Doc On The Run Podcast

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...

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. Th...

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 trut...

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...

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, th...

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 o...

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,...

 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 s...

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!   Irrespec...

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 fung...

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 doct...

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 s...

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 wal...

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...

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 gro...

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...

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 hav...

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 f...

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 abou...

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 th...

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 tu...

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...

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...

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,...

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 you...