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Doc On The Run Podcast

Dr. Christopher Segler

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

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23 episodes
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Avg 10 min
English

Episodes 23

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#1049
Thursday · 5 min
Noise From Your Healing Running Injury Is a Good Thing
A runner recovering from an overtraining injury may notice new sensations, tension, discomfort, or other “noise” as activity increases. That can be confusing, especially when the goal is to rebuild strength without overloading tissue that is still weaker than normal. In this episode, Dr. Christopher Segler explains a simple construction-site analogy for understanding some of the sensations that can show up during recovery. Healing tissue requires materials to be carried in and damaged materials to be carried out, and fluid movement around the injury can create sensations that become more noticeable as activity increases. The key is not to ignore pain or major swelling. It is to understand what the changes mean by carefully tracking injury severity, daily steps, repetitions, symptoms, and how those measurements change as activity increases. The goal is to match the strength of the healing tissue with the right strength-building activity so you can keep progressing without overloading the injured structure.
#1048
September 17 · 17 min
Stress Fracture 5 Weeks Before a Half Marathon: What Should a Runner Do?
What should you do if you are five weeks away from a half marathon and develop a metatarsal stress reaction? In this episode, Dr. Christopher Segler talks with a real runner who is preparing for a half marathon in Argentina after developing a fifth metatarsal stress reaction. He has already stopped running for five weeks and has been maintaining fitness with stationary cycling. The discussion focuses on the information a runner needs in order to decide what activity can be added safely: establishing injury severity, tracking pain trends, monitoring tenderness, reducing inflammation, maintaining strength and stability, and increasing stress on the bone systematically instead of simply going out for a test run. Dr. Segler also explains why X-rays can miss some stress fractures, how MRI and ultrasound may provide additional information, why zero pain is not always the only useful benchmark, and why runners need measurable baseline numbers before progressing activity.
#1047
September 10 · 4 min
How Much Ankle Motion With a Metatarsal Stress Fracture?
How much should you move your ankle when you have a metatarsal stress fracture? An elite Masters track athlete asked Dr. Christopher Segler this question after noticing that her ankle was getting stiff while wearing a fracture walking boot for a third metatarsal fracture. Ankle stiffness matters because once you return to running, restricted motion can increase the forces applied to the foot and may contribute to other overtraining injuries. But aggressively forcing ankle motion while the metatarsal is still healing can also put unnecessary stress on the injured bone. In this episode, Dr. Segler explains the concept of doing “a little motion, a lot” instead of “a lot of motion, a little,” why frequent gentle ankle movement may be preferable to forceful end-range stretching, and why tracking discomfort is essential when deciding when to increase activity.
#1046
September 3 · 19 min
Achilles Tendon Pain Came Back: What Should A Runner Do Next?
What should you do when Achilles tendon pain comes back after you thought it was better? In this episode, we listen in on a real strategy call with a runner who had Achilles tendinosis for years, improved after treatment, returned to running, and then had the pain flare again after hill training. The key lesson is that the next step is not guessing which treatment might work. The next step is figuring out exactly how severe the problem is, what activities trigger it, and what information you need to make a smart decision about running, treatment, and recovery. If you have Achilles pain that keeps coming back, this episode will help you think more clearly about what to track, what to avoid, and how to build a better plan.
#1045
August 27 · 6 min
Why Your Good Foot Starts Hurting During Stress Fracture Recovery
A runner with a third metatarsal stress fracture was doing everything right. Her injured left foot was getting much better — but then her “good” right foot started aching. That can be frightening. Does it mean you are developing another stress fracture? In this episode, Dr. Christopher Segler explains why the uninjured foot can become overloaded when you are using a fracture walking boot, crutches, or a knee walker, how compensatory stress can trigger metatarsal aching, and why you should not simply ignore new pain in the other foot. You’ll also learn why systematically tracking pain and activity can help you determine whether the aching foot is getting better or heading toward a more significant problem.
#1044
August 20 · 26 min
He Passed the Ankle Fracture Test...But His Ankle Was Broken!
