Doc On The Run Podcast

During a recent call with a runner who signed up for a series of phone calls, we were trying to figure out exactly what happened to cause his foot pain.   The way that doctors are taught to think goes something like this:  Come up with a particular name called a "diagnosis" and then do a "procedure" that the insurance covers.  Doctors focus on making sure the diagnosis code matches the insurance r...

One of the most common nerve related running injuries is a thing called Morton's neuroma. A "neuroma" is just an irritated nerve. A "Morton's neuroma" occurs specifically in the foot between the 3rd and 4th toes. When a neuroma first starts, the nerve is just a little bit irritated, and it may feel a bit weird. In one of the original descriptions of Morton's neuroma, it described a sensation or fe...

If you have a soft tissue injury in your foot related to overtraining, you (or your doctor) may be thinking about getting an MRI. If you have a ligament injury, plantar plate sprain, partial tear of the plantar fascia, an Achilles tendon partial rupture, Achilles tendinosis, or peroneal tendinitis,  the timing of the MRI is extremely important. MRIs can be really useful tools. They give you over a...

I was just on a call with a runner who has a plantar plate sprain. A plantar plate sprain is an injury to a very small ligament right at the base of the toe, usually the second toe, right where it attaches to the metatarsal at what we call the metatarsophalangeal joint.  That sprain typically causes aching in the ball of the foot. These are tough injuries to get better. I have had one myself, and...

I just got off the phone with an elite athlete recently who asked a great question. He called me and said, "I have custom orthotics and I know they support my foot better. So the question is, can I use a broader range of shoes?" What he really wants to know is whether or not he can ONLY use motion control shoes. He was really asking, "Since I have an unstable foot that's now stabilized by the cust...

One of the things about getting an MRI has to do with timing of the injury. What do I mean by that? Well, it means timing in terms of when the MRI is done relative to how long it has been since you actually beat it up and injured that structure. When is an MRI most reliable for a bone running injury like a stress fracture? Well, that's what we're talking about today on the Doc The On Run Podcast.

Every time I talk to a recovering runner who is trying to figure out how to run, and help figure out what's causing all their trouble, I ask them to keep a pain journal. Why do you think that is? Pain is the lowest cost, most abundant, and most underutilized diagnostic resource available to help an injured runner guide the recovery. Imagine a contest between doctors trying to get injured runners b...

When you get a stress fracture, you have to remember that it is a stress related injury. That's why it's called a "stress" fracture. It is not a "run-too-much" fracture. It is not a "ran-too-far" fracture. It is a "too-much-stress" fracture. So, if you want to know whether or not you're at risk of getting one as you ramp up your training, one of the simplest things you can do is look at your runni...

If you get an overtraining injury and your doctor tells you to stop running, so you sit still doing nothing, lots of bad things happen.    If you stop running, you will feel terrible physically. Zero exercise makes athletes feel worse.  Additionally, you're probably going to get super grumpy. Don't be surprised if your spouse, your kids, and your friends start to think you're being a little bit of...

A runner with a calcaneal stress fracture has a problem. So we got on a call.  The problem with calcaneal stress fractures is not healing. The heel bone "heals" fast! Runners with calcaneal stress fractures really have 2 problems: 1. How do I let the heel bone heal fast 2. How can I fix the scarring that happens during step 1? I was recently doing a call with a real runner who had a calcaneal stre...

If you recently got an MRI and then looked at the MRI report, it may seem like a bunch of gibberish.  What you really want to see is a picture of the actual injury. So you do the most reasonable thing...you try to look at the actual MRI images to see if you can see the stuff mentioned in the report. You put your MRI disc in your computer, or you go on an online viewing portal and you pull up your...

Let's say you're out on a run and you start feeling some aching pain in your foot. The next day you wake up, it really hurts when you step out of bed.    You go see a doctor and you're told you have a stress fracture.  Being told you have a stress fracture is a real bummer because the doctor will probably tell you it will take about six weeks to heal. Then things get worse... You are told you need...

