Doc On The Run Podcast

I was just on a second opinion call with a runner. He is a triathlete, and he has had a long course of foot trouble. He was diagnosed with a plantar plate injury, but was not getting better.  We figured out some missing pieces of his recovery puzzle and developed a plan of action. Well, he acted on that game plan and turns out he had been misdiagnosed. What he has is a neuroma (not a plantar plate...

If you get a sesamoid fracture, you are probably worried. This is a scary injury if you are a runner.  Since stretching is one of the main components of physical therapy after many running injuries, you may think about stretching and why it might help your injury recover faster.  What is the single most important stretch if you are a runner who has had a sesamoid fracture?  Well, that is what we a...

One of the most difficult running injuries is a plantar plate injury.  I know, because I have had a plantar plate sprain myself.  Plantar plate sprains are really frustrating because the plantar plate is a very small ligament. It takes very little to aggravate or stress the plantar plate, to irritate it, to stretch it, strain it, or injure it further when you are running.  I had a patient who aske...

If you have a fractured sesamoid bone, the biggest concern is that the sesamoid fracture will turn into a fracture nonunion. "Non-union" means it did not unite. The two broken pieces did not get back together, and the fractured sesamoid bone did not heal.  I was talking to a runner who had a sesamoid injury and she wanted to know whether or not surgery was a good option in her case.  We talked bro...

I got an interesting question from a runner who had a plantar plate injury.  This runner had a long course of sort of misdiagnosis, mistreatment and various plantar plate "misadventures."  But when we started working together, he started to do some specific things to improve quickly, and he is doing great now.  He asked: “Which comes first after my plantar plate sprain heals, will I be running, or...

I had a call from a patient who wanted to know about surgical removal of Morton's neuroma.  She said she went to the doctor. The doctor said, “Well, we can just take the nerve out. It is not a big deal. We do this all the time.” The reason she called me for a second opinion was because the doctor told her we have to cut a ligament to take the painful nerve out.  She wanted to know if that was true...

I got a comment from a runner who posted this question on one of the YouTube videos on the Doc On The Run YouTube channel. He says he had plantar fascia surgery just over 3 months ago. He said that following the operation, he followed all of the surgeons post-operative instructions "to a tee."  He was feeling great, until he started developing a small pain at the back of the arch right where the h...

I was just on a call with a runner who had a plantar plate injury that has been bothering him for about a year and a half. We did a series of calls to talk about some changes in his treatment that could get him moving in the right direction. He asked me a great question when I was on a call with him this morning.  He said: “Can I run in zero drop shoes once it is really healed? Not today, but like...

When you have hallux rigidus, the problem is the big toe joint does not want to move.  Many doctors will simply tell you that your big toe joint, or the "first metatarsal phalangeal joint" is getting progressively stiffer and developing arthritis.  If you wear shoes that irritate the joint more, the condition will only gets worse. The question is what sandals won't make hallux rigidus worse? What...

Today's episode comes from a comment on one of the YouTube videos on peroneal tendinitis. A limping runner asked the question:  “Can peroneal nerve tendinitis cause fifth metatarsal to be tender to the touch and when walking, I am not sure if I have a stress fracture.” When I read this comment, I became confused because I am not sure what is going on with this runner, but I am going to try to expl...

I got a great question from a runner with a sesamoid fracture that turned into a "non-union." The sesamoid bones are two tiny little bones under the big toe joint. When you break one of the sesamoids, if two pieces of bone do not heal back together, we call a "sesamoid fracture non-union." In this runner's case, she used a bone stimulator. She wore a fracture boot. She used crutches. But after a y...

The primary way I help runners is through telemedicine second opinions.  I help runners who are not running, who have not been getting better, who are frustrated, and help them figure out what they need to do to get past the injury and back to running.  Once they are on track and have made lots of progress, they want to know “When should we check in for our next call?” I feel like I am on track wi...

