I was just given a talk at the International Foot and Ankle Foundation's 40th Annual Hawaii Seminar. And at the end of the session, we got a couple of questions from the audience during the live Q&A for the doctors. A doctor in the audience she had a runner who is one of her patients.  This runner had been basically running on a mild stress fracture, which I would really consider a stress reaction, for a period of about two months but wanted to do a race.  Today on the Doc on the Run Podcast, we're talking about what a doctor should do when she is helping a runner with a stress fracture who has been running on it for 2 months and still wants to run a race.

Doc On The Run Podcast

Doctor has a runner with a stress fracture for 2 months

This episode comes from a question from a runner I saw in person during a second opinion house call.  She had a  metatarsal stress fracture and felt like it was more comfortable when she was barefoot.  The more you can reduce the stress and strain to the injured metatarsal bone and the healing stress fracture the faster it will heal.  The types of shoes you wear during the recovery can change those stresses for better or worse depending upon which shoes you are wearing.  You need to focus on protecting and healing that metatarsal stress fracture if you want to get back to running as fast as possible.  Today on the Doc on the Run Podcast, we're talking about whether or not it is better to go barefoot with a stress fracture.

Is it better to go barefoot with a stress fracture?

If you want to get back to running faster after a foot fracture (or any overtraining injury), the whole key is make sure that you are increasing your activity to get stronger, instead of just sitting around and waiting, while you get weaker. But the only way you can do that is with constant readjustment based on how you feel and what happens in response to that activity during that recovery process. This episode is about runner with a healing fracture who was told by a doctor, “don’t run.” Instead he was supposed to wait for another x-ray to prove it was healed.  And after I did a consultation call with him, I actually cleared him to start running now. Today on the Doc on the Run Podcast, we're talking about a recovering runner with a fracture who wants to ramp up his intensity today.

Recovering after fracture should I ramp up running intensity today

A podcast listeners wrote in and she asked,  "How long do I need to stop running or take it easy after taking five doses, meaning two and a half days, of Cipro?  I told my doctor I was a runner, so I didn't trust their opinion on when or how I should run.  I haven't run since finding out the side effects two weeks ago, and the Achilles feels weak and a little thicker than the other side." This is a great question, and she is right to be concerned because the FDA issued a black box warning because of an association between Cirpo antibiotics and Achilles tendon ruptures. Today on the Doc on the Run podcast, we're talking about a runner with Achilles tendon worries after taking Cipro antibiotics.

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A couple of weeks ago, I was working on my motorcycle, and I accidentally cut myself open.  Long story short…I let a middle school kid put the stitches in the wound.  In this episode we talk about how that turned out.  We also talk about how that story applies to running injury recovery. Which is more important when you have surgery to heal a running injury?   Is the actual procedure done by the surgeon the most important? Or is the process of injury recovery after the surgery more important? Today on the Doc On The Run podcast we’re talking about procedure vs process in healing faster.

Procedure vs Process in healing faster

A new runner was having some aching in pain in the shins and he asked,  "I just started running. I started having shin splints. Some people told me I have to stop. Some people, say I don't. What do I have to do?"  Obviously, if you started running, you're starting to develop some fitness and you're finally getting to the place where you can run consistently, the last thing you want to do is give up your running routine.  The good news is that in some cases you don’t have to stop running just because you have aching pain in your shins. You just have two figure out whether or not it is really a big problem or something that can improve with minor changes in your running routine. Do I have to stop running to cure shin splints? That's what we're talking about today on the Doc On The Run podcast.

Do I have to stop running to cure shin splints?

I was just doing a second opinion consultation over webcam with a runner who had an overtraining injury.  She was really worried that she could to lose all of her fitness while waiting to heal.  It is just not okay for a runner to sit and wait for weeks, or months, to heal an injury.  If you don’t exercise at all, you will lose your base of aerobic fitness, the neuromuscular connections that keep you coordinated and help you maintain good running form.  You start to lose it all at a very fast rate compared to how long it takes to build that running fitness. Today on the Doc On The Run Podcast, we’re talking about how healing running injuries is a race a against time.

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I just did a second opinion consultation with a runner who called and said she was diagnosed with a grade five stress fracture.  The doctor didn't actually explain what that meant. He just said it was serious. Stress fracture are rated by severity from grade one through a grade five. Grade five is obviously the worst to runner. She wanted to know if she needed a bone stimulator since her stress fracture was serious. Do I need a bone stimulator for a grade five stress fracture? That's what we're talking about today on the Doc On The Run podcast.

