Doc On The Run Podcast

MRI essentials for Runners, T1 vs T2 images

If you're a runner who got injured and got an MRI, I'll bet that you've already tried to look at it...but you have simply no idea what you're looking at. 

You see there are more than a hundred images of your foot on the MRI. So, you're not even sure where to start. MRI's can be really overwhelming!

But MRI images are not really that complicated. 
 
In this series on how to read your own MRI, I'm going to break it down and help you understand your own MRI images, especially if you want to see  what was in the MRI report from the radiologist.
 
Today on the Doc On The Run Podcast, we're talking about MRI Essentials for Runners, T1 versus T2 Images.

Injured runners need a Goal Race

If you're injured, you really need to have a goal.

If you were to call me for a private consultation or a house call, I would not accept "I want to get over my foot pain" as a goal.

But interestingly, when injured runners call me, that's often what they say. 

Think about this. When you sign up for a race, it's really easy to get motivated. It's easy to decide on your training plan and just get to work.

But when you are injured, you think the process has to stop.

Today on the Doc On The Run Podcast, we're talking about why injured runners need a goal race.

How to get access to an Alter-G treadmill

Today's episode comes from a recent question from a runner who I advised to begin running on this thing called an AlterG treadmill. 
 
First of all, I do not own an AlterG treadmill. I do not own the company. I don't own stock in the company. I do not get paid a referral fee or anything else if you use one. 
 
I'm not pitching the AlterG treadmill because I get paid for it. 
 
But the AlterG treadmill is a tool that I not only use frequently with athletes who are returning to running, but it is a tool that I teach physicians at conferences to use with their patients as well.
 
How can you get access to an AlterG treadmill when the physical therapy place says no? 
 
That's what we're talking about today on the Doc On The Run Podcast. 

Your brain is your adversary when you first start running

You and your brain are supposed to be on the same team. You work hard with long runs, tempo runs and speed work to get your brain used to the idea of letting you run fast.  

But sometimes your mind can work against you. This is especially true when you first return to running after a foot injury. 

Your brain remembers your pre-injury ability. If not restrained, your brain instinctively wants to get you back to running at that same pace. 

If you just started running post-injury, a little more detail may help you avoid a common trap.  

You need to understand how powerful your mind is when it comes to your pace, your return to running and staying below your threshold for re-injury. 
 
Your brain can be your adversary when you first start running after an over-training injury. 
 
That's what we're talking about today on the Doc On The Run Podcast.

Value of getting an MRI on both feet

There are only a few occasions when you might want to get an MRI on both feet. 
 
Truthfully, getting an insurance company to agree to pay for an MRI on both feet is not easy to do. 

A few years ago I helped a runner who was training for marathons when he got injured. He was super fit. But on a long, super steep run in Yosemite he did some damage to tendons in both of his feet.

He really needed an MRI on both feet. So, I wrote an order for his MRI's. But, when the MRI facility tried to get prioritization, the insurance company denied the MRI request.

That just didn't make any sense to me. 

Is it valuable to get an MRI on both feet?

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

3 variables you can modify when you run after injury

When you're trying to get back to running, you have to think about all of the variables that can increase the stress and strain to your injured tissues.

Your "threshold for recovery" or your "threshold for re-injury," are really the same. 
 
When I lecture at medical conferences, I always tell doctors there are 3 variables you have to play with. 

And you do have to play with the variables if you want to get an athlete back to running as quickly as possible.
 
What are three variables you can modify when you're starting to run after you've had an injury? 
 
Well, that's what we're going to talk about today on the Doc On The Run Podcast. 

You got injured because you were too weak

Yesterday it started to snow. So I decided to go out on a trail run on the trail in this picture.  

I only saw one deer and two people.

As I ran around a corner under a cliff two climbers approached wearing jackets, with fleece hats under their helmets and all their climbing gear.

I stopped, looked at them and I asked, "Isn't it too cold for climbing?" 

One of the climbers smiled and said, "Isn't it too cold for a trail run?" We all started to laugh.

The reality is that it is never too cold to go for a trail run. But excuses for getting stronger abound. 

This is true when you are injured, too.

You got injured because you were too weak.

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

Lacing running shoes with bursitis from tailor’s bunion

One of my Elite Access patients sent me a message. He was having pain from an inflamed Tailor's bunion bursa at the base of the pinky toe.

He got a bigger shoe with a wider toe box that decreased the pressure. But when he was running, his foot was sliding around in the shoe, and it was still causing a problem.

He asked me if there was any solution. And yes, there is...

Today, on the Doc On The Run Podcast, we're talking about how you can lace your running shoes differently when you have bursitis pain from a tailor's bunion. 

The longer you wait the more pain you can expect when you run

When you get injured, a lot of things go wrong. 
 
1. Because you have pain, you suspect you have to stop training.

2. When you see a doctor, they confirm your fear and tell you that you really need to rest. 
 
You translate that into really strict rest, doing nothing basically. You stop exercising. You stop training. 
 
All kinds of bad stuff starts to happen. It is a lot more than just losing aerobic fitness. 
 
Today on the Doc On The Run Podcast, we're talking about how it is that the longer you wait, the more pain you can expect when you actually return to running after you get an over-training injury. 

Do I need surgery if metatarsal fracture non-union starts hurting?

Today we're talking about metatarsal fracture, nonunion surgery versus no surgery.

I know some people will think that I probably should have gone straight from #665 to 667 because frankly, there are some negative connotations surrounding those three letters, 666...the number of the beast.

But I decided to do this episode anyway. And, I decided to dedicate this one to a buddy who is a beast. 

He's tough, he's active, and he happens to have a metatarsal nonunion that hasn't stopped him from doing a whole lot of fun, active things. 

I'm hoping in this episode you can learn a little bit about the different options you have when you get a metatarsal fracture nonunion.