A runner thought he had another ordinary ankle sprain. He could still walk, he checked the Ottawa Ankle Rules on himself, and he concluded that he did not need an X-ray. But almost a week later, the swelling and bruising still were not behaving like his previous ankle sprains - and the X-rays showed that his ankle was actually broken. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains why runners can be especially vulnerable to self-diagnosis after an ankle injury, how an athlete's pain tolerance can make a serious injury seem deceptively manageable, and why a clinical decision rule is not the same thing as examining yourself. In this episode you'll learn: • Why runners may underestimate the significance of pain after an ankle injury • What the Ottawa Ankle Rules are actually designed to do • Why being able to walk does not prove that your ankle is not broken • How extensive bruising and persistent swelling change the level of concern • Why a violent inversion-and-eversion mechanism deserves extra attention • How anchoring bias can make a familiar ankle sprain diagnosis feel more certain than it really is • When an ankle injury is not following the expected recovery trajectory • Why objective evaluation matters when an injury simply is not behaving normally
#1043
August 13 · 6 min
When Too Much Healing Becomes a Stress Fracture Problem
Can a stress fracture actually heal with too much bone? Yes - and in some runners, that extra bone canbecome a problem of its own. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains why a very large bone callus does not always mean a stress fracture is safely healed. He walks through two runner cases: one in which a large callus hid an unstable fracture heading toward nonunion, and another in which prolonged irritation produced a completely healed but excessively thick metatarsal that crowded the surrounding soft tissues. In this episode you'll learn: • Why bone callus forms around a stress fracture • How continued motion can create a deceptively large callus • Why a big callus can coexist with an unstable fracture or nonunion • How prolonged irritation can leave a healed bone too thick • Why excess bone can crowd muscles, nerves, and other soft tissues • Why simply “running less” may not reduce stress enough • What pain, bruising, and swelling can tell you about injury severity • Why measuring improvement matters before you increase activity
#1042
August 6 · 17 min
Can You Still Run Your Race With A Broken Toe?
Can you still do your race after breaking a toe? Many runners assume a broken toe automatically means canceling the event. But that's not always true. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler shares a real strategy call with a runner preparing to hike the Tour du Mont Blanc after suffering a displaced fourth toe fracture only one week before departure. In this episode you'll learn: • The two complications that can permanently affect future running after a broken toe • Why pain isn't the only thing you should monitor • How swelling predicts future problems • Why shoe stiffness matters more than most runners realize • How to determine whether your toe is stable enough to test • Why a broken toe doesn't always mean canceling your race
#1041
July 31 · 5 min
The Mental Trick To Reframe Hard Workouts After A Stress Fracture
Have you ever felt guilty about taking a day off during stress fracture recovery? For many runners, the hardest part of getting back to running isn't the injury itself—it's resisting the urge to complete every planned workout. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler shares a simple mental strategy that can help runners recover faster by changing the way they think about recovery days. In this episode, you'll learn: • Why runners often feel guilty about taking a recovery day • The biggest mental mistake competitive runners make during stress fracture recovery • How soreness and fatigue can actually become valuable warning signs • Why your coach wants you close to the injury threshold—but never across it • The simple mindset shift that can prevent setbacks • Why "earning" a day off can help you recover faster and race sooner • How to balance fitness gains with protecting a healing stress fracture The goal isn't simply working harder. The goal is getting stronger while protecting your healing bone so you can get back to racing as quickly as possible.
#1040
July 23 · 6 min
The Dreaded Running Injury Rubber Band Sign
Have you ever felt a strange sensation that seemed like a rubber band squeezing your Achilles tendon, shin, or foot? It may not be pain… But it might be one of the earliest warning signs that you're about to make a running injury worse. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler introduces what he calls the "Rubber Band Sign"—a subtle sensation reported by runners with Achilles tendon injuries, tibial stress fractures, and metatarsal stress fractures that may signal increasing stress before significant pain develops. In this episode, you'll learn: • What the "Rubber Band Sign" feels like • Why runners describe it before pain develops • How it may relate to Achilles tendinosis and stress fractures • Why swelling around injured tissue may create this sensation • What to do if you notice it during your return to running • Why paying attention early may help you avoid a bigger setback The goal isn't simply recognizing another symptom. The goal is recognizing an early warning sign before your injury gets worse.
