Doc On The Run Podcast

Are calcified Achilles tendons more prone to rupture in runners?

Today's episode comes from a question from one of the YouTube viewers. The specific question was, are calcified Achilles tendons more prone to tendon rupture in runners?

That's a great question.

I think if you ask most doctors, their answer is probably going to be yes. 

But since I got this very specific question, I actually wanted to see if there is any research that truly proves whether or not Achilles tendons that have calcification or ossification within them, whether or not they're actually more prone to rupture in runners.

Are calcified Achilles tendons more prone to rupture in runners? 

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

Ask for an hour and tell your doctor you need more time because you are a runner

What would happen if you did this? 

Walk into your doctor's office and say, 

"Hey, look, I'm a runner. My situation is complicated. I really want to train. I really want to get back to running. I would like you to take an hour, sit down with me and let's really work through this so that I can get back to training."

Right now when you picture yourself going into your doctor's office and asking for a full hour, how does that make you feel?

If you don't think you could walk in and ask the doctor directly, what if you called the office in advance and tried to explain you have a complicated situation and you would like an hour of the doctor's time.

What do you think would happen?

Ask for an hour and tell your doctor you need more time because you are a runner. 

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

Capsulitis vs. Plantar Plate Sprain. What is the difference?

If you're a runner and you have pain in the ball of the foot, especially around your second toe joint where the toe attaches to the foot, you may be suffering from a plantar plate sprain.

Many years ago, if you had this kind of pain, it would probably have just been called "capsulitis" by your doctor.

But a plantar plate injury is something that has become more recognized as a distinct pathology in the last 10 or 20 years. Plantar plate injuries do not get misdiagnosed nor ignored as often as before.

Plantar plate injuries are very difficult to heal in runners because the ligament gets stretched and strained every time you stand on your foot or bend your toe. 

But the joint capsule can also get injured. Joint capsule injuries and plantar plate injuries are not the same.

Capsulitis vs. plantar plate sprain. What's the difference? 

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

Plantar Plate Imaging: MRI vs. Ultrasound

Every time a runner calls me who has a plantar plate sprain, they're trying to figure out how they can know for sure they actually do have a plantar plate sprain. They often also want to know how bad the plantar plate injury really is. 

When you're a runner, the problem with plantar plate sprains is that many doctors will offer a standardized cookie cutter approach.

I most often help runners get better without surgery.

That's not because I'm a better doctor. It is because I really put a lot of attention into educating injured runners about how to do all of the additional things to get the injury to heal quickly...so that they can skip the surgery.

One way to start healing faster is by imaging the plantar plate to determine the extent of tissue injury. 

Plantar plate imaging, MRI vs. Ultrasound.

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

Don’t search for less than what is needed

After years of doing the Doc On The Run Podcast and making YouTube videos to explain overtraining injuries that can interfere with running, I have gotten a lot of interesting questions. 
 
We've had over a million views on YouTube, and over 300,000 downloads of the podcast which all equal a lot of questions.
 
Mostly overtraining injury questions center on a search for a shortcut. Many injured runners also think the solution is in only one action.
 
Don't search for less than what is needed. 
 
That's what we're talking about today on the Doc On The Run Podcast. 

Mistakes mean the most time off running

If you are a runner and you have an injury, my guess is that you are most worried about how long you will need to stop running.

When people call me for a webcam consultation or an in-person second opinion evaluation, I see runners making the same mistakes over and over.

If you've made one of these mistakes, don't beat yourself up too much.

There is not that much you can do about the past.

But you can take action today, change course and get focused on what you need to do right now to get back to running faster.  

Dwelling on what you have done incorrectly will only slow you down.

But if you don't identify mistakes, you can't fix them.

Today, on the Doc On The Run Podcast, we're talking about how mistakes mean the most time off running. 

Wanna heal a stress fracture? Make bone faster than you break it down!

Last week I was lecturing at the International Foot & Ankle Foundation medical conference in Hawaii. Specifically, I had been asked to give a couple of talks on treating running injuries.

During the day I was moderating the surgery and sports medicine session, Dr. Gary Labianco was giving a lecture on Metatarsal Fractures.

He said something that led us to today's episode.  It was genius!

"If you want to heal a metatarsal fracture, you have to break bone faster than you break it down."

What he means is that you have osteoclasts and osteoblasts, not just repairing bone, but also removing bone throughout the healing process.

That is true. But let's think about the other side of that equation.

Not just physicians pulling your activity back to stop breaking bone down so fast, but all of the things you as a patient could do to make bone faster.

Wanna heal a stress fracture faster? Make bone faster than you break it down!

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

Is your doctor pushing you out of your comfort zone?

Growth happens outside of your comfort zone. This is true for both emotional growth and physical growth.

Very few patients who call me for help with a stress fracture are not really upset.

They all feel like they wasted months of time with treatments that either didn’t help, or made them worse. They are still not running.

All of these runners seem to express the same concern, the fastest path back to running seems just as mysterious as that supposedly invisible crack in the bone.

Is your doctor pushing you out of your comfort zone?

And is that discomfort going to help you heal that stress fracture so you can run?

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

How can a runner tell a heel bone stress fracture from plantar fasciitis

I just did a consultation call with an injured runner who had a really interesting history with his heel pain. There was some concern that he might actually have a calcaneal stress fracture and not a plantar fascia issue. 
 
In case you don't know, "calcaneal stress fracture" is just the medical term for a stress fracture in the heel bone.
 
The heel bone is the largest bone in your foot, and runners can sometimes develop a stress fracture in the heel bone. 
 
They are relatively rare, but there are a couple of ways that you can get these stress fractures.
 
The good news is calcaneal stress fractures heal pretty quickly. But if you have one, you really don't want to run on it.
 
How can a runner tell a heel bone stress fracture from plantar fasciitis? 
 
Well, that's what we're talking about today on the Doc on the Run podcast.

Cuboid stress fracture vs. Capsoluloligamentous strain associated with cavus foot. How can a runner tell the difference?

If you have this pain on the outside of your foot near the cuboid bone, you might start worrying you have a cuboid stress fracture.

Cuboid stress fractures are rare. 
 
In fact, cuboid stress fractures account for  less than 1% of all the stress fractures that happen in the foot in athletes. 

But there is something more common that can feel like a cuboid stress fracture. 
 
Doctors call it "capsuloligamentous strain."
 
How can a runner tell the difference between a cuboid stress fracture and this thing called capsuloligamentous strain? 
 
Well, that's what we're talking about today on the Doc on the Run podcast.