20:This Knee Injury Ends a 400-Day Run Streak… But Surgery Isn’t the Answer?

20:This Knee Injury Ends a 400-Day Run Streak… But Surgery Isn’t the Answer?

What happens when a lifelong runner is forced to stop just short of a 400-day streak? In Episode 20 of Interdisciplinary Case Miles, a real case highlights the challenges of a 52-year-old runner dealing with a degenerative medial meniscus injury and the decisions that follow when running is part of your identity. This episode covers how these injuries present, what imaging like MRI actually tells us, and why physical therapy is often just as effective as surgery for long-term outcomes. You’ll hear how biomechanics, strength, and running form all influence knee stress and what can be adjusted to stay active without making things worse. There’s also an important conversation around nutrition and long-held beliefs in running culture, including the risks of underfueling and the pressure to chase an “ideal” race weight. For many experienced runners, habits built over decades can become the very thing that increases injury risk. Whether you're managing knee pain, coaching athletes, or working in sports medicine, this episode offers practical, evidence-informed strategies to support recovery and longevity in the sport. Topics include: Degenerative meniscus injuries in runners MRI vs. clinical diagnosis PT vs. surgery outcomes Running biomechanics and cadence adjustments Nutrition myths and underfueling Injury trends in long-term runners  00:00 – Introduction to the Case A 52-year-old runner’s streak ends due to knee pain 02:00 – Understanding the Medial Meniscus What it does and why it matters for runners 04:30 – Diagnosis & Imaging When MRIs are helpful—and when they aren’t 08:00 – PT vs. Surgery What the research says about outcomes 12:30 – Running Mechanics & Knee Load How form and movement patterns contribute to pain 18:00 – Strength, Stability & Gait Changes Key rehab strategies to stay running 22:30 – The “Race Weight” Mindset Why this belief can backfire 27:00 – Underfueling & Recovery How nutrition impacts healing and performance 31:00 – Long-Term Runners & Injury Risk Why experience doesn’t always mean protection 35:00 – Expert Takeaways Key insights from medicine, PT, and nutrition 39:00 – Closing Thoughts & Call to Action Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support [https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support?utm_source=rss&utm_medium=rss&utm_campaign=rss]. If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case. Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at runcasemiles@gmail.com.

19: Navicular Stress Fractures in Runners: Why Foot Pain Lingers and What You Might be Missing

Foot pain that lingers, comes and goes, or never fully heals can signal something more serious especially in runners. Episode 19 of Interdisciplinary Case Miles centers on a high school track athlete dealing with a navicular bone stress injury that persisted for nearly a year. This type of injury is one of the most challenging in running due to limited blood supply, high biomechanical demand, and the need for strict management early on. This case highlights how bone stress injuries develop from a combination of training load, biomechanics, and nutrition especially low energy availability in adolescent athletes. It also addresses why navicular injuries require careful progression, non-weight bearing phases, and long-term follow-up to avoid delayed healing or recurrence. You’ll hear how foot mechanics, posterior tibial function, and arch control influence stress at the navicular, along with how strength, mobility, and confidence all play a role in returning to sport. The conversation also emphasizes the importance of fueling, growth demands, and the unique challenges faced by youth and first-generation athletes navigating high training loads.  Whether you’re a runner dealing with stubborn foot pain, a parent supporting a young athlete, or training in high-impact environments like track, trail, or jumping sports, this episode provides clear direction on preventing and managing navicular stress injuries. 00:00 – Intro to Interdisciplinary Case Miles Overview of the podcast and today’s complex case. 01:05 – Case Overview: High School Athlete with Persistent Foot Pain Track athlete with a year-long navicular bone stress injury. 03:10 – What Is the Navicular Bone & Why It Matters Location, function, and role as the “keystone” of the arch. 06:00 – Why Navicular Stress Injuries Are High Risk Limited blood supply and challenges with healing. 09:20 – The Perfect Storm: Load, Biomechanics & Nutrition How multiple factors combine to create bone stress injuries. 12:40 – Low Energy Availability in Young Athletes How underfueling impacts bone health and recovery. 16:30 – Growth, Development & High Calorie Needs Why adolescent runners require more fuel than expected. 20:10 – Practical Fueling Strategies for Busy Athletes Snacking, meal timing, and closing energy gaps. 24:00 – Posterior Tibial Function & Foot Mechanics How pronation control affects stress at the navicular. 27:45 – Physical Therapy Approach to Navicular Injuries Strength, mobility, stability, and load management. 31:20 – Confidence & Fear in Return to Sport Mental barriers after long-term injury. 35:00 – When to Repeat Imaging & Monitor Healing Using MRI and clinical signs to guide progression. 38:40 – Surgical vs Conservative Treatment Options When athletes consider early intervention. 42:10 – Athlete Stage Matters: Youth vs Elite Decisions How treatment varies by age and competition level. 45:30 – Key Takeaways from Each Expert Education, fueling, and whole-athlete care. Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support [https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support?utm_source=rss&utm_medium=rss&utm_campaign=rss]. If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case. Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at runcasemiles@gmail.com.