#1039
July 16 · 6 min
The Surgery Question Most Runners Are Afraid to Ask
When your doctor recommends surgery, there is one question most runners never ask. But it may be the most important question of the entire conversation. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains why runners should not simply accept a recommendation for surgery without understanding how confident the surgeon is that the procedure will actually get them back to running. Using a recent second-opinion strategy call with an experienced ultrarunner, Dr. Segler discusses how asking for a "guarantee" isn't really about demanding certainty—it's about understanding your surgeon's confidence, expectations, and reasoning. In this episode, you'll learn: • The one question most runners are afraid to ask before surgery • Why "Can you guarantee I'll get back to running?" is really about confidence, not contracts • How surgeons think differently about different injuries • Why vague surgical recommendations should prompt more questions • How to decide whether surgery truly supports your running goals • Why reassurance and clarity matter before making a permanent decision The goal is not simply having surgery. The goal is choosing the treatment that gives you the best chance of getting back to running.
#1038
July 9 · 8 min
Most Critical Healing Time for a Metatarsal Fracture
When is the single most important time during the healing of a metatarsal fracture? Most runners assume the hardest part is waiting weeks to get back to running. In reality, the most critical period may be the very first week after the fracture occurs. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains why the first seven days after a metatarsal fracture lay the biological foundation for healing, and why seemingly small mistakes during that first week can delay your recovery. In this episode, you'll learn: • Why the first week is biologically the most important phase of healing • What happens during the inflammatory phase after a fracture • Why bone stability is essential for successful healing • How movement disrupts the body's repair process • Why even sleeping without your boot may slow healing during the first week • How small movements from exercise can delay recovery • What runners should focus on before worrying about fitness The goal is not simply surviving the first week. The goal is creating the strongest possible foundation for the bone to heal so you can get back to running sooner.
#1037
July 2 · 6 min
Why Identical Runs Can Keep Your Stress Fracture Weak
If your stress fracture seems to be healing, should you keep repeating the exact same run? It sounds safe… But it may actually slow your progress. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains why repeating identical runs can prevent a healing stress fracture from adapting and getting stronger. Using the example of a runner returning from a tibial stress fracture with a race only three and a half months away, Dr. Segler explains why variability—not repetition—is the key to safely rebuilding bone strength. In this episode, you'll learn: • Why repeating the exact same run can stall bone remodeling • Why soreness beginning around mile two matters • How cumulative fatigue changes the stress on a healing bone • Why bone adapts to progressive, varied loading—not identical loading • Different ways to vary your running without increasing injury risk • How to build fitness while reducing the chance of another setback The goal is not simply proving you can repeat the same run. The goal is helping the bone become stronger so you can safely return to racing.
#1036
June 25 · 3 min
The Test That Might Be Preventing Your Stress Fracture From Healing
Are you testing your stress fracture every day just to see if it's getting better? That simple habit may actually be slowing your recovery. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains why repeatedly testing a stress fracture—especially by intentionally reproducing pain—can keep you above your healing threshold and delay your return to running. In this episode you'll learn: • Why runners naturally want to "check" their injury • How repeated testing can increase stress on a healing metatarsal • Why pain-testing is different from progress tracking • How to identify useful recovery milestones without slowing healing • The concept of your healing threshold—and why it matters • A smarter way to monitor recovery while preserving your fitness
#1032
June 18 · 6 min
Can You Run After Multiple Fifth Metatarsal Fractures And Osteoporosis?
If you’ve had multiple fifth metatarsal fractures and you also have osteoporosis, can you still run safely? Many runners assume the answer is automatically “no.” But that is not necessarily true. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains how runners with osteoporosis can sometimes continue running safely after stress fractures or fifth metatarsal fractures—as long as they understand the specific risks that may have caused the fractures in the first place. In this episode, you’ll learn: • Why osteoporosis increases stress fracture risk • Why repeated fifth metatarsal fractures may not just be about bone density • How road slope can overload the fifth metatarsal • Why biomechanics matter in recurrent fractures • The difference between healing and remodeling • Why runners with osteoporosis have to be more vigilant about stress management • The key questions runners should ask before returning to training The goal is not simply avoiding fractures. The goal is staying active without re-injuring the bone.
