Doc On The Run Podcast

Non-steroidal anti-inflammatory drugs (or NSAIDs for short), like Ibuprofen and Naproxen, what we call  are extremely popular with runners because they get rid of lots of aches and pains.  We often think inflammation results from hard exercise, so it stands to reason a non-steroidal anti-inflammatory will actually help after a long run. I don't normally recommend runners take NSAIDs as a part of a...

I had a call with a runner who asked me an interesting question about the difference between a mild stress fracture and a serious stress reaction in a runner. She wanted to know if the difference was based on the amount of tenderness or pain that she had.  Although it stands to reason that the more tenderness, the more pain you have, the worse it must be. However, that is not really what different...

If you get gout, it's going to be painful. It hurts because you get so much uric acid buildup in your bloodstream that it starts to crystallize, forming little bitty needle shaped crystals in the joint. They are pointed, they're sharp and they are poking the tissue on the synovial tissue inside of the joint, and it hurts.  When is the worst time to check for gout with a blood test?  Well, that's w...

Every runner who has heel pain wants it fixed.  A lot of us think about this in the way that we fix automobiles. The alternator goes out in your car, you go get a new one put in. Your battery dies, you go get a new battery. But your foot doesn't work this way. So unfortunately, when you have surgery, you're trading one problem for another. I have done endoscopic plantar fascia release surgeries, b...

If you have a tear in the plantar fascia, you probably know what a frustrating injury it can be. If you think it's better, and you're going to start running, one of your big questions is probably,  “How do I avoid a second tear in the plantar fascia?”  That's a great question and that's what we're talking about today in the Doc On The Run Podcast. 

If your doctor said you have gout, you might have heard about a gout specific diet.  A gout diet is not a specific diet in terms of a plan. It's avoiding foods that are high in purines that can contribute to high blood levels of uric acid. What is the most ignored part of a diet for somebody who's a runner and thinks they have gout?  Well, that's what we're talking about today on the Doc On The Ru...

Don't ever forget that when you get a running injury, the goal is not to heal the injury. The goal is to get back to running.  If you heal the injury and you get so weak and so stiff, that you wind up getting another overtraining injury, that is a failure.  The thing you have to really think about as you're returning to running isn't just about the possible other injuries you could get but incompl...

Why would you want to add stress?  We're not talking about psychological stress. We're not talking about the stress of a screaming baby or a boss yelling at you.  We're talking about stress on the tissues that will actually stimulate a healing response that makes them stronger later, just like working out.  If you're an injured runner who's getting back to running, you need to add stress systemati...

One of the problems with the plantar fascia is that you may think you have plantar fasciitis, but eventually you find out that it was not really fasciitis at all. It's actually a partially torn plantar fascia ligament. That can be a problem since it is the largest ligament in your foot. When somebody says: “Can I run with a small tear in the plantar fascia?” I say that depends. Is it a big deal if...

When you have a running injury and you know what your goal is you are halfway there. But if you're trying to get back to running, you've really got to do three things. You have to start moving, not make the injury anything worse, and you've got to get fit as fast as possible. Every day is a test run after you've healed a running injury. That's what we're talking about today on the Doc On The Run P...

One of the problems with being a runner is that you have a higher pain threshold.  If you have a minor attack of gout, it may not bother you as much as it would other people and what Gout is, is that you get painful crystals forming within a joint like the big toe joint. If you have what we call sub-acute gout, meaning it's not really killing you, it's just kind of a minor thing that's building up...

A runner called me to follow up and asked: "I've been doing the routine that we discussed during our first call and I've got no pain, I’ve got no tenderness. How can I tell if I'm really ready to run now without hurting it?” You have to realize that if you run and you are weak and unstable, you are at higher risk. Those gaps in recovery create unnecessary risk. You have to figure the pieces you ha...

Your doctor might recommend custom orthotics if you're an athlete, and you happen to be pregnant.  When you get pregnant, you have lots of hormones going through your systems that can cause ligamentous laxity.  The reason that's a problem if you're a runner is that you have rapid weight gain during pregnancy. That weight combined with additional relaxation in your feet can accentuate mild foot pro...

