Doc On The Run Podcast

Is there any proof that you don't have to stop running when you get a metatarsal stress response in your foot?  A lot of doctors and patients are really confused about the differences between a stress fracture and a stress reaction and a stress response in runners. A stress response is a normal physiologic response when you stress any tissue as a component of training. The goal of your running wor...

When a runner gets an overtraining injury and goes to a doctor, the doctor’s only priority is healing the injured tissue. Most runners also think healing the injured tissue is the highest priority. Healing is not really a problem. All tissue will heal eventually, if you reduce the stress and strain enough to allow healing. The problem is healing an overtraining injury can take weeks or months.  If...

I just got off a telemedicine call with a runner who wanted to know why she sometimes feel popping and clicking in the ball of the foot after she runs. She saw a doctor and was diagnosed with a Morton's neuroma.  The doctor gave her some metatarsal pads, which made the neuroma feel better.  But she could not figure out why she seemed to only get this weird popping and clicking sensation after she...

One of my favorite podcasts is called The Not Your Average Runner Podcast. I recently sat down with Jill Angie, who hosts that show.  Self-criticism heals no wounds! When you have an injury, and you have been training hard, it is very easy to beat yourself up. Jill is the best person to explain how we can take an injury and reframe it so we don’t beat ourselves up when we are injured. Today on the...

I get questions all the time on social media from people who want to know if they can run, and at the base of their question is really, how long does it take for some particular injury to heal? There's actually a wide variety of timelines on how long it takes for all of different injuries to different types of  tissues to heal, even depending upon anatomic location. Your age plays into the timelin...

This episode comes from a question sent in by an injured runner who was listening to the Doc On The Run Podcast.  "I am 30 with medium arches. No prior injuries. 7 months ago I began having left med ankle pain at the calcaneal insertion.  MRI confirmed a plantar fascia rupture of med cord. I was told to just ice and stretch.  I have a distal 4th fracture on the right. Both feet at once?!  What sho...

This episode comes from a question from one of the Doc On The Run YouTube channel viewers who wanted to know about “bilateral bipartite sesamoid bones” and what that really means.  I get these kind of questions all the time, when somebody really wants to know what a term means, and what the implications are for them as a runner. Usually the runner is trying to figure out how to keep running while...

This episode comes from a question from a runner, who wanted to know what it means when calf muscles are tight and you have metatarsal stress fractures.  He wrote in and said, "Hey doc, I meant to inquire about stress fractures in the metatarsal joints and how you can tell. I have a friend who's experienced a stress fracture, and he says his calves seemed to tighten up when the pain developed."  T...

I was just doing telemedicine visit with a runner who has a red, painful big toe joint.  Gout is an accumulation of painful sharp crystals in the joint.  Gout certainly can cause your big toe joint to become red, hot, swollen and painful. But gout is only one of three different conditions that might cause big toe joint pain. The pattern of redness around the big toe joint can help you decide which...

The other day I was doing a telemedicine visit with a trail runner who asked me, "Which is better, soft or hard trail running shoes?" If you're thinking about getting some new trail running shoes, you have to really think about what's going to be best for you.  When comes to how stiff or how soft the shoes should be depends upon three variables: Your foot type.  How hard or soft is the trail. How...

A runner with pain under the big toe joint said she was told she had a problem with the sesamoid bones in her foot.  The doctor said maybe it was sesamoiditis, or a sesamoid stress reaction or possibly even a sesamoid stress fracture.  Her question was, “What exactly are the sesamoid bones in the foot?” Today on the Doc On The Run Podcast, we're talking about these weird little things called the s...

A plantar plate ligament sprain can cause aching pain in the ball of the foot when you run.  Plantar plate sprains are caused by excess stress applied to the ligament at the base of the toe.  If you want to heal it and keep running, you have to decrease the stress and strain on the plantar plate, and address the root cause of the injury. A runner with a plantar plate sprain, and tight calf muscles...

