Doc On The Run Podcast

If you feel an unusual ache in your foot during marathon or triathlon training, you might worry that you have a stress fracture. But many runners actually develop a stress reaction before a true stress fracture occurs.

The problem is that runners often ignore the early warning signs. They experiment with shorter runs, slower workouts, or simply hope the discomfort goes away.

In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains three critical first aid steps runners should take immediately when they suspect a stress reaction in the foot.

If you suspect a metatarsal stress fracture but your most important marathon is on the calendar, you need a plan—not panic. In this episode, Dr. Christopher Segler explains the only two questions that determine whether you can keep training (or even race) without making the stress fracture worse, plus what you should measure and track starting today.

If you think you have a stress fracture, you’re probably wondering how long it will take to heal — and when you can run again.

In this episode, Dr. Christopher Segler explains the three stages of bone healing, why early protection matters, why pain can disappear before the bone is strong, and how to safely apply stress at the right time so you don’t restart the healing clock.

If you want to heal faster and protect your race, this episode is for you.

If you’re a runner dealing with a stress fracture, you’ve probably been told to “just stop running” and come back in six to eight weeks. But that advice completely ignores the way runners think. In this episode, Dr. Christopher Segler is going to walk you through the crucial questions every runner with a stress fracture should be asking—but that most doctors never do. We’re talking about what might actually be slowing your healing down, what you could be doing right now to maintain your running fitness, and what objective metrics you should be tracking so you know exa...

When does a metatarsal stress reaction actually show up on imaging? In this episode of the Doc On The Run Podcast, Dr. Christopher Segler explains the difference between a stress response, stress reaction, and true stress fracture—and why timing matters when choosing X-rays, MRI, ultrasound, or CT scans. Learn how early imaging can help you make smarter race decisions, avoid false reassurance from a “normal” X-ray, and protect your fitness without turning a minor stress reaction into a full fracture.

Can you still run a race if you have a stress fracture—or will it permanently set you back? In this episode of Doc On The Run, Dr. Christopher Segler answers the most urgent question injured runners ask when a big event is approaching: can I still run my race with a stress fracture? You’ll learn how to assess risk, distinguish pain from damage, and make a clear decision without sabotaging your long-term recovery.

How much walking is too much when you have a tibial stress fracture? In this episode of Doc On The Run, Dr. Christopher Segler breaks down how runners can safely stay active while healing, explains the key differences between Fredrickson Grade 1 and Grade 2 tibial stress fractures, and outlines the two critical factors that determine how fast you can recover—without making the injury worse.

Today I was on a strategy call with an injured, but recovering runner who is trying to figure out how to organize his workouts to get strong quickly, without re-injuring his stress fracture.

He was headed in the right direction, but was making a critical mistake when trying to do more with split workouts. It’s not about splitting workouts. 

It's all about the stressors that are applied to the stress out bone. But this also applies to other overtrain injuries like Achilles tendinitis, perennial, tendinitis, or plantar plate sprains.

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The Walk-Run Routine is likely the most overprescribed and least understood plan for returning to running after an overtraining injury like a metatarsal stress fracture for a plantar plate sprain. 

But the commutative forces that result from that specific routine may put your foot at unnecessary risk of re-injury. Understanding how and why those unique stresses happen may help you make better decisions about your first few runs after you feel your stress fracture or plantar plate sprain has healed enough to resume running. 

Today on the Doc On The Run podc...

Kettlebell workouts can be a great way to maintaining strength, even if you have a running injury. 

If you are a runner who has an overtraining injury like a metatarsal stress fracture or a plantar plate sprain, you are probably doing everything you can to keep the rest of your running body strong, while that one injured part heals. 

Kettlebell training can help, as long as you don’t let those kettlebell workouts overload that injury to the ball of the foot.

You have to pay close attenti...

This morning I was on a webcam call with a runner who had healed a fracture and started running again. He has been running every Monday, Wednesday and Friday, with cross-training in between.  

