Explore every episode of the podcast Sports Medicine Project

with Dr Pat Vallance

In this episode:

1. Bent knee versus straight knee calf raises for Achilles rehab
2. Why calf position changes muscle activation
3. Achilles tendinopathy and tendon strain
4. Tendon stiffness and why it matters
5. Whether plyometrics build tendon stiffness
6. Whether running should be stopped during rehab
7. Load monitoring and pain guided rehab
8. Muscular endurance testing with single leg heel raises
9. Normative values for calf endurance
10. Psychological factors in tendinopathy
11. Kinesiophobia and pain catastrophising
12. Cortical versus spinal inhibition
13. How rehab may differ for Achilles compared with patellar tendinopathy

Resources mentioned:

Tampa Scale of Kinesiophobia
https://www.physio-pedia.com/Tampa_Scale_of_Kinesiophobia

Where to find Pat:

Tendinopathy Circuit Breaker
https://tendinopathycircuitbreaker.com/

Instagram
https://www.instagram.com/tendinopathy_circuit_breaker/

Supercharge Your Tendon Rehab course
https://events.humanitix.com/supercharge-your-tendon-rehab-cutting-edge-tendon-injury-rehab

Pat's recent publications:

Vallance, P., Kidgell, D. J., & Malliaras, P. (2026). Greater endogenous pain facilitation is associated with lower spinal excitability and maximal knee extension strength deficits in athletes with patellar tendinopathy. European Journal of Applied Physiology, 1-14.

Vallance, P., Malliaras, P., & Kidgell, D. J. (2026). Temporal motor evoked potential decomposition reveals that cortico-reticulospinal excitability is increased in athletes with patellar tendinopathy. Preliminary evidence of compensatory adaptation for diminished motor drive. Journal of Electromyography and Kinesiology, 103142.

Vallance, P. (2025). Neural deficits relevant to pain symptoms and functional impairments in individuals with Achilles or patellar tendinopathy (PhD Academy Award). British Journal of Sports Medicine.

Vallance, P., Siddique, U., Frazer, A., Malliaras, P., Vicenzino, B., & Kidgell, D. J. (2025). Transcranial magnetic stimulation and electrical stimulation techniques used to measure the excitability of distinct neuronal populations that influence motor output in people with persistent musculoskeletal conditions: A scoping review and narrative synthesis of evidence. Journal of Electromyography and Kinesiology, 103011.

Vallance, P., Kidgell, D. J., Vicenzino, B., & Malliaras, P. (2025). Endogenous pain modulation is not different in basketball or volleyball athletes with patellar tendinopathy compared to asymptomatic athletic controls. Musculoskeletal Science and Practice, 76, 103280.

Every major osteoarthritis guideline in the world lists weight management as core care. Ben Steele-Turner's scoping review pulled together 79 records on what physiotherapists do, and the picture is messy. Clinician surveys have 60 to 94 per cent of physios saying they include weight management. Notes audits and patient interviews put it closer to 8 to 22 per cent.

Ben is a physiotherapist and PhD candidate at the University of Portsmouth, and he joins me to talk through why that gap exists and what to do about it. We get into scope of practice and why so many clinicians find the conversation awkward.

We also cover the part I've always struggled with. Osteoarthritis is a whole system condition, inflammatory, metabolic, psychological, and yet the mechanical side is the bit I know how to do. Sets, reps, load, progression.. Ben and I dig into whether the lifestyle side actually outperforms what we're already doing, what someone can be offered for faster relief in the first few weeks, and where taping, footwear, orthoses and injections sit.

Then there's the steroid question. If a knee is angry and inflamed we know what that environment does to cartilage, but the drug that settles it is itself chondrotoxic. Do we steer people away from it or put it on the table and let them decide? And can we really blame someone for wanting the pain gone now, when most of us wouldn't accept "just live with it" for our own injuries either.

Ben finishes with how he selects exercise for someone with knee OA, whether he starts local or zooms out, and the one thing he wants every patient to walk away understanding about their knee.

Papers discussed:

Steele-Turner B, Gonçalves AC, Shepherd AI, Drummond H, Allison K, Bennell KL, Exell TA. Physiotherapist-led weight management for people with osteoarthritis: A scoping review. Osteoarthritis and Cartilage 2026;34:121-138. https://pubmed.ncbi.nlm.nih.gov/41276008/

Moseng T, Vliet Vlieland TPM, Battista S, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024;83:730-740. https://pubmed.ncbi.nlm.nih.gov/38212040/

Muscle injuries remain one of the most challenging conditions in sport. In this episode, sports physiotherapist Murray Leyland joins us to discuss the latest evidence on muscle injury diagnosis, rehabilitation, and return to play. We cover muscle injury classification, the role of MRI, load management, eccentric training, calf and hamstring injuries, and how clinicians can make more informed return to play decisions. This episode is packed with practical, evidence-based insights for clinicians working with athletes and active individuals.

Murray's Practice Below:

https://www.valleyphysiotherapy.au/

Paper: https://bjsm.bmj.com/content/early/2026/05/03/bjsports-2025-110986

In this episode, Professor Joanne Kemp discusses the latest evidence on femoroacetabular impingement (FAI) syndrome and challenges common assumptions about hip pain. We explore why structural findings such as cam morphology are often seen in pain-free individuals, how imaging should be interpreted alongside the clinical picture, and what the new PhysioFIRST randomised controlled trial tells us about strengthening versus stretching. Joanne also shares practical advice for clinicians on patient education, treatment decision making, and translating research into everyday practice. Whether you're a clinician, student, or interested patient, this episode provides an evidence-based perspective on the assessment and management of hip pain.

Professor Joanne Kemp is a physiotherapist, researcher, and Professor at La Trobe University. She leads internationally recognised research in hip pain and femoroacetabular impingement (FAI) syndrome, with a focus on improving non-surgical management through high quality clinical trials. Joanne has authored more than 150 peer reviewed publications and is the lead author of the recent PhysioFIRST randomised controlled trial published in the British Journal of Sports Medicine.

Follow Kim https://www.linkedin.com/in/kim-hebert-losier/

Summary

Dr. Kim Hebert-Loser shares insights on calf muscle function, footwear technology, injury prevention, and the future of personalized shoe design. Discover how research, biomechanics, and individual preferences shape optimal running and rehabilitation strategies.

Stress fractures feel like they're everywhere lately but I don't think its changing disproportionately. I dig into why, what's really going on, and which bits of the "epidemic" narrative I think hold up.

Refs:

Bennell KL, Malcolm SA, Thomas SA, Reid SJ, Brukner PD, Ebeling PR, Wark JD. Risk factors for stress fractures in track and field athletes: a twelve-month prospective study. American Journal of Sports Medicine. 1996;24(6):810–818.

Knapik J, Montain SJ, McGraw S, Grier T, Ely M, Jones BH. Stress fracture risk factors in basic combat training. International Journal of Sports Medicine. 2012;33(11):940–946.

Changstrom BG, Brou L, Khodaee M, Braund C, Comstock RD. Epidemiology of stress fracture injuries among US high school athletes, 2005–2006 through 2012–2013. American Journal of Sports Medicine. 2015;43(1):26–33.

Rizzone KH, Ackerman KE, Roos KG, Dompier TP, Kerr ZY. The epidemiology of stress fractures in collegiate student-athletes, 2004–2005 through 2013–2014 academic years. Journal of Athletic Training. 2017;52(10):966–975.

Shi BY, Castaneda C, Sriram V, Yamasaki S, Wu SY, Kremen TJ. Changes in the incidence of stress reactions and fractures among intercollegiate athletes after the COVID-19 pandemic. Journal of Orthopaedic Surgery and Research. 2023;18(1):788.

Bergman AG, Fredericson M, Ho C, Matheson GO. Asymptomatic tibial stress reactions: MRI detection and clinical follow-up in distance runners. American Journal of Roentgenology. 2004;183(3):635–638.

Kiuru MJ, Niva M, Reponen A, Pihlajamäki HK. Bone stress injuries in asymptomatic elite recruits: a clinical and magnetic resonance imaging study. American Journal of Sports Medicine. 2005;33(2):272–276.

