Doc On The Run Podcast

I was on a second opinion call with a runner. She developed a stress fracture in her accessory navicular bone. If that wasn’t enough, she then started having pain in her arch in the tendon that pulls on her big toe. That tendon is called the Flexor Hallucis Longus Tendon, or FHL Tendon.  Can an accessory navicular stress fracture cause flexor hallucis longus tendinitis in a runner? Well, the short...

Jones fracture is a scary injury if you are a runner. If you have been diagnosed with a Jones fracture and want to start running sooner, you must understand the severity. Can a bone scan help you tell the difference between a Jones fracture stress reaction and a styloid stress reaction in a runner? Well, good question and that is what we're talking about today on the Doc On The Run Podcast. 

If you get a stress fracture in the fifth metatarsal, there are a couple of reasons why you might want to sleep in a fracture walking boot. Your goal is to keep the total amount of stress applied to that stress fracture under your threshold for healing, throughout the entire 24-hour period.  Why should I sleep in a boot for a fifth metatarsal stress fracture?  Well, that is a great question and th...

If you get a metatarsal stress reaction or a metatarsal stress fracture your doctor may order medical imaging to figure out how bad it really is.  Your doctor's goal is to really figure out if it is a stress reaction or is it a stress fracture. What is the difference when it comes to medical imaging using a bone scan versus an x-ray when you are looking for a second metatarsal stress fracture in a...

You have a couple of options when you get injured.  One option is to wait so long that you know for a fact it has to be healed enough that it can withstand the forces of running.  The other option is to move that timeline faster and make things happen a lot quicker. The only way to do that is by testing. One of the things you can test with is a test run.  A runner asked me how long her first test...

Whenever you consciously give your brain direction, your subconscious brain will go to work to achieve it. Your subconscious mind is not just controlling things that you want to happen but it's controlling things that you don't want, too.  If you focus on negativity, if you focus on your injury getting worse, you will probably get worse. So, the question is can you take this aspect of your brain a...

Which do you think is worse, a stress fracture or a stress reaction?  Well, since a fracture is a crack and a reaction is just inflamed and irritating, you probably think stress reaction. However, it's not true. Sometimes stress reactions take longer than stress fractures to heal in runners. Why can a stress reaction take longer than stress fractures to heal in a runner? Well, that is what we're t...

I was just on a call with an injured runner who is about to go out for a test run.  She is very excited because she is going to get either a yes or a no on deciding if the tissue in her foot that is been healing is strong enough to withstand a little bit of running at a medium pace for a short distance.  This is an important test because if it hurts, obviously no running, right? You got to wait so...

What if you were ramping up for several years to run 100 miles, but then you got tendinitis? If you start getting pain because you have been doing lots of hill repeats, you could get irritation of the FHL tendon and specifically the tendon sheath that surrounds it where it bends around the back of the ankle. One of the treatment options is to inject it with corticosteroids.  So, this runner called...

If you get pain on the top of your foot because you irritated the extensor tendons, they can be very painful.  A runner asked me recently about using athletic tape to heal extensor tenosynovitis. Since it seems like athletic tape can help almost any type of musculoskeletal injury, you might be wondering, could taping help the tendons or the tendon sheath on the top of your foot when it gets aggrav...

Yesterday I was at the Twin Cities Foot and Ankle Conference in St. Paul, Minnesota. The reason I was there is I was invited by the Minnesota Podiatric Medical Association to come and give a one-hour lecture, about "What's New in Sports Medicine."  It may not surprise you that most of what I was talking about was how to help injured runners get back to training, full activity, after overtraining i...

Today's episode comes from a running injury from Jamie. He wanted to know about hallux rigidus.  He asked: “Are there any non-surgical approaches to helping hallux rigidus when you are not a good candidate for a cheilectomy?”  What can a runner do when you have hallux rigidus but you're not a good candidate for cheilectomy surgery?  Well, that is what we're talking about today on the Doc On The Ru...