18: Chronic Ankle Instability in Runners: One Overlooked Cause of Hip and Back Pain

What if your hip pain is actually coming from your ankle? Episode 18 of Interdisciplinary Case Miles follows a 38-year-old ultra marathon runner with lateral hip pain, back discomfort, and a long history of recurring ankle sprains. What many runners dismiss as “no big deal” can lead to instability, altered mechanics, and long-term performance limitations. This conversation connects chronic ankle sprains to changes in the kinetic chain, showing how foot and ankle instability can drive hip and back pain. It also highlights the role of ligament health, balance, and neuromuscular control in keeping runners strong and resilient. Nutrition and hydration are also key factors especially for ultra and trail runners. Fueling, collagen support, and electrolyte balance all influence healing, coordination, and injury risk. Whether you’re running trails in the mountains, training for your next ultra, or dealing with nagging injuries that won’t go away, this episode offers practical, evidence-informed strategies to improve stability, prevent setbacks, and optimize performance.  00:00 – Intro to Interdisciplinary Case Miles Meet the team and today’s focus on real runner cases. 01:10 – Case Overview: Ultra Runner with Hip & Back Pain A 38-year-old athlete presents with lateral hip pain, but there’s more to the story. 03:15 – The Overlooked Clue: Chronic Ankle Sprains Why “it doesn’t hurt” doesn’t mean it’s not a problem. 06:20 – Hip Impingement vs. Kinetic Chain Dysfunction How foot and ankle issues can drive hip pathology. 09:10 – Hypermobility vs. Tightness Explained Why some joints are loose while others compensate. 12:00 – What Happens When You Keep Spraining Your Ankle Ligament damage, collagen breakdown, and loss of stability over time. 15:30 – The 2% Stability Loss Rule Why repeated ankle sprains create long-term dysfunction. 18:40 – How Ankle Instability Causes Hip & Back Pain Connection between foot mechanics, glutes, and loading patterns. 22:10 – Physical Therapy Strategies for Ankle Stability Balance training, foot control, joint mobilization, and plyometrics. 27:00 – Collagen, Nutrition & Ligament Healing What runners need to know about fueling and recovery. 30:15 – Electrolytes, Hydration & Injury Risk How dehydration affects reaction time, coordination, and proprioception. 34:40 – Trail Running Risks & Cognitive Fatigue Why fueling impacts decision-making and injury prevention. 38:10 – Shoe Choice & Terrain Considerations Stack height, stability, and trail-specific risks. 42:20 – When an “Ankle Sprain” Might Be More Serious Recognizing fractures and complications. 45:00 – Key Takeaways from Each Expert Simple, actionable advice to prevent and manage ankle instability. Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support [https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support?utm_source=rss&utm_medium=rss&utm_campaign=rss]. If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case. Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at runcasemiles@gmail.com.

