Doc On The Run Podcast

I was recently on a follow-up call with a runner who is recovering from a calcaneal stress fracture.

She was doing really well, the stress fracture was healing, and her heel pain had completely resolved. So it was time to start ramping up her running. 

Since she wanted strategies to decrease stress on the stress fracture, we talked about increasing her running cadence. 

She asked me specifically about the difference between pace and cadence, as she wanted to be absolutely clear on what they were.

What is a method you can use to alter your cadence when you have been recovering from a running injury? 

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

If you get a metatarsal stress reaction, you might be confused for a number of reasons. First You are probably trying to figure out whether or not it is really just a subtle stress fracture or, if it is something more ominous? 

Second, you are also probably trying to figure out how to make the pain go away as fast as possible so you can get back to running. 

Last night I was talking to a physician who referred a runner who had a fourth metatarsal stress reaction. 

She wanted to know if it really was a good idea or a bad idea for her to take something like ibuprofen or some other non-steroidal anti-inflammatory drug which we call NSAIDs.

Should I take NSAIDs when I have a fourth metatarsal stress reaction? 

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

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.

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. 

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. 

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. 

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. 

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. 

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.

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.