Hoenig T, Ackerman KE, Beck BR, Bouxsein ML, Burr DB, Hollander K, Popp KL, Rolvien T, Tenforde AS, Warden SJ. Bone stress injuries. Nature Reviews Disease Primers. 2022;8(1):26.

AusPlay (Australian Sports Commission). National participation data on running and jogging, 2015–present. https://www.clearinghouseforsport.gov.au/research/ausplay

In this episode, we explore questions such as:

Why does pain persist despite multiple high-quality treatments?

What does it actually mean to say pain is multifaceted, and how should that change clinical decision making?

How should clinicians communicate about pain in a way that is accurate, validating, and actionable?

What should clinics stop doing, start doing, and measure if they want to improve care?

In this episode, we speak with Dr Nardia-Rose Klem, a physiotherapist and research academic at Curtin University whose work focuses on young people living with persisting pain, particularly the relationship between pain, mental wellbeing, and access to appropriate care.

She is involved in several important clinical translation and public education initiatives, including young painHEALTH, painHEALTH, and the Musculoskeletal Clinical Translation Framework, all of which aim to improve the way pain and musculoskeletal conditions are understood, communicated, and managed. Her research spans young people with chronic musculoskeletal pain, co-existing mental health conditions, pain care experiences, and qualitative work exploring patient experiences across musculoskeletal healthcare contexts. 

Links mentioned

Profile and socials

Curtin University staff profile

Instagram: @physio_nardia

Websites and resources

young painHEALTH

painHEALTH

Musculoskeletal Clinical Translation Framework

Örebro Musculoskeletal Pain Screening Questionnaire, short form

Publications

Characterizing phenotypes and clinical and health utilization associations of young people with chronic pain: latent class analysis using the electronic Persistent Pain Outcomes Collaboration database 

“It’s kind of just like a never-ending cycle”: Young people’s experiences of co-existing chronic musculoskeletal pain and mental health conditions 

Lived and care experiences of young people with chronic musculoskeletal pain and mental health conditions: a systematic review with qualitative evidence synthesis 

A Prospective Qualitative Inquiry of Patient Experiences of Cognitive Functional Therapy for Chronic Low Back Pain During the RESTORE Trial 

What Influences Patient Satisfaction after TKA? A Qualitative Investigation

In this episode of the Sports Medicine Project, Blake Withers is joined by Dr. Gerald Yeo, a renowned foot and ankle orthopedic surgeon, to discuss the intricacies of foot and ankle surgeries, particularly focusing on Achilles tendon and navicular stress fractures. Dr. Yeo shares insights from his extensive experience, discussing the challenges and advancements in surgical techniques, and the importance of a multidisciplinary approach in treatment.

• Dr. Gerald Yeo emphasizes the complexity of foot and ankle surgeries compared to other orthopedic procedures.
• The discussion highlights the importance of a multidisciplinary approach involving physiotherapists and podiatrists.
• Dr. Yeo explains the traditional and modern approaches to treating Achilles tendonitis.
• The episode explores the challenges of measuring surgical outcomes for foot and ankle procedures.
• Dr. Yeo shares insights on the use of Richie braces in managing foot conditions.
• The conversation covers the role of imaging in diagnosing and planning surgeries.
• Dr. Yeo discusses the potential of minimally invasive techniques in foot and ankle surgery.
• The episode addresses the common misconceptions about Haglund's deformity and its treatment.
• Dr. Yeo talks about the importance of patient education in managing expectations post-surgery.
• The discussion includes the future of orthopedic surgery and potential advancements in treatment options.

Keywords: Achilles tendon, navicular stress fractures, orthopedic surgery, foot and ankle, multidisciplinary approachTakeaways:

Dr Gerald Yeo is a Queensland trained orthopaedic surgeon (BMedSci, FRACS (Ortho), FAOrthA) with subspecialist fellowship training in foot and ankle surgery. His clinical interests include minimally invasive and arthroscopic techniques, total ankle replacement, and lower-limb trauma, with a focus on supporting recovery through early, functional rehabilitation and multidisciplinary care. He consults and operates in Brisbane, including at Brisbane Orthopaedic Specialist Services and St Vincent’s Private Hospital Northside, and also consults at North Lakes and operates at North West Private Hospital. (drgeraldyeo.com.au)

Confused by all the ASICS “Blast” shoes? In this video I break down the entire Blast family and help you match the right shoe to your running.Megablast – max stack, FF TURBO SQUARED, ultra-bouncy long run and easy day optionSonicblast – dual-foam midsole with Pebax plate, built for tempo and faster long runs Superblast 2 – the super trainer sweet spot for daily training, long runs and some workouts Novablast 5 – the classic bouncy daily trainer, 8 mm drop, big stack without feeling unstable  Dynablast – more affordable, lower stack, flexible Blast option that still feels fun underfoot Which models suit higher weekly mileage and long runsWhen I might lean towards Megablast or Superblast?Where Dynablast and Novablast fit for newer runners or those not used to very high stack shoes?

Summary

In this conversation, Blake Withers interviews Aidan Rich, a sports and exercise physiotherapist, about his research on proximal hamstring tendinopathy and the recent randomized control trial comparing physiotherapy and shockwave therapy. Aidan shares his journey into the field, the challenges of designing the study, and the importance of education in treatment. They discuss the nuances of exercise rehabilitation, patient experiences, and the surprising results of the trial, which showed no significant difference between the two treatment methods. Aidan emphasizes the need for individualized care and the potential for future research in this area.

Paper links:

Main RCT: https://journals.sagepub.com/doi/10.1177/03635465251391134

https://pubmed.ncbi.nlm.nih.gov/41037932/

https://pubmed.ncbi.nlm.nih.gov/40469642/

https://www.jsams.org/article/S1440-2440(25)00275-0/pdf

Aidan Rich:

PhD Candidate | APA Titled Sports and Exercise Physiotherapist | State Manager
A dedicated and passionate physiotherapy professional with extensive experience in both academic research and clinical management. Currently pursuing a PhD with the topic of 'Physiotherapy for Proximal Hamstring Tendinopathy,' where he has conducted two randomised trials. In addition to his academic pursuits, he oversee the clinical, financial, and cultural performance of a network of 20 physiotherapy and sports medicine clinics across Victoria. His role involves ensuring the highest standards of patient care, optimising financial performance, and fostering a positive and collaborative work environment.

Chapters

00:00 Introduction and Background of Aidan Rich

03:48 The Evolution of Tendinopathy Treatment

08:30 Shockwave Therapy: Insights and Experiences

13:13 Designing the RCT: Methodology and Protocols

18:20 The Exercise Program: Structure and Rationale

23:07 Education in Rehabilitation: Importance and Implementation

28:39 The Benefits of Resistance Training

29:52 Qualitative Insights from RCT Participants

31:36 Surprising Strength Outcomes in Rehabilitation

33:42 Effect Modifiers in Treatment Response

35:20 Clinical Applications of Shockwave Therapy

37:01 Patient Preferences in Treatment Choices

38:00 Individualized Treatment Approaches

39:04 Evaluating Shockwave Therapy Effectiveness

41:22 Challenges in Designing Effective Trials

43:22 Comparative Outcomes in Tendinopathy Treatments

45:43 Acute Responses to Shockwave Therapy

48:36 Key Takeaways for Clinicians

50:59 Future Directions in Research

Audio a little quiet last 54 mins.

Ian is a sports podiatrist and educator who helps people stay active and reach their goals through evidence-based pain and injury management. A keen runner himself, he pairs lived experience with top-tier credentials—degrees in Podiatric Medicine and Sports Injury, postgraduate training in Sports Podiatry and Academic Practice, and Fellowships of the Royal College of Podiatry, the Royal College of Physicians & Surgeons of Glasgow, and the Higher Education Academy—while lecturing at Queen Mary University of London and holding adjunct roles at Monash and Ziauddin Universities. He has presented internationally and supported elite teams including the PGA European Tour, England Rugby 7s, Surrey Cricket, GB Men’s Hockey and Arsenal (including London 2012), but takes greatest pride in helping everyday athletes stay healthy, resilient and able to enjoy their sport.

