Doc On The Run Podcast

I was just on a call with an injured runner who is about to go out for a test run. 

She is very excited because she is going to get either a yes or a no on deciding if the tissue in her foot that is been healing is strong enough to withstand a little bit of running at a medium pace for a short distance. 

This is an important test because if it hurts, obviously no running, right? You got to wait some more. But because you want to get a yes, you want to make sure that your chances of getting the yes are as high as possible. 

The way that you do that is you protect the foot as much as possible. So, the shoes you should use for your test run really do matter a lot. 

If you are going to go out and try a test run after you have been injured, what kind of shoes should you wear? Cushioning shoes or stability shoes? 

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

What if you were ramping up for several years to run 100 miles, but then you got tendinitis?

If you start getting pain because you have been doing lots of hill repeats, you could get irritation of the FHL tendon and specifically the tendon sheath that surrounds it where it bends around the back of the ankle. One of the treatment options is to inject it with corticosteroids. 

So, this runner called me and wanted to know whether or not it would be a good idea for her to inject the tendon sheath with cortisone before her trail race. 

If my FHL tendon is inflamed and irritated, should I inject the tendon sheath before my 100-mile trail race? 

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

If you get pain on the top of your foot because you irritated the extensor tendons, they can be very painful. 

A runner asked me recently about using athletic tape to heal extensor tenosynovitis.

Since it seems like athletic tape can help almost any type of musculoskeletal injury, you might be wondering, could taping help the tendons or the tendon sheath on the top of your foot when it gets aggravated.

Should I use tape if I have extensor tenosynovitis? 

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

Yesterday I was at the Twin Cities Foot and Ankle Conference in St. Paul, Minnesota. The reason I was there is I was invited by the Minnesota Podiatric Medical Association to come and give a one-hour lecture, about "What's New in Sports Medicine." 

It may not surprise you that most of what I was talking about was how to help injured runners get back to training, full activity, after overtraining injuries, as quickly as possible.

After my talk, another doctor out in the hallway approached me, and she asked an interesting question. What she asked was... 

“If you yourself had an overtraining injury, whether it was a stress fracture, a plantar plate sprain, a tear of the plantar fascia, a split in the peroneal tendon, no matter what the injury was, if you yourself were given a deadline of 30 days to healing that thing enough, you could actually run outside without worrying about re-injuring that piece of tissue, what exactly would you do?” 

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

Today's episode comes from a running injury from Jamie. He wanted to know about hallux rigidus. 

He asked:

“Are there any non-surgical approaches to helping hallux rigidus when you are not a good candidate for a cheilectomy?” 

What can a runner do when you have hallux rigidus but you're not a good candidate for cheilectomy surgery? 

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

I often get some questions from listeners I would never imagine. 

I just got one of those questions from a runner who has a mallet toe. 

Her doctor suggested surgery. The runner was worried because she been researching hammer toes and mallet toes. During that search she learned a lot about the plantar plate ligament as it relates to crooked toes. 

She was worried that if she had the surgery, it might cause a plantar plate injury.

Can a percutaneous tenotomy surgery cause a plantar plate injury? 

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

Today's episode comes from a question posted on one of the YouTube videos, specifically on an episode called, “Should I get an MRI to see if I can run now?” 

Haitham wanted to know:

“Would you say it is okay to walk if you are pain-free after being non-weight-bearing for two weeks? Does one always have to finish the standard five to six weeks of crutches?”

Does a runner always have to finish the standard five or six weeks on crutches? 

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

I was on a call this morning with a former professional Ironman triathlete. This guy is the real deal. He is not lazy. 

He is not unmotivated. He is not unathletic. He is a top tier kind of athletic guy, and he is very, very aware of his body. He is also very adept at the process of damaging tissue we call "training" and the need for healing those tissues to make his body stronger.

What he also understands is that the process of healing a ligament sprain (or "injury") is the same thing. 

During our call this morning, he pointed out that he barely slept last night. Since his plan was to ride on the trainer today, we were talking about the risk to the sesamoids. 

He used a term I had not heard before, calling it "multifaceted negatives."

Should I work out today if I did not sleep well last night? 

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

I got a question from a runner with a fibular stress fracture.

She said her primary care doctor got r x-rays of the fibula bone.

The doctor could not tell from the x-rays if the spot on my fibula that looks odd might be an old stress fracture or a new stress fracture in the fibula bone.

The recommendation from the primary care physician was basically to just wait for four weeks, let it heal, let it calm down. 

She asked:

“Is my primary care doctor's advice wrong?"  

Should I just wait for weeks to let my fibular stress fracture heal? 

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