If you get gout, it's going to be painful. It hurts because you get so much uric acid buildup in your bloodstream that it starts to crystallize, forming little bitty needle shaped crystals in the joint.

They are pointed, they're sharp and they are poking the tissue on the synovial tissue inside of the joint, and it hurts. 

When is the worst time to check for gout with a blood test? 

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

Every runner who has heel pain wants it fixed. 

A lot of us think about this in the way that we fix automobiles. The alternator goes out in your car, you go get a new one put in. Your battery dies, you go get a new battery. But your foot doesn't work this way. So unfortunately, when you have surgery, you're trading one problem for another.

I have done endoscopic plantar fascia release surgeries, but not on any runners for more than a decade. Why do you think that is? 

Can an endoscopic plantar fascia release surgery get me back to running faster? 

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

If you have a tear in the plantar fascia, you probably know what a frustrating injury it can be. If you think it's better, and you're going to start running, one of your big questions is probably, 

“How do I avoid a second tear in the plantar fascia?” 

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

If your doctor said you have gout, you might have heard about a gout specific diet. 

A gout diet is not a specific diet in terms of a plan. It's avoiding foods that are high in purines that can contribute to high blood levels of uric acid.

What is the most ignored part of a diet for somebody who's a runner and thinks they have gout? 

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

Don't ever forget that when you get a running injury, the goal is not to heal the injury. The goal is to get back to running. 

If you heal the injury and you get so weak and so stiff, that you wind up getting another overtraining injury, that is a failure. 

The thing you have to really think about as you're returning to running isn't just about the possible other injuries you could get but incomplete healing.

The goal is to always strengthen everything as much as possible without obviously causing a real injury to the specific injury that got you in the fracture walking boot, on the crutches or thinking about canceling your race. 

Today on the Doc On The Run Podcast, we're talking about partial credit versus pass or fail with running injuries. 

Why would you want to add stress? 

We're not talking about psychological stress. We're not talking about the stress of a screaming baby or a boss yelling at you. 

We're talking about stress on the tissues that will actually stimulate a healing response that makes them stronger later, just like working out. 

If you're an injured runner who's getting back to running, you need to add stress systematically. 

And that's what we're talking about today on the Doc On The Run Podcast. 

One of the problems with the plantar fascia is that you may think you have plantar fasciitis, but eventually you find out that it was not really fasciitis at all.

It's actually a partially torn plantar fascia ligament. That can be a problem since it is the largest ligament in your foot.

When somebody says:

“Can I run with a small tear in the plantar fascia?”

I say that depends.

Is it a big deal if I run with a torn plantar fascia? 

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

When you have a running injury and you know what your goal is you are halfway there. But if you're trying to get back to running, you've really got to do three things.

You have to start moving, not make the injury anything worse, and you've got to get fit as fast as possible.

Every day is a test run after you've healed a running injury.

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

One of the problems with being a runner is that you have a higher pain threshold. 

If you have a minor attack of gout, it may not bother you as much as it would other people and what Gout is, is that you get painful crystals forming within a joint like the big toe joint.

If you have what we call sub-acute gout, meaning it's not really killing you, it's just kind of a minor thing that's building up gradually, then the condition might actually sort of fly under the radar. 

You might be gradually building up crystals in the joint that you're not really aware of at all. 

How can gout lead to hallux rigidus? 

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

A runner called me to follow up and asked:

"I've been doing the routine that we discussed during our first call and I've got no pain, I’ve got no tenderness. How can I tell if I'm really ready to run now without hurting it?”

You have to realize that if you run and you are weak and unstable, you are at higher risk. Those gaps in recovery create unnecessary risk.

You have to figure the pieces you haven't really considered that could put you at risk of re-injury.

Find the gaps between where you are and your running. 

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