Doc On The Run Podcast

Most of the runners I see who have pain in the ball of the foot from a plantar plate sprain rarely start out with a completely torn plantar plate tear.  More often, runners ignore the pain from the plantar plate sprain and it evolves into a full thickness plantar plate tear.  Surgery is only needed when the plantar plate is torn in such a way that the plantar plate ligament cannot be expected to h...

Sometimes when you get injured and have to stop running, you start to lose your identity. One of the things that I notice most in runners who have gone weeks or months without running, is they are really bummed out.  These runners seem really grumpy. In some cases, they don't even view themselves as a "runner" anymore...well, because they're "not running." If you want to heal and get back to runni...

I just had a consultation with a runner who had foot pain that she thought might be a stress fracture that had been coming and going for about a month.  She had been increasing her training volume and doing strength exercises that are supposed to build her running fitness.  The pain seemed to be volume related. The more training she did, the more she would notice the discomfort in her foot. But wh...

Just this morning, during the live Stress Fracture Masterclass I had an interesting question.  The story went like this. An athlete who is a State ranked high school cross country and track, had to suddenly stop running due to intense pain that started about 15 days ago. He went and saw a doctor. He got x-rays. He got an MRI, had a physical exam where the orthopedic doctor poked around and tried t...

Let's say you had an ankle injury a long time ago.  You sprained the ankle when you were out on a trail run, it got better , and you went right back to running. But over time, you slowly got more and more pain in the ankle.  In that case, you doctor might order an MRI of your ankle, or a similar imaging study called an MRA (instead of MRI).  What's the difference between MRI or MRA in a runner wit...

I recently saw a runner who thought that he might have a tibial stress fracture. But it turns out, it was just shin splints, which of course is good news. Because you don't really want a tibial stress fracture. Shin splints is much easier to treat.  One of the questions he asked me was about the best running shoes based on his foot type.  This runner really needed more stability than got from the...

If you got pain on the ball of the foot, at the base on the 2nd, and you have been running in a minimalist shoe,  running uphill, doing lots of calf raises, or running on steps, you could have an injury to a little bitty ligament called the plantar plate ligament.  If you get an injury to the plantar plate, sometimes your second toe will drift toward your big toe or away from your big toe. The toe...

If you roll your ankle on a trail run and it turns black and blue and swollen, you may think you just have to take a few days off.  In fact, if you research how long it will take to get back to running, you might find a study that says that if you do early range of motion after an ankle sprain, it only takes 4 days to get back to pre-injury levels of activity.  However, if you do that, you can win...

Last night, I was doing a consultation with an athlete who had a fracture when she accidentally kicked a piece of furniture.  Her foot was swollen, it was black and blue. The foot was really painful and she couldn’t walk on it.  She went to urgent care and they took x-rays. She was a little concerned that they told her that it wasn't broken. So, she called me for a second opinion. My doctor missed...

If you're out on a run, and you have heel pain that suddenly hurts a lot, you may have a calcaneal stress fracture, especially if you see bruising and swelling. If you go see a doctor, they take an x-ray, and they don't see anything at all but they squeeze your heel and it hurts. The suspicion goes up.   If your doctor gets an MRI that shows a calcaneal stress fracture, the doctor is probably goin...

Last night, I was doing a consultation with an athlete who actually broke one of her toes and her main question was: Can I compete in four weeks? I have a competition in four weeks, I want to compete. Do you think I'll be ready?  Well, I actually told her, no joke, I actually said, “I'm very sorry, but my crystal ball is broken.”  However, I can tell you how to figure that out because that is what...

Yesterday, I went to an appointment with a friend who had an appointment with an orthopedist.  She had 3 fractures. She wanted to know what she could do in terms of activity while she's healing and recovering from these different injuries.  I just went with her, not as her physician, but to serve as a friend and advocate for her at her appointment. This episode is going to explain why you really n...

Yesterday, I was doing a consultation with an athlete who broke one of her toes when she accidentally kicked a piece of furniture. If you fracture your toe, and you just run and ignore it, it can turn into a painful nonunion (non-healed fracture).  As a runner, you want to speed the healing as much as possible. One of the ways to stimulate fracture healing is with a thing called a bone stimulator....

If you're a runner with heel pain you may think you have plantar fasciitis. But if it is not getting better, your heel pain may be caused by "neuritis." I was just giving a lecture to a group of physicians getting their continuing medical education credits at the International foot Medical Foundation medical conference in Lake Tahoe. I was giving a lecture called “When Heel Pain is NOT Plantar Fas...

I recently did a consultation with a runner who had gotten a plantar plate injury. He had been getting better by using some of the tricks I teach in the Plantar Plate Course For Runners.  He got better, he was protecting it, he reduced the stress and strain on the ligament, and he got back to running. He was doing great.  But then he had a setback when he went to the synagogue. He was dressed up a...

I was just at the International Foot & Ankle foundation meeting in Lake Tahoe listening to a lecture given by a Professor of Biomechanics and Podiatric Medicine at Barry University. He said that a cortisone injection can be used as a "stop gap treatment" in heel pain caused by plantar fasciitis.  The idea is that some runners may need pain relief sooner than would normally be expected. It is t...

I just had a conversation with a runner who has a plantar plate injury.  He got the plantar plate sprain trying to build his uphill running strength in preparation for a trail race.  This is no rookie mistake. He is a longtime ultra marathoner with lots of experience. But he made a common mistake determined runners can make.  Today on the Doc On The Run Podcast, we're talking about one of the wors...

Taping is one of the oldest and simplest ways to treat foot pain and injuries to the toes, feet and ankles. There is a specific way to take your ankles after an ankle sprain so you can start running earlier.  If you have a plantar plate sprain you might try taping the toe to decrease some of the stress and strain on the plantar plate ligament when you run. If you have a broken toe, buddy-splinting...

I recently saw an elite runner who had what he thought was shin splints. One of the findings on the MRI report was something called "hyperemia." He asked me: “What does that mean? Does that mean I have a stress fracture? Does that mean I have shin splints?” What does hyperemia mean when you see it on an MRI report or an ultrasound report and you have something like shin splints or a tibial stress...

I believe the most commonly prescribed and most overprescribed treatment for injured runners is probably a fracture walking boot.  The big question for your doctor is... Is the fracture walking boot really necessary or not, given my stage of injury recovery? When is a fracture walking boot really necessary for a metatarsal stress fracture?  Well, that's a great question and that's what we're talki...

When you get an overtraining injury from running, it's not because you did too much, because you were too strong or too motivated. You got injured because you were too weak. You were too weak to sustain the stress applied to that piece of tissue, that one injured piece of tissue that got injured when you did one workout. That's what really happened.  If you get injured, you have to understand how...

There are a lot of confusing things you can see on an MRI report, on an x-ray report or an ultrasound report when you're a runner with pain that you think might be a stress fracture.  One of those findings that may be reported on your medical imaging study is a thing called "cortical thickening." I want to explain what that is so you can better understand it in case you happen to see it on an MRI...

I just had an interesting call with an elite runner, who's a high school cross country runner.  He developed a tibial stress fracture, or stress reaction.  But he thought it was shin splints. When I looked at it with ultrasound, I saw some stuff that made me really worried about it. So, I got an MRI to confirm.  The first question he had was, what's the grade? Grading scales cause confusion. Today...

When you get a stress fracture, one of the earliest visible indications on an X-ray or an MRI or a CT scan is a thing called periosteal elevation. Your doctor might see it on ultrasound, x-rays or MRI studies....way before your ever see a crack in the bone.   Since it's one of the earliest changes in the bone when you start to get a stress fracture, I thought it might be useful to talk about the t...

I got an interesting question in the Injured Runners Aid Station, “Should I run without my custom orthotics to strengthen my feet?” It seems logical that stronger runners are less prone to injury. The premise behind this question is whether or not orthotics may cause weakness in your feet or legs.  Never ignore your doctor's advice. But you have to ask your doctor the right questions about treatme...