Doc On The Run Podcast

When can you resume pushups with hallux rigidus?

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. 

The 3 problems (not 2) solved by boot and crutches

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 fitness. 

What are the three time-sensitive problems solved when you use a fracture walking boot and crutches at the same time? 

Well, that's what we're talking about today on the Doc On The Run Podcast!

Plantar plate surgery is a failure to act quickly

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 heal without surgery. 

But there are some mistakes that could lead a runner to the operating room.

Plantar plate surgery is a failure to act quickly. 

That's what we're talking about today on the Doc On The Run Podcast. 

How self judgment may be slowing your injury recovery

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 running as quickly as possible this can be a real problem. 

How can self-judgment actually slow down your injury recovery when you have an overtraining injury as a runner? 

Well, that's what we're talking about today on the Doc On The Run Podcast.

Chronic stress reaction versus acute on chronic stress reaction in a runner

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 when we x-rays of her foot, the radiologist suggested this could be an "acute on chronic" stress reaction. 

What does that mean? 

What is the difference between a chronic stress reaction, or an acute on chronic stress reaction in a runner? 

Well, that's what we're talking about today on the Doc On The Run Podcast. 

Radiologist and Orthopedic doctor disagree on my stress fracture diagnosis

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 to figure out what was going on. The Orthopedist gave on diagnosis, but the Radiologist suggested a different diagnosis.

This is where the trouble comes in.

So, the runner was told a couple of different things, 1) a stress reaction, or 2) stress fracture, possibly of A) the third metatarsal or B) intermediate cuneiform bone, at the base of the third metatarsal.

Confused yet?

So was this runner! 

What do you do if you think you have a stress fracture, you see an orthopedic doctor and the radiologist who reads your images s disagrees about your diagnosis. 

Well, that's what we're talking about today on the Doc On The Run Podcast.

Difference between MRI vs MRA in runner with ankle injury

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 with an old nagging ankle injury?

That's what we're talking about today on the Doc On The Run Podcast.

2 Ways running shoes cause shin splints

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 running shoes that he was wearing.

What are two different ways shoes can actually cause shin splints in runners?

That's what we're talking about today on the Doc On The Run Podcast. 

2 reasons toe drifts sideways with plantar plate injury

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 drifting sideways can happen for two different reasons.

They are very different causes and so they are treated differently. 

Why does the toe drift sideways when you have a plantar plate injury? 

Well, that's what we're talking about today on the Doc On The Run Podcast. 

3 Phases of ankle sprain recovery in runners

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 wind up with a lot of trouble later.  

When I lecture at medical conferences on how doctors should treat ankle sprains in runners, I teach 3 phases of ankle sprain injury recovery.

If you are a runner with an ankle sprain, and you understand them, it'll help you get back to training and running without another ankle sprain. 

What are the three phases of ankle sprain recovery in runners? 

Well, that's what we're talking about today on the Doc On The Run Podcast.