Doc On The Run Podcast

Does the plantar plate need to "heal” on MRI before I can run?

I was recently doing a call with an athlete who has a sprain of the plantar plate ligament. 

One of the things that happens with runners is we get an MRI, sometimes just for what we suspect is a plantar plate sprain. 

He went and got an MRI. In fact, he got a couple of MRIs. The MRIs were different. 

It is reasonable to want reassurance that your foot is healing before you start running. But an MRI doesn't always provide the reassurance you seek. 

Today on the Doc On The Run podcast we are  talking about whether or not you need to see healing of the plantar plate ligament on your MRI before you can run.

Healing leaves subtle clues

We always want obvious signs when we are healing form something like a metatarsal stress fracture, Achilles tendinitis or peroneal tendinitis or any injury that is keeping his from training as much as we would like.

But the results aren’t always obvious.

Think about your pace, what it feels like. Think about how those feelings of pace, perceived exertion and heart rate keep you on track.

These are are performance clues when training and racing.

We also have to look for performance clues when recovering.

Today on the Doc On The Run Podcast we're talking about how healing leaves clues, but they are often subtle.

Runners do not recover faster by guesswork

I was just talking to a runner in one of the sessions where people call in who are taking the One Run Away challenge. In that challenge course, I'm helping you try to figure out what is the step that you're not taking that is holding you back from recovering as quickly as possible. So this is the thing that goes on and every few days I do calls and let people ask questions directly to me over webcam.

I got an interesting question and this was about how to actually do something that Dr. Schreider talked about during the recent runners rapid recovery summit. Now he works with professional soccer players and he was talking about how he gets athletes back on track after they have an Achilles tendon rupture and have to have surgery. Now these are professional athletes. So the owner of the team is not going to do things by guesswork. They want to make sure that these athletes are on track as quickly as possible.

Today on the Doc On The Run Podcast we're talking about how runners do not recover faster by guesswork.

Can x-rays show a plantar plate injury?

I was just doing a telemedicine visit with a runner who has had an injury to the plantar plate ligament with pain for months. 

He's been getting better slowly, but he was trying to figure out how bad it really is. And one of his first questions he asked me was what I see on the x-rays.

Can you see anything about the plantar plate where it's torn, where it's injured or anything else?

Most of what doctors see on a foot x-rays are changes that imply ligament damage. 

But there is really only one thing on an x-ray that truly indicates that you probably have a tear or rupture of the plantar plate ligament.

Today on the Doc On The Run Podcast we're talking about whether or not x-rays can show a plantar plate sprain.

Am I on the right track?

I just got off a telemedicine call with a runner and she asked me an interesting question, she said, "I just want to know, am I on the right track?”

When a runner calls me for a telemedicine visit, after they've seen two or three or four other doctors, I do something differently. 

What I do differently is something you can do on your own right now, you don't even have to talk to me. Just look at your results.

If you track those results, you look at those results, you will know what's going on and then you can change course faster. 

Today on the Doc On The Run Podcast we're talking about how you can tell whether or not you're on the right track when you're recovering from a running injury.

Hip Pain in Runners with Dr. Duane Scotti

Dr. Duane Scotti, host of the Healthy Runner podcast was one of the guest experts at the 2-Day Runner’s Rapid Recovery Summit. 

This replay is a recording of his session on Hip Pain in Runners is one you won’t want to miss. Here is some of what we’re going to cover: 

The top 3 most common causes of hip pain in runners.

What exactly is the labrum and how does it get injured in runners?

How does joint laxity or hip instability contribute to hip injuries?

What is the number one indication that somebody has a tear of the labrum and should seek medical attention before continuing to run? 

Today the Doc On The Run Podcast, we’re talking about hip pain in runners and some simple things you can do to address it, improve it and keep it from getting worse.

Is my healing timeline realistic?

I was just doing a telemedicine visit with a runner who needed a second opinion for a metatarsal stress fracture. 

She wanted to know if her healing timeline was accurate and if her estimate on getting back to running was realistic. 

The healing timeline for any running injury always depends upon is what you do. Not what your read, and not what your doctor said. 

The “realistic” part is based on what you do, not arbitrary timelines.

Today the Doc On The Run Podcast, we’re talking about whether or not your healing timeline is realistic.

You are not getting better. Great!

If you're a runner who's been injured, recovering, and you feel like you're plateaued or you're not really getting anywhere, I have some very good news for you today. That's awesome! 

Most of the runners who call me for a telemedicine visit, they've hit a plateau. 

Although that can be really frustrating, I can tell you from experience, this is very, very good news.

What's going on is really simple. 

The changes you need to make, they're all around you, they're right in front of you, and they're available to you right now. You just have to notice them.

Today the Doc On The Run Podcast, we’re talking about how it is actually great if you’re not getting better.

From broken heels to whole champion Barbara Edelston Peterson

Just for a moment I want you to imagine something. You made a decision to become a champion. And after years of continual effort and constant training you have won a World Championship.

Today you are packing and getting ready to travel to Switzerland to defend your European title. And then you fall and break both heel bones. In that painful moment everything changes.

You aren't getting on a plane to go to defend your European title. Instead you're going to the emergency room.

The question is what would you do to rebuild your life and your own self-perception as an is athlete immediately after that kind of injury.

Today the Doc On The Run Podcast, we’re talking with Barbara Edelston Peterson about what she did to go from two broken heel bones becoming a Whole Champion.

3 ways to run hills without rupturing achilles

One of the worst possible injuries you could get as a runner would be a rupture of the Achilles tendon.  

 

Because if you tear the Achilles, whether you have surgery to repair the Achilles tendon or you if don't have surgery and allow the tendon to heal without surgery, even if it heals, I can promise you, you are never going to be the same.

 

Running hills puts a lot of stress on the Achilles.

 

If you have Achilles tendinitis, Achilles tendonosis or just mild Achilles irritation, understanding what to do to avoid rupturing the Achilles will also help you avoid aggravating the tendon when running hills. 

 

There are really three simple things that you really need to do when you're going to run up hills so that you don't put yourself at risk of an Achilles tendon rupture.