Doc On The Run Podcast

Best test for a runner with ankle sprain

If you're out on a run and you roll your ankle, you need to know how you can test the ankle to figure out what is wrong.
 
More importantly, what tests can tell you how likely it is that you're actually going to get back to running and not have an ankle sprain again.  

There are several tests doctors use in evaluating injured ankles. Some are more important than others.

What is the single most important test for a runner with an ankle sprain? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast.

Fracture that seemed like a plantar plate sprain

There are times when you might have a suspected stress fracture in your foot. If so, your doctor may order an X-ray. 

There are other times when it's extremely unlikely that you have a broken bone at all, but it is almost certainly just a soft tissue injury.
 
One of the questions I get a lot from runners with plantar plate sprains is how to make sure the pain is not from  a stress fracture.  

I have only seen one case where somebody had fracture pain in the exact same spot you would have pain when you had a plantar plate injury. 
 
Can a fracture in the metatarsal seem like a plantar plate sprain? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast.

How to rule out soft tissue vs. bone injury

If you are running with foot or ankle pain, and you're trying to figure out what's wrong, the first step is deciding if it is a bone injury or  soft tissue injury. 
 
It might be useful to talk about the thought process I use when trying to figure out whether or not you have bone versus soft tissue injury. 
 
How do you rule out soft tissue versus a bone injury when you're a runner and you've rolled your ankle? 
 

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

Why does a Lister’s corn hurt when I run

I recently did an episode where I was talking about Lister’s corns.

If you missed it, a "Lister's corn" is really just a callus or thick skin that looks like the pinky toenail or the little toenail has a split in it. 

That edge of the nail that looks like a completely separate piece of nail.

But it's not a nail at all, it's callus.
 
I just saw a runner who had this problem where his Lister's corn was really painful. It hurt so much he thought the nail might be ingrown. He asked,

Why does a lister’s corn hurt when I run? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

How to tell soft tissue vs bone injury in a runner

All overtraining injuries are difficult. 

The problem is that you're trying to not lose your running fitness while giving the injured part enough of a rest so it can actually heal.
 
A runner asked me an interesting question the other day, he actually said, “Okay, if I have bruising and swelling, does that mean I'm more likely to have a bone injury or a soft tissue injury?”
 
What are the key differences between a soft tissue injury and a bone injury in a runner? 
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

Was the plantar plate ligament injured before my MRI?

I was recently doing a second opinion consultation with a runner over a webcam to review the MRI of his foot. 
 
What we found was that he had what looked to be attenuation and a partial tear in the plantar plate ligament on his MRI. 
 
There was a lot of inflammation in the foot around the ligament, not just within the ligament itself. 

He asked me was really good question:
 
“Could my plantar plate ligament been have injured long before I ever got an MRI?”
 
Well, that's what we're talking about today on the Doc On The Run Podcast. 

Running injuries are like compounded interest in reverse

Every runner who gets injured is in a race against time.  

It is a race to not lose your running fitness. 
 
You know you are going to get weaker. You know you're going to get stiffer. You're probably really concerned that you're going to lose all that aerobic fitness that took months or years building up.
 
Running injuries are like compound interest but in reverse. 
 
That's what we're going to talk about today on the Doc On The Run Podcast. 

When to worry an ankle sprain is a Lateral Process Fracture

I just saw a runner who sprained her ankle.  It's been about a month and she's still having pain. Pain and swelling persisting a month later, are not good. There are a couple of reasons that that can happen. 
 

Anytime doctors see persistent swelling and pain after an ankle injury, they become concerned there might be a fracture. 
 

When should a runner who rolled an ankle be concerned that there might be a fracture like a lateral process fracture? 
 

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

Worst imaging study for plantar plate injury in runners

If you are a runner with pain in the ball of the foot at the base of the second toe and start researching online, you may become concerned you have a thing called a plantar plate injury. 
 

If so, you may be wondering whether X-rays or MRI imaging may be needed to tell what is wrong. Before seeing a doctor, it may be helpful to understand which are helpful, and which imaging studies are a waste of time. 
 

What is the worst possible medical imaging study you could get if you're a runner with a suspected plantar plate injury? 
 

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

My pinky toenail split in half

Just this week, I got a call from an injured runner about a new problem. I've seen him before for some other issues, but in this case.

He said that he thought maybe he actually had an ingrown toenail on his pinky or that the toenail itself had split in half and it was bugging him a little bit.

I said “Well, send me a picture. I'll take a look and see.”

My pinky toenail split in half. Is that a problem?

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