Breakdown of Relative Energy Deficiency in Sport (RED-S), what it is, why clinicians and athletes should care, key stats/facts that often get missed, and practical screening you can use tomorrow in clinic or with your squad.

What you’ll learn

• What RED-S actually is (beyond “under-fuelling”)

• Why it matters for health, performance, and injury risk

• Prevalence, red flags, and common pitfalls

• How to screen in real life: which tools, when to use them, and how to interpret results

• When to refer and build a multidisciplinary plan

LEAF-Q (Low Energy Availability in Females Questionnaire)

https://bjsm.bmj.com/content/bjsports/suppl/2014/02/21/

bjsports-2013-093240.DC1/bjsports-2013-093240supp1.pdf

LEAF-Q Scoring Guide:

https://bjsm.bmj.com/content/bjsports/suppl/2014/02/21/

bjsports-2013-093240.DC1/bjsports-2013-093240supp2.pdf

• LEAM-Q (Low Energy Availability in Males Questionnaire) 6

https://www.mdpi.com/2072-6643/14/9/1873 (see supplementary material)

• RST (RED-S Specific Screening Tool) 7

https://assets.cureus.com/uploads/original_article/

pdf/30734/1612430181-1612430175-20210204-18268-i9k6n7.pdf

(Questionnaire in appendix C, scoring guide in appendix B)

• SEAQ-I (Sport-Specific Energy Availability Questionnaire and

Interview) 8

https://bmjopensem.bmj.com/content/4/1/e000424

(see supplementary material)

• EDE-Q (Eating Disorder Examination Questionnaire) 9

https://socialwork.buffalo.edu/content/dam/socialwork/continuing-

education/documents/Eating-Questionairre-EDE-Q.pdf

• SCOFF (Sick, Control, One (stone), Fat, and Food Questionnaire) 10

https://www.nutritionhealth.com.au/site/assets/files/1064/scoff-

questionnaire.pdf

• EAI (Exercise Addiction Inventory) 11

https://doi.org/10.1080/16066350310001637363 (see appendix 1)

• EDS (Exercise Dependence Scale) 12

https://www.personal.psu.edu/dsd11/EDS/EDS21Manual.pdf

Stress fractures are one of the most common running injuries (up to 20% of them), but what actually are they, why do they happen, and why do some take longer to recover than others?In this video, I explain: • What a stress fracture is and how it develops • Why taking time off running is often essential for healing • Why not all stress fractures are the same (location and severity matter) • What runners should know about recovery and reducing riskI’m a Sports Podiatrist and PhD researcher candidate in running injuries, and my goal is to give runners clear, evidence-based information to help them train smarter and stay injury free.

Find Gabriel:

https://www.researchgate.net/profile/Gabriel-Moisan

https://www.linkedin.com/in/gabriel-moisan-a382aaa7/

In this conversation, Blake Withers interviews Gabriel Moisan, a podiatrist and researcher, about his journey in the field of podiatry, the evolution of foot orthoses, and the ongoing debates surrounding their use. They discuss the challenges of research in podiatry, the mechanisms of foot orthoses, and the differences between custom and prefabricated devices. Moisan shares insights on how to determine the appropriate dosage of foot orthoses for patients and critiques the terminology used in describing conditions like adult acquired flatfoot. The conversation emphasizes the importance of understanding both the mechanical and psychosocial effects of foot orthoses in patient care. In this conversation, Blake Withers and Gabriel Moisan delve into the advancements in podiatry, particularly focusing on foot orthosis, 3D printing technology, and the importance of clinical outcomes. They discuss the role of footwear in treatment, the evolution of materials used in orthotics, and the integration of technology to enhance patient care. The conversation also highlights the significance of teaching and learning in podiatry, the challenges of research, and the future directions of the field, including the potential of AI in predicting treatment outcomes.takeaways

• Gabriel Moisan's journey in podiatry began with a desire to understand foot orthoses.
• Research often leads to more questions than answers in podiatry.
• The traditional view of pronation as 'evil' is being challenged.
• Alignment theories in podiatry are being replaced by a focus on function.
• Research needs to control for biases to accurately assess treatment outcomes.
• Foot orthoses work through mechanical, somatosensory, and psychosocial effects.
• Comfort in foot orthoses is not always the priority for effective treatment.
• The debate between custom and prefabricated foot orthoses continues.
• Determining the appropriate dosage of foot orthoses is crucial for patient outcomes.
• Terminology in podiatry needs to evolve to better reflect current understanding. 3D printing has revolutionized the manufacturing of orthotics.
• Clinical outcomes are prioritized over biomechanical outcomes.
• Footwear plays a crucial role in the effectiveness of orthotic devices.
• Material science is evolving, but significant changes are still needed.
• Technology integration in orthotics could improve patient outcomes.
• Patient feedback is essential for effective treatment.
• Teaching students about orthotic modifications is vital.
• Research in podiatry is often limited by funding and resources.
• The evolution of foot orthosis has been slow but necessary.
• Future research may focus on AI to predict treatment success.

• Exploring the World of Podiatry
• The Journey of a Podiatrist: Gabriel Moisan

• "Pronation is evil."
• "I just want to see it."
• "We should think outside the box."

titlesSound BitesChapters00:00Introduction and Name Pronunciation00:32Gabriel Moisan's Journey in Podiatry04:33The Evolution of Foot Orthosis Understanding10:33Research Challenges in Foot Orthosis16:40The Mechanisms of Foot Orthosis20:15Clinical Applications and Effectiveness of Foot Orthosis32:49Understanding Foot Orthosis for Adult Acquired Flatfoot39:44The Debate on Terminology in Podiatry46:54Long-Term Use of Foot Orthosis: A Patient-Centric Approach51:35Advancements in Foot Orthosis Manufacturing56:15Customizing Foot Orthosis for Specific Conditions01:04:08The Future of Foot Orthosis: Technology and Innovation01:09:29The Role of Technology in Podiatry01:12:25Understanding Foot Orthosis and Patient Outcomes01:15:29Predicting Biomechanical Effects of Orthoses01:18:26The Impact of 3D Printing on Orthotic Modifications01:22:36Future of Foot Orthosis: Research and Innovations01:26:05The Need for Comprehensive Resources in Podiatry01:26:41Influential Figures in Podiatry and Research Aspirations

Find Luke: https://www.instagram.com/sportschiroluke/

Luke is a titled Sports & Exercise Chiropractor, Running Coach, and Strength Coach with over 20 years of experience in private practice in Melbourne. He has lectured extensively across Australia and internationally on sports injuries, with a focus on running-related topics. As an avid fitness enthusiast, Luke has completed 11 marathons, an ultra-marathon, and two Ironman triathlons. In recognition of his expertise, Luke was awarded Fellowship status by the Australasian Institute of Chiropractic Education in 2019, inducted as a Fellow of the Australian Sports Medicine Federation in 2024, and honoured as the 2022 ACA Chiropractor of the Year for his contributions to the profession.Luke Nelson
Sports & Exercise Chiropractor
Director Health & High PerformanceB App Sci (Clin Sci.)/B Chiro Sci, ICCSP, Postgrad.Dip.Sport Chiro, M.Sport.Sci, ASCA Lev 1, FAICE, FASMF
w. https://www.healthhp.com.au/

Chapters

00:00 Introduction to Podiatry and Chiropractic Practices

00:58 Evolving Perspectives in Healthcare

03:36 The Journey of a Chiropractor

06:47 The Role of Social Media in Healthcare

09:32 Strength Training and Injury Prevention

12:37 Plyometrics in Running Training

15:24 Individualized Training Approaches

18:34 Managing Tendon Injuries

21:11 Patient Education and Communication

29:06 Effective Communication in Consultations

33:14 Understanding Running Programming

40:23 Assessment Techniques for Runners

47:14 The Importance of Strength Assessment

53:47 Managing Bone Stress Injuries

01:01:24 Reflecting on Gratitude and Perspective

01:01:48 Foot Strike Patterns and Gait Interventions

01:04:59 Sustaining Changes in Running Technique

01:06:35 Programming for Return to Running

01:10:57 Adding Intensity to Training

01:11:59 Managing Pain and Progressing Training

01:16:52 Mechanical Interventions in Running

01:20:03 Favorite Running Shoes and Recommendations

01:23:09 Interviewing the Greats and Research Aspirations

01:27:06 Future Endeavors and Closing Thoughts

Takeaways

The breakdown of traditional silos in healthcare is beneficial for patient care.

