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How Mentally Strong Runners Navigate Injury & Races with Claire Bartholic

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Mental strength is one of the most overlooked aspects of running performance. Most runners spend countless hours improving their fitness, strength, and nutrition, yet rarely dedicate any time to training their mindset. In this episode, Brodie sits down with running coach and host of The Planted Runner podcast, Claire Bartholic, to discuss the science of cognitive conditioning and how runners can develop greater confidence, resilience, and emotional control.

Whether you're struggling with race-day anxiety, negative self-talk, fear of re-injury, or the emotional challenges of a long-term setback, Claire shares practical strategies that can help you train your brain just as deliberately as you train your body.

In this episode, you'll learn:

•  What cognitive conditioning is and why it matters for runners 
•  How your self-talk influences performance and confidence 
•  Why race-day nerves aren't necessarily a bad thing 
•  The difference between mental strength and simply "thinking positive" 
•  How to stop spiralling after a missed workout 
•  Practical techniques to manage anxiety before races 
•  Why confidence is built through action, not waiting to feel ready 
•  How runners can better cope with injury setbacks 
•  Strategies to overcome fear of re-injury 
•  The importance of focusing on what you can control 
•  Why your identity as a runner can become problematic during injury 
•  How small wins build self-trust and long-term resilience 
•  The science behind repetition, neuroplasticity, and mindset training 

Key Takeaways

•  Your brain believes what you repeatedly tell it. 
•  Mental strength can be trained just like fitness. 
•  Confidence isn't something you wait for—it's something you build. 
•  Injury recovery becomes easier when you focus on what you can do rather than what you can't. 
•  Race-day anxiety often reflects how much you care, not a weakness. 
•  The way you respond to emotions matters more than the emotions themselves. 

Resources & Links

Learn more about Claire and her work:

• The Planted Runner Insta
• Begin With 10 Program
• The Planted Runner Website

Episode 444: What to Focus on When You Can't Run

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Being sidelined by injury can feel like a double blow. Not only are you dealing with pain and frustration, but you've also lost one of your biggest outlets for stress relief, fitness, and social connection. In this episode, Brodie shares a practical framework to help injured runners stay proactive, maintain perspective, and come back stronger than before. 

In this episode, you'll learn:

•  Why injury often impacts your mental health more than you expect 
•  The "double whammy" effect of losing both running and your stress-relief outlet 
•  How to identify the true causes behind recurring injuries 
•  Common patterns that keep runners trapped in injury cycles 
•  Why injuries can be valuable opportunities to uncover weak links 
•  How to use rehab to build resilience rather than simply become pain-free 
•  The importance of addressing strength deficits, imbalances, and movement control 
•  Cross-training options that can preserve fitness while recovering 
•  How to tailor cardio alternatives based on your injury type 
•  Brodie's favourite injury-friendly VO₂ max workouts 
•  Why many runners benefit from keeping cross-training in their routine long after recovery 
•  The overlooked role of strength training for injury prevention, bone health, and long-term performance 
•  How muscle mass acts as "metabolic currency" for health and longevity 
•  Practical ways to improve sleep, stress management, and recovery during injury 
•  The importance of maintaining social connection when you're unable to run 
•  Nutrition strategies that can support healing and future performance 
•  Why injury can be the perfect time to improve habits that often get neglected during heavy training 

Key Takeaway

An injury doesn't have to be wasted time. By shifting your focus toward rehabilitation, fitness maintenance, strength development, sleep, nutrition, stress management, and social connection, you can emerge from injury healthier, more resilient, and better prepared for future training than before.

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Luke is a Sports & Exercise Chiropractor who has a particular interest in the management, treatment and prevention of calf and achilles injuries. 

I interview Luke and explore the common causes for this injury and the most common mistakes runners make in their recovery plan.

Luke also provides his checklist if calf strains are a regular occurrence in your training. We also go through your patron questions including:

1. Is collagen supplementation effective for achilles tendinopathy?
2. What is the best plyometric exercise to perform?
3. Can pain behind the knee come from the calf?

