If the top of your foot hurts because you have extensor tenosynovitis, it can cause a lot of pain. But the condition is not complicated.

The extensor tendons run down across the top of your foot. The extensor tendons continue all the way out to the toes. The function of the tendons is to pull your toes up when you swing through in the swing phase of gait, so you don't trip over your toes when you run.

If you start running and your shoelaces actually push on the tendons with just a tiny bit too much force, the tendon sheath surrounding the tendons can get irritated. With continued aggravation, you get inflammation within the tendon sheath. A big painful spot right on the top of your foot is the result. 

So, there's a simple way you can decrease the irritation of the tendon sheath when you have extensor tenosynovitis.

Today on the Doc On The Run Podcast, we're talking about how you can alter your running shoe lacing pattern if you have this condition called tenosynovitis.

All of us want to get better when we have a running injury. 

We just want to run. But when you go to the doctor, things can start getting confusing.  The doctor may tell you what you need to do, but it doesn't always jive with what you really want to do. 

I thought it might be helpful for you to understand a little bit about the difference between true wants and needs when you go to the doctor. This may help you get your doctor to focus on what you really do need so you can get back to running sooner.

Today on the Doc On The Run Podcast, we're talking about distinguishing your wants from your needs and your running injury recovery. 

Any time you get a running injury you are facing a tremendous task. 

You might think that your job is to get help and heal the injuries quickly as possible. 

But that would only be partially correct.

Your real job as an injured runner is to seek the full solution.

Today on the Doc On The Run Podcast, we're talking about how injured runners need the full solution.

If you are a runner who thinks you have a tendon tear, ligament tear or other overtraining injury, you may want an MRI. In fact, you may be convinced an MRI will give you a crystal clear picture of what may be wrong inside your foot or ankle. 

But, I believe many many runners and doctors rely way to heavily on MRI for running injuries. 

Today we are going to talk about a study published in Foot and Ankle International in 1998.

The research study was led by Dr. Matthew Rocket (a well-respected foot and ankle surgeon) in Houston Texas.

This was a great study comparing the effectiveness of MRI and diagnostic ultrasound when trying to decide whether or not there is an actual tear in a tendon around the foot and ankle.

Is an MRI best way to check for a tendon tear in a runner?

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

I got a call recently from a runner with a torn plantar fascia. It was a unique situation, but truthfully really not that rare.

Any time you have an injury and you want to run, you have to make some really important key decisions, based on only a few important factors. 

This case will be instructive in helping you figure out how you can make that decision, and decide if (and when) it might be safe for you to run.

If you just had an injury, but you have a really important event you want to run, you gotta check out this episode!

"I think I tore my plantar fascia. Can I run this weekend?"

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

Most runners understandably feel like a victim of an over-training injury.

They say something like, "Well, I was feeling strong, I was feeling ready for my race, I was really feeling great, and then this happened to me. I got a stress fracture, I got Achilles tendonitis, I got peroneal tendonitis, got plantar fasciitis, something happened to me and now I feel like I've lost all my fitness and I can't run my race." 

Well, most of the time we just reflexively think that things happen to us, but sometimes things really do happen for us. 

What do I mean by that? Well, sometimes the bad thing actually has a silver lining that you can't even see.

Today on the Doc On The Run Podcast, we're talking about how if you PR with an injury, the injury happened for you and not to you.

Today's episode actually comes from a comment and a question sent in by one of the viewers of the Doc On The Run YouTube channel. 

This was Jean, wrote in and she said, 

"Hello, Dr. Segler. I had a fifth metatarsal fracture repair surgery five weeks ago. I was started to walk without crutches and a knee walker or a scooter as of yesterday, but my foot feels achy, though. Well, as a runner, when can I possibly resume running after my metatarsal surgery?"

This is what everybody wants to know. 

I didn't do the surgery and I don't know all the details, but I can tell you that depending upon when you're going to run after a surgery depends upon several things.

How soon can I run after fifth metatarsal fracture surgery? 

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

I was just talking to a runner over webcam who had been researching metatarsal stress fractures, but heard something about a "malunion" and knew that a fracture malunion was a really bad thing. 

He had been diagnosed with a stress reaction in one of his metatarsals. 

If you continue to stress a metatarsal stress reaction enough, it can progress to a full-on metatarsal fracture. 

So, he wanted to know, "If I run on my stress reaction, is it going to turn into a malunion?"

How can a bone stress reaction turn into a malunion, from running? 

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

Many years ago when I was first in practice, I met someone who was a doctor, and who was a runner herself. She liked to treat runners and she happened to make a lot of money. A whole lot of money!

I was very impressed with her, so I actually flew across the country to spend one day in her office following her around to see exactly what she does to make so much money working with runners. 

There was one particular visit with one runner, which really struck me.  

Right before we walked into the treatment room, the doctor spun around, looked at me and said, "Okay, this guy's a runner. He has plantar fasciitis. I'm going to show you how to treat plantar fasciitis in a runner in under a minute."

The encounter was nothing like I expected...

Treating injuries is fast, but treating runners is slow. 

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