interesting response via email, where she wanted to know what free advice I had for her son.

First of all, I don’t give advice when I don’t know what the problem is. I didn’t really know the story with her son.

We didn’t do a consultation, and no physician is going to give you advice if they don’t actually know what your circumstances are.

Today on the Doc On The Run podcast, we’re talking about the best free advice for injured runners.

#528 Should I Use A Boot For Shin Splints

Believe it or not, most of the time when I see a runner, either on webcam or in their home, and they have shin splints, and they’ve been given a fracture walking boot, they need the fracture walking boot and maybe even more.

But what that really tells me when a doctor says you have shin splints but you need a boot, that it’s really that the doctor is uncertain about the actual diagnosis, because in my view, most of the time, if you have shin splints, you do not need a fracture walking boot.

Should I use a fracture walking boot for shin splints?

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

#527 Pain Is A Guide But Only If You Read The Signs

I was just lecturing at the IFAF meeting in Lake Tahoe and I was giving a couple of different lectures on running injuries, and one of them was about the protocols that I use with injured runners so that they can maintain their fitness, stay fit, stay active, and keep running.

One of the doctors asked me about how I make these decisions and I explained to them was that the worst piece of advice I myself ever received as someone who was injured was when this doctor told me, “Just let pain be your guide.”

How can you as an injured runner use pain as your guide? Well, that’s what we’re talking about today on the Doc On The Run podcast.

#526 Is A Boot Enough For A Tibial Stress Fracture In Runners?

Today’s episode is going to be a good one for you to listen to, if you’ve been told that you have a tibial stress fracture, or if you just think you might have a tibial stress fracture.

If you get a tibial stress fracture, the chances are really good that the doctor’s going to do something to really restrict your running, and potentially your ability to move around at all.

For example, if you get a fracture walking boot and it’s on your right foot, well, you can’t even drive a car so you’ve got to take this seriously.

Is a fracture walking boot enough when you have a tibial stress fracture and you’re a runner?

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

#525 Nothing In Medicine Is Free Especially With Running Injuries

One of the phrases I often tell injured runners is that “nothing in medicine is free.”
For every potential treatment that might help some particular injury, you pay for it in risk.
A fracture walking boot is one of the simplest and most-often-prescribed treatments for overtraining injuries in runners. And although fracture walking boots maybe inexpensive, treating your running injury with one is definitely not free.
Today on the Doc On The Run podcast, we’re talking about how nothing in medicine is free especially with running injuries.

#524 3 Ways Plantar Plate Injuries Occur In Runners

Today’s episode actually comes from a question sent in by Shay.

She said, “I have a plantar plate complete tear and I had surgery on my left foot in October 2019. So that was a couple years ago. I’m running with some new issues in the right calf, but the main thing I want to learn is how this injury occurs. I’m really afraid of it happening to my right foot.”

I talk to injured runners all the time. I lecture at medical conferences, teaching doctors what I do with runners who have these plantar plate injuries and Shay is reasonable to be concerned about this.

Today on the Doc On the Run podcast, we’re talking about the three ways plantar plate injuries occur in runners.

#523 Finally The Correct Answer On How Long Before You Can Run After Injury

This weekend I was lecturing at the International Foot & Ankle Foundation meeting in lake Tahoe, and I was lecturing on running injuries.

At the beginning of that lecture, I was asking the group of doctors there and I said, “Well, if you had a runner with a fourth metatarsal stress fracture and they had this level of pain and this level of disability and this level of complaint about it, how long would you expect to have them in a fracture walking boot?”

There was a doctor from Flagstaff, Arizona who actually raised his hand and he said, “It depends.”

I was shocked because normally, people say four weeks or six weeks.

Today on the Doc On The Run podcast, we’re talking about how I finally got the correct answer on how long before you can run after injury.

#522 How Long Until A Plantar Plate Sprain Is Completely Healed?

I just got off the phone with a runner who had a plantar plate sprain. He was out on a run, he got a plantar plate sprain.

I saw him, I helped him understand what to do and what I showed him to do was exactly the same stuff I show you in the plantar plate sprain course.

He was doing much better, but he had a great question.

His question was, “When is my plantar plate sprain really healed enough that I don’t have to worry about it anymore?”

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

#521 Running Fitness Is Transient

Yesterday I was giving a lecture at the International Foot & Ankle Foundation meeting in Lake Tahoe. The topic was on protocols for return to running after recovering from over training injuries.

One of the most important points I was trying to make to the doctors in that session was that fitness is transient.

Fitness is only present in the presence of growth. If you’re an injured runner this is terrible news.

Today on the Doc On The Run podcast, we’re talking about why running fitness is transient.

