Doc On The Run Podcast

Tibialis Anterior Tendon Transfer for Chronic 5th Metatarsal Stress Fracture

I just got a really obscure question from a runner suffering from chronic stress fractures. 

She was asking about a surgical procedure called a tibialis anterior tendon lengthening in order to address a situation where she had the same kind of 5th metatarsal stress fracture, again.  

Today on the Doc on the Run podcast, we're talking about tibialis anterior tendon lengthening for chronic fifth metatarsal stress fractures.

What size compression socks should I get after a bad ankle sprain?

If you sprain your ankle, you know that you need to protect it. 

The old treatment algorithm used to be R.I.C.E.: rest, ice, compression and elevation.

The newer protocol is P.R.I.C.E.: protection, rest, ice, compression and elevation. 

Compression is one of the main things you need to do when you get an ankle sprain. When you sprain the ankle, it swells a lot and it's not going to get better, and you are not going to get back to running until sometime after that swelling goes away. 
 
The point of this episode is that when your ankle is swollen, it is a different size from your non-swollen ankle. 

What size compression socks should I get after a bad ankle sprain? 

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

Sesamoidectomy vs 1st Metatarsal Osteotomy for big toe joint pain

Sometimes runners have to do a whole lot of digging trying to figure out the difference between a couple of different surgical solutions for a recurring injury. 

Pain under the big toe joint can be because you are getting a stress reaction or a stress fracture in one of the two little sesamoid bones. It is pressure to that bone that is causing all the trouble. 

How can a doctor surgically reduce that pressure? 

What is the difference between a sesamoidectomy and a first metatarsal osteotomy for pain under the big toe joint? 

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

What is Metatarsal Stress Fracture Displacement?

I got a call from a worried runner who had a stress fracture. 

The fracture was not healing so he called for a second opinion. 

One of the things that he did not understand was this x-ray report that he got. The x-ray report and it said that he had "two millimeters of displacement of the fractured metatarsal bone without angulation."

So, in this episode, I am going to try to explain to you (the same way I explained to him) what "fracture displacement" really means and how it shows up on the x-ray in a runner. 

What is metatarsal stress fracture displacement on an x-ray? 

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

Icing or NSAID’s better for an inflamed plantar plate in a runner?

The plantar plate ligament that gets injured in runners is typically located on the bottom of the foot, at the base of the second toe. 

It gets inflamed, it gets irritated, it may feel weird at first. The plantar plate may not even feel sprained, or sore, or injured. It might just feel like this weird sort of fullness sensation.

I got a question from a runner who had those same strange symptoms. He was trying to figure out what treatment would best address the "fullness" sensation in and around the plantar plate.

Which is better for an inflamed plantar plate in a runner who wants to run? Icing, cryotherapy, NSAIDs, which one is going to help the most? 

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

 

What is Metatarsal Stress Fracture Troughing?

I got a call from a runner who had a stress fracture that was not healing, who needed a second opinion. 

When we were on the webcam call, one of the things that he did not understand was the specific medical terms on his MRI report. The MRI report said that he had "troughing" of the fractured metatarsal bone. 

I just thought that it might be helpful to explain to you what metatarsal troughing really means and how it shows up on an MRI.

Today on the Doc On The Run podcast, we’re talking about what is metatarsal stress fracture troughing.

Does swimming help your running fitness improve after injury?

I was on a call with an active athlete who is recovering from a couple of different injuries and her main goal is to get back to running at high intensity.

But while she has been injured and she cannot really run, what she has been doing is cycling, swimming, and doing a number of different strength training workouts to supplement her running fitness.

She asked me an interesting question and she wanted to know whether or not swimming was really helpful in terms of her cardiovascular fitness more than just her specific running related strength.

Does swimming really help your running fitness improve after an injury? 

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

Why running is better than lunges or planks when you have a plantar plate sprain

When you have a plantar plate injury, it can be frustrating. The whole problem stems from a tiny little ligament right at the base of the second toe that is getting irritated, stretched, and strained. If its really bad, you might even have some tiny little tears in the plantar plate ligament.

I was just talking to a runner who asked me about other exercises. Because, she had been told... 

       "stop running, do other exercises to get stronger."

So, she signed up for a boot camp training class.  Although she wasn't running, shewas doing lots of exercises that were potentially harmful to the plantar plate and slowing her recovery, and eventual rturn to pain-free running. 

So, which is better for a healing sprained plantar plate, running more or doing exercises that make you stronger like planks, push-ups, and burpees? 

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

What is shortening of a metatarsal stress fracture on a CT scan?

I get lots of calls from runners who need a second opinion for running injuries like metatarsal stress fractures.  Many times they are confused by medical terminology in their imaging reports. 

In this particular case, the runner wanted to know what it meant when her radiology report said that there was "5 millimeters of shortening of the second metatarsal bone," the bone that had the stress fracture. 

In this episode, I am going to explain what fracture "shortening" really means and how it shows up on a CT scan. 

What exactly is shortening of a fracture when it shows up on a CT scan? 

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

Is time or intensity more important after running injury?

I was just on a call with a trail runner who is recovering from both a sesamoid bone injury as well as a peroneal tendon injury.

Right now she is focusing on working toward running on long technical trail runs in the mountains. To that end she is doing a lot of different forms of activity to supplement her running fitness.  

During our call, she asked a great question...

"Should I be adding a lot more time or a lot more intensity to rebuild her running fitness."

Which is more important to increase first, after you have had a running injury, time or intensity? 

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