Doc On The Run Podcast

If you a runner in training and you break one of your toes, or snap a metatarsal bone, you may worry about hoe long you need to stop running.  When you are get a fractured bone, you probably want to know what it will take to heal the bone and how quickly it is going to heal.  One of the ways doctors classify broken bones in the feet and toes is whether it is a “displaced fracture" or a “non-displa...

Yesterday I was talking to a runner who had an ankle sprain that didn't improve. After about a year of not be able to run, having pain when walking and becoming really frustrated with not being able to run, he called me for a second opinion.  During that discussion he asked me whether or not it would be better to get an MRI or a CT scan to evaluate the bone, joint and surrounding soft tissue to de...

Anytime you make a mistake in training, push a little too hard and get injured, you have pain.  That pain creates an urgent need for answers. Specifically a need to answer three specific questions:  1. What is causing this pain? What is the diagnosis?   2. What is the treatment? What can I have to do to heal it?  3. How fast is it going to get better?    Basically you want to know what happened, a...

Runners often get dark discoloration in the toenails. That discoloring can happen after long runs, trail runs, wearing ill-fitting running shoes or trauma. The question is whether or not the dark brown, blue or black area in the toenail is just a bruise or something more ominous.  If you get a bruise under the toenail, it will gradually get better. If you get toenail fungus, it will gradually get...

If you're a runner and you've been injured, you need to challenge your doctor to do better. You are going to probably feel like challenging your doctor would have to be somewhat confrontational.  That doesn't mean you have to be offensive.  But you have to do something different if you really want to get your doctor on board with a rapid return to running. Today on the Doc On The Run podcast, we'r...

Everybody wants to believe that there is some best practice, some standard of care, some safest way for you to heal when you get a metatarsal stress fracture or achilles tendinitis or peroneal tendinitis or plantar fasciitis or any other common overuse training injury when you're a runner. But there is nothing that is risk-free.  Nothing is free in medicine.  It's not free in terms of costs, and i...

How much time do I need to take off from running after my race? The time you need to take off from running after race all depends on how long the race is and how hard you ran. How much time do I need to take off from running if I get a running injury? That depends upon your physiology and the status of your healing machine today. You need to think about how fast you think you can heal, based on yo...

A runner with a metatarsal stress fracture recently asked…  “Isn’t it true that a fracture walking boot and crutches is the risk-free way to heal a metatarsal stress fracture?"  Although I hope you won’t tell my daughter, there are no unicorns.  And there is no risk-free way to heal a metatarsal stress fracture.  Today on the Doc On The Run podcast, we're talking about how the risk free way to hea...

This weekend I was rock climbing in Joshua Tree National Park with my son. At one point he started climbing up to a point where we were going to practice rappelling.  He chose to climb up a way I knew was more difficult than necessary. But he wanted to proceed, so I let him. You have to know whether or not you can proceed with the given activity without getting hurt. Today on the Doc On The Run po...

Toenail fungus may be gross but it's common, especially in runners.  Running shoes are perfect little incubators for foot fungus. The inside of shoes are hot, dark and moist. Running shoes can be the ideal environment for fungal infections. And you want to make sure you don't get a toenail fungus infections, you need to make sure you keep the fungus out of your shoes.  But there are three simple p...

Many years ago I heard a quote from Tony Robbins. He said, “Remember, a real decision is measured by the fact that you've taken new action. If there's no action, you haven't truly decided.” When you're an injured runner you can't just wait for it to heal like a normal patient because the whole time you're waiting, things are getting worse. You are losing your aerobic fitness, you are getting weake...

If you are a runner and you have some pain, and maybe a little bit of swelling, in the ball of the foot under the toes, you might be concerned you have a plantar plate sprain.    Maybe you were diagnosed with “metatarsalgia.” Maybe you thought you had a metatarsal stress fracture.  But maybe after listening to one of these talks on plantar plate injuries, you started to think you might have planta...