#1034
June 11 · 7 min
My Number One Secret Weapon For Extensor Tenosynovitis In Runners
What is the fastest way to calm down extensor tenosynovitis when you are a runner trying to keep training? In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains his personal “secret weapon” for reducing inflammation in extensor tenosynovitis and helping runners get back to training faster. Extensor tenosynovitis happens when the tendon sheaths on the top of the foot become irritated and inflamed. It can become painful with every step, every toe movement, and every run. In this episode, you’ll learn: • What extensor tenosynovitis actually is • Why inflammation inside the tendon sheath becomes so painful • Why tight shoelaces often trigger the problem • Why oral anti-inflammatory medications may not help much • The risks of corticosteroid injections around tendons • How the contrast bath routine works • Why alternating hot and cold water may rapidly reduce swelling • How runners can calm irritation while protecting fitness The goal is not simply reducing pain. The goal is calming the inflammation fast enough that you can safely get back to running.
#1033
June 4 · 8 min
MRI Versus CT Scan For Stress Fractures: Which One Actually Tells You If You Can Run?
If you have a stress fracture and you’re trying to figure out whether it is safe to run again, should you get an MRI or a CT scan? Many runners assume there is one perfect imaging test that can tell them exactly when they are cleared to run. Unfortunately, it is not that simple. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains the real difference between MRI scans and CT scans for stress fractures, what each test actually shows, and why imaging alone often does not give runners the “green light” to return to training. In this episode, you’ll learn: • Why MRI is usually better for detecting early stress reactions • Why CT scans are better at identifying true cracks in bone • Why inflammation on MRI does not always mean you cannot run • How bone remodeling can confuse runners and radiologists • Why repeat imaging can sometimes create more confusion • How CT scans may help determine whether a fracture is truly healing • Why imaging findings have to match your symptoms and training goals The goal is not simply getting another scan. The goal is understanding whether the bone is actually tolerating stress well enough for you to safely return to running.
#1035
May 28 · 19 min
Plantar Plate Sprain in Triathletes: Real Strategy Call With a Former Pro
What happens when a former professional triathlete and endurance coach suddenly develops a painful plantar plate sprain? In this episode of the Doc On The Run Podcast, Dr. Christopher Segler speaks with Marcus, a former professional triathlete and current triathlon coach from Brazil, during a real running injury strategy call focused on plantar plate injuries in runners and triathletes. Marcus had to cancel an upcoming 45K trail race after developing sudden pain under the ball of the foot consistent with a plantar plate sprain. During the call, they discuss how plantar plate injuries develop, why bunions and shoe selection can increase stress on the plantar plate ligament, and how endurance athletes can protect the injured ligament while maintaining fitness. They also discuss: • Why MRIs often fail to tell the whole story with plantar plate tears • Whether carbon-plated running shoes can reduce plantar plate strain • How to maintain fitness without worsening the injury • Why boots alone are often not enough • The biggest mistakes runners make during plantar plate recovery • How shoe construction can affect forefoot stress • Why triathletes are uniquely vulnerable to forefoot overload injuries If you’re a runner or triathlete struggling with forefoot pain, second toe pain, a plantar plate tear, or a plantar plate sprain, this episode will help you better understand the injury and what actually matters during recovery.
#1031
May 21 · 9 min
5 Reasons A Runner Might Want Popping Peroneal Tendon Surgery
If you have popping or clicking around the outside of your ankle, do you actually need peroneal tendon surgery? Not necessarily. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains the 5 reasons runners might actually consider surgery for painful popping peroneal tendons—and why many runners may not need surgery at all. In this episode, you’ll learn: • What the peroneal tendons actually do • Why peroneal tendons pop or click • When popping is actually dangerous • The difference between painful instability and harmless clicking • Why some split peroneal tendons heal without surgery • The most important question runners forget to ask surgeons • How to think about surgery from a runner’s perspective The real goal is not simply fixing the tendon. The goal is getting back to running.
#1030
May 14 · 6 min
5 Signs Stress Reaction Turned Into a Stress Fracture
How do you know if your stress reaction just turned into a stress fracture? That’s one of the most important questions a runner can ask—because once there’s a crack in the bone, everything changes. In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains the 5 key signs that indicate your stress reaction may have progressed into a true stress fracture. Understanding these signs can help you avoid making the injury worse and make smarter decisions about training and recovery. In this episode, you’ll learn: • The difference between a stress reaction and a stress fracture • Why that distinction matters for runners • The 5 warning signs your injury has progressed • The most reliable sign that you may have a crack in the bone • Why bruising is a major red flag • How to think about injury severity when making training decisions If you want a clearer way to assess your injury, get the free Stress Fracture or Injury Self-Assessment Worksheet at: https://www.stressfracturesecrets.com/mistake

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