Interdisciplinary collaboration leads to better treatment outcomes.

Social media can enhance the dissemination of healthcare knowledge.

Strength training is crucial for injury prevention in runners.

Plyometrics can improve performance and aid in rehabilitation.

Patient education is essential for effective treatment.

Understanding patient goals helps tailor treatment plans.

Assessment techniques are vital for identifying issues in runners.

Research translation is important for evidence-based practice.

Healthcare professionals should continuously evolve their practices. Strength parameters should be assessed in context, not isolation.

The act of doing training is more important than just numbers.

Weakness can be a precursor to injuries, but it's not the only factor.

Criteria-based rehabilitation is often more effective than time-based.

Managing bone stress injuries requires careful progression and monitoring.

Runners often need mental support when facing injuries.

Foot strike patterns should be assessed but not always changed.

Easy running builds the foundation; speed work enhances performance.

Individualized programming is crucial for effective rehabilitation.

The future of injury prevention research is multifactorial and complex.

Get some help with Jack: https://www.clinicmastery.com

Find Jack: https://www.instagram.com/jackdobrien/

Summary

In this episode, Blake Withers and Jack O'Brien discuss the often-overlooked aspects of business and finance in healthcare. They explore the importance of sustainability, negotiation strategies for new graduates, and the realities of income potential in allied health professions. Jack shares his journey from clinician to business owner and emphasizes the need for effective communication and understanding of financial literacy in the healthcare field. The conversation also touches on the challenges of starting a private practice, the significance of KPIs, and the value of patient-centered care.

Chapters

00:00 Introduction to the Conversation

00:29 The Importance of Business in Allied Health

01:41 Jack O'Brien's Journey in Healthcare

03:36 Sustainability in Healthcare Practices

07:42 Negotiating Your First Job

10:48 Work-Life Balance vs. Work-Life Tension

12:49 Understanding Income Potential in Healthcare

16:06 The Reality of Business Expenses

19:47 Profit Sharing and Employee Satisfaction

20:55 Effective Communication in Negotiations

25:00 Increasing Your Income Potential

27:51 Ethical Revenue Generation in Healthcare

32:55 The Challenges of Starting Your Own Practice

33:46 The Reality of Starting a Clinic

37:29 Exploring Career Progression in Healthcare

41:24 Financial Strategies for Clinicians

41:58 Contractor vs Employee: Weighing the Risks

45:18 Creating a Reward Structure in Clinics

48:20 The Value of Patient Care and Communication

58:12 Believing in the Value of Every Patient Interaction

study link :https://pmc.ncbi.nlm.nih.gov/articles/PMC9884822/pdf/fspor-04-1048655.pdf

Key takeaways:

• Gait modifications can immediately reduce patellofemoral pain in some runners.

• The most effective strategies were increasing step rate by 10% and adopting a forefoot strike pattern.

• Runners with a rearfoot strike benefitted more from forefoot strike and “running softer,” while non-RFS mainly improved with a higher step rate.

• Reductions in patellofemoral joint force were linked to pain decreases, but not always — suggesting other mechanisms (psychological/central factors) may also contribute.

• Increasing step rate is likely the safest first option; forefoot strike may work but carries higher Achilles tendon load, so requires caution.

Issac instagram: https://www.instagram.com/isaacheyne/

Substack: https://substack.com/@isaacheyne?r=jxf68&utm_medium=ios&utm_source=profile&fbclid=PAZXh0bgNhZW0CMTEAAadhAnzfZo7PbmOOABf-9MoarClQRKfYUPEdbOD-PgKY6y7d1bBdYhSKAcUV1A_aem_2VWcJabI4cL4gvFebIjang

Skip to 8mins to get started!

What way to evaluate information is:Applying the CRAAP test

CRAAP framework

Currency: Is the information up‑to‑date?

Relevance: Does it directly address your question or topic?

Authority: Who is the author? What are their credentials and affiliations?

Accuracy: Is the content supported by verifiable evidence and citations?

Purpose: What is the reason behind the content—informative, persuasive, commercial, or satirical

keywords: running, influencers, training load, misinformation, social media, sports medicine, physiotherapy, nutrition, community, injury prevention, running culture, injury prevention, running community, evidence-based practice, footwear innovation, personal experience, inclusivity, social media, athlete support, training methodssummaryIn this conversation, Blake Withers and Isaac Hain discuss the influence of running influencers on the sport, the importance of understanding training load, and the challenges of navigating misinformation in the running community. They explore the evolution of running knowledge, the impact of social media, and the necessity of critique in professional development. The discussion also touches on the role of nutrition in injury prevention and the positive aspects of running communities. In this conversation, the speakers explore the evolution of running culture, the impact of increased participation in the sport, and the importance of inclusivity within the running community. They discuss the challenges of traditional running paths and the role of evidence in running practices, emphasizing the need for individualized approaches to running injuries. The conversation also touches on the balance between tradition and innovation in running, the emotional connection to the sport, and the significance of engaging with the running community online. Ultimately, the speakers reflect on their personal experiences and the purpose they find in helping others navigate their running journeys.

Chapters

00:00 Introduction to Running and Physiotherapy

10:18 Isaac's Journey: Runner and Clinician

13:34 The Evolution of Running Knowledge

16:15 The Impact of Misinformation in Running

19:25 Navigating Social Media and Running Advice

22:30 The Role of Critique in Professional Growth

25:33 Finding Truth in Running Information

28:22 The Balance of Sharing Knowledge

31:25 Conclusion: The Future of Running and Health Information

37:54 Understanding Knowledge Gaps in Physiotherapy

41:34 Navigating Scope of Practice and Online Influence

43:45 The Role of Nutrition in Physiotherapy

46:58 The Impact of Social Media on Running Culture

52:34 The Evolution of Running and Its Community

58:36 Challenging Traditional Paths in Running

01:03:27 Balancing Old and New Practices in Training

01:08:25 Understanding Individualized Treatment in Healthcare

01:11:28 The Complexity of Physiotherapy and Patient Care

01:14:22 The Role of Social Media in Running and Community Engagement

01:17:21 Personal Experiences Shaping Professional Passion

01:20:36 Navigating Online Presence and Telehealth in Physiotherapy

01:22:38 The Evolution of Running Footwear and Personal Preferences

Foot orthoses are more than just plastic shells and we need to evaluate them appropriately if we want to better help patients.

Here is how I think about foot orthoses—covering assessment, materials, and the clinical reasoning that underpins effective prescription. Whether you’re a podiatrist, physiotherapist, or other allied health professional, this 30-minute discussion will help you understand how to approach orthoses with clarity and confidence in practice.

 Blake Withers and Jack Craigo discuss the nuances of running shoes, particularly focusing on super shoes and their suitability for different runners. They explore the importance of shoe fit, the role of retail in guiding shoe selection, and the potential injury risks associated with performance footwear. The discussion also highlights the significance of comfort and the impact of shoe technology on running performance, concluding with recommendations for runners on choosing the right shoes for their needs.

Jack Crago youtube and instagram: @jog.on.crago

super shoes, running shoes, injury prevention, shoe fit, marathon training, footwear technology, running performance, retail experience, shoe selection, running community

Super shoes, also known as advanced footwear technology (AFT), are designed to enhance running performance by incorporating features like aggressive rocker geometry, high stack heights (often ≥35–50 mm), lightweight and compliant foams, carbon or composite plates, and minimal weight. These features aim to improve running economy and propulsion. However, their widespread use has prompted questions about whether they are the best option for all runners—especially when it comes to injury risk and biomechanical stability.

Running participation continues to grow, with events like marathons selling out rapidly (Barrons et al., 2023). Many runners get their footwear advice from online sources or retail staff. Research suggests that both runners and retailers prioritise comfort, with super shoes often perceived as more comfortable than generic alternatives (Malisoux et al., 2020). While footwear is known to influence both performance and injury risk (Nigg et al., 2023), the assumption that super shoes are universally superior oversimplifies a complex trade-off.