I just got an email recently from someone who is a runner and one of the things he asked, he said, "Should I be patient, and are the chances good that the pain will subside after four to six weeks on its own, of just not running?” Well, that's a good question, but that depends.  The first thing that you have to think about when a doctor tells you, you just should take off running, and stop activit...

If you go to the doctor, and you tell the doctor that you run on trails, you've sprained your ankles before, and you seem to roll ankles frequently, the doctor will tell you that you are suffering from “chronic ankle instability.” If your ankle just feels unstable when you're on uneven ground, when you step on a root, or rock, or something, if your ankle sort of flips out from under you a little b...

Training for a marathon is an active process. You have to think about what you're going to do, you have to come up with a plan.  You have to design a training program that will get you stronger, get you faster, get you more fit and better prepared for your event, if you're going to finish your race on time.  When you get injured, healing itself from that injury is an active process, but unfortunat...

There are only two cases in which a metatarsal stress fracture needs surgery. Before we get into that, I want to stress one point.  If someone tells you you need surgery, you need a second opinion. Never, ever, ever have surgery when only one person tells a runner should have metatarsal surgery! Today on the Doc On The Run Podcast, we're talking about the only 2 times a metatarsal stress fracture...

Today on the Doc On The Run Podcast, we're talking about how lack of discipline causes running injury. This episode is probably going to rub a lot of runners the wrong way. No runner wants to think they lack discipline. Running is all about discipline. Running is about getting up early in the morning, about going for long runs in the dark, running when it's raining, running when it's hot, running...

Lots of runners who are in the midst of training, for some reason, they want to get custom orthotics. I know that we, as runners, we're always looking for the tools, the latest training techniques, the newest, coolest shoes, the best kind of socks, the newest heart rate monitors, whatever...to help us train better and be faster. There are a lot of misconceptions about custom orthotics and there ar...

A few days ago, I got an email from a runner who wanted to know whether or not he should have surgery to fix his Jones fracture.  Well, the first thing you have to know about this is that you should only have surgery if you believe that is the only way you're going to heal appropriately.  When you're a runner, you really have to think about surgery very carefully. Because when you have surgery, yo...

A couple of days ago I saw a runner who started having some arch pain in his left foot after he was did a run.  After he noticed this arch pain, he got some arch supports, and they actually made his arch hurt a lot worse. Arch supports are supposed to take pressure off of the arch.  They are supposed to support the arch. They are supposed to make you feel better. But sometimes, arch supports can a...

It's that time of year, and here in California there is tons of poison oak out on the trails!  I recently ran the American River 50 mile Endurance Run, and I got poison oak on that run.  Now, I've had many episodes with poison oak. I also see lots of runners who get it on these long events, I see lots of runners that get it on their normal trail runs on Saturday or Sunday.  In the first place, you...

For about 15 years now, I've been teaching other doctors about running injuries. Every time I speak in a medical conference now, I ask doctors why they don't like treating runners.  I know some runners are actually surprised to hear this, but if you are a runner, yourself, and you've been to the doctor and you've had some doctor look at your intake form or some nurse look at your intake form, and...

A plantar plate sprain is actually one of the worst possible injuries for an injured runner. They can be notoriously difficult to heal quickly if you don't do everything right. Plantar plate sprains also have a tendency to evolve into a chronic nagging pain that just keeps you off of running and training for months. Even worse, if you don't treat it correctly, the plantar plate ligament can get so...

If you are runner and you started having pain in your foot and you concerned you have a metatarsal stress fracture, you may think you need to get an x-ray of your foot.  But why? You probably want to know how bad it is!   You probably also want to know whether or not you can run, right now. But you may be surprised to hear that x-rays of your foot will not really help answer either of those two qu...

When you've been injured and you are starting to run again you have a very delicate balance to maintain.  Your number one goal is to increase your fitness without stressing the injured tissue enough to inhibit the recovery.  The goal is to get stronger without slowing the healing process. That healing process is always in motion. Every day the healing tissue gets stronger. And every day for healin...