Doctor’s Soapbox: Don’t Rely on the Internet to Fix Your Running Injuries

The smartphone has not only irreparably altered our social interactions but also how we view and access healthcare. Dr. Google is instantly available to anyone at any time to diagnose and offer treatment advice for every ache and pain. Our frenetic schedules along with high patient co-pays and astronomic insurance deductibles encourage many to seek cheaper self-help options via the internet– although it can be a valuable resource, it is important to understand what you can treat yourself and what requires a visit to your doctor.

A doctor who regularly sees athletes has the experience and first-hand knowledge to diagnose injuries more accurately, ensure speedy healing and most importantly prevent recurrence. They are more likely for example, to treat a non-fractured ankle with a brace and physical therapy referral rather than to immobilize it in a cast with crutches. A resourceful sports medicine doctor will not order you to stop running when modifications such as lowering miles or adding cross training will suffice.

These doctors can prescribe an array of diagnostic tests, such as x-rays, ultrasounds, MRI’s, and bloodwork to discover underlying problems. Pain and swelling in the lower leg can be a tendonitis caused by overuse, poor biomechanics, or ill-fitting shoes. It can also be caused by cholesterol- lowering meds, homeopathic compounds, peripheral venous insufficiency, tendon tears, or blood clots. An undetected blood clot or deep vein thrombosis (DVT) in the leg can migrate into the lungs and brain and be fatal if left untreated. Runners are susceptible to DVT’s post-race due to dehydration, trauma to the legs, and inactivity (driving or flying home after a race). Rather than spending time reading WebMD, runners with leg pain and swelling need prompt medical intervention with a venogram or doppler to quickly identify it and begin life-saving prescription blood thinners.

Forefoot pain may be from a local nerve irritation or neuroma, but it may also be a tendonitis, or a metatarsal stress fracture that can be picked up by x-ray. Many runners are more susceptible to stress fractures due to suboptimal nutrition that can be seen in bloodwork or underlying osteopenia or osteoporosis which is diagnosed with a dexascan test. Female distance runners are more at risk after age 35, especially if they over train and do not rest sufficiently between races. Nerve pain in the foot may also resemble neuropathy and an early sign of diabetes.

Everyone assumes that heel pain is due to plantar fasciitis; however, the pain could be due to nerve irritation, or possibly a stress fracture or bone cyst. Often it is the adjacent posterior tibial tendon that is the culprit and requires a different treatment approach. Arthritic diseases such as gout commonly cause heel pain as well.

As Einstein once famously noted, “information is not knowledge!” The internet should be used as an adjunct not a substitute for an in-person physician assessment. If you have unresolved lower extremity problems, use your computer or smartphone to make an appointment. Then turn your smartphone off (the web says they may cause cancer anyways), look your friends in the eye and engage in live communication. You will feel better, guaranteed.

Foot and Ankle Surgeon Dr. Adam SpectorDr. Adam Spector  works in our Rockville, MD (Shady Grove) and Wheaton, MD offices.

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