Doc On The Run Podcast

Surgical options sesamoid fracture nonunion

If you have a fractured sesamoid bone, the biggest concern is that the sesamoid fracture will turn into a fracture nonunion.

"Non-union" means it did not unite. The two broken pieces did not get back together, and the fractured sesamoid bone did not heal. 

I was talking to a runner who had a sesamoid injury and she wanted to know whether or not surgery was a good option in her case. 

We talked broadly speaking about three different possible kinds of sesamoid surgeries.

Today on the Doc On The Run podcast, we’re talking about surgical options for sesamoid fracture nonunion.

Which comes first after plantar plate heals running or dress shoes

I got an interesting question from a runner who had a plantar plate injury. 

This runner had a long course of sort of misdiagnosis, mistreatment and various plantar plate "misadventures." 

But when we started working together, he started to do some specific things to improve quickly, and he is doing great now. 

He asked:

“Which comes first after my plantar plate sprain heals, will I be running, or will I be wearing dress shoes?”

Well, that is a good question and that is what we're talking about today on the Doc On The Run Podcast. 

Do you have to a cut a ligament to remove a painful neuroma?

I had a call from a patient who wanted to know about surgical removal of Morton's neuroma. 

She said she went to the doctor. The doctor said, “Well, we can just take the nerve out. It is not a big deal. We do this all the time.”

The reason she called me for a second opinion was because the doctor told her we have to cut a ligament to take the painful nerve out. 

She wanted to know if that was true, and whether or not that could cause a problem later.

Do you have to cut a ligament in the foot to remove a painful neuroma? 

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

Did I tear my fascia after plantar fascia surgery?

I got a comment from a runner who posted this question on one of the YouTube videos on the Doc On The Run YouTube channel.

He says he had plantar fascia surgery just over 3 months ago.

He said that following the operation, he followed all of the surgeons post-operative instructions "to a tee." 

He was feeling great, until he started developing a small pain at the back of the arch right where the heel starts. 

He said:

“My whole arch is in pain. Do you think I could have a torn plantar fascia? It was tolerable but in hindsight this has not been ignored.”

Did I tear my fascia after plantar fasciitis surgery? 

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

 

Can I run in zero drop shoes after plantar plate sprain heals?

I was just on a call with a runner who had a plantar plate injury that has been bothering him for about a year and a half.

We did a series of calls to talk about some changes in his treatment that could get him moving in the right direction.

He asked me a great question when I was on a call with him this morning. 

He said:

“Can I run in zero drop shoes once it is really healed? Not today, but like when it is really, really healed and it is stronger and all that kind of stuff.” 

I said, “You can do whatever you want, you just have to be willing to pay the consequences.”

Can I run in zero drop shoes after a plantar plate sprain heals? 

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

What sandals can I wear with hallux rigidus?

When you have hallux rigidus, the problem is the big toe joint does not want to move. 

Many doctors will simply tell you that your big toe joint, or the "first metatarsal phalangeal joint" is getting progressively stiffer and developing arthritis. 

If you wear shoes that irritate the joint more, the condition will only gets worse. The question is what sandals won't make hallux rigidus worse?

What sandals can I wear with hallux rigidus? 

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

Can peroneal nerve tendinitis cause 5th metatarsal pain?

Today's episode comes from a comment on one of the YouTube videos on peroneal tendinitis. A limping runner asked the question: 

“Can peroneal nerve tendinitis cause fifth metatarsal to be tender to the touch and when walking, I am not sure if I have a stress fracture.”

When I read this comment, I became confused because I am not sure what is going on with this runner, but I am going to try to explain and answer the question as best I can in this episode.

Can peroneal nerve tendinitis cause fifth metatarsal pain? 

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

Is it possible to run with a sesamoid fracture non-union?

I got a great question from a runner with a sesamoid fracture that turned into a "non-union."

The sesamoid bones are two tiny little bones under the big toe joint. When you break one of the sesamoids, if two pieces of bone do not heal back together, we call a "sesamoid fracture non-union."

In this runner's case, she used a bone stimulator. She wore a fracture boot. She used crutches. But after a year of treatment, the doctor looked at her X-ray and said, “You have a non-union, we should take it out.”

Is it possible to run if you have a sesamoid fracture non-union?

That is a great question and that is what we're talking about today on the Doc On The Run Podcast. 

I am on track should I book a call to check in?

The primary way I help runners is through telemedicine second opinions. 

I help runners who are not running, who have not been getting better, who are frustrated, and help them figure out what they need to do to get past the injury and back to running. 

Once they are on track and have made lots of progress, they want to know “When should we check in for our next call?”

I feel like I am on track with my running injury, should we book another consulting call or a series of calls to talk about it? 

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

Should I have serial injections for sinus tarsi syndrome

I saw a runner today and I did a cortisone injection to treat her sinus tarsi syndrome.  She asked me a great question. 

She said, “Is the cortizone injection something I am going to need to do every three to six months?”

She had been reading up on corticosteroid injections and had found that some athletes with certain conditions may have injections scheduled every few months.

Should I have serial injections for sinus tarsi syndrome? 

Well, that is a great question and that is what we are talking about today on the Doc On The Run Podcast.