Be sure to follow luke on instagram

Find Luke's website here

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Latest Research: Performance Gains, Shockwave Debate, Arch Support Science

In this month’s research roundup, Brodie breaks down three fascinating new papers covering running performance, Achilles rehab and plantar fasciitis management.

First, a large systematic review investigates what actually predicts better running performance in non-elite runners — from 5K athletes through to ultramarathoners. The findings reveal how the demands of performance dramatically change depending on race distance, highlighting the importance of physiology, training consistency, psychology and fueling strategies.

Next, Brodie unpacks a controversial new systematic review and meta-analysis on shockwave therapy for Achilles tendinopathy. Does shockwave actually improve outcomes, or has the treatment become overhyped within sports medicine? The findings may surprise clinicians and runners alike.

Finally, a new plantar fasciitis paper explores whether arch supports genuinely help reduce pain and — more importantly — why. Using imaging, biomechanics and computational modeling, the researchers attempted to uncover the mechanical effects of orthotics and how they may redistribute stress through the foot.

Papers discussed in this episode

1. Performance predictors in recreational runners

A systematic review examining the factors associated with performance in non-elite runners across distances ranging from 5K to ultramarathons.

Topics discussed:

•  VO₂ max and running economy 
•  Strength training and plyometrics 
•  Weekly mileage and consistency 
•  Emotional intelligence and pacing 
•  Fueling strategies in ultramarathons 
•  Environmental impacts on performance 

2. Shockwave therapy for Achilles tendinopathy

A systematic review and meta-analysis investigating whether shockwave therapy improves outcomes for midportion and insertional Achilles tendinopathy.

Topics discussed:

•  Radial vs focused shockwave 
•  Placebo effects and sham treatment 
•  Exercise vs shockwave outcomes 
•  Why exercise-based rehab still remains the gold standard 
•  Whether shockwave is worth the cost 

3. Arch supports and plantar fasciitis

A prospective study exploring the effects of arch-support insoles on pain, foot alignment and heel stress distribution in plantar fasciitis patients.

Topics discussed:

•  Orthotics and pain reduction 
•  Foot alignment changes on imaging 
•  Heel pressure redistribution 
•  Finite element biomechanical modeling 
•  Why orthotics may help symptoms without restoring tissue capacity 

Key takeaways

•  The predictors of running performance depend heavily on race distance. 
•  Strength training continues to show benefits for running economy and shorter-distance performance. 
•  Marathon success is strongly linked to consistency and uninterrupted training. 
•  Ultramarathons rely increasingly on pacing, fueling and race management rather than pure physiology. 
•  Current evidence for shockwave therapy in Achilles tendinopathy remains inconsistent and underwhelming. 
•  Exercise-based rehab continues to have the strongest evidence for tendon recovery. 
•  Arch supports may reduce plantar fascia stress and improve symptoms short-term, but should not replace progressive loading strategies.

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The Missing Link in Rehab You’re Probably Ignoring

Pain isn’t always just about tissues, load, or biomechanics.

In this episode, Brodie explores one of the most overlooked contributors to prolonged running injuries: the psychosocial side of pain. Drawing from both research and years of working with chronic injury cases, he introduces a 20-question “Pain & Wellness Score” designed to uncover the emotional, cognitive, and social factors that may be quietly influencing your recovery. 

You’ll learn why some runners continue to struggle despite doing all the “right” rehab exercises, how hypervigilance and fear can amplify symptoms, and why recovery should be approached through a biopsychosocial lens rather than purely mechanical thinking. Brodie also breaks down the science behind chronic pain, nervous system hypersensitivity, catastrophisation, fear of movement, and the powerful role attention plays in symptom intensity. 

Throughout the episode, Brodie walks listeners through the full questionnaire so they can assess themselves in real time. He explains how low scores may reveal missing pieces in recovery and shares practical interventions that can help calm the nervous system, reduce fear, and improve recovery outcomes. 