An injured runner called me with a problem. "I rolled my ankle and it hurts HERE. The explanation from my doctor didn't make any sense, because the pain on the top of my foot is not where the trouble was on the X-ray."  I asked for some pictures showing where he felt the pain. And then it started to make sense.  Ankle ligaments are not the only structures that get injured when you roll your ankle!...

If you're a runner who got injured and got an MRI, I'll bet that you've already tried to look at it...but you have simply no idea what you're looking at.  You see there are more than a hundred images of your foot on the MRI. So, you're not even sure where to start. MRI's can be really overwhelming! But MRI images are not really that complicated.    In this series on how to read your own MRI, I'm g...

If you're injured, you really need to have a goal. If you were to call me for a private consultation or a house call, I would not accept "I want to get over my foot pain" as a goal. But interestingly, when injured runners call me, that's often what they say.  Think about this. When you sign up for a race, it's really easy to get motivated. It's easy to decide on your training plan and just get to...

Today's episode comes from a recent question from a runner who I advised to begin running on this thing called an AlterG treadmill.    First of all, I do not own an AlterG treadmill. I do not own the company. I don't own stock in the company. I do not get paid a referral fee or anything else if you use one.    I'm not pitching the AlterG treadmill because I get paid for it.    But the AlterG tread...

You and your brain are supposed to be on the same team. You work hard with long runs, tempo runs and speed work to get your brain used to the idea of letting you run fast.   But sometimes your mind can work against you. This is especially true when you first return to running after a foot injury.  Your brain remembers your pre-injury ability. If not restrained, your brain instinctively wants to ge...

There are only a few occasions when you might want to get an MRI on both feet.    Truthfully, getting an insurance company to agree to pay for an MRI on both feet is not easy to do.  A few years ago I helped a runner who was training for marathons when he got injured. He was super fit. But on a long, super steep run in Yosemite he did some damage to tendons in both of his feet. He really needed an...

When you're trying to get back to running, you have to think about all of the variables that can increase the stress and strain to your injured tissues. Your "threshold for recovery" or your "threshold for re-injury," are really the same.    When I lecture at medical conferences, I always tell doctors there are 3 variables you have to play with.  And you do have to play with the variables if you w...

Yesterday it started to snow. So I decided to go out on a trail run on the trail in this picture.   I only saw one deer and two people. As I ran around a corner under a cliff two climbers approached wearing jackets, with fleece hats under their helmets and all their climbing gear. I stopped, looked at them and I asked, "Isn't it too cold for climbing?"  One of the climbers smiled and said, "Isn't...

One of my Elite Access patients sent me a message. He was having pain from an inflamed Tailor's bunion bursa at the base of the pinky toe. He got a bigger shoe with a wider toe box that decreased the pressure. But when he was running, his foot was sliding around in the shoe, and it was still causing a problem. He asked me if there was any solution. And yes, there is... Today, on the Doc On The Run...

When you get injured, a lot of things go wrong.    1. Because you have pain, you suspect you have to stop training. 2. When you see a doctor, they confirm your fear and tell you that you really need to rest.    You translate that into really strict rest, doing nothing basically. You stop exercising. You stop training.    All kinds of bad stuff starts to happen. It is a lot more than just losing ae...

Today we're talking about metatarsal fracture, nonunion surgery versus no surgery. I know some people will think that I probably should have gone straight from #665 to 667 because frankly, there are some negative connotations surrounding those three letters, 666...the number of the beast. But I decided to do this episode anyway. And, I decided to dedicate this one to a buddy who is a beast.  He's...

A calcaneal stress fracture is a terrible injury.    What is a calcaneal stress fracture?    "Calcaneus" is the medical term for heel bone.  When you get a stress fracture in the heel bone, doctors call it a calcaneal stress fracture.  When you run with a calcaneal stress fracture there is a risk the bone can actually shatter and break apart.  That obviously would be bad.    But there are three re...

Today I went out for a run, but truthfully I wasn't really excited about it. It was cold, it was pouring rain, and I had a lot of stuff to do. I could have easily justified not putting on my running shoes, not going out and slogging through a bunch of mud puddles.    I also hate to admit that part of the truth is, I had new running shoes. I just didn't want to get them all nasty and dirty running...