#520 Why Do Plantar Plate Sprains Take So Long To Heal In A Runner?

One of the worst overtraining injuries you can get is a plantar plate ligament sprain.

The plantar plate ligament is a very small ligament on the bottom of the foot, where the toe attaches to the metatarsal phalangeal joint, right at the ball of the foot.

Injuries can happen in this spot for lots of different reasons. Regardless of the plantar plate sprain cause, the unfortunate reality is this…every single time that you stand, you’re stepping on the ligament.

Why do plantar plate sprains take so long to heal?

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

#519 Injured Runner Or Recovering Runner?

There are 2 types of injured runners who call me.

Some runners are over the hump. They are in motion.

They’ve accepted that they’re injured and they’re going to have to do a whole lot of work to actually get back to running quickly.

Then there are other runners I see who are basically demoralized and depressed because they’re stuck in a rut. Are you an injured runner or a recovering runner?

There is a difference, and that’s what we’re talking about today on the Doc On The Run Podcast.

#518 How Long To Wait Before Running With A Stress Fracture?

I got a question from a runner who’s had a metatarsal stress fracture who’s very frustrated, who’s trying to figure out how to get back to running.
He went and saw a doctor and he was told that he had a stress fracture and the doctor told him to take some time off of running.

Then he started watching some YouTube videos, started listening to some podcasts, and then asked me a very serious question:

How long do I have to wait to run with a metatarsal stress fracture?

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

#517 I Am Not Built To Be A Runner

I just got off a consultation call with a runner who called me for a second opinion. She had an injury. But she wanted to get back to running.

She said that a doctor told her she “wasn’t built to be a runner.”

Could that be true? What does a runner look like?

Does it make sense that you are (or are not) built like a runner?

​​​​​​​And what if you start thinking you got injured because… I’m not built to be a runner.

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

#516 Rest = Recovery

In this podcast episode we’re talking about one of my favorite false beliefs.

“Rest Equals Recovery.” The idea that rest is essential to recovery after a workout makes sense to most runners.

But injured runners call me for a second opinion when they are told that complete rest is essential to recovery from a running injury. It seems excessive.

So why do I say “Rest equals recovery,” is a “false belief?” That’s what we’re talking about today on the Doc On The Run podcast.

#515 I Cannot Run Because It Got A Running Injury

In this episode we’re talking about whether or not you can’t run just because you got a running injury and this is a thing I hear all the time from injured runners.

They call me because they’re frustrated because they’re runners, they got a metatarsal stress fracture, or a plantar fasciitis, or a plantar plate ligament sprain, or Achilles tendonitis.

They say, “My doctor said I can’t run because I got a running injury. Does that make sense to you?”

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

#514 The Slippery Slope Of Running Injury Recovery

A running injury is always bad. No runner is ever happy to have a stress fracture or to have plantar fasciitis or Achilles tendonitis…or something worse.

If you get an overtraining injury and you’re trying to recover, but you’re not getting better fast, you need to stop and evaluate.

The biggest problem I see with most injured runners is that they half do the recovery.

You stop running. You stop working out. All you do is sit around.

You are waiting and waiting and waiting to heal. But all of that waiting puts injured runners in a dangerous place.

Today on the Doc On The Run podcast we’re talking about the slippery slope of running injury recovery.

#513 Should A Runner Have Surgery For A Plantar Plate Tear?

If you are a runner with a plantar plate injury, it is pretty easy for a doctor to make a convincing sales pitch on surgery. There are a couple of reasons that you should consider surgery for a plantar plate sprain.

The first reason surgery makes sense is you tried everything else and nothing non-surgical will work.

But you have to be honest about your non-surgical attempts.

Here are some examples I often hear from injured runners.

“I used the fracture boot a little bit, but had to take it off to drive.”

I “sort of taped the toe.”

I used some pads, “but I’m not sure if they are in the right spot.”

You have to be honest with yourself about those treatments before you can say that you failed those treatments. that.

But when you have clearly failed all of the non-surgical treatments and you cannot get better, then and only then does surgery makes sense.

Should a runner have surgery for a plantar plate injury?

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

#512 Should An Injury Runner Assess Running Form?

I was recently doing a webcam call with an injured runner who wanted to know whether or not he should try to work on his running form.

He got injured and he started to get better. But the injury kept coming back. He was in a cycle of yo-yo healing. Better, then worse, then better again.

After a big race he got a lot worse. His question was whether or not working on his running form might help halt the recurring running injury cycle.

Should an injured runner work on running form?

Well, that depends and that’s what we’re going to talk about today on The Doc on the Run podcast.

#511 Can A Stress Fracture Spread From One Metatarsal To The Bone Next To It?

One thing that’s really demoralizing if you get a stress fracture is to spend a bunch of time in a fracture walking boot and then go get something like an MRI and be shocked and horrified when the doctor says, “Well, not only do you have a stress fracture in that bone, it looks like you’ve got a stress fracture in another bone as well.”

If you think this stress fracture might have spread well, it could. But not the way an infection would spread.

There is a way that stress related inflammation in a neighboring bone can spread after getting the original stress fracture.

Can a stress fractures spread from one bone to another?

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

#510 How To Take An Honest Injury Inventory For Runners

I was just on a call with an injured runner who’s been having trouble for a couple of months. He wanted to know what to do next.

The very next step in most cases is getting baseline numbers so you can figure out where you really are with your fitness, your injury, and your recovery…or lack thereof.

You’ve got to take an honest inventory!

The whole key to getting recovered as quickly as possible is letting the injury heal…while you work to maintain your running fitness so that you can get back to running faster.

Today on the Doc On The Run podcast, we’re talking about taking an honest inventory when you’re a runner with an injury who’s trying to get back to running.

#509 How To Tell Tenosynovitis From Neuritis In A Runner

If you’re a runner with running pain on the top of the foot, it could be lots of different things.

The actual diagnosis depends on what happened, what you did, and what it feels like now.

There are a couple of really common things causing pain in the top of the foot in runners.

Let’s talk about two common causes. It may be either a tendon or a nerve on the top of your foot.

Today on the Doc On The Run Podcast, we’re talking about how a runner can tell tenosynovitis from neuritis in the top of the foot.

#508 Injury Hackers Are Not Normal

If you’ve got an overtraining injury and you’re trying to figure out how to stay fit, a lot of people are going to think that you’re not normal.

You’re not going to be told that you’re normal when you’re trying to figure out how to maintain your running fitness while you’re recovering from a running injury and that’s exactly what all the people do that I work with.

I call them injury hackers.

Today on the Doc On The Run Podcast, we’re talking about how injury hackers are not normal.

#507 Good News And Bad News

I just saw a comment on our YouTube videos from a runner named Mary. She viewed the video on permanent calf atrophy, and how that can happen if you spend way too long in a fracture walking boot or a cast.

Mary replied and basically said, “Great. Now you depressed the crap out of me. Thanks. Ugh.”

Realizing that you have lost fitness to the point of atrophy can be really upsetting for any runner.

Well, I’ve got some good news and some bad news for you, and that’s what we’re talking about today on the Doc On the Run podcast.

#506 Can I Run With Jones Fracture?

If you’ve been running and you started having pain on the outside of your foot and then you went to see a doctor who diagnosed you with a thing called a Jones fracture, you’re probably really worried right now and that would be reasonable because most of the time when you get a Jones fracture you might wind up in surgery.

I think it’s important, if you’re considering whether or not you could run with a Jones fracture, you really have to think about what a Jones fracture is, where it’s located, why it’s so scary, and what you can do about it. The first thing is, of course, what is a Jones fracture exactly?

Can I run with a Jones fracture? Well, that’s what we’re talking about today on the Doc On The Run Podcast.

#505 Can I Ski With A Metatarsal Stress Fracture?

This may seem like a crazy question when you first think about it, because skiing seems like a high stress activity. But I have had lots of runners who have asked me this question, and usually when they do, they have thought about it, and they point out that a ski boot is a very stiff and very protective piece of equipment.

The question though is not really, if it’s safe for you to wear the boot, the problem is, is it safe for you to ski with the boot and that leads to several questions that you’ve really got to ask yourself if you want to think about whether or not it’s actually safe for you to do it.

Can I ski with 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.

#504 The 2 Most Important Questions For Recovering Runners

If you rest long enough any overtraining injury will eventually calm down.

But if you rest too long, you will lose all of your running fitness.

The difference between elite athlete who get better fast, and average runners who take forever to recover are the daily activities they focus on while recovering.

Today, on the Doc on the Run podcast, we’re talking about the two most important questions for recovering runners.

#503 First Aid For Metatarsal Stress Fracture In A Runner

Let’s say you’re out on a run and you start noticing this weird aching pain in your foot and so you suspect you have a metatarsal stress fracture. I often get consultation calls and webcam visits, and I even do house calls for athletes who have metatarsal stress fractures.

The good news is that a lot of the times, if you actually do something, when you first notice that aching pain in your foot, when you’re running, it may not actually be a true stress fracture.

Today on the Doc On The Run podcast we’re talking about the five most important things you can do for first aid for a metatarsal stress fracture if you’re a runner.

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