Shin splints and tibial stress fractures can feel similar when you run. Most runners understand there is a huge difference between shin splints and a tibial stress fractures.  I recently did a telemedicine second opinion call with a runner who had a tibial stress fracture.  What she did not understand, and what her doctor had not explained is why some tibial stress fractures are very low risk of b...

I was just doing a telemedicine call with a runner with a stress fracture, and he had a really interesting question.  He said, "Look, I just really want to know if I really have a stress fracture because my doctor took an x-ray and there was no crack in the bone. I looked it up myself and the definition of a fracture is a visible crack."  Do I really have a stress fracture, or not? This is a great...

Raynaud’s Phenomenon is an interesting condition in which spasms of small blood vessels cause changes in the skin color of the hands and feet. Raynaud’s phenomenon can also cause pain in the feet. Foot pain is also very common in runners.  Raynauds is one of those conditions that isn’t typically diagnosed with a blood test or and x-ray. The diagnosis is typically made “clinically” meaning the doct...

When you get any stage of Achilles injury and you're a runner, you're trying to figure out what you can do to get it to heal as quickly as possible.  The biggest concern with runners when they have an Achilles tendon injury is that the tendon is going to continue to degenerate, turn into Achilles tendinosis, and then potentially even rupture. But the good news is that stress, when actually applied...

There are the three forms of stress that can affect you and the injured tissue when you actually get back to running after you've been injured and you feel like you've recovered. I was just recently doing a telemedicine visit with someone who had an injury and was getting better. She was told to start running, but she wasn't really given any specific instructions.  She was told, "You can go and ju...

Just a couple of days ago I was doing a telemedicine call with a runner who wanted to know what it meant to have “thinning of the plantar plate ligament on his MRI. He asked, "What does ‘thinning’ really mean? Do I really have a plantar plate tear? Is it a problem? Will I be able to continue to run?"  “What is the issue with this idea of thinning of the plantar plate ligament, and why does it happ...

When you break down the goal of running a marathon, it really only has 3 key elements.  You are crystal clear on the distance, the starting point and the end point.  All you have to do to compete the marathon successfully is break your training down into the daily and weekly stages of growth to establish the fitness required of your body on race day. Running injuries are difficult because they lac...

Metatarsal stress fractures are one of the most common injuries in runners. Unfortunately for runners, 4 weeks to 6 weeks in a fracture walking it boot is the common recommendation from doctors.   Part of the reason you get the boot for 4-6 weeks, is that you didn’t give your doctor enough information to recommend anything else. The doctor wants you to heal. The way you tell your stress fracture f...

This weekend, I was giving a lecture at a medical conference that was specific to running injuries.  During the question and answer period, one of the physicians in the audience asked a completely valid question.  She asked, "Why wouldn't you just begin with a prescription medication if you're 100% sure that medication had the highest probability of reducing the patient's symptoms?” The difference...

Think back to the last time you really remember getting a second wind. Maybe it was 2 miles into your fastest 5K. Maybe it was mile 18 or mile 22 of a marathon. Just when you felt you really couldn’t got on, just when you hit an all time low, your energy started to grow. You felt revived. Energized, you pressed on the the finish, thrilled with the boost of energy moving you forward.  Every runner...

A few minutes ago I was on a second opinion telemedicine call with runner who was told he had an MRI showing an “osteochondral defect.”  The doctor told him to stop running. If a joint surface gets damage, you may develop a little soft-spot called an “osteochondral defect.”  Just because you have an osteochondral defect, it doesn't necessarily mean you have to stop running, but you do need to figu...

I just got off a telemedicine call with a woman who was an elite runner in college. She has been having a difficult time getting back to an acceptable level of activity after recovering from her overtraining injury.  When you have been doing a certain run at a certain pace, as a part of your training for years, you always fell like you can do that workout.  But when you get a running injury and ta...

If you over-stretch any nerve it can become inflamed and painful. If you roll your ankle on a trail you can get a condition called traction neuritis. Most of the time when I am on a telemedicine or second opinion call with a runner with traction neuritis, they have been misdiagnosed with some other condition. If you understand how to tell the difference, you can understand how to get back to runni...