Doc On The Run Podcast

Intractable dubious metatarsalgia diagnosis

Today's episode comes from one of the Doc On The Run YouTube viewers.  

Casey wrote in and he said, 

“This year I suffered from this problem after switching to zero drop running shoes and I was finally running pain free. The zero drop running shoes made me into a forefoot runner instead of a heel striker. I was doing great but then I started having pain in the ball of my foot from a callus. I then started having this pain and I did exactly what you said to do in this video and it worked great and specifically this video showing how to remove a callus in a specific way with a specific technique.”

He also said, “Great information here, everything I was researching kept saying it was metatarsalgia but my pain was different. Thank you for the great video.”

Many runners get unfairly stuck with a metatarsalgia diagnosis. 

What is the intractable dubious metatarsalgia diagnosis? 

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

What is the sinus tarsi?

I get lots of questions about "sinus tarsi syndrome" in runners.

It seems like most runners who call me don't even really know what it is. 

The sinus tarsi is not a structure, so much as a space.  

That space contains some structures that can cause pain after an ankle sprain. The sinus tarsi may also ache in flatfooted runners as well.

The sinus tarsi confuses many runners because it is kind of in the ankle, but kind of in the foot as well.

What is the sinus tarsi? 

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

Biggest danger with popping a broken toe back in place (avascular necrosis)

I had a question on one of my YouTube videos in which I was trying to explain the procedure for broken toes called "closed reduction."  That's the fancy term for popping the broken bone back in place or "re-setting the fracture." 

You may have heard someone say, “Well, I had a fracture and the doctor had to "set it" or the doctor had "put the broken bone back in place.”

There is a risk and a benefit to everything. Even with non-surgical fracture treatment.

Putting a fractured piece of bone (in a broken toe) back where it belongs is more likely to make it heal in the right position, because you put it back in the right position. 

If you leave the broken bone in the wrong position, it may heal and then cause problems later because it's crooked. 

Today on the Doc On The Run Podcast we're talking about the biggest danger with popping a broken toe back in place. 

Should a runner have surgery to shorten a long second metatarsal bone?

Today's episode comes from a second opinion discussion with a runner suffering with a nagging plantar plate ligament injury. 

She was considering surgery for a plantar plate sprain.

Truth is, her plantar plate sprain was not really that bad. 

It's pretty common when runners have trouble healing a plantar plate sprain, the doctor may recommend a number of different surgeries.

One of those surgeries is where we actually shorten a bone in an attempt to decrease the tension and pressure on the plantar plate ligament.

Should a runner have surgery to shorten a long second metatarsal bone? 

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

Can I still run after I heal a fibular stress fracture?

Today's episode comes from a question from one of the Doc On The Run YouTube channel viewers about fibular stress fractures. 

There are only tow bones between your knee and your foot: The Tibia (or shin bone) and the fibula bone, which is much smaller. 

The fibula bone supports very little of your weight when you run. Your knee is at the top of the tibia bone, and the other end of the tibia sits on top of the talus bone at the top of your foot. 

The tibia is the bone that really takes the pressure from your knee and redistributes it to your foot. The fibula bone is a stabilizing bone on the outside of your leg, it is not a weight bearing bone and it really does not support your weight or hold a lot of vertical force. 

Understanding the leg bone anatomy can help you understand the stresses that may cause a stress fracture in either one of the leg bones.  

Can I still run after I heal of fibular stress fracture? 

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

Fast & Easy vs. Fast & Cheap fracture imaging

I was just speaking with a runner who scheduled a second opinion consultation. He asked, "what is the best way to tell if my foot is broken." 

I said, "Well, there's the fast and easy way and then there's the fast and cheap way.”

Today on the Doc On The Run Podcast, we're talking about fast and easy versus fast and cheap ways to tell if your foot is broken. 

Bone bruise for 10 months still not running

Today's episode comes from a comment on Doc On The Run YouTube channel. 

Colin watched the video explaining: “Bone bruise vs stress reaction in a runner.” He posted a question asking what he should do after a frustrating 10 months off from running, without improvement. 

I've had a bone bruise for 10 months and I'm still not running. What does that mean? 

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

You cannot run early without data

I just had a conversation with a runner who signed up for one of the self-help courses. She booked a short call just to get a jumpstart, prioritize and figure out what she really needed to do first, so she could get better as quickly as possible. 
 
She asked me a really interesting question at the end of our call and she said,

“Okay, based on what we talked about, are you sure that my ligament is not going to just rip apart if I start running?”

I said,

“No, I'm not sure of that at all. In fact, we didn't even talk about your injury. You told me that you think you have this injury. But you (and your doctors) are not even 100% certain you have a ligament injury. You don't even know what's really wrong. Right now, you don't know where you are, because you have no reliable data."

You cannot run early without data. 
 
And that's what we're talking about today on the Doc On The Run Podcast. 

Do bunions cause plantar plate sprain in runners?

Perhaps the most nagging injury, and most difficult to deal with if you're a runner, is something called a "plantar plate sprain." 

The plantar plate ligament is on the bottom of the foot, usually at the base of the second toe. 

I got a question from a runner who actually had a plantar plate injury. She also happened to have bunions. So, she asked: 

"Do bunions cause plantar plate sprains in runners?" 

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

Is returning pain normal when running after a healed stress fracture?

Today's episode comes from Janet ,who posted a comment and question on the Doc On The Run YouTube channel. 
 
She said, 
 
“I got a healed stress fracture, returned to running. I got into cross country and it started to flare up and hurt around the tibia again, is this normal or should I be concerned?” 
 
Is returning pain normal when returning to running after a healed stress fracture? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast.