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Ask the Expert: Dr. Jordan Metzl, Primary Sports Medicine Physician, Answers Questions About Marathon Training & Injury Prevention – Part 1

Running on Track

The ING New York City Marathon is coming up soon! Last week, Dr. Jordan Metzl, Primary Sports Medicine Physician, answered questions during a live chat on the ING New York City Marathon Facebook page. As a 28-time marathon runner and nine-time Ironman finisher, Dr. Metzl combines his knowledge as an athlete and experience as a physician to treat and educate athletes of all levels.

Q1. Is there any way to treat plantar fibromas?

This is kind of a rare entity. Plantar fibroma is a non-malignant thickening of the feet’s deep connective tissue and can cause the foot to become stiff and painful. Try to rolling your foot on a lacrosse ball to loosen up the tissue, and try wearing arch supports. If that doesn’t help, sometimes a cortisones shot can.

Q2. I’ve been dealing with shin splints for weeks, any advice?

Start with your feet- buy proper running shoes and try an over-the-counter orthotic. The key point is if it hurts too much to run smoothly, get it checked out so you don’t run yourself into a worse injury.

Q3. Is it better to take a weekly, recovery day-off from running with no exercise, or to at least cross train during these days?

It’s ok to cross train on the days that you’re not running. I like to run three to four times per week and cross train other days. I suggest strength training, yoga, swimming and bicycling. An ice bath after a long run can be really helpful.

Q4. I have peroneal tendon pain in my ankle. I’ve been icing it a lot, but it’s been six weeks and it’s the same: no better, no worse. Is there anything else I can do?

You’re doing the right thing by icing it. If it doesn’t get better, you might consider either a cortisone shot or platelet rich plasma (PRP) injections. Doctors who offer PRP, inject your own concentrated blood-platelets into the abnormal tissue, which can promote tendon healing. PRP injections can help with many nagging tissue injuries; however, it takes a month to work, so I would only do it if you aren’t running the New York City Marathon and after you’ve had an MRI to assess any damage.

Q5. The joints in my ankles, knees and feet hurt, but I’m afraid to switch up shoes or try inserts. Can you suggest a good insert?

An insert like Superfeet or Powerstep is fine to try out. I would also consider submerging your feet in an ice bath, which should help a lot with pain.

Q6. I’m dealing with a mild calf strain. Am I better off taking a few days to rest and or staying on schedule getting my mileage in before the race?

Don’t make the injury worse. If the injury changes the way you run, layoff running and just cross train for a few days.

Q7. It’s 30 days until race-day and I’m dealing with some iliotibial band syndrome (ITBS) issues. What’s your advice to help me recover from ITBS?

The iliotibial band (ITB) is a thick tendon that connects the tensor fascia lata muscle, which starts on the outside of the hip, to the outside part of the tibia, the major bone in the lower leg. When the ITB is tight, it creates tension on the outside of the hip and knee and may cause pain in these areas. The key to ITBS treatment is to massage the area with a foam roller, or you may try a corticosteroid injection if there is focal pain.

Click to read Part 2

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.