In today’s podcast episode we're talking about fracture healing versus skin healing.

This talk comes from a discussion I had at the International Foot and Ankle Foundation meeting in Hawaii where I was recently giving a lecture on Runner's Heel Pain to a whole roomful of doctors. 

A doctor asked me a question about how to get a runner back to running as quickly as possible after injury.

If you get a fracture of one of the metatarsal bones in your foot, you are not going to be able to run until it heals. 

But as soon as it's healed, you will want to start running again. 

I was just lecturing at the International Foot and Ankle Foundation meeting in Hawaii. One of the podiatrists came up to me and asked me a question after one of the sessions.

He said that he was going to be working with a local high school cross-country team.

He wanted to know what I thought would be the most important things to share with cross-country runners to try to reduce their risk of injuries amongst the team throughout their cross-country season. 

What information would I want to share with a high school cross-country team? 

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

If you're a trail runner or a marathon runner or an ultra-marathoner, well, the last thing you want to do is get a fracture. 

Bruised toenails are extremely common in runners. Many consider black and blue toenails a rite of passage when training for your first marathon. 

A solitary dark linear streak is alarming to dermatologists and podiatrists. Because if you get a solitary linear bruise that doesn't drift out like a typical bruise under the nail usually does, your doctor might be concerned that you have something called acral-lentiginous melanoma.

If you get a fracture of the metatarsal, you have to make sure that it's healed before you start running on it. 

It doesn't matter if it's a stress fracture, or a traumatic fracture where you stepped in a hole, tripped or fell off a ladder. 

Deciding when it appears to be healed enough to withstand the forces of running is the key.

The most common way doctors decide when the fracture is fully healed is by taking an X-ray. 

Plantar plate injuries are one of the most difficult injuries for runners. 

The reason is that they can take a long time to get better. Every time you take a step, you're applying direct pressure to the plantar plate ligament. 

I was on a call with a marathoner who had a cuboid fracture.

He was getting better, and he was trying to figure out how he could start running.

The cuboid bone is an irregular bone at the base of the metatarsals, and it's sandwiched in between the fourth and fifth metatarsal bones and the heel bone. It is a bad bone to break. So he had a valid question:

Is it risky to run with a cuboid fracture? 

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

I don't like it when I hear a doctor said, "Don't run." 

What the doctor should say is, "Let's figure out how you can run." 

And if you're injured, that's what you should be thinking about too. 

Not, "When can I run?" 

But, "How can I work out right now?"

When can I run if my doctor says "don't run" because of an injury? 

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

Today I got a great question from a runner who had a 4th metatarsal stress fracture while training for a marathon. He wanted to know how likely it was to get a setback, or re-injury, if he is running while the stress fracture heals.

How likely is a setback if I run while my stress fracture heals? 

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