One of the major proposed performance benefits of high stack height is an increase in effective leg length, which may lengthen stride and improve running economy (Burns & Tam, 2020). However, these gains may come at the cost of reduced frontal plane ankle stability, particularly at higher speeds (Hoogkamer, 2020; Barrons et al., 2023). This potential drawback becomes even more important in longer races when fatigue sets in and motor control becomes more challenged.

Recent studies have begun to test these assumptions more rigorously. Garofolini et al. (2024) and Möhler et al. (2022) hypothesised that high-stack shoes increase instability in the control of the centre of mass (CoM), and that these effects are exacerbated at higher speeds due to the added demands on motor coordination. Their findings suggest that super shoes may impose additional coordination demands that not all runners can accommodate.

In one of the most comprehensive studies to date, Kettner et al. (2025) tested runners using shoes with low (27 mm), medium (35 mm), and high (50 mm) stack heights. The high stack shoes caused measurable changes in running style: increased vertical oscillation of the centre of mass (COMosc), lower step frequency, and higher duty factor (i.e., more time spent on the ground). These shoes also altered ankle mechanics, especially increasing time in eversion and eversion angles. Critically, they found lower local dynamic stability at the hip—measured using Maximum Lyapunov Exponent (MLE)—with the high stack shoes, suggesting impaired control of the centre of mass. These changes were largely independent of running speed, appearing consistently at both 10 and 15 km/h.

From a clinical perspective, this evidence indicates that super shoes are not one-size-fits-all. Runners with a history of injury, reduced neuromuscular coordination, or poor fatigue resistance may be better served by lower stack, more stable footwear. Coordination and stability may be just as critical as cushioning and propulsion—especially in long races or for less experienced runners.

Dr Myles Murphy is a clinical physiotherapist and early-career clinician researcher from the Nutrition and Health Innovation Research Institute at Edith Cowan University. Myles’ works clinically at SportsMed Subiaco and has worked with or consulted for a variety of elite sporting teams. While working clinically, Myles’ completed his PhD part-time at The University of Notre Dame Australia investigating the different mechanisms related to pain and dysfunction in people with lower-limb tendinopathy. Myles’ research involves investigating the drivers of pain and impairment in people with lower-limb musculoskeletal injury and disa

In this conversation, Blake Withers and Kelly Kortick host Esther Keown and Dr Claire Badenhorst to discuss the importance of understanding female physiology in sport, particularly running. They explore the challenges young female athletes face regarding body image and performance, the significance of individualised training programs, and the role of communication in supporting female athletes. The discussion also highlights the launch of Femmi's membership, which aims to empower women through education, community support, and personalised training that considers the unique physiological needs of women.

The Femmi app is available for download on iOS and android:

iOS: https://apps.apple.com/au/app/femmi-running-plans-for-women/id1672881899

Android: https://play.google.com/store/apps/details?id=com.femmico.femmi&hl=en&pli=1

Femmi: https://tinyurl.com/c7r732bs

Esther: https://www.instagram.com/estherkeown/?hl=en

Claire: https://www.instagram.com/claire_bades/?hl=en

Takeaways

Understanding female physiology is crucial for optimizing training and performance.

Communication about body image and performance is essential for young female athletes.

Individualized training programs are necessary to accommodate the unique needs of female runners.

FEMI provides resources and support for women to understand their bodies better.

The menstrual cycle significantly impacts training and performance for women.

Empowerment through education can enhance confidence in female athletes.

Community support plays a vital role in encouraging women to participate in running.

Research on female physiology is still evolving and needs to be more inclusive.

FEMI's membership offers personalized training and expert guidance for women runners.

Tracking menstrual cycles can help women understand their bodies and improve performance.

Chapters

00:00 Introduction to FEMMI and Its Mission

01:29 Understanding Female Physiology in Training

02:17 Optimizing Communication and Support for Female Athletes

02:44 The Impact of Societal Norms on Female Athletes

04:21 New Chapter

04:36 The Role of Coaches and Clinicians in Body Positivity

07:24 Understanding Female Physiology and Injury Prevention

10:04 Research Insights on Female Athlete Well-being

13:08 The Importance of Open Conversations in Sports Medicine

15:45 Celebrating Progress in Female Sports Education

24:24 Understanding Menstrual Cycle Research Limitations

30:16 Individual Variability in Menstrual Cycle Symptoms

33:13 FEMI: Tailoring Training to Female Physiology

37:24 The Complexity of Hormonal Impact on Performance

42:52 Recognizing Luteal Phase Defects and Their Implications

51:31 Empowering Women Through Cycle Tracking

56:12 Understanding Your Body and Hormones

57:12 The Importance of Iron for Female Athletes

01:06:43 Debunking Foot Strike Hemolysis

01:11:30 The Dangers of Generic Training Programs

01:14:35 Maximizing Performance for Female Athletes

01:17:54 Introducing the Femi Membership

Keywords

FEMMI, female physiology, running, training programs, women's health, empowerment, communication, performance, menstrual cycle, community support

Takeaways

Metatarsal stress fractures are common injuries in athletes.

Understanding the remodeling process of bones is crucial for recovery.

Subjective questioning can reveal important clues about the injury.

Palpation techniques are essential for accurate diagnosis.

Systemic factors like energy availability can influence bone health.

Imaging, particularly MRI, is vital for diagnosing bone stress injuries.

Treatment should focus on offloading the affected area.

Recovery time varies significantly between individuals and injuries.

Communication with patients about their condition is key to effective treatment.

Injury prevention strategies should include monitoring training loads.

** You should always see a medical professional for diagnoses and assessment. This is not medical advice and is for educational purposes only.

Summary

In this episode of the Sports Medicine Project, hosts Blake and Kelly delve into the complexities of diagnosing metatarsal stress fractures and bone stress injuries. They discuss the importance of understanding the clinical assessment process, including subjective questioning, palpation techniques, and the role of imaging in diagnosis. The conversation emphasizes the significance of systemic factors and adequate recovery in preventing these injuries, as well as the need for effective treatment strategies. The hosts share insights from their clinical experiences, making the discussion both informative and engaging for listeners interested in sports medicine and injury management.

Chapters

00:00 Introduction and Overview of Metatarsal Injuries

03:01 Understanding Bone Stress Injuries

05:46 Diagnosis and Clinical Assessment

09:04 The Role of Training Load and Recovery

12:06 Systemic Factors Influencing Bone Health

14:49 Imaging and Diagnostics for Metatarsal Injuries

18:01 Palpation Techniques and Patient History

20:53 Conclusion and Key Takeaways

25:35 Palpation Techniques for Metatarsal Assessment

32:06 Clinical Decision-Making in Bone Stress Injuries

37:54 Differentiating Between Tendon and Bone Injuries

48:02 Imaging and Diagnosis of Bone Stress Injuries

Keywords

metatarsal stress fracture, bone stress injury, diagnosis, clinical assessment, imaging, treatment, sports medicine, recovery, palpation techniques, systemic factors

Gregs social: https://www.instagram.com/greglehman/

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Gregs Website: https://www.greglehman.ca/

Chapters

00:00 Evaluating Shockwave Therapy in Tendinopathy

00:44 The Role of Exercise in Rehabilitation

03:43 Understanding Patient Ecosystems and Health

06:23 Case Studies: Practical Applications in Treatment

08:49 The Complexity of Pain Management

11:43 Research Critique: Shockwave Therapy and Evidence

14:10 Psychological Factors in Pain Perception

17:02 Clinical Decision-Making in Patient Care

26:00 Trusting Experts and Knowledge Translation

27:21 Challenging Established Beliefs

28:30 Comparing Treatment Philosophies

31:03 The Role of Patient Understanding

33:35 Exercise vs. Alternative Treatments

34:26 Load Management in Rehabilitation

35:54 Creative Approaches to Running Rehabilitation

37:06 Resistance Training for Runners

40:12 Skepticism Towards New Research

42:50 Understanding Bone Stress Injuries

54:53 Understanding Pain and Structural Changes

58:59 Navigating Risks in Running Injuries

01:04:20 The Role of Social Media in Health Information

01:09:39 Strength Training and Recovery Insights

01:12:24 Research Aspirations and Future Directions

Keywords:

shockwave therapy, tendon rehabilitation, exercise, pain management, sports medicine, patient education, metabolic health, case studies, research appraisal, individualized treatment, training protocols, bone health, stress fractures, plyometric training, rehabilitation, pain management, social media, health information, research ethics, performance.

