Doc On The Run Podcast

Doctor missed fracture on my X-rays

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 a fracture on my x-rays. What should I do about that? 

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

Calcaneal stress fracture in runners good news bad news

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 going to tell you, "you can't do anything until the stress fracture heels."

Today on the Doc On The Run Podcast, we're talking about calcaneal stress fractures in runners and I have some good news and some bad news. 

Broken toe can I compete in 4 weeks?

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 I teach athletes to figure out when they do the Fast Track challenge.

I have a broken toe and I want to compete in four weeks. Is it possible? 

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

Orthopedic doctor said come back 4 weeks after fracture

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 need to take an advocate with you to any doctor's appointment. 

I went to an orthopedic appointment yesterday and they told me to come back in four weeks. What do I do now? 

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

Can I use a bone stimulator for a broken toe?

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. 

This particular athlete actually happened to already have a bone stimulator. Her question was pretty obvious:

“Can I just use that bone stimulator for this broken toe since it's a different kind of fracture?”

Well, that's what we're talking about today on the doc on the run podcast.

 

Medial calcaneal neuritis vs Baxter's neuritis in runners with heel pain

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 Fasciitis in Runners.”  One of the conditions I was talking about was "medial calcaneal neuritis." 

One of the doctors in the audience asked a really great question...

He said, “I see a lot of people that have Baxter’s neuritis, and it's down on the bottom of the heel it's plantar , it’s not on the side of the heel, it’s not medial neuritis, it's different. What would you do to tell the difference between these two conditions in a runner, given the circumstances you just explained in the talk?”

Today on the Doc On The Run Podcast we're talking about medial calcaneal neuritis versus Baxter’s neuritis in a runner. 

How dress shoes with long toe box act as a lever to stress plantar plate

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 and wearing some fancy dress shoes, and he started to get plantar plate pain again.

Today on the Doc On The Run Podcast, we're talking about how dress shoes with a long toe box can actually work as a lever against your plantar plate. 

Can a Cortisone injection as stop gap for plantar fasciitis in runner

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 true that corticosteroid injections can reduce the inflammation in and around the plantar fascia and quickly reduce pain. 

When I had "normal practice" with "normal patients," I used to treat plantar fasciitis with corticosteroid injections pretty much daily. 

But I almost never do plantar fascia cortisone injections now.

Can a corticosteroid injection serve as a stop gap for runners with heel pain? 

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

 

Worse exercise for plantar plate when building uphill strength

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 worst exercises you can do if you have a plantar plate sprain and you've been trying to build your uphill running strength for a trail race. 

How to patch test for tape allergy

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 with tape can really help hold the broken bone still so it can hurt less and heal faster. 

But if your skin gets irritated, and you are forced to stop using it, the tape can't help you at all. 

Today on the Doc On The Run Podcast, we’re talking about how to patch test for tape allergy.