Topics include:

•  Hypervigilance and constantly monitoring symptoms 
•  Fear of movement (kinesiophobia) 
•  Catastrophisation and emotional amplification of pain 
•  The role of social support in recovery 
•  How stress, trauma, anxiety, and perfectionist tendencies influence chronic pain 
•  Why distraction, enjoyable movement, and positive coping strategies can help 
•  The importance of resilience, optimism, and confidence in movement 
•  Why scans and conflicting diagnoses can sometimes worsen recovery outcomes 

Brodie also discusses research on chronic pain neuroplasticity and highlights therapies shown to help regulate the nervous system, including:

•  Cognitive behavioural therapy (CBT) 
•  Mindfulness practices 
•  Guided meditations and breathing exercises 
•  Gradual exposure to feared movements 
•  Active coping strategies versus passive coping behaviours 

If you’ve been stuck in an injury cycle, feel emotionally exhausted by pain, or feel like your rehab is missing something despite doing the exercises correctly, this episode may provide an entirely new perspective on recovery.

Resources & Links:
Click here to learn about Brodie's Chronic Pain Reset Course

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In this exclusive AMA release, Brodie answers three practical listener questions that many runners quietly struggle with. From deciding whether to see a physio or doctor for persistent knee pain, to knowing when it’s safe to introduce back-to-back running days during rehab, to understanding why your lower back tightens on longer runs… this episode is packed with evidence-based guidance and real-world rehab insights.

If you’ve been stuck in an injury cycle, unsure whether your rehab is working, or second-guessing your training decisions, this episode will help you simplify the process and run smarter.

In this episode, Brodie discusses:

•  How to tell when persistent knee pain needs professional assessment 
•  The difference between seeing a physio vs a doctor for running injuries 
•  Why accurate diagnosis matters more than chasing random rehab exercises 
•  Practical advice for pes anserine tendinopathy and bursitis management 
•  The hamstring curl exercise Brodie personally used during his own rehab 
•  When it’s appropriate to reintroduce back-to-back running days 
•  Why symptom response matters more than arbitrary mileage milestones 
•  How to safely structure consecutive run days during Achilles rehab 
•  The role of “trial and error” in successful injury management 
•  Why recovery runs should stay genuinely easy 
•  Common reasons runners develop lower back tightness during long runs 
•  How cadence and impact forces may influence spinal muscle fatigue 
•  Why overthinking posture and “activating your core” can sometimes backfire 
•  The importance of running relaxed and naturally economical 
•  Lower back strengthening strategies that improve running durability 
•  Lumbar hyperextensions and how Brodie uses them himself 

Key Takeaways:

•  Persistent injuries that worsen over time deserve professional assessment. 
•  Rehab should produce gradual week-to-week improvement, not months of frustration. 
•  Back-to-back running should start conservatively and be guided by symptom recovery. 
•  Easy recovery runs reduce the risk of overload accumulation. 
•  Many runners unknowingly create unnecessary tension through posture overcorrection. 
•  Strong postural muscles help reduce compensatory tightness during longer runs. 
•  Running relaxed is often more efficient than trying to “hold perfect form.”

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Coach Claire Bartholic wasn’t always a runner.  She started running in her mid-30s simply to get in shape for her high school reunion. She caught the running bug and finished her first marathon at age 38 in a respectable 4:02 and was immediately hooked.   With dedicated coaching and training, she successfully lowered her marathon PR to 2:58, remarkably without injury, and entirely plant-based.   Today, we talk about all things masters running, including the common mistakes and misconceptions Claire often sees working with masters athletes.   We also answer all your patron questions, including ways to best prepare in your younger years, how to adjust your goals, how to increase mileage safely and how to recover from long runs.

Follow The Run to the Top podcast by RunnersConnect

Head to Claire's website to receive your free download about the ultimate fuel plan for runners 

Follow @theplantedrunner on insta

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In this episode, Brodie breaks down a brand-new 2026 systematic review investigating whether collagen supplementation truly improves tendon health, recovery, and performance. With conflicting advice from experts and unclear evidence in the past, this paper helps clarify what actually works—and more importantly, how to apply it to your training.