I saw a runner today and I did a cortisone injection to treat her sinus tarsi syndrome.  She asked me a great question.  She said, “Is the cortizone injection something I am going to need to do every three to six months?” She had been reading up on corticosteroid injections and had found that some athletes with certain conditions may have injections scheduled every few months. Should I have serial...

The most important first step with any athlete who signs up for a webcam second opinion or series of coach coaching calls is to ask, “What is your goal?”    I was lecturing at a medical conference in Wisconsin where I was doing a whole morning session on running injury talks and diagnosis of subtle fracture patterns in athletes.  What I told those doctors is they have to ask the athlete, “What is...

Today, I  had a final follow-up call with a runner who did a series of consultation calls with me to get advice every week. After the series of calls he had improved and was better, but disclosed to me that he felt like he had been depressed. He thought he might have depression because he realized something had significantly changed in his goal setting.  He said, “I can't even imagine myself doing...

This morning, I was on a second opinion call with a runner who had a couple of different injuries in his foot.  The main problem keeping him from running was an injury to the collateral ligaments in one of his toes. "The toe feels weak and unstable." He is understandably worried that the instability is going to cause a problem if he runs. He was asking me: “Well, can we surgically repair the ligam...

This morning, I had a conversation with a runner who had an injury. He has been getting a lot better and one of the things that really seemed to help the injury improve was wearing compression socks.  His question was a really good one. He said: “I had so much improvement with wearing compression socks, but with the injury I have, every time I take the socks off and on, it feels like I am moving t...

If you get an overtraining injury like a metatarsal stress fracture or a plantar plate sprain or Achilles tendonitis, or peroneal tendonitis, a doctor might prescribe a fracture walking boot.  Well, it is designed to hold you still so that you can hopefully walk on something like a fracture and still let it heal.   The reason for this episode is this morning I was on a call with someone who has be...

I was doing a second opinion webcam consultation with a runner who noticed a lump in the calf muscle.    The knot in the leg wasn't limiting his running. In fact, when he was running, this lump in the calf muscle felt better, not worse.  So, you have to wonder, could the knot "not" be a big deal?  There are really 3 things a runner can do immediately after noticing a bump in the leg.   Today on th...

Today I am about to drive to the airport, get on a plane, fly to Wisconsin to give five lectures on running injuries at a medical conference. As I was finalizing that talk on medical imaging strategies for athletes, I was thinking about a conversation that I had yesterday with an athlete who had a very frustrating course and actually called me for a second opinion.  He had an injury that hass been...

I know. You don't want plantar plate surgery.  But if your plantar plate ligament doesn't repair itself, or your doctor doesn't help it repair itself, you might get talked into surgery.  If you have plantar plate repair surgery, you may spend a lot less time running over the weeks following surgery...because you have to let it heal.  There are really three mistakes that I see runners make when the...

This episode comes from a question posted by one of the Doc On The Run YouTube viewers as a comment on the video “Where to run with plantar fasciitis.” In the video, I was trying to explain which surfaces can help you the most when you're trying to run with plantar fasciitis. The only way to do that is to make sure you are decreasing the stress and strain on the plantar fascia ligament.  But the q...

There are three ways that a doctor might convince you that it's really time to have surgery and fix that plantar plate ligament that's been making you miserable when you've been trying to run.  To you, it may not seem that bad. It kind of aches. It kind of swells. It kind of bugs you. But then the doctor suddenly says, “Look, it's not getting better, let's have surgery.”  Well, how does the doctor...

Today's episode comes from one of the YouTube videos and it was specifically a comment that someone posted on one of the videos that was called “Five worst exercises for hallux rigidus”. This came from Matt and he asked: "When can you start doing push-ups again, if you have hallux rigidus?"  Well, that's what we're talking about today on the Doc On The Run Podcast. 

I'm not going to tell you that any runner should want to use crutches. I'm also not going to tell you that you will enjoy wearing a fracture walking boot. But there are reasons that you may want to do things a little differently if you're a runner.  The critical issue is that runners must really try to speed up the healing process as much as possible, so that you can avoid losing your running fitn...