I often get some questions from listeners I would never imagine.  I just got one of those questions from a runner who has a mallet toe.  Her doctor suggested surgery. The runner was worried because she been researching hammer toes and mallet toes. During that search she learned a lot about the plantar plate ligament as it relates to crooked toes.  She was worried that if she had the surgery, it mi...

Today's episode comes from a question posted on one of the YouTube videos, specifically on an episode called, “Should I get an MRI to see if I can run now?”  Haitham wanted to know: “Would you say it is okay to walk if you are pain-free after being non-weight-bearing for two weeks? Does one always have to finish the standard five to six weeks of crutches?” Does a runner always have to finish the s...

I was on a call this morning with a former professional Ironman triathlete. This guy is the real deal. He is not lazy.  He is not unmotivated. He is not unathletic. He is a top tier kind of athletic guy, and he is very, very aware of his body. He is also very adept at the process of damaging tissue we call "training" and the need for healing those tissues to make his body stronger. What he also un...

I got a question from a runner with a fibular stress fracture. She said her primary care doctor got r x-rays of the fibula bone. The doctor could not tell from the x-rays if the spot on my fibula that looks odd might be an old stress fracture or a new stress fracture in the fibula bone. The recommendation from the primary care physician was basically to just wait for four weeks, let it heal, let i...

I was on a call with a patient who was a professional Ironman triathlete. He had a tibial sesamoid stress fracture. The sesamoid bones are little bones underneath your big toe joint. They are kind of like tiny little kneecaps that you stand on. And when you are trying to heal one, AND maintain your fitness, it can be a real challenge. But a couple of little tricks can help. How does taping a tibia...

I was just lecturing at the International Foot and Ankle Foundation meeting in Hawaii.  In the very first talk, I asked one of the doctors sitting on the front row,  "What is your most important question about this patient?”  And he answered, “How did it start?”  I replied, “You do not care about how it started, you do not even care about the injury, you should care more about the runner's goals.”...

Today's episode comes from a runner who asked me a very interesting question during a surgical second opinion webcam call. She seemed to be really confused because the doctor had recommended performing hammertoe surgery in the doctor's office, and not an operating room.  She thought that was weird. She was also confused because the surgery would be performed using only a needle and not a scalpel....

Last week, I was in Hawaii lecturing at the International Foot & Ankle Foundation Medical Conference. meeting.   I had been invited to give several lectures on running injuries. One of those was about stress fractures for physicians, podiatrists, foot and ankle surgeons. One of the objectives was to help them understand how they can look at stress induced injuries differently, with the intent...

Plantar plate injuries in runners are a common topic at medical conferences because they cause a lot of pain in the ball of the foot.  I just spoke to a runner who had an interesting question about plantar plate injuries, which was a question I never would have imagined. She wanted to know whether or not a "mallet toe" might lead to a plantar plate sprain.  She didn't really understand the differe...

Today I was on the call with an injured runner who is trying to figure out how soon she can start running. She had been having pain and she was getting relief by taking over-the-counter medication. She asked me whether not that was good or bad. Whenever we have pain, we can simply take a pill, and the pain will go away. Non-steroidal anti-inflammatory drugs or NSAIDs are powerful readily available...

Today I was doing a consultation with a runner who has a thing called an "accessory navicular." She thought that the bump was much more swollen than normal.  She had basically rolled her ankle and banged that bone into a rock and then she was having some swelling there over the arch. She did a form of cryotherapy called the contrast bath routine to reduce the inflammation.  It suddenly got much sm...

Okay...I'm just gonna say it...lots of runners get funky toenails. Runners get bruised toenails, black toenails.  But the worst thing  is when the nail lifts up off the nail bed and you get fungal filaments that cause athlete's foot underneath the toenail. Then you get toenail fungus or onychomycosis. If your doctor recommends oral antifungal medications, you may get worried about the side-effects...

If you start getting pain in the ball of the foot, especially in the area between the metatarsals, it might be caused by a little fluid-filled sack (called a bursa) that sits between the metatarsals.  Sometimes you get swelling of that little bursa, and it causes pain in the forefoot.  This problem could be misdiagnosed or thought to be caused by a neuroma, an inflamed nerve that runs in that same...