Doc On The Run Podcast

Why plantar plate injuries get misdiagnosed so frequently in runners

Every time I do a second opinion consultation with a runner who has a plantar plate injury, I hate to tell you this, but I hear the same story over and over and over.

Basically they call me and they say, "Well, I have a plantar plate sprain. I know I have a plantar plate sprain. I went through the plantar plate sprain course and I've been doing some of those things to actually try to get it better and it's starting to improve, but I was misdiagnosed with another condition."

And we're going to talk about why runners get misdiagnosed so frequently when they have plantar plate injuries and why it can be difficult to figure out whether or not that's actually a problem in the first place.

Today on the Doc On The Run Podcast, we're talking about why plantar plate injuries get misdiagnosed so frequently in runners.

Best way to tell a stress fracture from a stress reaction

Metatarsal stress fractures are one of the most common overtraining injuries afflicting runners.
Much of the time the stress fracture is preceded by what we as doctors call a “stress reaction.”

If you ignore the warning signs of a stress reaction and keep on running in the same way,
applying the same stress, the stress reaction will advance to a full on stress fracture they can
keep you out of training for months. Most people think and X-ray of the foot is the best way to
tell the difference between the stress fracture and a stress reaction. But that assumption is
false.

If you're trying to figure out whether or not you're in the early phases of the stress fracture injury
process you have to take action to figure out what is going on immediately. This episode will
explain that process.

Today on the Doc On The Run Podcast we’re talking about the difference between stress fracture and stress reaction.

Which running shoes show running form wear pattern best?

This question came up from somebody in the coaching groups who wanted to make sure that she wasn't going to get re-injured.

She wanted to know which running shoes she should use to reassess her pattern, and make sure that she's working her way out of this compensation pattern, where she's essentially limping because of this prior injury and that's a really useful thing to do.

Today on the Doc On The Run podcast, we're talking about which running shoes show running form wear patterns best.

Why runners should always get second MRI at the same facility

An MRI can be very helpful when you have a strange injury that doesn't seem to fit in any of the common running injury boxes. 

I just had a call from a runner in that very situation. He is someone who has an injury and has something kind of strange going on. 

He actually had an abnormal finding on an MRI from a little more than three years ago. 

At the time that he had that previous MRI that thing that was a little weird on his MRI wasn't really causing a problem, but now his pain is in exactly that same spot.

Today on the Doc on the Run podcast, we're talking about why runners should always get the second MRI at the same imaging facility.

How can a tarsal coalition start causing pain in a runner?

Today's episode actually comes from a second opinion telemedicine visit with a runner who wanted to know more about a tarsal coalition. 

He had an X-ray and the doctor found this thing called a "C-sign." 

The "C-sign" is an abnormal appearance on an x-ray that suggests a tarsal coalition. When you look at the lateral view of the foot X-ray, a bridge of bone can form, partially encircling the talus bone and the calcaneus or the heel bone. It creates a bridging bright white thing that looks like the letter C on your X-ray.

A C-sign is abnormal, and it is one of the classic signs of a tarsal coalition. 

How can a tarsal coalition start causing pain in a runner? Well, that's a great question, and that's what we're talking about today on the Doc On The Run Podcast. 

How did bone chips get in my peroneal tendon?

Today's episode comes from an injured runner who saw a doctor, got x-rays and found what looked like bone fragments in the peroneal tendons. 

We were doing a telemedicine second opinion consultation, and she wanted to know whether or not she should have surgery to take the bone chips out of the peroneal tendon. 

That's a great question!

How did bone chips get in my peroneal tendon? Well, that's what we're talking about today on the Doc On The Run Podcast.

Why runners should always get a copy of X-ray or MRI image disk!

I was just on a second opinion telemedicine call with an injured runner.

She had a recurring injury that was still keeping her from running. 

Unfortunately, that injury first started eight years ago. 

When you have an injury, and you get x-rays, an MRI or a CT scan, or any kind of medical imaging study that shows more detail than the x-rays, you should always get a copy of that disc.  

This runner's story is a great example of why you need those images.

Today on the Doc On The Run podcast we're talking about why runners should always get copies of the x-ray or MRI imaging disk.

Should a runner have surgery to remove bone fragments?

Today's question comes from a telemedicine visit second opinion for a runner. 

She was asking if she should have surgery to remove bone fragments.

I said, "Well, let's talk about what's going on with you first." 

Anytime we see something abnormal on an x-ray or an MRI, we often think that it's pathologic. We presume something is wrong, just because it doesn't look right. 

We think if something's wrong, we should go cut your foot open and fix it.

Should a runner have surgery to remove bone fragments? Well, that's a great question and that's what we're talking about today on the Doc On The Run podcast.

Pathologic vs. abnormal x-ray and MRI findings in runners

The other day I was talking to a runner who had some abnormal findings on the x-rays. 

What we could see was calcification in the Achilles tendon that looked like bone chips. 

She wanted to know if she should have surgery to remove the calcification or little bony chips that were inside her Achilles tendon.

Now, the interesting part of the story is that the Achilles calcification was discovered from an x-ray where she had a stress fracture in one of the metatarsals....in a completely different part of her foot!

The pain she was having when running didn't even come from an Achilles tendon problem. 

Today on the Doc On The Run Podcast, we're talking about the difference between pathologic versus abnormal findings on x-rays and MRIs in runners.

2 Opposite ways injections can help a tarsal coalition in a runner

Today's episode comes from a runner who was having some weird aches and pains when running.

One doctor suspected he might have a thing called a "tarsal coalition."

A tarsal coalition is an abnormal union or connection between two bones.

He was even told me might need surgery to remove the tarsal coalition.

He asked me whether or not an injection, like a stem cell injection, might actually help a tarsal coalition.

You have to think about the runner's goals, and we expect different injections will actually do to figure out which is best for you.

Today on the Doc on the Run podcast, we're talking about two opposite ways injections could help a tarsal coalition in a runner.