Summary:

This conversation delves into the complexities of sports medicine, focusing on shockwave therapy, exercise rehabilitation, and the importance of understanding patient ecosystems. The speakers discuss recent research findings, the role of exercise in pain management, and the need for individualized treatment approaches. They also explore the psychological factors influencing pain and the critical appraisal of existing research in the field. In this conversation, Blake Withers and Greg delve into various aspects of training protocols, bone health, and the complexities of rehabilitation. They discuss the importance of flexibility in training, the role of frequency in plyometric exercises, and the nuances of managing pain in relation to structural changes. The dialogue also touches on the ethical considerations of pain in research, the impact of social media on health information, and future directions in rehabilitation research.takeaways

• Shockwave therapy may not provide additional benefits compared to exercise.
• Exercise should be critically evaluated just like other treatments.
• Improving a patient's overall health ecosystem is challenging but essential.
• Patient motivation is crucial for successful rehabilitation.
• Understanding the mechanisms of pain can enhance treatment outcomes.
• Research in sports medicine often lacks strong evidence for certain treatments.
• Individualized treatment plans are necessary for effective rehabilitation.
• Psychological factors play a significant role in pain perception.
• Exercise can positively influence peripheral nociception.
• Critical appraisal of research is vital for informed clinical practice. People can improve despite not following traditional protocols.
• Flexibility in training is crucial for optimal results.
• Frequency of training may be more important than intensity.
• Understanding bone health is essential for preventing stress fractures.
• Pain is not always a reliable indicator of injury severity.
• Social media can be a double-edged sword for health information.
• Research ethics play a significant role in studying pain management.
• The relationship between structure and pain is complex and often misunderstood.

We discuss the latest review PMID: 39704142 with Prof Peter Malliaras

✅ Identifying early responders – Can we predict who will benefit?

✅ Effect – Does it work?

✅ Diminishing returns – When does adding SWT to exercise stop being beneficial?

✅ Types of shockwave therapy – Why radial shockwave was chosen in this study

✅ Sham treatments – Do they still have a therapeutic effect?

✅ Mechanisms of action – Neuromodulation, therapeutic alliance, and tendon adaptation

✅ The ‘Big Machine Effect’ – Is patient belief in SWT part of its effectiveness?

✅ Comparisons to exercise – Would fewer appointments with exercise yield similar outcomes?

We also discuss clinical implications—will these findings change how shockwave therapy is used in practice?

🔗 References & Studies Discussed:

• Alsulaimani et al. (2024) - Achilles tendinopathy & shockwave RCT

• Benli et al. - SWT vs. exercise alone

• Heide et al. - Shockwave therapy for plantar heel pain

Find out about Peter and upcoming course:

https://www.tendinopathyrehab.com/home

Socials: https://www.instagram.com/tendinopathyrehab/

https://www.linkedin.com/posts/petermalliaras_my-new-tendinopathy-rehabilitation-framework-activity-7296743926009368576-GNRW/?utm_source=share&utm_medium=member_ios&rcm=ACoAAAexDmkBlV5e4jGTX2E4X9J6s8ZitO8yX0M&fbclid=PAZXh0bgNhZW0CMTEAAabnnAaDDYH_S3We7eJaZZbOHWHxrtGYC_5AiRO-rDUtmh29GdmHqrWh9fI_aem_FLbCehDnORljxK3cgMA8fQ

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1. Keep Intensity the Same

This is the biggest and easiest mistake. If your Achilles is sore, what will aggravate it most is higher rates of loading—formally, this happens more when you run faster. Yes, it might warm up during the run, but you’ll pay for it 24 hours later. You need to stress it just a little, see how it responds, and build from there.

2. Rest, Then Go Straight Back to Full Load

You shouldn’t completely rest and then jump straight back to the same training load. If you usually do speed work on Tuesdays, and you’ve had a week or two off, that first run back shouldn’t be the same session. Don’t do that. Start gradually—try something like 6 x 1-minute efforts and progress from there.

3. Wear Flat Shoes

Heel pitch helps Achilles tendon pain. A higher heel reduces both tensile and compressive forces by limiting dorsiflexion. Achilles pain isn’t just about the run—it’s about everything you do throughout the week. If you’re on your feet all day, even if it’s not sore at the time, that will contribute to your pain during training.

4. Not Question the Diagnosis

Sometimes, it’s not Achilles tendinopathy. Yes, if you’ve had it before, you can get it again—but not always. Other things mimic Achilles pain. Be sure.

5. Keep Training Load the Same

If you’re dealing with Achilles pain, take something away. Reduce intensity or volume—adjust something. If you’re not sure how, see someone who can help you make it graded.

6. Think the Adjuncts Are the Answer

They can help, but they’re not the solution. Shockwave, massage, needling—useful, sure. But if you’re not loading appropriately, nothing else will fix it.

7. Not Load It Properly

You have to load it. Strength, plyometrics, progressing appropriately—it all matters.

8. Smash the Anti-Inflammatories and Think That’s Enough

Anti-inflammatories aren’t bad, but if that’s all you’re doing, you’re missing the point. This isn’t an inflammatory condition—it’s a load issue.

9. Think Injections Are the Quick Fix

Too many people jump to injections too early. They can have a role in specific cases, but they’re not a cure.

10. Ignore the Psychology Behind Injury

This is huge. Achilles pain isn’t just about the tendon—it’s about the mental load of not running, the frustration, the identity shift. Understanding this can change everything.

Achilles tendinopathy, injury management, running injuries, health professionals, rehabilitation, load management, resistance training, anti-inflammatories, psychological impact, running performance

Mr. Ian Reilly qualified as a Podiatrist in 1988 and became a Podiatric Surgeon in 1996. Over his career, he has performed more than 11,000 surgical procedures under various anaesthesia types, showcasing his extensive expertise.

You can out more below by clicking the link on his website.

From 2001 to 2024, he led Podiatric Surgery at Northamptonshire Trust, significantly advancing podiatric care. Now retired from NHS practice, he focuses on private care, operating weekly at Three Shires Hospital in Northampton and treating patients across self-pay, insured, and NHS pathways.

Mr. Reilly specializes in:

Injection Therapy:

• Cortisone Injections

Podiatric Surgery:

• Cyst and ganglion excision (soft tissue lumps and bumps)

• Morton’s neuroma surgery (trapped nerves)

• Subungual and other bony exostectomies (bony bumps)

• Lesser toe correction (hammer toes)

• Metatarsal surgery for forefoot pain

• Surgery for hallux limitus (arthritis of the great toe)

• Surgery for hallux valgus (bunions)

• Haglund’s deformity (heel bumps)

• Plantar fasciitis (heel pain)

• Flatfoot surgery

Minor Surgery:

• Verrucae, corn, and skin surgery

• Nail surgery

Dr Ian Reilly website:

https://podsurgeon.co.uk/

Youtube: https://youtube.com/@ianreillypodsurgeon?si=rDK6BHAwRGBu4L3F

What it takes to become a Podiatric surgeon?

file:///Users/blakewithers/Desktop/ian%20pod/The%20Royal%20College%20of%20Podiatry.html

Mary PoppinsProbably Needed Orthotics article https://podiatrym.com/Highlights2.cfm?id=3286

Patreon: https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink

00:00Introduction to Dr. Ian Riley02:07Career Progression in Podiatry05:53Surgical Experience and Case Studies07:24Injection Therapy in Podiatry13:55Managing Neuritis and Injection Guidelines18:43Understanding Osteoarthritis and Injection Therapy23:41Patient Case Study and Emotional Impact26:50The Role of Podiatry Post-Surgery32:22The Evolving Perspective on Orthotics35:12International Standards in Podiatry37:06The Importance of Imaging in Diagnosis39:42The Forefoot Examination Process42:28Understanding Morton's Neuroma46:02The Role of Imaging in Treatment Decisions48:31Surgical Indicators for Forefoot Conditions01:03:10Understanding Patient Concerns and Predictions01:05:14The Role of Orthotics in Treatment01:06:53The Importance of Communication in Healthcare01:08:57Navigating Conflicting Opinions Among Clinicians01:11:18Injection Therapy and Its Efficacy01:15:29Challenges in Treating Mid-Foot Osteoarthritis01:22:33Research Aspirations in Injection Therapy01:24:45Interviewing Historical Figures for Insight01:26:24Future Teaching and Learning Opportunities

We get so many questions each week that need more then a voice note or instagram post to answer so we're doing it here.

