Doc On The Run Podcast

Aching pain in heels from standing desk during pandemic

I just did a telemedicine call with a runner who had a very interesting complaint. This  was heel pain and heel pain in itself is not really interesting, because most of the people who get heel pain have plantar fasciitis, but this was one of those cases where somebody had heel pain that was not plantar fasciitis, and was definitely something else.

I actually had this exact same problem myself during the last year. I work at a standing desk, I record podcasts at a standing desk, I do Zoom calls with all kinds of people, all kinds of different meetings.

Most people who get plantar fasciitis, or bursitis, or a partial rupture of the plantar fascia, or even a stress fracture in the heel bone, they generally get it only in one foot, but this pain was pretty much the same in both feet.

Today on the Doc On The Run Podcast, we're talking about aching pain in the heels from standing at a desk during the pandemic.

If your hand was broken, would you walk on it?

I was doing a telemedicine, second opinion consultation with an elite triathlete who got a stress fracture and this is actually a very common sort of discussion that I have with runners who schedule telemedicine visits, who call me for coaching calls and second opinion advice.

This guy has been athletic his entire life and he was ramping up for an event and then he got a metatarsal stress fracture and you would think that it's pretty simple. In this particular case, the doctor looked at his x-rays and told him that she thought she saw a crack in the x-ray and so she thought there was a crack in the bone but she wasn't really a hundred percent sure.

Now he asked me a really great question. He said, "Well, if it doesn't really hurt that much, is it okay if I walk on it?"

Today on Doc On The Run Podcast, we're talking about if your hand was broken, would you walk on it?

Is cortisone good or bad for hallux rigidus?

A question came up during a recent telemedicine visit I was doing with a runner who has hallux rigidus. He wanted to know whether or not it was a good idea or a bad idea to inject the big toe joint with cortisone to treat his hallux rigidus.

The doctor is basically looking at your circumstances, trying to figure out what you really want short-term and long-term, and then figuring out whether or not that treatment is actually appropriate given your circumstances.

There is nothing risk-free in medicine. 

So when you have a cortisone injection in the big toe joint for hallux rigidus, the goal is to reduce the inflammation. Corticosteroids, however, are also very effective at breaking up collagen bonds.

Today on the Doc On The Run podcast, we're talking about whether or not cortisone injections are good or bad for hallux rigidus.

Is it okay to jump rope with shin splints?

This episode comes from a question sent in by one of the Doc On The Run Podcast listeners, and she wanted to know whether or not it was okay to jump rope if she has shin splints?

Well, the short answer is, you can do whatever you want. You just have to be willing to pay the consequences.  You can have a couple of different consequences from jumping rope with shin splints.

But if you're sure that you just have shin splints, if you've done a telemedicine consultation with an expert on running injuries, or if you've seen your doctor and your doctor poked around on you and was sure that you really and truly only have shin splints, then in that case, it is probably safe for you to do it and just see what happens.

Today on the Doc On The Run Podcast, we're talking about whether or not it's okay to jump rope with shin splints.

Plantar heel bursitis misdiagnosed as plantar fasciitis

I was just doing a telemedicine call with a runner with a long history of plantar fasciitis, that has not been getting better. She had been doing stretches, icing, and even an injection of corticosteroids around the plantar fascia. 

We were doing a second opinion telemedicine call to talk about what's really going on. We talked about her whole history. She had been keeping track and has kept a pain journal. 

During this one hour second opinion call, we figured out that she had been misdiagnosed.

We figured out she actually had bursitis on the bottom of the heel.

Today on the Doc On The Run podcast, we're talking about plantar heel bursitis, misdiagnosed as plantar fasciitis.

Questions runners should ask doctor during a telemedicine visit

Just this morning I was interviewed on a television program about telemedicine.  Since I have been doing telemedicine for a little more than 10 years they invited me to come on as an expert to talk about the changes in telemedicine resulting from the pandemic.

During the interview, we were discussing all the different ways telemedicine can be more helpful than in-office visits. At the end, I was asked an interesting question, and I remembered that I actually created a check-list years ago for runners to actually take to their in-person doctor visits. That same list can help make telemedicine visits more helpful as well.

Today on the Doc On The Run podcast, we're talking about why you need to make a list for your telemedicine visit.

Hallux Rigidus running shoes should they be hard or soft

This episode comes from a discussion I just had with a runner during a telemedicine visit where I was helping her figure out a second opinion and what to do about her hallux rigidus. So she was very confused because she's been diagnosed with hallux rigidus.

She's been told that that's what's causing the pain in her big toe joint when she runs and she was a little confused because she said the doctor explained to her that she might want to get some kind of plate to put in her shoe to make it stiffer.

But at the same time said that she has high arches and because she has high arches and what we call a neutral foot type that have in part, led to her hallux rigidus, that she needs to have more cushioning in her running shoes.

Today on The Doc on the Run Podcast we're talking about running shoes for hallux rigidus. Should they be hard or soft?

Find your line to recover from injury faster

This episode comes from a discussion I just had with a runner during a telemedicine visit. This person brought up a great idea that really seemed like it would make a great episode and something that' would be really helpful for you to understand.

 

When you get injured, your goal is to actually recover as fast as possible and maintain your running fitness while you heal that specific injury.

 

Now, everybody wants some timeline, like two weeks, four weeks, six weeks, something that says this is how long I have to wait for it to be healed and me to get back to running safely. But it never works out that way consistently. What you have to do is you have to figure out how you can push your timeline and how you can actually speed things up.

Today, on the Doc on the Run podcast we're talking about how you need to find your line if you want to recover from running injury faster.

Heel bone repositioning to run with plantar fasciitis

On this episode, we're just giving you a quick tip on how you can actually reduce some of the stress and strain on the plantar fascial ligament when you have plantar fasciitis and you want to keep running.

Now everybody knows, if you stop running you're going to lose your running fitness. That's not really confusing. That's not hard to understand. But what you really need to understand is that plantar fasciitis is not really self-limiting.

It does not miraculously go away like a cold virus. It hangs around if you continue to aggravate it because the stress and strain to the plantar fascia that makes it irritable and causes this condition called plantar fasciitis, is a consequence of excess stress and strain.

Today on the Doc On The Run Podcast, we're talking about repositioning your heel bone so you can run with plantar fasciitis.

Question #1 How bad is my injury

The number one question I get on social media is can I run with this injury? 

So the problem with this is that whenever I get this question, whenever somebody says, "Can I run?" what's really never disclosed to me in that runners question is how bad is it? 

The thing that determines whether or not you can run is whether or not you can reduce the stress and strain on that injured piece of tissue enough that you're not going to make it worse by running. 

I get this same question for people with Achilles tendonitis, with plantar fasciitis, with metatarsal stress fractures, plantar plate strains, you name it. 

The thing everybody wants to know is can I run right now or not.

Today on the Doc on the Run Podcast, we're talking about question number one, how bad is my injury?