Paper: Collagen Supplementation on Tendon-Related Structural and Performance Outcomes: A Systematic Review 

Key Takeaways

•  Collagen can improve tendon structure and stiffness—but only when combined with proper strength training 
• Dosage matters: 15–30g appears more effective than lower doses 
• Timing matters: ~60 minutes before training aligns with peak amino acid availability 
• Vitamin C enhances the process, helping collagen synthesis and cross-linking 
•  Collagen does NOT improve muscle strength beyond what training alone achieves

Bottom line: collagen seems tendon-specific, not a general performance enhancer

Training Requirements

•  Must include structured resistance training
•  Target 70–90% of 1RM (heavy loading)
•  Tendons need a strong mechanical stimulus to adapt

Collagen without loading = minimal benefit

Final Thoughts

This paper helps move us from confusion to clarity.

Collagen isn’t a magic fix—but when used strategically alongside heavy strength training, it may:

•  Improve tendon structure 
•  Increase stiffness 
•  Enhance long-term resilience 

In other words, it’s a potential amplifier—not a replacement—for good rehab and training principles.

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Stem cells are one of the most talked-about frontiers in medicine—but how much of it actually applies to runners dealing with tendon pain?

In this episode, I’m joined by orthopaedic surgeon and researcher Chukwuweike Gwam to break down the latest evidence on stem cells and tendon healing. We unpack what stem cells actually are, how they work in the body, and whether they live up to the hype when it comes to treating tendinopathy.

We also explore the real-world limitations, risks, and costs—alongside what the future might hold for regenerative medicine in running injuries.

If you’ve ever considered injections, biologics, or wondered if stem cells are “the next big thing”… this episode will bring you up to speed.

About Chukwuweike Gwam MD:

•  Orthopaedic surgeon (USA) specialising in hip & knee reconstruction 
•  MD (Howard University), PhD in Molecular Medicine (Wake Forest), MBA 
•  Research focus: regenerative medicine, stem cells, and translational science 
•  Passion for improving healthcare access and bringing lab discoveries into real-world treatment 

Follow him on Instagram:
https://www.instagram.com/chukwuweike_g/

Key Topics & Insights

What Are Stem Cells (In Simple Terms)?

•  Think of stem cells as the body’s “repair reserve”
•  They help regenerate tissue by: 
  •  Creating new cells 
  •  Regulating inflammation 
•  We all have them—but: 
  • Quantity decreases with age
  • Quality declines significantly

Why Do We Heal Slower As We Age?

It’s not just one factor—it’s a combination:

•  Reduced stem cell quality and number 
•  Slower blood vessel formation 
•  Reduced cellular signalling 
•  Increased “senescent” (non-functioning) cells 

In other words: your repair system is still there… just less efficient.

Stem Cells & Tendon Healing — The Theory

The idea is simple:

1.  Harvest stem cells (fat, bone marrow, etc.) 
2.  Process them 
3.  Inject them into the injured tendon 

The goal:

•  Improve collagen structure 
•  Enhance healing response 
•  Accelerate recovery 

But here’s the key point…

👉 They are NOT a magic bullet—they’re an adjunct.

What the Research Actually Shows

From their literature review (2015–2025):

•  ~1,800 papers screened 
•  ~150 relevant studies included 

Findings:

•  Improved collagen alignment (under a microscope) 
•  Increased tensile strength (in animal models) 
•  No consistent improvement in long-term human outcomes 

👉 Especially beyond 6–12 months, results tend to equalise.

The Most Interesting Finding

In rotator cuff studies:

•  Stem cells improved early recovery (first ~6 months)
•  But no long-term difference compared to standard treatment 

Why?

•  Stem cells likely help regulate early inflammation 
•  The body eventually “catches up” on its own 

Why Results Are So Inconsistent

This is the biggest limitation:

No standardisation.

•  Different sources (fat, bone marrow, skin) 
•  Different processing methods 
•  Different patient health profiles 

👉 Your stem cells ≠ someone else’s stem cells

Risks & Limitations

•  Potential for tumour formation (teratomas) with certain stem cell types 
•  High variability in outcomes 
•  Mostly animal-based evidence
•  Difficult to control how cells behave once injected 

Cost vs Benefit (Reality Check)

•  Stem cell injections: ~$3,000–$5,000+ 
•  Cortisone: ~$200 
•  Rehab: far cheaper, highly effective 

In most cases:
 You’re paying a premium for uncertain benefit.

What About PRP?