Now he is ready to add a fourth running workout to his weekly training schedule. 

The question is: 

“What day of the week is best to add an additional run, because I want to make sure I don’t overload the healing tissue and re-injure it.”

Today on the Doc On The Run po...

The half-ass boot routine is no good. Slow improvement with unnecessarily increased risk of atrophy, weakness, stiffness, loss of neuromuscular connections, and destruction of your running form. Your running form, your strength, your flexibility, all protect you from another overtraining injury. 

When you wear a fracture walking boot for a long time inconsistently, or a long time walking on it, you're going to get more of those bad things. 

The other thing that is good, the sort of polar opposite of that, is a half-ass weight routine. 

Whaat is that...

The biggest enemy in the injured runner’s battle is your desire to run as fast or faster than you were right before you got injured.

This morning I was on a call with a recovering elite Masters athlete and she has been doing great, but she seems to be drifting into dangerous territory! 

During our call, I got worried about the way she was thinking about her upcoming workouts. But was thinking was very common, and very dangerous. And that is the reason I decided to record this episode.

Today on the Doc...

This morning I was on a consultation call with a runner at 4:30 a.m. and he's been suffering from a plantar plate injury.  But he's been doing pretty well. He actually just finished his first run!

Now, what I asked him about was his plan for his next run. What he said, made me uneasy. 

It seemed risky, and I started kind of squirming as he was describing his plan to me. It wasn't really a bad plan. It wasn't really a crazy plan. But based on all the experience I have working with injured ru...

Runners glorify the suffering needed to keep moving in spite of pain, and the payoff is almost always increased fitness, and improvements and mental fortitude needed for running endurance.

No pain, no gain is a terrible approach when you are an injured runner. If you really want to get back to training, racing in full return to running fitness as fast as possible after a running injury you have to stop causing pain in that one injured part. Do not confuse that with stopping running-related exercise. That's the lazy doctor's way. 

In this episode, we d...

Today on the Doc On The Run Podcast we are talking about Mental Rehab for Recovering Runners with Mental Skills Coach Carrie Jackson.

It may sound dramatic, but in reference to doctors casually telling runners they just cannot run a race (when maybe the runner could run), or worse…they may never run again, Carrie says, “These doctors have no idea the trauma they are causing to the runner by saying that.”

Carrie co-authored “Rebound: Train Your Mind to Bounce Back Stronger from Sports Injuries.” So, she is not just empathetic toward runners, she is 100% qualified...

Today on the Doc On The Run Podcast we are talking with Dr. Samantha Braun about training fro Ultra’s, running Hell’s Hills and how her training as a Physical and Rehabilitation Medicine Physician helps her avoid overtraining injuries. How do you think you're training in rehabilitation help you understand your own mechanics, physical training limits and overtraining injury prevention while training for Ultra’s?  During the 50 mile trail race, what did you do to restore a more positive mindset and keep running to your potential? Knowing what you know now, what would you do differently to prevent that in...

Over the past couple of months I have done a whole bunch of stress fracture strategy calls with runners who seem to be stuck. I take notes every time I do those calls and there're number of steps that all of them seem to be missing. Let's face it, if they weren't missing some critical steps, we would've never gotten on a call to try to figure out a strategy to get them back on the path to healing and running again.

In this episode I'm going to explain the five critical stress fracture steps every runner...

I just got off of a Stress Fracture Strategy call with a real runner who has been suffering from a stress fracture for 47 days. 

Over the past five weeks she has been getting worse, not better.

And she hasn’t even been running for more than a month!

If you have a stress fracture, or a stress reaction and you are:

1. worried about canceling race because of a stress fracture
2. your stress fracture is not getting better fast enough
3. worried you're going to lose your running fitness waiting for the...

Today on the Doc On The Run Podcast we are talking with Alexandre Dufresne about his journey and getting back to running after having suffered 2 metatarsal stress fractures at same time!