Casual yarn about what it is being a health professional with questions we get asked over the week.

Support the shoe - new content out on Patreon. How to assess the 1st MPJ (30 min how-to video) + how weekly video realises on the treatment of those common big toe pathologies, joint/sesamoid/adventitialbursa/met stress/FHL, PF.

https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink

Cheers,

Blake and Kelly (sub 20 parkrunners)

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Takeaways

Bone health is crucial for injury prevention.

Resistance training is essential for building strong bones.

High strain rates and magnitudes are key for bone loading. In this episode, you will hear me talk about moving quickly to increase strain rate. I briefly touch on you can try to move the weight quickly (despite it moving slowly) and still a fast loading rate.

Bones adapt better to varied and dynamic movements.

Short bouts of loading can effectively stimulate bone health.

Recovery and nutrition are vital for bone remodeling.

Consult professionals for personalized rehabilitation plans.

Incorporate plyometrics for better bone stimulus.

Regular strength training benefits overall health.

Understanding bone mechanics can enhance athletic performance.

In this episode, we discuss the importance of understanding bone health, particularly in relation to stress injuries and rehabilitation. We explore the role of resistance training in building stronger bones and break down key principles for effective bone loading. You'll also hear why keeping exercises dynamic is crucial to prevent bones from adapting to repetitive movements. Backed by research insights, this conversation offers practical applications for improving bone health and preventing injuries—essential listening for athletes, clinicians, and anyone passionate about optimizing physical performance.

Chapters

00:00 Understanding Bone Health and Injury Recovery

04:21 The Importance of Resistance Training for Bone Strength

08:45 Key Principles for Building Strong Bones

16:21 The Role of Variability in Bone Loading

23:48 Recap and Research Insights on Bone Adaptation

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Follow Dr Bradley Neal, Ph.D. & Dr Simon Lack, Ph.D. and their upcoming education. It is well worth it.

https://linktr.ee/teampfp?fbclid=PAZXh0bgNhZW0CMTEAAabq-xxjXZLjaBghdw5ljiKbvKlw7yoHNqJVS3UoeWtqVhyEhsEsCjpPPUk_aem_NyxdN3NoW2Jz8S6V2LppPA

Agenda. Chapters available.

Clinical recap - Foot orthosis and PFP, Surgical case rehab & PRP for chondromalacia patella - good or bad?

Understanding patellofemoral pain biomechanics

Evidence-based interventions

Strategies for long-term management

Impact of anatomical variations

Effective patient education

Optimizing foot orthoses and footwear

Gait retraining for pain relief

Developing return-to-running protocols

Exercise programming for symptom management

Tailoring rehabilitation dosages

Advancing sports medicine practice

Breaking down myths about patellofemoral pain

Exploring cutting-edge research in rehabilitation

Learnings:

Takeaways:

Patellofemoral pain is prevalent among recreational athletes. Orthoses can be effective for patellofemoral pain management. Loading strategies are crucial for rehabilitation. Patient education is key in managing expectations and outcomes. Biomechanics play a significant role in understanding knee pain. Research is evolving, and clinicians must stay updated. The relationship between pain and tissue capacity is complex. Effective treatment requires a personalized approach. Understanding pain mechanisms can improve treatment outcomes. Collaboration between clinicians and researchers is essential for progress. Patient symptoms should guide treatment strategies. Long-term pain is common in patellofemoral pain cases. Expectations for recovery should be realistic and based on evidence. Anatomical variations can significantly impact treatment outcomes. Resistance training is crucial for joint and muscle health. Education is a key component of effective patient care. Research is needed to establish long-term treatment efficacy. Individualized return-to-run programs can enhance recovery. Understanding biomechanics is important for treatment planning. Effective communication with patients can improve treatment adherence.

PMID: 39401870 PMID: 25716151 PMID: 29793124 PMID: 25558288  PMID: 26884223  PMID: 31475628 PMID: 25569281

Chapters

00:00 Introduction and Background of Brad Neal

02:56 The Journey into Patellofemoral Pain Research

05:20 Collaboration in Research and Clinical Practice

06:11 Case 1: Foot orthosis & PFP - Do or Don't?

07:39 Orthoses in Patellofemoral Pain Management

08:42 Evidence for orthosis and PFP

10:14 Loading Strategies for Patellofemoral Pain

11:25 Foot orthosis and different feet

17:06 case study 2: PFP need surgery?

25:29 Explaining chondromalacia patelli

30:12 Diagnosing PFP

32:14 Understanding Pain: Kneecap vs. Back Pain

33:21 Nociceptive Tissue and Treatment Tailoring

35:35 The Importance of Accurate Diagnosis

37:22 The Role of Physiological Changes in Pain

38:46 Prognosis and Long-Term Pain Management

45:09 Factors Influencing Pain Duration

48:45 The Impact of Structural Variations on Pain

52:01 The Role of Resistance Training in Joint Health

54:34 mindfulness and recreational runners with patellofemoral pain.

56:06 Dosing Activity vs. Traditional Exercise

01:03:49 Pain Neuroscience Education and Its Application

01:04:52 The Impact of Exercise on Osteoarthritis

01:05:18 The Role of Education in Patient Care

01:06:09 Innovative Approaches to Patient Education

01:07:23 Navigating NHS Waiting Lists

01:08:01 The Importance of Accessible Information

01:10:05 The Future of Patient Education

01:11:26 The Balance of Information and Clinical Guidance

01:12:53 Running Rehabilitation Strategies

01:13:34 The Mechanics of Running Retraining

01:17:00 Research Aspirations in Physiotherapy

01:21:35 Personal Insights and Future Directions

In this episode of The Sports Medicine Project, we explore navicular stress fractures—a high-risk injury requiring a unique approach due to the bone’s anatomy, biomechanics, and healing challenges.

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We cover:

• ​Anatomy and biomechanics of the navicular.
• ​Risk factors: young athletes, biomechanics, and bone health.
• ​Delayed diagnosis and the role of imaging (CT vs. MRI).
• ​The debate over blood supply and its impact on healing.
• ​Management strategies: non-weight-bearing protocols, surgery vs. conservative care.
• ​Rehabilitation and return-to-sport considerations.

• ​PMID: 8775123
• ​PMID: 28110392
• ​PMID: 39348218
• ​PMID: 37489055
• ​PMID: 33512847

This episode is for educational purposes only and should not be taken as medical advice.

Support the show if it brought you value. The only thing we want to do the money is crate a better show and better resources

https://www.patreon.com/SportsMedicineProject?utm_campaign=creatorshare_creator

00:00 Welcome to Season Two

04:31 Bilateral Insertional Achilles Tendinopathy

22:05 Better Subjective Questioning

28:27 Neck of Femur Stress Fracture

31:39 Understanding Navicular Stress Fractures

32:35 Introduction to Navicular Stress Fractures

35:06 Incidence of Navicular Stress Fractures

35:15 Who Gets Navicular Stress Fractures?

36:57 Time to Diagnosis of Navicular Stress Fractures

38:20 Anatomy of the Navicular

41:46 Biomechanics of the Navicular

45:18 Risk Factors for Navicular Stress Fractures

50:27 Foot Stiffness and Navicular Stress Fractures

55:28 Diagnostic Tests for Navicular Stress Fractures

01:00:11 Differential Diagnosis for Navicular Stress Fractures

01:01:24 Understanding Mid-Foot Pain and Injuries

01:02:57 Blood Supply to the Navicular

01:03:32 Do Naviculars Have Blood Flow?