•  Some benefit for: 
  •  Tennis elbow 
  •  Chronic tendinopathy 
•  But: 
  •  Highly variable 
  •  Not clearly superior to rehab 

Again, works best alongside loading—not instead of it.

Practical Takeaways (For Runners)

•  Stem cells are promising—but not ready for prime time (yet)
•  They may: 
  •  Speed up early recovery 
  •  Improve tissue quality (in theory) 
•  But: 
  •  Don’t outperform rehab long-term 
  •  Are expensive and inconsistent 

The fundamentals still win:

•  Progressive loading 
•  Smart training 
•  Patience 

•  📲 Follow Dr. Gwam: https://www.instagram.com/chukwuweike_g/

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On today’s Q&A episode, Brodie tackles a wide range of listener-submitted questions—covering everything from preparing for mountain races without hills, structuring marathon training in your 50s, and the science of hydration, to managing lateral knee pain, deload weeks, and cardiac drift in ultra events.

The common thread is learning how to train smarter by understanding why your body responds the way it does—and how to adjust accordingly.

Key Questions & Insights

Training for Mountain Events (While Living on the Flats)

•  Prioritise VO₂ max development (e.g. Norwegian 4x4 or 30:30 intervals) 
•  Build strength and power: 
  •  Walking lunges, split squats, calf raises 
•  Prepare for downhill demands with eccentric quad training (e.g. reverse Nordics) 
•  Use incline treadmills and stairs to simulate terrain 
•  Key principle: bridge the gap between your environment and race demands 

Marathon Training at 57 (Sub 3:30 Goal)

•  Current structure (4 runs + 2 strength days) is solid 
•  Ensure 80/20 intensity balance (most running easy) 
•  Strength training should include: 
  •  Squats, deadlifts, lunges, calf raises 
  •  Focus on heavier loads (6–8 reps) for performance gains 
•  Don’t overlook: 
  •  Recovery (sleep, nutrition) 
  •  Deload weeks every 4–5 weeks 

Hydration & Recovery (The Science)

Hydration plays a critical role in recovery through:

•  Nutrient delivery (oxygen, glucose, amino acids via blood plasma) 
•  Muscle repair signaling: 
  •  Hydrated cells promote protein synthesis 
  •  Dehydrated cells increase protein breakdown 
•  Glycogen replenishment efficiency 

Practical takeaway:

•  Measure sweat rate (pre/post run weighing) 
•  Replace both fluids and electrolytes, especially in long or hot runs 

Lateral Knee Pain in Runners

Potential causes discussed:

•  ITB friction syndrome (load/repetition-based irritation) 
•  Patellofemoral pain 
•  Other joint-related issues (requires proper diagnosis) 

Key management strategies:

•  Stay below pain threshold (0–1/10) 
•  Use run-walk strategies to manage load 
•  Address contributing factors: 
  •  Cadence 
  •  Step width 
  •  Downhill running exposure 
•  Strength helps, but load management is the priority 

How to Structure a Deload Week

Purpose: allow accumulated fatigue to recover and adaptations to occur

Options for strength training deload:

•  Reduce frequency 
•  Reduce load (~30%) 
•  Reduce range of motion 
•  Or a combination 

Key goal:
 Start the next training block feeling fresh, strong, and ready to progress

Cardiac Drift in Long Runs & Ultras

What it is:

•  Gradual rise in heart rate despite constant effort 

Main contributors:

•  Dehydration 
•  Heat stress 
•  Glycogen depletion 
•  Neuromuscular fatigue 

Strategies to delay drift:

•  Start conservatively (70–75% HR max) 
•  Prioritise hydration and electrolytes 
•  Maintain carbohydrate intake (60–90g/hr) 
•  Manage heat (cooling strategies, pacing adjustments) 

Key Takeaways

•  Train the physiology required, even if you can’t replicate the exact environment 
•  Recovery (hydration, sleep, nutrition) is just as important as training 
•  Pain management = load management first, not just strengthening 
•  Deload weeks are essential for long-term progression 
•  Cardiac drift is inevitable, but you can delay and manage it

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Returning to running after injury isn’t as simple as waiting until you’re pain-free and heading back out the door.