If you think back about your training leading up to the 2 stress fractures, if you could go back in time, do you think there's any one thing you could have changed in your training routine that might have prevented it from developing into such a serious problem? Listen up to find out!

Today on the Doc On The Run Podcast we are talking with Patrick Durante about Automatic Negative Thoughts and how they affect runners.

Many years ago I was having a discussion about daily stressors with a friend of mine name Maury. He said something I have never forgotten.

“It's not the lions and tigers that will get you. It's the ants and mosquitoes because problems.”

Every single over training injury that afflicts runners as a consequence of developing too much stress. The constant buzzing of mosquitoes and ants ma...

If you're a runner with a stress fracture you're probably trying to figure out everything you can do right now this going to speed up healing of the injured bone, so you can get back to running as soon as possible.

If you have been thinking about bone broth or nutritional supplements like vitamin D and calcium you already know how important it is to get the nutritional building blocks into your system so your osteoblast cells can't start repairing and rebuilding the crack in the bone.

Did you know there's ac...

No matter what injury you have, it could be a stress fracture or it could be tendinitis or it could be a sprained ligament, but whatever you do you have to sure you don't get re-injured, because that could be brutally demoralizing!

Because most runners think jogging is a lot easier than “real running” you might presume it's a lot safer for you to just start jogging to test out your state of recovery.

Today on the Doc On The Run Podcast, we’re talking about why jogging is a terrible way to test the state...

Hussein asked me an interesting question. He said, 

“I fractured my tibia and fibula. Is it normal after 50 days the fracture is still visible under x-ray, but I am walking with crutches and putting partial weight bearing without any pain or discomfort? My treatment was with a fiberglass cast without any surgery since the bones were not displaced.”

Is it normal for a fracture to be visible on my x-ray after 50 days? 

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

If you have a high arched foot that is prone to getting stress fractures, a podiatrist may have told you that you need cushy running shoes.

I got a question from someone who was given that advice. She said,

“I am so confused, I thought stress fractures were from pounding. I got a stress fracture, and my doc said it was my cushy shoes. I do not understand how this is true.”

How do cushy running shoes cause stress fractures in the foot? 

Well, that is a great question and that is wh...

I talk to lots of runners who have been given very bad advice. 

If you are reading this, you are probably a runner, and you have probably had to deal with some kind of injury that interfered with your running.

If you have seen a doctor, I am very curious to know what advice you got.

Sometimes I am curious if the "bad advice" is what the doctor said, or if it is just a misinterpretation of what the doctor said to the runner. 

Today on the Doc On The Run Po...

Today's episode comes from Jordan, who was watching a video called “Proof you do not have to stop running with a metatarsal stress response”.

Jordan wanted to know, “Do you think treadmill at a 5% incline will take some of the stress off the tibia?”

Can a 5% incline on your treadmill reduce the stress on a tibial stress fracture? 

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

Today's question comes from Priscilla, after she watched the video “Proof you do not have to stop running with a metatarsal stress response.” 

She says:

“I am a distance runner, I got a fourth metatarsal stress fracture, I was in the boot 3 months. X-ray is showing some healing but not 100%. I have been walking but I fear it will open up again. Is pain and fear of putting full pressure without the boot normal? I want to run, it is frustrating.”

Is pain and fear normal after a fourth metatarsal stress fracture? 

Well, th...

I have heard lots of different things that runners tell me their doctors said...,

"You are not built like a runner."

"You cannot run with your foot type."

"Running just does not work for you. 

Decades ago, an orthopedic surgeon who did my reconstructive knee surgery said to me, 

"If you ever run, you will have to have a total knee replacement within 10 years."

My knee is still good. And I have been running for decades. I did my first 50-mile trail race when I turned 50. I ha...

Today's episode comes from a question on the Doc On The Run YouTube channel regarding the video entitled “Proof you do not have to stop running with a metatarsal stress response.” 

