Doc On The Run Podcast

When should I start working out with a plantar plate sprain?

Plantar plate injuries are one of the most difficult injuries for runners. 

The reason is that they can take a long time to get better. Every time you take a step, you're applying direct pressure to the plantar plate ligament. 
 
Every time your heel comes up off the ground, you bend the toes, and you're stretching the plantar plate ligament. 
 
The plantar plate ligament doesn't really have a great blood supply, and they can be extremely frustrating for runners. So the big question is: 
 
When can I start working out if I have a plantar plate sprain? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast.

Is it risky to run with cuboid fracture?

I was on a call with a marathoner who had a cuboid fracture.

He was getting better, and he was trying to figure out how he could start running.

The cuboid bone is an irregular bone at the base of the metatarsals, and it's sandwiched in between the fourth and fifth metatarsal bones and the heel bone. It is a bad bone to break. So he had a valid question:

Is it risky to run with a cuboid fracture? 

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

When can I run if my doctor says don’t run?

I don't like it when I hear a doctor said, "Don't run." 

What the doctor should say is, "Let's figure out how you can run." 

And if you're injured, that's what you should be thinking about too. 

Not, "When can I run?" 

But, "How can I work out right now?"

When can I run if my doctor says "don't run" because of an injury? 

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

How likely is a setback if I run while stress fracture heals?

Today I got a great question from a runner who had a 4th metatarsal stress fracture while training for a marathon. He wanted to know how likely it was to get a setback, or re-injury, if he is running while the stress fracture heals.

How likely is a setback if I run while my stress fracture heals? 

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

What can doctors do to relate to runners?

Today's episode comes from the question-and-answer session at the International Foot & Ankle Foundation meeting in Las Vegas. I was lecturing on Medical Imaging Strategies in Runners to Avert Misdiagnosis.
 
At the end of this talk that I was giving, one of the doctors, Dr. Brad Hayman, asked a great question, 
 
"A lot of us doctors who are not runners have a very difficult time relating to some of these runners because we don't necessarily get why it's so important that they're doing a particular race."
 
What can doctors do to relate to injured runners? 
 
Well, that's a great question, and that's what we're talking about today on the Doc On The Run Podcast.

Can I let runners run in an ankle brace after an ankle sprain?

Today's episode comes from the question-and-answer period when I was lecturing at the International Foot & Ankle Foundation Medical Conference in Las Vegas. The talk was Conservative Management of Ankle Sprains in Runners Who Want to Run.
 
During that talk, I explained to the doctors everything that I do with runners who have ankle sprains. Afterward I got a great question from Dr. Bryan Markinson, who is a  prominent  physician from New York.

He said:
 
"Okay. Is this stupid or is this not stupid? Because, I get runners who really want to run. I figure when they're in good shape, it's okay for them to run in an ankle brace. Is that really a thing that you recommend or not?"
 
Can I let runners run in an ankle brace after they've had an ankle sprain? 
 
Well, that's a great question, and that's what we're talking about today on the Doc On The Run Podcast

Workout while waiting to heal

All injured runners realize it's a problem.

You're not working out when they get an overtraining injury. You're told to sit still. But the problem is not that you're going stir crazy because you feel like you need to exercise. 
 
The problem you notice is that you're getting weaker, you're losing your fitness. And although I know that you're worried about losing your fitness, there is another problem you may not see. 
 
You should work out while you're waiting to heal. 
 
And that's what we're talking about today on the Doc On The Run Podcast.

How to add miles and speed at lower risk if running after injury

I just got a great question from a runner with a cuboid fracture. He signed up for four weekly coaching calls as he was returning to running. 

He just wanted to make sure that he didn't make the fracture worse as he was actually getting back to activity. 
 
He asked, “Once I start running outside, can I use the Alter-G treadmill to add miles and speed while lowering overall tissue stress?”
 
Can I use the Alter-G treadmill to add miles and speed while lowering overall tissue stress after recovering from an injury? 
 
That's a great question and that's what we're talking about today on the Doc On The Run Podcast. 

Can heel raises make insertional Achilles Tendinitis worse?

I got a question on one of the Doc On The Run YouTube channel videos about insertional Achilles tendinitis.

Kevin asked:
 
“For a few weeks, I had insertional Achilles tendinitis. I have read that doing heel raises over a step could make the situation even worse. Some suggest doing it on barefoot in a flat zone. What do you think?”
 
Can heel raises make insertional Achilles tendinitis worse? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast

Can Ultrasound have a false positive for fracture?

When I see a runner who's had a sprain or a trip or a fall or something, the #1 concern is to make sure no bones are broken. 

Most of the time, what I do is I take a portable ultrasound unit with me so that I can look at the foot on the spot and try to figure out whether or not there is a fracture. 
 
I had a question about this as a comment on one of the Doc On The Run YouTube video episodes where I was talking about ultrasound imaging in the foot when you're a runner. 

The question was, “Can you get a false negative? Can you get a false positive?”
 
Can you get a false negative if you're looking for a fracture with an ultrasound unit? 

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