Doc On The Run Podcast

Does callus reduction decrease risk of plantar plate sprain?

I got a specific question about a recent episode on calluses in runners. 

The question was, “Well, if you have that pattern of callus, and reduce the thickness of the callus so the callus is going away, does that mean there is less pressure there?”

You may have checked out the episode on the three callus patterns that I see in runners at high risk for getting a plantar plate injury. 

Does callus reduction reduce your risk or decrease the risk that you're going to get a plantar plate sprain? 

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

Traumatic disappointment and delayed healing

I was just on a call with an interesting elite athlete, and he's been injured. 
 
He had one particular injury in his foot and then started having a completely different injury, as soon as that injury in his foot was starting to heal.
 
We were talking about how disappointment can lead to more and more setbacks.

The phrase he used struck me. 

He said, “I think it might be traumatic disappointment.”

What is traumatic disappointment and what kind of effect can it have on delayed healing in an injured runner? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

First step sit still and wait

Yesterday I called a recovering runner, just to check in and see how he was doing, because he had done the Fast Track Challenge 2 months ago. 
 
He's doing great. He has recovered and gotten past his injury. 

He said he learned a lot in the Challenge and has applied it to his training. 
 
He's on track for running ultra-marathons this year.  He has a coach. Training is in full swing with no limitation from the injury and got him into the Fast Track challenge. 
 
Something he said on that call actually kind of shocked me. 

I asked him, “Is there anything that you wish you could have done differently if you went back?” 

He answered, “Yeah, I would have called you sooner for a consultation.”
 
If you ever run into injury many times, your first step is to sit still and wait. Sometimes that's a problem and that's what we're talking about today on the Doc On The Run Podcast. 

 

3 Callus patterns show risk for Plantar Plate Sprain in runners

If you are a runner and you get pain in the ball of the foot, particularly at the base of the second toe right. It could be a plantar plate sprain. 
 
Whenever I see a runner on webcam who has pain that sounds like a plantar plate sprain, the first thing I do is look for any callus pattern in the skin that suggests they have too much pressure and friction at that area that could injure the plantar plate ligament underneath the skin. 
 
This episode will help you understand how certain callus patterns relate to some basic foot mechanics when you're trying to figure out what is causing your ball of foot pain. 
 
Today on the Doc On The Run Podcast we're talking about three callus patterns I often see that can suggest you have a risk for getting a plantar plate sprain if you are a runner.

Most valuable stretches after a running injury

Everybody's short on time. This is true for runners in training, but it's also true for injured runners. 

If you're trying to make progress as fast as possible, you really have to do the things that will give you the most progress in the least amount of time. 
 
Many runners I talk to on a second opinion consultation webcam call really want to know which stretches will help them. Specifically, which two or three stretches will help the most.

What are the most valuable stretches you can do after a running injury? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

 

3 reasons for Cheilectomy failure after Hallux Rigidus surgery

If you have a condition called "hallux rigidus" or "hallux limitus," the name tells you what's wrong. 

"Hallux" means big toe.

"Rigidus" means the big toe joint doesn't move at all.

"Limitus" just means the big toe joint movement is limited and stiff.

There are three problems with hallux rigidus, which are: 1) damage to the cartilage, 2) bone spurs around the joint and 3) restriction of the soft tissues such that the toe doesn't move up and down the way it should. 

Those three reasons that cause the condition are the same reasons that can fail if you have a cheilectomy surgery.

Today on the Doc On The Run Podcast we're talking about three reasons for cheilectomy failure after hallux rigidus surgery.

What is a tendon synovectomy surgery?

Let's say you have a nagging tendon injury that's really been painful. It's been bugging you a lot when you run. 

You have had persistent pain either on the side of the ankle that just won't seem to go away, even if you run less.  

You see the doctor and she says, “Look, we tried everything. We should do surgery. Your tendon is not really torn, but we should do this surgical procedure called a "synovectomy" to get it to calm down so it will finally stop hurting.”
 
What is a tendon synovectomy surgery? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

 

Broken toes with an ankle sprain?

Let's say you're out on a trail run, you roll your ankle and sprain it. So what do you do?

You limp home, you get back to the car, you ice it, you take some pressure off of it, you elevate it, you do all the right stuff. But, it's really painful and swollen the next few days.

Then, maybe a day or two later, it's black, it's blue and swollen. But even worse, you look down and you're kind of dismayed because your toes are swollen like sausages.

Believe it or not, I have had a number of patients who called me, not because they sprained their ankle, but because they were actually worried they may have broken toes as well.

Is it possible to break your toes at the same time you get an ankle sprain? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

 

Should I get a CT scan or test walking to see if fracture is healed?

Today's episode comes from a discussion I just had yesterday with an athlete. He had a metatarsal fracture non-union.

A "fracture non-union" can develop when there is a crack in the bone that moving a little bit too much and doesn't completely heal.

Non-unions can happen if you get a stress fracture, and you keep running on it and you're tough and you're strong and it doesn't really hurt that bad.

If you keep running and repeatedly stress that crack, it can't heal.

Should I get a CT scan or should I test walking to see if my fracture is healed?

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

What is a bone callus in a metatarsal stress fracture

When you get an injury to a bone like a metatarsal stress fracture, you can develop a thing called a "bone callus."

You might even see it as a lump visible on the x-ray in your doctors office.

Whether the lump is made up of hard bone, fibrocartilage or something in between, it may help you to understand the significance of that lump in your foot.

When the bone callous appears, and the size of the bone callous itself, can tell your whole lot about your progression of healing, and whether or not you might get other problems in the future.

What is a bone callus in a metatarsal stress fracture? Well, that's what we're talking about today on the Doc On The Run Podcast!