In this episode, I sit down with Eric Hegedus to break down a structured, evidence-informed approach to returning to running—based on his clinical commentary and years of working with injured runners.

We dive into how to bridge the gap between rehab and performance, why so many runners get re-injured, and how to use simple tools like TRIMP to guide your training decisions.

If you’ve ever felt unsure about when to run, how much to do, or whether you’re progressing too quickly… this episode gives you a clear framework to follow.

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In this month’s Latest Running Research episode, Brodie breaks down three fascinating studies that challenge common beliefs and refine how runners should approach performance and injury prevention. First, a randomized controlled trial on ketone supplementation reveals that while ketones significantly improve cognitive function—helping with reaction time and mental clarity—they do not improve running performance, efficiency, or fuel utilization. Despite feeling better during efforts, runners didn’t run faster, and some even experienced gastrointestinal issues, raising questions about their real-world value for endurance athletes. 

Next, Brodie explores a meta-analysis comparing high-intensity interval training (HIIT) vs moderate continuous running (MICT). The key takeaway: HIIT is more effective at improving running economy (efficiency at submax speeds), particularly at moderate intensities, while steady running is better for improving VO₂ max (your aerobic engine). This reinforces the idea that both training styles serve different physiological purposes—and combining them strategically is the smartest approach for performance gains.

Finally, a newly released review challenges one of the most common rehab narratives: that weak glutes cause poor running mechanics. Across 19 studies, there was no consistent link between hip strength and running biomechanics, and even strengthening programs failed to meaningfully change running form. Instead, Brodie reframes strength training as a way to increase load capacity, not “fix” technique—highlighting the importance of gait retraining and smart load management over blindly strengthening muscles.

🎯 Key Takeaways

•  Ketones may sharpen your brain—but won’t make you run faster
•  HIIT improves efficiency, steady running builds aerobic capacity → you need both
•  Stronger glutes ≠ better running form → focus on capacity, not just mechanics
•  Fatigue, load, and training errors remain the biggest drivers of injury risk

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Episode Summary

In this Q&A episode, Brodie answers listener-submitted questions covering everything from transitioning to zero drop shoes to fixing ITB pain, understanding Zone 2 training accuracy, and safely introducing sprint work.

Along the way, he breaks down common misconceptions, highlights what actually matters, and provides practical, step-by-step strategies you can apply straight away.

If you’ve ever felt confused by conflicting advice or stuck in an injury cycle, this episode will help you cut through the noise and run smarter.

🧠 Questions Covered

• How do you safely transition to zero drop / minimalist shoes (especially with a neuroma)?
• What are the best exercises for ITB syndrome—and are exercises even the priority?
• Do you need a VO2 max test to truly train in Zone 2?
• What’s the safest way to introduce sprint training?
• Why do your calves (soleus) feel like they’re burning early in runs—and what can you do about it?

🔑 Key Takeaways

Zero Drop Transition

• Transition gradually—this is non-negotiable
• Start with walking / strength work before running
• Introduce running in small doses (5–10 minutes per run)
• Build volume slowly (~10% per week)
• Monitor for warning signs: calf tightness, foot pain, Achilles stiffness

ITB Pain (What Actually Matters)

• The cause is usually load + mechanics, not just weakness
• Common triggers:
  • Downhill running
  • Narrow or crossover step width
  • Cambered surfaces
• First line of treatment:
  • Modify training load and mechanics
• Strength work (secondary but helpful):
  • Step-downs
  • Crab walks
  • Hip hikes
  • Single-leg control work

Zone 2 Training (Do You Need Lab Testing?)

