Doc On The Run Podcast

Difference between a sesamoid fracture non-union and bi-partite sesamoid sprain

I recently got a great question from someone who was watching one of the videos on sesamoid fractures.

Underneath the big toe joint, you have two little bones called sesamoid bones.
 
Sometimes you can get a fracture or crack in the bone that doesn't heal. Then it turns into what we call a non-union. 

Some people have sesamoids called "bi-partite" sesamoids. It looks like a fractured sesamoid. But its' normal. The two pieces are connected by soft tissue. But that soft tissue connection can become injured or sprained. 
 
What's the difference between a sesamoid fracture non-union and a disrupted bipartite sesamoid sprain? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast.

The #1 question for a runner with a second stress fracture

Stress fractures are the most common overtraining injury I treat in runners. 

If you're a runner with a stress fracture, your first question is probably "When can I run?"

Since the answer is always, "When it is healed enough to withstand running..."

Your second question is likely “What can I do to heal a stress fracture as quickly as possible.” 

But if you heal it, get back to running and then get another stress fracture, a recurrent stress fracture, your number one question should be “why”. 

What is the number one question for a runner with a second stress fracture? 

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

When should I give in and have plantar plate surgery?

If you are a runner struggling with a plantar plate sprain, it is probably going to be extremely frustrating trying to get it to heal so you can get back to running. 

The plantar plate a very small ligament. It does not have a great blood supply. Every time you take a step, you put pressure on the plantar plate. Every time your heel comes up off the ground when you walk, you stretch the plantar plate.

Because it is so difficult to heal, runners typically have frustrating setbacks. 

That state of discouragement makes it pretty easy for a doctor to talk you into plantar plate surgery. 

When should a runner just give up and have plantar plate surgery for a plantar plate sprain? 

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

Reduce your risk of the #1 most common injury by 35%?

Just last week, I was giving a lecture at the International Foot and Ankle Foundation meeting in Hawaii. The lecture was on Conservative Management of Ankle Sprains in Runners Who Want to Run.

One of the worst things that can happen to a runner with an ankle sprain is that you can lose what we call proprioceptive ability. But that is preventable.

What would you do if I told you, you can reduce your risk of the number one most common musculoskeletal injury by 35%? 

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

 

What do injured runners do that makes as much a sense as picking at a healing skin incision?

In today’s podcast episode we're talking about fracture healing versus skin healing.

This talk comes from a discussion I had at the International Foot and Ankle Foundation meeting in Hawaii where I was recently giving a lecture on Runner's Heel Pain to a whole roomful of doctors. 

A doctor asked me a question about how to get a runner back to running as quickly as possible after injury.
 
What do injured runners do that makes about as much sense as picking at a healing skin incision? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

 

How much earlier than X-ray can ultrasound prove fracture healing?

If you get a fracture of one of the metatarsal bones in your foot, you are not going to be able to run until it heals. 

But as soon as it's healed, you will want to start running again. 
 
You may have recently seen the episode that I did where I was talking about how ultrasound may show signs of healing sooner than X-rays.
 
How much earlier can ultrasound show healing of a fracture as compared to X-ray? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast.

What info would I give to a high school cross-country team?

I was just lecturing at the International Foot and Ankle Foundation meeting in Hawaii. One of the podiatrists came up to me and asked me a question after one of the sessions.

He said that he was going to be working with a local high school cross-country team.

He wanted to know what I thought would be the most important things to share with cross-country runners to try to reduce their risk of injuries amongst the team throughout their cross-country season. 

What information would I want to share with a high school cross-country team? 

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

What is a common cause of 5th metatarsal fracture in a trail runner?

If you're a trail runner or a marathon runner or an ultra-marathoner, well, the last thing you want to do is get a fracture. 
 
If you break something, you have to sit still until it heals, and that can take a long time. 
 
What is a common cause of fracture in a trail runner? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

Can the toenail grow back if the root of the nail is removed by biopsy?

Bruised toenails are extremely common in runners. Many consider black and blue toenails a rite of passage when training for your first marathon. 
 
However, if a bruise under the toenail appears without any trauma, it can be worrisome. 

A solitary dark linear streak is alarming to dermatologists and podiatrists. Because if you get a solitary linear bruise that doesn't drift out like a typical bruise under the nail usually does, your doctor might be concerned that you have something called acral-lentiginous melanoma.
  
If your doctor performs a tissue biopsy of the nail matrix to make sure you don't have cancer, well, you might be worried that your nail is going to be deformed.
 
Can the toenail grow back normally if you remove part of the root of the nail because you had a biopsy?
 
Well, that's what we're talking about today on the Doc On The Run Podcast.

When can I start running after metatarsal fracture if no healing on the x-ray?

If you get a fracture of the metatarsal, you have to make sure that it's healed before you start running on it. 

It doesn't matter if it's a stress fracture, or a traumatic fracture where you stepped in a hole, tripped or fell off a ladder. 

Deciding when it appears to be healed enough to withstand the forces of running is the key.

The most common way doctors decide when the fracture is fully healed is by taking an X-ray. 
 
When can I start running after a metatarsal fracture if I have no healing on the X-ray? 
 
Well, that's a great question and that's what we're talking about today on the Doc On The Run Podcast.