Brian was clearly frustrated. He commented:

“I wish… I have a big swollen reason under the second metatarsal. It tingles a bit while running. Slight burning. I have to alter my landing to not irritate it. I'm finished. Rest in peace to my running VO2 max. I got to focus on cycling.”

Does a stress response equal "rest in peace" to my VO2 max? <...

Just this morning I was on a coaching call with a runner who is recovering from a stress fracture.

Almost every runner I talk to can immediately start exercising and start doing stuff to maintain their running fitness if they understand how severe the injury is, and they don't have to just take time off. 

It is heartbreaking to me truthfully when I talk to somebody who has been completely off of their foot and on crutches in a fracture walking boot and worse, not exercising at all for two weeks, four weeks, or six w...

I got a question from an injured runner, and she wants to know about the amount of time it takes to heal a stress reaction in the sesamoid bone in your foot.

She said:

“I have had a stress reaction in my tibial sesamoid that led to a lot of pain and swelling. I am reading mixed reviews on healing time. I have been off it for three weeks now, either on crutches and taping the toe to immobilize it or in a walking boot with tape on the toe and sesamoid dancing pads to av...

Today's question comes from someone who watched the YouTube video on the Doc On The Run YouTube channel called “How long before I can run with a stress fracture.”

The comment was:

“Thank you so much for this video. I want to ask if resting for three weeks, complete bed rest and I can afford to do this because I am a student, and it is summer holiday then I can walk to my college to do daily normal tasks. I do not do any physical training or running and my college is about a kilome...

There is nothing worse than being told to stop running, especially when you have no idea how long you're not going to be able to run. 

You like your doctor. She is nice. She is smart and helpful. She seems to really care about your running, and even listens to you talk about your last run. 

But when she tells you, that you cannot run, there are three questions that you need to ask.

Today on the Doc On The Run Podcast, we're talking about the top three questions to ask your doctor wh...

When you get a stress fracture, the main thing you are trying to do is figure out how bad it is.

How much does it hurt?

How can you get it to heal as quickly as possible?

Although inflammation is an important part of the healing process, it can be very disruptive to two parts of your process of getting back to running. 
 
What are the two worst things about inflammation when you have a stress fracture? 

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

When you get a stress fracture, the main thing you are trying to do is figure out how bad it is.

How much does it hurt?

How can you get it to heal as quickly as possible?

Although inflammation is an important part of the healing process, it can be very disruptive to two parts of your process of getting back to running. 
 
What are the two worst things about inflammation when you have a stress fracture? 

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

One of the most useless obsessions I witness in runners is to focus on the grade a doctor uses to label the stress fracture. 

You should care if you can run, you should care if you can work out, you should care if you have to sit around in a fracture walking boot and do nothing.

Most of the time runners call me and they are trying to get an answer from me on what they can do, I know their stress fracture grading is useless. 

The reason for that is because I ju...

Ibuprofen is a very popular medication among runners. I have seen ibuprofen tablets scattered on the course at every marathon and triathlon I have ever done. 

Runners take it when they have aches and pains, or to get through races, but I can tell you that there is only one valid reason to take ibuprofen.

To me, the only time a runner with a stress fracture should take ibuprofen is when you have what I call a non-skippable race.

Today on the Doc On The Run Podcast we're talking about the only time a...

If you are a runner, it is critical that you do not lose your running fitness while waiting for a stress fracture to heal. Because that puts you at risk of getting another stress fracture once you have recovered and start running again. 

I am always trying to think about a way that I can simplify the explanations of what I do with runners when they call me because they are not getting better after a period of being in a fracture walking boot for way too long. 

There are really six steps that I fo...

After you recover from a stress fracture and you are getting back to running, there really are some details you have to pay attention to if you want to avoid a re-injury. 

The name of the game is increasing your activity to the point that your metatarsal stress fracture can withstand the stresses you are applying to it. 

What are the two most dangerous parts of a run when you have a stress fracture? 

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