Doc On The Run Podcast

Compressive stress on plantar plate in runners

I recently posted an episode that was talking about four different kinds of stress and strain that can be applied to the plantar plate ligament that might slow down the healing of that little bitty ligament in runners. 

I got a couple of questions about that and one of them was specifically about how to tell whether or not that is really a problem and one person wanted to know if they had a dropped metatarsal if that might be contributing to this issue of compressive stress. 

Today on the Doc On The Run Podcast, we're talking a little bit more about compressive stress on the plantar plate ligament in runners.

Fat Pad Displacement vs. Atrophy in runners with plantar plate injury

If you have a pain in the ball of the foot, underneath the base of the toes, that is right where your fat pad cushioning is located. 

There is a lot of misunderstanding about what fat pad atrophy really is, particularly when it is related to something like a plantar plate injury.

Sometimes runners have true fat pad atrophy, but that is rare. 

More often runners have fat pad displacement that feels like atrophy. 

I think that fat pad displacement is more common than atrophy, and I am going to try to explain why. 

What is the difference between fat pad atrophy and fat pad displacement in runners? 

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

 

Difference between plantar plate stress and strain

I know I talk a lot about how necessary it is to reduce the stress and strain on the plantar plate ligament when you are a runner, especially if you are trying to get ready for a race while healing.  

It is really difficult to do, but not impossible. 

What are the four forms of stress and strain that can affect runners with plantar plate injuries? 

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

 

Single leg exercise benefits for injured runners

I am going to make a statement and see if you agree with me. 

“Rest is bad, and exercise is good.” 

Do you agree? 

Almost every runner who calls me for a second  opinion consultation has been injured, has been told they have to rest, and they have been told they cannot exercise in order to get better.

Sometimes that is true. But 100% rest is rarely the case in runners. Unless you fell off the roof and broke your back and both, then you can probably use one of your legs to exercise and maintain some of your running fitness while your other foot that is injured is resting and recovering. 

Today on the Doc On The Run Podcast, we're talking about single leg exercise benefits for injured runners. 

Is stress on the plantar plate ligament bad for runners?

I was just on a call with an injured runner who has been healing from a plantar plate sprain. If you have had one of these, you know they're problematic. 

The thing was that he asked me a question that really made me stop and think.

What he asked was, “Is stress good or bad for the plantar plate ligament?”

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

Fat Pad Atrophy: withering away or wearing away?

Let me ask you to read 4 words and see how they land on you.

Skinny, weak, atrophy, neglect. 

As a runner, would you want any of those words used to describe you?

When the fat pad cushion between the bones and the skin under the heel or the ball of the foot gets thinner, doctors call it “atrophy.”  But don’t take it as an insult. 

What really causes more atrophy of the fat pad cushion under the ball the foot in runners…inactivity, or too much activity?

Well, that’s what we are talking about today on the Doc On the Run Podcast!

Biggest mistake doctor can make in runner who was on crutches

I was just giving a lecture at the 46th annual International Foot & Ankle foundation meeting at the Swedish Medical Center in Seattle.

A foot surgeon in the audience asked a great question during the question-and-answer period following one of my lectures. Specifically, the lecture was medical imaging strategies to avert misdiagnosis in runners.

She asked,  “After a runner has been offloaded with crutches and placed in a fracture walking boot or a cast for immobilization, do you incorporate cross training, or only focus on running?”

What is the one biggest mistake any doctor can make with a runner who has been on crutches? 

Well, that is what we’re talking about today on the Doc On The Run podcast.

Endoscopic surgery for chronic plantar fasciitis in runners

Is taping the sesamoids good or bad for swelling?

I was recently working with a runner who had really bad sesamoid issues.

She was taping it to try to decrease some of the motion around the big toe joint that could have been irritating the sesamoid bones. 

She had a bunch of tape around the forefoot holding everything still. Weird thing was, she did not have swelling there. She had swelling elsewhere. 

Is taping the sesamoids good or bad if you have swelling in the foot? 

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

Ankle exercises for plantar plate?

I was on a call with a runner, and he has had a long history of plantar plate trouble. He had a whole bunch of different treatments, done time in a fracture walking boot and then got worse when he started running a number of different types. 

He was very frustrated. 

Over the last month since we started working together, he has been doing significantly better than he ever has in a year and a half.

I had him do a couple of things over the last week. It made a huge difference for him that he noticed right away.

Do I need to do ankle exercises if I had a plantar plate sprain? 

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