01:06:25 Healing Variability and Factors Affecting Recovery

01:09:49 Imaging of Navicular Stress Fractures

01:14:00 Differential Diagnoses Not to Miss

01:14:55 Management Strategies for Navicular Stress Fractures

01:14:58 Müller-Weiss Syndrome

01:15:14 Management of Navicular Stress Fracture

Addressing all the myths we hear about Bone stress Injuries and explaining the FACTS.

We're tackling a topic that’s often misunderstood—bone stress injuries. From runners to weekend warriors, many people have heard myths about these injuries that just aren’t true. In this episode, we're breaking down the myths and uncovering the real facts about bone stress injuries.

With Beau Tyrrell

https://www.instagram.com/stressfracturephysio/

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Send us a Text Message.Ian Harris, an orthopedic surgeon practicing in Sydney and a Professor of Orthopedic Surgery at UNSW, has published extensively on the effectiveness of surgical interventions.Key Discussion Points:Key Findings in Surgical EffectivenessEthics and ImprovementsUnderstanding PlaceboPersistence of Ineffective SurgeriesImpact of the COVID-19 PandemicClinician’s Role and Informed ConsentDiagnosis and Treatment DecisionsPRP and Other TreatmentsRethinking MedicineFeatured Books:...

Send us a Text Message.No guest this week legends,Clinical Case reviews + Social media & HealthcareSupport the Show.Clinical content to help you day to day:https://patreon.com/SportsMedicineProject?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=creatorshare_creator&utm_content=join_linkSign up for a free weekly Research review about topics related to Sports Medicine straight to your email: https://gmail.us14.list-manage.com/subscribe?u=c3dca95db0740390c605a128e&...

Send us a Text Message.We chatted about the details of Lisfranc injuries and midfoot osteoarthritis We explored the unique structures involved and why this injury is distinct. We discussed the key steps in diagnosing a Lisfranc injury, including the essential imaging techniques. We covered the various surgical options available and what these procedures entailed.We also addressed the potential risks of delayed intervention and the importance of foot orthoses and appropriate footwear...

Send us a Text Message.https://www.drstacysims.com/Dr. Stacy T. Sims is an internationally recognized exercise physiologist and nutrition scientist.Her research focuses on female athlete health and performance, challenging existing dogma and improving research on women.Dr. Sims authored the book "ROAR," which explores sex differences in training and nutrition across the lifespan.She has been named one of the top 50 visionaries of the running industry and one of the top 40 women changing the p...

Send us a Text Message.Explore the intricate relationship between hormones and performance in this podcast episode. Delve into common myths and truths about hormones, particularly regarding their impact on soft tissue and bone changes as we age. Learn about the nuances of the ovarian hormone profile and its influence on training and performance, including strategies to alleviate menstrual cycle symptoms. Discover the debate surrounding phase-based training and the considerations for women usi...

Send us a Text Message.Dr. Barton is a Melbourne-based practitioner and researcher specializing in sports and musculoskeletal therapy. With additional training in implementation science and communications, he contributes to physiotherapy education at Bundoora campus and conducts research on implementation science. He serves as an Associate Editor and Deputy Social Media Editor at the British Journal of Sports Medicine and is involved with the Victorian branch of the Musculoskeletal Physiother...

Send us a Text Message.Throughout the episode, Ben provides invaluable insights and practical tips for clinicians seeking to enhance their understanding of pain, movement, and patient-centered care.In this episode of the Sports Medicine Project, we are joined by Ben Cormack, the owner and founder of Cor-Kinetic. Ben brings over 15 years of experience in musculoskeletal therapy, rehabilitation, and exercise, with a particular focus on pain and its relationship to movement. As a highly sought-a...

Send us a Text Message.Chatting about:How does structure affect the risk of injury and pathology? MRI detailing Type 1 and Type 2 muscle fibers and what this means for injury and performanceACL risk in femalesWhy do females get injured more?When to stop running with pain?Should you run with pain?When should a navicular stress fracture go into a boot and for how long? (Corrected "aboot" to "boot")Approaching women's sports discussions (Changed "sprites" to "sports")Surfing for females in ...

Send us a Text Message.Papers referenced: Female Strength Training: https://pubmed.ncbi.nlm.nih.gov/37948036/#:~:text=These%20studies%20indicated%20that%20concurrent,were%20reported%20in%20individual%20studies.Achilles RCT: https://pubmed.ncbi.nlm.nih.gov/36095045/NOI group - https://www.noigroup.com/We feature two prominent speakers: Luke Bongiorno, Director of Noigroup, and Brendan Mouatt, Accredited Exercise Physiologist. The speakers delve into profound questions about pain, the purp...

Send us a Text Message.Steven Collins, a Physiotherapist and ASCA Level 2 Strength and Conditioning coach, delved into the intricacies of exercise prescription and programming for rehab and performance on the podcast. He addressed the challenge of appropriate dosing for patients, emphasizing the common issue of underloading. Understanding the 'why' behind exercises emerged as crucial, with insights on overcoming compliance barriers. Collins highlighted the significance of integrating strength...

Send us a Text Message.Join our Patreon:https://patreon.com/SportsMedicineProject?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=creatorshare_creator&utm_content=join_linkDr Chad Cook profile:https://medschool.duke.edu/personnel/chad-e-cook-pt-phd-mba-faptahttps://twitter.com/chadcookptWe cover:Challenges in behavior change at patient-practitioner level.Emphasis on social norms and health policies influencing desired outcomes.Do Health professionals' roles extend beyon...

Send us a Text Message.Enjoy listening our Podcast Highlights of 2023:We can't wait for 2024! Cracking year of guests already lined up!Brief Summary:Rich Willy: Emphasizes biomechanics' importance close to the ground and the impact of energy availability as you move away. Discusses the unique load distribution in the sacrum and its connection to low energy availability.Peter Malliaris: Challenges the notion of heavy resistance for tendinopathy management, highlighting the significance of tend...

Send us a Text Message.G'day legends!First 18 minutes we discuss Acupuncture for Achilles pain, Adjuncts for tendinopathy heel pain care, Big toe OA and cavus feet.Skip to 18 mins to get straight to John Osbourne talking heel pain.In-depth exploration of Plantar Heel Pain (PHP)Examination of factors accompanying PHP, including considerations of tight calves, flat feet, and the impact of footwear.Insightful discussion on the nuanced relationship between exercise, pain, and movement in the effe...

Send us a Text Message.Dam! You're all going to love this!Welcome Dr Keith Baar. If you see tendons in clinic, you need to listen to this!What does Keith do? (In his own words)The goal of my laboratory is to understand the molecular determinants of musculoskeletal development and the role of exercise in improving health and performance. To achieve this goal, we work on muscle, tendon, and ligaments from 2- and 3-dimensional tissue culture, in vivo wild type and genetically modified animals, a...

Send us a Text Message.Link to Dr Tim Gabbet's websitehttps://gabbettperformance.com.au/profile/Welcome to our podcast featuring Dr. Tim Gabbett, a seasoned applied sport scientist with a remarkable 25 years of experience working alongside athletes and coaches from diverse sports backgrounds. Tim's expertise spans the spectrum of high-performance strategies, from effectively overloading rehabilitation and training programs to maintaining athletes' skills under pressure and fatigue. Whether yo...

Send us a Text Message.It's been an interesting journey learning about pain. We were both exposed to it at different times and we think about it differently. If pain has been something you've found interesting or perhaps you've struggled to understand its origins, you'll enjoy this podcast.Book link:https://www.noigroup.com/product/explain-pain-second-edition/Support the Show.Clinical content to help you day to day:https://patreon.com/SportsMedicineProject?utm_medium=clipboard_copy&utm_so...

Send us a Text Message.Paper review:Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? J L Cook, E Rio, C R Purdam, S I DockingWe discuss this paper in length working from function and pain, tendon pathology and and we how think it comes about to describing relevant clinical elements (pain, function and structure) to begin to build a better understanding of the condition. It is a great paper with lots of clinical translation.Paper link bel...