Do I Need a Bone Stimulator for a Grade 5 Stress Fracture?

I was just doing a second opinion consultation with a runner who was really stressed out. She said, "I'm going to lose all my aerobic fitness. I'm going to get weaker. I'm going to get stiff or my running form is going to be terrible!” There are some mental tricks you can use that will be very helpful anytime you get an over-training injury, whether it's a stress fracture, Achilles tendonitis, or any injury. If a doctor tells you, you have to rest and sit still, that can be stressful. But all runners have the tools to navigate it, whether you have ever been injured or not. Today on the Doc On The Run Podcast, we're talking about how you should think of your over-training injury recovery, as an extended rest day.

Think of injury recovery as an expanded rest day

The fifth metatarsal bone goes from your midfoot out to your little toe. And if you break it, it could be one of three things.  You could have a shaft fracture, which heals pretty uneventfully, most of the time.  You could have an evulsion fracture, where it actually rips a piece of bone off when your peroneus brevis tendon tries to pull so hard to keep your foot under you, that it actually cracks the bone.  Or you could get this thing called a Jones fracture. Now, if you have a Jones fracture, that is a bad thing. Out of those three, it is definitely the worst.  But sometimes a doctor will say you have something called a pseudo-Jones fracture, which implies it's kind of like a Jones fracture, but not really as bad. What is a pseudo-Jones fracture? Well, that's what we're talking about, today, on the Doc On The Run podcast.

What is a Pseudo-Jones fracture?

This episode actually comes from a YouTube comment. This runner saw an image from when I was running a 50 mile trail race wearing Hoka trail running shoes.  He said, "I would never take advice from a coach, a biomechanics expert, or a running injury expert who was wearing Hokas." Would you take your running coach seriously if he was wearing clown shoes?  Well, that's what we're talking about today on the Doc On The Run Podcast.

Never listen to a coach wearing clown shoes

Today's episode actually comes from a podcast listener who had a question:  "I got an MRI just to give me the green light to resume training and it showed a grade three stress reaction of the left tibia. Do you think I can run?"  Deciding whether or not you can run with a stress fracture really depends on understanding how bad it was when it started, and how bad it is right now.  How bad is a grade three stress fracture? Well, that's what we're talking about today on the Doc on the Run podcast. 

How bad is Grade 3 Stress Fracture?

Today’s episode comes from a podcast listener with a stress fracture and wants to get back to running. Jennifer says, "I went to see my doctor again today for my MRI results. He told me that I still have a stress fracture.  I was a bit confused, because after 10 weeks without running I thought there would have been more signs of healing.  So I asked if he could see a fracture line and he said, 'Yes and that I should stop running immediately!' (I guess my doctor forgot that I had stopped a long time ago).  I want to get back to running and I don’t believe my doctor is truly getting me there. Prior to this appointment, I was feeling confident  that I could continue with my walk/jog routine as long as there was no pain.  However, now I am feeling scared because he could still see the fracture." In short, it sounds like Jennoifer is saying, "I don't trust my doctor." Well, that's what we're talking about today on the Doc On The Run podcast.

I don’t trust my doctor

I had a really great question from a patient on a second opinion webcam visit.  “I have a partially torn plantar fascia. Can I keep running and let it heal later?” He had purchased The Runner's Heel Pain course and based on his self-diagnosis, he concluded that he definitely did not just have plantar fasciitis. It was more likely plantar fasciosis with a small tear in the plantar fascia.  Unfortunately, the treatment that we would normally do and normally recommend for somebody with a partial tear in the plantar fascia, well, he just cannot do right now. He does not have time to actually take off of his activity and stop running completely right now.  Today on the Doc On the Run podcast, we’re talking about Torn Plantar Fascia: If I run can it heal it later?

Torn Plantar Fascia: If I run can it heal it later?

It's no secret..I like to talk about running injuries! But after so many years working with injured runners, helping runenrs race after they get an injury, and showing them how to maintain their running fitness while injured: I have uncovered a couple of "secrets" that really help injured runners most.  If you have a running injury and you're trying to figure out what to do, if you're confused why the doctors are just telling you to sit around and wait, this episode may help you understand it. Today on the Doc on the Run podcast, we're talking about the top three running injury recovery secrets.

Top 3 running injury secrets

Running injury tips on self-diagnosis and self-treatment. Simple strategies for rapid recovery of running injuries.

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Doc On The Run Podcast

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