Doc On The Run Podcast

How can a bruised toenail from running cause toenail fungus?

If you're reading this, it's probably not because you love toenail fungus. It it also probably not because you think black toenails are pretty. In fact, you probably think both are pretty gross and you would be right.

But this bruised black toenails and toenail fungus joining the party is mostly preventable.

All runners should understand the circumstances that can put you at risk of getting a fungus infection in the nail which runners call "toenail fungus," or which doctors call "onychomycosis."

It is often the fungus that actually causes the skin infection called athlete's foot.

It's very, very common. Fungus is all over the place! Don't freak out, but it's probably in your shoes right now! 

Whether or not the fungal spores and fungal filaments will cause an infection on your feet, just depends upon the circumstances that you set up as a runner that actually allow it to get in and cause real trouble.

How can a bruised toenail from running cause toenail fungus?

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

Did my doctor do the wrong plantar plate injection?

If you get a plantar plate sprain, the first thing you may notice is pain and irritation at the ball of the foot, right where the second toe attaches to the foot. If the foot feels swollen, puffy or sore in that spot, it could be a plantar plate sprain.

A one common injection performed for plantar plate ligament sprains is a corticosteroid injection.

I just spoke with a runner who thought the doctor did the injection in the wrong part of the foot. 

She saw a podiatrist, and the doctor did a corticosteroid injection for the plantar plate sprain. She was confused afterward and asked me if the doctor did the injection with the right or wrong technique. I'll explain why she was confused.

I think my doctor did the wrong injection for the plantar plate ligament.

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

 

Do I have to stop running and lose my fitness entirely to heal?

This morning I was on a call answering injury questions live in the Injured Runners Aid Station.

This runner actually said,

"Well, my doctor said that since I got a running injury, the solution is to stop running."

When I think about this, there are really only two approaches to the questions of whether or not you have to stop running entirely to heal an overtraining running injury.

Do I have to stop running and lose my running fitness entirely just to heal?

Well, that's a great question and that's what we're talking about today on the Doc on the Run podcast.

Does a mild plantar plate sprain always hurt?

I was just speaking with a woman who has a suspected mild plantar plate sprain. What was interesting is the fact that she doesn't really have a whole lot of pain.

I was explaining how important it is that she actually figures out her baseline "pain" numbers. I was explaining that even if you don't call it "pain" you have to rate the level of discomfort so you can track it.  

How bad is it when walking with or without running shoes, or simple things like walking up and downstairs.

Now, the problem is that she said, "well, it's not really painful so I can't put a pain number on it."

I understand it may not really be painful. Particularly if you're an athlete with a high pain tolerance. 

When you have a mild plantar plate sprain you must figure out what it is that you call discomfort or pain. You have to track it.

Does a mild plantar plate sprain always hurt?

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

Can my foot injury heal while I am sick?

I just got off a webcam call in the Injured Runners Aid Station. The runner who called me, had some down with a cold.

He had been sick for a few days. He wasn't running. He was curious about whether or not his injury was going to actually get worse while he was ill. Because he knows that when he's sick, his immune system is working really hard to try to fight the infection. And your immune system can't do everything all at once.

If you have an injury, it is widely accepted that the illness is going to slow down your potential ability to rebuild tissue and repair damaged tissue, whether a metatarsal stress fracture or an Achilles tendon injury.

Can my foot injury heal while I'm sick?

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

Best exercise for plantar plate sprain in runners

The plantar plate ligament is a little ligament on the bottom of the ball of the foot, right where the toe attaches to the foot. The function of the plantar plate ligament is to reinforce the joint and support the toe by helping to hold it down against the ground.

Anatomically, the plantar plate ligament resists the motion doctors call "dorsiflexion," where the toe gets pulled up away from the ground.

Even though the plantar plate ligament is really small, its funcion is vital. 

Doing exercises to help support the plantar plate, can help to decrease some load on the ligament.

Today on the Doc On The Run Podcast, we're talking about the single most effective exercise to support the plantar plate in runners. 

How to tell peroneus longus from peroneus brevis

If you recently started getting some aching pain on the outside of your ankle every time you run, you might have a condition called peroneal tendonitis. 

Peroneal tendonitis is a problem often encountered by runners with high arches. It can often be exacerbated by running in ultralight unstable shoes or running on trails when you're feeling too tired to maintain good form.

The two peroneal tendons are both on the outside of the ankle. But they do different things. The way you position your foot to reduce the stress and strain on the one injured tendon, will have to be different because they each do different things.

Today on the Doc On The Run podcast, we're talking about how to tell the difference between the peroneus longus and the peroneus tendon when you're a runner.

How to lace running shoes with extensor tenosynovitis

If you get pain on the top of the foot when you're running you might discover  you have a painful condition called extensor tenosynovitis.

"Tenosynovitis" just  means you have irritation and inflammation within the tendon sheath, or the little tube that surrounds the extensor tendons that fan out toward the toes on the top of the foot. 

There are really 2 keys to calming the tendon sheath. You have to decrease the inflammation with the tendon sheath. But you also have to stop irritating the swollen tissue inside the tendon sheath. The easiest way to stop that irritation when you run is to stop putting pressure right on that irritated spot.

Today on the Doc On The Run podcast, we're talking about how to lace your running shoes when you have extensor tenosynovitis.

 

Is weight loss important for running injury recovery?

The other day in the Recovering Runner's Aid Station, I got a great question:

“If I get stress and strain on my foot, because I'm overweight, should losing weight be part of the strategy to actually get my foot to recover as fast as possible?”

There are lots of ways to reduce the stress and strain on one injured part of your foot.  

Obviously, the more your body weight, the more pressure on your foot when you stand, walk or run.

Sometimes doctors will tell patients, "If you weighed 20 pounds less or 40 pounds less, well, there'd be less stress and strain on your foot...and you would heal faster."

But it's an unrealistic strategy for several reasons.

Should weight loss be a part of your running injury recovery strategy? 

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

Should I stretch the toe with plantar plate sprain?

Yesterday I saw a runner with a plantar plate sprain. She wanted to know if stretching the toe would help the plantar plate ligament heal faster. 

Plantar plate sprains happen because the plantar plate ligament gets overstretched, and strained. 

When you get a plantar plate injury, the fastest way to allow healing is to reduce the stress and strain on that injured ligament.

If you're thinking about whether or not to stretch the toe or do something to try to help the condition improve faster, you really need to think about the mechanics that are actually involved when you have a plantar plate injury.

Should you stretch the toe that has a plantar plate sprain? 

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