Doc On The Run Podcast

Most important tibial stress fracture detail is location

Andrea ran 3:09 in the Tokyo Marathon with calcaneal stress fracture!

Don’t ask when can I run after an injury… Ask how I can run

One of the worst questions you can ask any doctor is, "when can I run?" 

 

Believe it or not, I get these questions every single day...from total strangers.

 

They get injured and go to the doctor. The doctor says, "You can't run." Then they will call me and ask, "When can I run?" 

Why am I going to give you the magic answer, if I don't even know you?

There is a better way.

The best questions that you can come up with are the ones that direct your doctor to start thinking about how to help you get back to running a whole lot faster.

If you got a running injury and you're trying to figure out how to run and you go to the doctor, don't ask them when you can run, ask them how you can run. 

That's what we're talking about today on Doc On The Run Podcast. 

Plantar Plate Sprain and Deep Peroneal Neuritis

An interesting runner called me for a second opinion. He had a couple of things going on that created a pretty confusing picture.

He had a plantar plate sprains (at least he was told he had plantar plate injuries) because his MRI showed evidence of injuries to the plantar plate ligaments of toes two, three, and four.

He also had some nerve type symptoms. But on the bottom of the foot, he also had this very interesting ridge of callus.

So what was REALLY causing all of his trouble when he ran?

Today, on the Doc On The Run Podcast, we're talking about a runner with a plantar plate injury and deep perineal neuritis. 

Can I run every day on the Alter G treadmill?

I got a great question from a runner who wanted to start running on an Alter G Treadmill. What she said was:

"I've been getting out of the boot. I started running on an Alter G Treadmill, and everything's been going great. I feel good. I feel like a million bucks because I'm finally moving again. Is it okay for me to run every day?" 

What if you had a friend, who was not fit at all, who wanted to run a marathon? Imagine she wanted to do her very first marathon, and you were going to help her train? Would you tell her to run every single day?

Can I run every day on an Alter G Treadmill? 

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

Can I run after a spiral fracture of the fibula?

Today's question actually comes from Elizabeth who explained she rolled her ankle, and sustained a fracture of the fibula bone. She wanted to see if she could get some advice.

She said, "I'm a 27-year-old female. I twisted my ankle and I was rushed off for x-rays and discovered a spiral displaced fracture of my fibula in my ankle joint. I'm dying to get back on the road and going a bit stir crazy. It's been 10 or 11 weeks post-break now. I want to know if I will do damage by starting to run in increments to gain back some fitness and cardiovascular fitness or if it'll be okay.”

Can I run after a spiral fracture of the fibula? 

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

How your running shoe insert can show risk of plantar plate sprain

One of the worst injuries you can get when you're a runner is a plantar plate sprain. It's a stretching, a straining, a tearing of this tiny little ligament at the ball of the foot called the plantar plate. 

Every time I do a second opinion consultation over webcam for a runner with a suspected plantar plate sprain,  I ask them to do one simple thing. 

I want to look at the insert in their running shoe: "Go get it, right now, preferably one you've been running in for a long time, not a brand new one." 

Pull out the insert and let's see what the wear pattern shows us. 

Today on the Doc On The Run Podcast, we're talking about how your running shoe insert can actually show whether or not you're at risk of a plantar plate sprain. 

How an injury happened is more important than what happened

During a recent call with a runner who signed up for a series of phone calls, we were trying to figure out exactly what happened to cause his foot pain. 

 The way that doctors are taught to think goes something like this:  Come up with a particular name called a "diagnosis" and then do a "procedure" that the insurance covers.

 Doctors focus on making sure the diagnosis code matches the insurance requirements so they will send a check.

This process does not serve runners well. Runners need to focus on how they got injured...so they do not do it again. 

 How an injury happened is much more important than what happened. 

 Does that make sense? 

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

The 4 worst traits of a running shoe for Morton’s neuroma

One of the most common nerve related running injuries is a thing called Morton's neuroma. A "neuroma" is just an irritated nerve. A "Morton's neuroma" occurs specifically in the foot between the 3rd and 4th toes.

When a neuroma first starts, the nerve is just a little bit irritated, and it may feel a bit weird.

In one of the original descriptions of Morton's neuroma, it described a sensation or feeling of wet leather being stuck to the bottom of the foot. That odd sensation is the result of the nerve getting aggravated. It starts to send little erroneous signals to your brain.

 

If the nerve is getting irritated, you want to make sure your running shoes are not making it worse. 

What are the four worst traits of a running shoe if you have a Morton's neuroma? 

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

When is an MRI most reliable for a soft-tissue running injury?

If you have a soft tissue injury in your foot related to overtraining, you (or your doctor) may be thinking about getting an MRI.

If you have a ligament injury, plantar plate sprain, partial tear of the plantar fascia, an Achilles tendon partial rupture, Achilles tendinosis, or peroneal tendinitis,  the timing of the MRI is extremely important.

MRIs can be really useful tools. They give you over a hundred images of your foot. Because you have so many pictures, the detail can fool you into believing the MRI is a complete picture, but it is not. 

When is an MRI most reliable for a soft tissue running injury? 

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