Today we're talking about the Yasso 800's developed by a guy named Bart Yasso.  I was lucky enough to meet him after he gave a talk before the Salt Lake City marathon back when I was in residency about 20 years ago. In any event, this workout is a useful way to analyze your fitness and determine your marathon pace. Yasso 800's can be really helpful to an injured runner who's returning to running w...

Today's episode comes from one of the YouTube viewers who was watching a video called "Can I run with a split peroneal tendon?" I was trying to explain the circumstances when you can run with a split tendon, and when you really shouldn't.  He wanted to know if his doctor could tell whether or not he needed surgery just by looking at his ankle.  “The MRI tells me I have a split tear. So, presumably...

This episode comes from a consultation call on webcam with a runner with a sesamoid stress fracture.  Interestingly, his doctor wasn't even sure what it was, if it was really a crack in the bone that wasn't healing, or if it was what I call a "sprain" of the bipartite sesamoid.  Today on the Doc On The Run Podcast we're talking about how big toe positioning can actually help a medial tibial sesamo...

Today's episode comes from Benda, who was watching a video called "12 steps to healing and running with a metatarsal stress fracture" on the Doc On The Run YouTube channel.  She asked a question,  “I'm so confused. I don't have a stress fracture. It was an acute injury. I have a half marathon in early December. Is there hope for me?” I got injured five weeks out from my half marathon. Is there hop...

I recently got a comment from Michael on a video on the Doc On The Run YouTube channel which was about how fracture walking boots are one of the worst treatments for an injured runner.  He posted an interesting comment which is really a valid question. He said,  “What is the boot for? Is it for protection? Is it for immobilization? Is it to keep weight off?" What does a fracture walking boot actua...

I recently got a great question from someone who was watching one of the videos on sesamoid fractures. Underneath the big toe joint, you have two little bones called sesamoid bones.   Sometimes you can get a fracture or crack in the bone that doesn't heal. Then it turns into what we call a non-union.  Some people have sesamoids called "bi-partite" sesamoids. It looks like a fractured sesamoid. But...

Stress fractures are the most common overtraining injury I treat in runners.  If you're a runner with a stress fracture, your first question is probably "When can I run?" Since the answer is always, "When it is healed enough to withstand running..." Your second question is likely “What can I do to heal a stress fracture as quickly as possible.”  But if you heal it, get back to running and then get...

If you are a runner struggling with a plantar plate sprain, it is probably going to be extremely frustrating trying to get it to heal so you can get back to running.  The plantar plate a very small ligament. It does not have a great blood supply. Every time you take a step, you put pressure on the plantar plate. Every time your heel comes up off the ground when you walk, you stretch the plantar pl...

Just last week, I was giving a lecture at the International Foot and Ankle Foundation meeting in Hawaii. The lecture was on Conservative Management of Ankle Sprains in Runners Who Want to Run. One of the worst things that can happen to a runner with an ankle sprain is that you can lose what we call proprioceptive ability. But that is preventable. What would you do if I told you, you can reduce you...

In today’s podcast episode we're talking about fracture healing versus skin healing. This talk comes from a discussion I had at the International Foot and Ankle Foundation meeting in Hawaii where I was recently giving a lecture on Runner's Heel Pain to a whole roomful of doctors.  A doctor asked me a question about how to get a runner back to running as quickly as possible after injury.   What do...

If you get a fracture of one of the metatarsal bones in your foot, you are not going to be able to run until it heals.  But as soon as it's healed, you will want to start running again.    You may have recently seen the episode that I did where I was talking about how ultrasound may show signs of healing sooner than X-rays.   How much earlier can ultrasound show healing of a fracture as compared t...

I was just lecturing at the International Foot and Ankle Foundation meeting in Hawaii. One of the podiatrists came up to me and asked me a question after one of the sessions. He said that he was going to be working with a local high school cross-country team. He wanted to know what I thought would be the most important things to share with cross-country runners to try to reduce their risk of injur...