Doc On The Run Podcast

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 examp...

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 h...

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...

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 possibl...

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...

If you've got an overtraining injury, but you're trying to figure out how to stay fit, a lot of people are going to think that you're not normal. But if you ran 50 miles you are not normal. If you signed up for a marathon, you're not normal. If you are a runner, you are not normal. Don't think you will be told you're normal when you are injured, in pain, but still working out. But that's exactly w...

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. W...

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 w...

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,...

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 athletes 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 question...

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, w...

I often get questions from runners and this is actually a common one that I get from runners when they have either enrolled in the plantar plate sprain treatment course for runners, or if they've signed up to do an individual webcam consultation. Everybody seems to think that an MRI will give you a crystal clear image of what's going on inside your body and in some sense, that's true. It is amazin...

I lecture at medical conferences about stress fractures, trying to teach physicians the difference between a stress response, a stress reaction, which is basically an irritated and inflamed metatarsal bone, and a stress fracture where there's actually a crack that can cause real trouble. One of the questions doctors ask me is what's the best way and the worst way to tell a stress reaction from a s...

If you only get one thing from this episode, let it be this…Thank you! From the bottom of my heart I am grateful for you as a listener of the show! More than 10 years ago I started writing a blog talking about running injuries, and the various treatments that we as physicians offer. A few years later, at which point I had actually only listened to a few podcasts myself, I thought it might be usefu...

Every time I do a second opinion consultation with a runner who has a plantar plate injury, I hate to tell you this, but I hear the same story over and over and over. Basically they call me and they say, "Well, I have a plantar plate sprain. I know I have a plantar plate sprain. I went through the plantar plate sprain course and I've been doing some of those things to actually try to get it better...

Metatarsal stress fractures are one of the most common overtraining injuries afflicting runners. Much of the time the stress fracture is preceded by what we as doctors call a “stress reaction.” If you ignore the warning signs of a stress reaction and keep on running in the same way, applying the same stress, the stress reaction will advance to a full on stress fracture they can keep you out of tra...

This question came up from somebody in the coaching groups who wanted to make sure that she wasn't going to get re-injured. She wanted to know which running shoes she should use to reassess her pattern, and make sure that she's working her way out of this compensation pattern, where she's essentially limping because of this prior injury and that's a really useful thing to do. Today on the Doc On T...

An MRI can be very helpful when you have a strange injury that doesn't seem to fit in any of the common running injury boxes.  I just had a call from a runner in that very situation. He is someone who has an injury and has something kind of strange going on.  He actually had an abnormal finding on an MRI from a little more than three years ago.  At the time that he had that previous MRI that thing...

Today's episode actually comes from a second opinion telemedicine visit with a runner who wanted to know more about a tarsal coalition.  He had an X-ray and the doctor found this thing called a "C-sign."  The "C-sign" is an abnormal appearance on an x-ray that suggests a tarsal coalition. When you look at the lateral view of the foot X-ray, a bridge of bone can form, partially encircling the talus...

Today's episode comes from an injured runner who saw a doctor, got x-rays and found what looked like bone fragments in the peroneal tendons.  We were doing a telemedicine second opinion consultation, and she wanted to know whether or not she should have surgery to take the bone chips out of the peroneal tendon.  That's a great question! How did bone chips get in my peroneal tendon? Well, that's wh...

I was just on a second opinion telemedicine call with an injured runner. She had a recurring injury that was still keeping her from running.  Unfortunately, that injury first started eight years ago.  When you have an injury, and you get x-rays, an MRI or a CT scan, or any kind of medical imaging study that shows more detail than the x-rays, you should always get a copy of that disc.   This runner...

Today's question comes from a telemedicine visit second opinion for a runner.  She was asking if she should have surgery to remove bone fragments. I said, "Well, let's talk about what's going on with you first."  Anytime we see something abnormal on an x-ray or an MRI, we often think that it's pathologic. We presume something is wrong, just because it doesn't look right.  We think if something's w...

The other day I was talking to a runner who had some abnormal findings on the x-rays.  What we could see was calcification in the Achilles tendon that looked like bone chips.  She wanted to know if she should have surgery to remove the calcification or little bony chips that were inside her Achilles tendon. Now, the interesting part of the story is that the Achilles calcification was discovered fr...

Today's episode comes from a runner who was having some weird aches and pains when running. One doctor suspected he might have a thing called a "tarsal coalition." A tarsal coalition is an abnormal union or connection between two bones. He was even told me might need surgery to remove the tarsal coalition. He asked me whether or not an injection, like a stem cell injection, might actually help a t...

A podcast listener sent in a great question for the Doc On The Run Podcast. Sandra asked, "Is there a best way to ascertain if a person has a leg length discrepancy? MRI, measuring, what is it?" "Limb length discrepancy" just means one leg is a little bit longer than the other. There are lots of different ways to figure out whether or not you have a limb length discrepancy. Figuring out how big th...