Today's episode comes from a runner who asked me a very interesting question during a surgical second opinion webcam call.

She seemed to be really confused because the doctor had recommended performing hammertoe surgery in the doctor's office, and not an operating room. 

She thought that was weird. She was also confused because the surgery would be performed using only a needle and not a scalpel.

Can a doctor really do a hammer toe surgery using nothing but a needle? 

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

Last week, I was in Hawaii lecturing at the International Foot & Ankle Foundation Medical Conference. meeting.  

I had been invited to give several lectures on running injuries. One of those was about stress fractures for physicians, podiatrists, foot and ankle surgeons.

One of the objectives was to help them understand how they can look at stress induced injuries differently, with the intent of teaching the doctors that they really have to consider these timelines.

Timelines, forced decisions and action in injured runners, and that is what we're talking about today on the Doc On The Run Podcast. 

Plantar plate injuries in runners are a common topic at medical conferences because they cause a lot of pain in the ball of the foot. 

I just spoke to a runner who had an interesting question about plantar plate injuries, which was a question I never would have imagined.

She wanted to know whether or not a "mallet toe" might lead to a plantar plate sprain.  She didn't really understand the difference between a "mallet toe" and a "hammer toe."  But she did understand that one or both are in some way related to plantar plate injuries. 

Does a mallet toe lead to a plantar plate sprain in runners? 

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

Today I was on the call with an injured runner who is trying to figure out how soon she can start running. She had been having pain and she was getting relief by taking over-the-counter medication. She asked me whether not that was good or bad.

Whenever we have pain, we can simply take a pill, and the pain will go away. Non-steroidal anti-inflammatory drugs or NSAIDs are powerful readily available painkillers. I do not just get rid of inflammation they also control or reduce pain.

So, when is it okay or not okay to reduce your pain with NSAIDs if you are in the process of recovering from a running over training injury?

That is a great question and that is what we’re talking about today on the Doc On The Run podcast!

She thought that the bump was much more swollen than normal. 

She had basically rolled her ankle and banged that bone into a rock and then she was having some swelling there over the arch.

She did a form of cryotherapy called the contrast bath routine to reduce the inflammation.  It suddenly got much smaller. Like the bone shrank.

How can that happen? 

If I have an accessory navicular bone in my foot and I do the contrast bath routine, will that fix it? 

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

Okay...I'm just gonna say it...lots of runners get funky toenails. Runners get bruised toenails, black toenails. 

But the worst thing  is when the nail lifts up off the nail bed and you get fungal filaments that cause athlete's foot underneath the toenail. Then you get toenail fungus or onychomycosis.

If your doctor recommends oral antifungal medications, you may get worried about the side-effects of the medication.

Just today I saw a runner with toenail fungus. He wants it gone!

So I was talking to his primary care doctor about the potential of modifying the normal routine for oral medication for him so that he could reduce his concern for having liver problems as a consequence of taking this medication. 

Today on the Doc on the Run podcast, we're talking about a couple of options you have if you are thinking about taking oral medications for toenail fungus. 

If you start getting pain in the ball of the foot, especially in the area between the metatarsals, it might be caused by a little fluid-filled sack (called a bursa) that sits between the metatarsals. 

Sometimes you get swelling of that little bursa, and it causes pain in the forefoot. 

This problem could be misdiagnosed or thought to be caused by a neuroma, an inflamed nerve that runs in that same area.

What is intermetatarsal bursitis in the runner's foot? 

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

I have recently gotten a bunch of questions on one of the episodes I did where I mentioned somebody who had a stress fracture, and I had suggested that she should increase her cadence to try to decrease some of the impact forces through that particular bone when she was running and getting back to training now that she is really started to recover in a meaningful way. 

Specifically, what we are talking about here is your cadence.

However, I think that since I have gotten so many questions about it, if you are interested in the idea of cadence and impact forces, this might be useful for you to get some clarification.

Is there any research on running cadence as it relates to impact forces in the foot? 

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

This episode comes from one of the YouTube viewers on the Doc On The Run YouTube channel and he posted a question as a comment on one of the videos, and he wanted to know, how can I tell if I broke the plate and screws on my calcaneal fracture.

But number one, my number one question here is, what is it that this guy could have done that would have made him think that he applied enough force to the broken heel bone that he then could have broken the plate after the surgery?

How can I tell if the plate and screws on my calcaneal fracture broke? 

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

Today's episode actually comes from a comment posted on one of the Doc On The Run YouTube videos.

The viewer asked, and he said exactly, “I dropped a piano on my foot. Will I run again?”

Well, that depends. If you drop a piano on your foot, maybe it would break your pinky toe. Maybe it would completely crush your foot.

I dropped a piano on my foot. Will I run again? 

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