17: Low Back Pain in Runners: When Hormones, Sleep, and Core Stability Collide

Is your low back pain coming from running or is it something else entirely? In this episode of Interdisciplinary Case Miles, Dr. Sara Raiser, sports medicine physician and running medicine speicalist, Dr. Kate Mihevc Edwards, orthopedic physical therapist and running PT, and sports dietitian Kelsey Pontius walk through a runner case involving low back pain during the perimenopause transition. The case involves a 41-year-old female physician and half-marathon runner who initially seeks help for nutrition during perimenopause. During the consultation, she casually mentions intermittent low back pain, poor sleep, and high work stress, factors that can all influence recovery and musculoskeletal health.The conversation expands into a deeper discussion of how hormonal changes, sleep quality, fueling habits, biomechanics, and pelvic floor health can all play a role in back pain for runners. We explain how shifting hormones like estrogen, progesterone, and testosterone influence collagen health, tendon recovery, muscle repair, sleep quality, and energy levels. For active women, these changes can show up as slower recovery, stubborn body changes, and nagging aches that weren’t there before.In this episode, we discuss: * Why low back pain in runners is often multifactorial * The impact of perimenopause and hormonal changes on recovery and connective tissue * How sleep and fueling patterns influence injury risk and healing * Why runners with back pain should evaluate core stability, breathing, and pelvic floor function * How hip mobility and running mechanics can affect the lower back * When back pain requires medical evaluation—and when runners can safely stay active * Strategies to keep running while managing back discomfort If you're a runner dealing with low back pain, sleep disruption, hormonal changes, or training stress, this episode explores how all of these factors intersect and what you can do to stay healthy and keep running. If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives. This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes  and stronger runners. 00:00 — Podcast Introduction Meet the hosts and overview of Interdisciplinary Case Miles. 01:05 — Case Introduction: Perimenopausal Runner. A 41-year-old half-marathoner experiencing body changes, sleep issues, and intermittent low back pain. 02:30 — Nutrition & Hormonal Changes in Perimenopause How hormonal shifts affect recovery, metabolism, and nutrition needs. 05:10 — Addressing Body Changes & Sleep First Body neutrality, sleep quality, and fueling regularly during busy workdays. 08:00 — Medical Evaluation of Low Back Pain Dr. Reiser explains axial back pain, possible causes, and clinical screening. 11:00 — Physical Therapy Assessment Core activation, breathing patterns, pelvic floor health, and movement mechanics. 14:00 — Running Mechanics & Back Pain Hip mobility, posture, and how running form can influence back stress. 17:00 — Training Modifications & Staying Active When runners should modify activity instead of stopping completely. 20:00 — Managing Persistent “Niggling” Pain Understanding chronic discomfort and avoiding unnecessary interventions. 22:00 — Pre-Run & Post-Run Strategies Simple mobility and activation exercises that may reduce pain. 23:30 — Key Takeaways from Each Expert Back pain management, nutrition mindset during body changes, and pelvic floor considerations. 24:45 — Episode Wrap-Up Closing thoughts and invitation to follow and share the podcast.   Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support [https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support?utm_source=rss&utm_medium=rss&utm_campaign=rss]. If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case. Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at runcasemiles@gmail.com.

16: Plantar Fasciitis in Runners: Are You Hobbling to the Bathroom in the Morning?

Are you hobbling to the bathroom in the morning because of heel pain? Many runners with plantar fasciitis ignore that early symptom for months until it starts affecting every run. In episode 16 of the Interdisciplinary Case Miles Podcast, Dr. Sara Raiser, sports medicine physician and running specialist, Dr. Kate Mihevc Edwards, orthopedic physical therapist and running PT, and sports dietitian Kelsey Pontius break down a case involving chronic plantar fasciitis that slowly worsened over time. The case involves a 42-year-old runner who runs 3–5 miles nearly every day to manage work stress. For over a year she ignored classic plantar fasciitis symptoms, morning heel pain and stiffness after sitting because the pain would improve once she started moving. Eventually, the pain began showing up during her runs and getting worse halfway through, forcing her to finally seek help.In this episode, the team explains why plantar fasciitis often becomes a chronic plantar fasciopathy, why morning heel pain happens, and why runners often wait far too long before addressing the root causes.You’ll learn: * Why morning heel pain and hobbling after sitting are classic plantar fasciitis symptoms * Why many runners develop plantar fasciitis after months or years of subtle warning signs * Why foot strength and running mechanics matter more than stretching alone * The role of calf mobility, great toe motion, and the kinetic chain in plantar fascia loading * When treatments like shockwave therapy, PRP, or injections may be appropriate * Why plantar fasciitis rehab can take 6–9 months for chronic cases * How nutrition, protein intake, vitamin D, and micronutrients support connective tissue healing * The mental side of injury when running is your primary stress relief * How long rehab realistically takes If you're a runner struggling with heel pain, plantar fasciitis, or foot pain when you first step out of bed, this episode will help you understand what’s really happening and how to recover without giving up running. If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives.This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes  and stronger runners. 00:00 — Podcast Introduction Meet the hosts and overview of Interdisciplinary Case Miles. 01:05 — Case: Chronic Plantar Fasciitis A 42-year-old runner dealing with persistent heel pain. 03:20 — What Plantar Fasciopathy Means Why this injury is usually chronic rather than inflammatory. 05:40 — Evaluation & Diagnosis Gait analysis, imaging, and identifying root causes. 08:40 — Treatment Foundations Strengthening the foot and addressing biomechanics. 11:20 — Physical Therapy & Rehab Timeline Why recovery may take several months. 14:10 — Running Mechanics & Foot Function Key mobility and strength factors affecting the plantar fascia. 17:00 — Nutrition for Healing Protein, collagen support, and key micronutrients. 19:30 — Vegetarian Diet Considerations Ensuring adequate amino acids and nutrients. 21:10 — Mental Side of Injury Managing stress and staying engaged during recovery. 23:20 — Key Takeaways Final advice from each expert. 24:40 — Episode Wrap-Up Closing thoughts and how to submit a case. Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support [https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support?utm_source=rss&utm_medium=rss&utm_campaign=rss]. If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case. Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at runcasemiles@gmail.com.