• VO2 max testing = gold standard, but not essential
• Most runners can rely on:
  • Effort (RPE)
  • Conversation test
• True Zone 2 should feel:
  • Sustainable for long durations
  • Minimal fatigue buildup
  • “Could do it all over again” effort

Introducing Sprint Training

• Start with strides, not all-out sprints
• Structure:
  • Gradual acceleration (15 sec)
  • Short peak speed (8–10 sec)
  • Full recovery (1–2 min)
• Progression:
  • Start with 4 reps at ~75% effort
  • Build to 6–8 reps at ~90–95% effort
• Keep it controlled and progress gradually

Burning Calves (Soleus Overload vs Something Else)

• The soleus handles very high loads during running
• Common overload factors:
  • High intensity or hills
  • Minimalist footwear
  • Rapid training increases

But… consider another possibility:

👉 Compartment syndrome

Clues it might not be “just tight calves”:

• Burning sensation early in runs
• Bilateral symptoms
• Long-standing issue despite rehab
• Forced to stop rather than push through

Helpful strategies:

• Longer, more gradual warm-ups
• Walk/run approach
• Avoid sudden intensity spikes
• Let symptoms settle before continuing

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This episode is a previously recorded Ask Me Anything (AMA) that was originally released exclusively to podcast patrons. Now that the patron platform has been discontinued, these conversations are being shared on the main feed so the broader Run Smarter audience can benefit from the questions and discussions.

In this AMA, Brodie answers listener questions on several common challenges runners face. The episode begins with a deep dive into a practical training question: Is it better to improve running performance using run-walk intervals or continuous running? Brodie explains that the “best” approach depends on factors such as experience level, recent time off running, current injury status, effort levels, fatigue, and overall training consistency. The key takeaway is that consistent mileage without injury is the biggest driver of improvement, and run-walk strategies can often help runners build volume safely while maintaining proper effort levels. 

The episode then shifts to injury management and race readiness. Brodie discusses how to distinguish between a manageable symptom flare-up and a warning sign that training load is too high. He emphasizes that runners should only race when their training has built enough confidence and tissue capacity to tolerate race demands, rather than rushing into events prematurely. Finally, he addresses a question about persistent knee pain and whether it’s better to consult a physio, doctor, or another professional. His advice: seek a practitioner you trust, someone who explains the problem clearly, provides a long-term plan, and adjusts treatment if progress stalls.

Key Takeaways for Runners

• Consistency beats everything. The best training strategy is the one you can maintain week after week without breaking down.
• Run-walk intervals can be powerful. They help manage fatigue, reduce repetitive loading, and allow runners to safely build mileage.
• Effort matters more than format. Easy runs should stay easy (roughly 2–3/10 effort) to maintain an effective training balance.
• Don’t rush back into racing. Confidence and capacity should be built gradually through training before entering an event.
• If rehab isn’t improving over time, something needs to change. Consider reassessing diagnosis, load management, or the practitioner guiding your rehab.

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Tendon pain is often treated as a purely physical problem. Strengthen the tendon, adjust the load, and eventually things should improve.

But what happens when the pain persists for months… or even years?

In this episode, Brodie speaks with physiotherapist and PhD researcher Jack Mest about a recent systematic review and meta-analysis exploring the psychological profile of people with persistent tendinopathy. The research compared people with chronic tendon pain to healthy controls and uncovered something surprising: fear of movement wasn’t the main psychological factor.

Instead, the research found that pain catastrophizing — a negative outlook toward pain and recovery — appeared more common in people with persistent tendinopathy.

This episode explores how psychological factors may influence tendon pain, why lower limb injuries may carry a greater psychological burden, and why clinicians need to treat the person behind the injury — not just the tendon itself.

If you’re a runner struggling with Achilles pain, plantar fasciopathy, proximal hamstring tendinopathy, or another persistent tendon injury, this conversation will help you understand why recovery can feel so frustrating — and what might help.

In This Episode

Brodie and Jack discuss:

• Why tendinopathy often becomes a chronic condition
• What the biopsychosocial model means for tendon rehab
• The difference between kinesiophobia (fear of movement) and pain catastrophizing
• Why catastrophizing appears more common in persistent tendon pain
• Why lower limb tendinopathies may have greater psychological impact than upper limb injuries
• The role of beliefs, expectations, and past experiences in shaping pain
• Why clinicians should ask about patients’ thoughts and fears about their injury
• Whether psychological traits are pre-existing or develop after chronic pain begins
• Practical advice for runners dealing with long-term tendon pain

About the Guest

Jack Mest is a physiotherapist and PhD researcher whose work focuses on understanding why tendinopathy becomes chronic and how psychological factors influence tendon pain.

His research aims to improve the way clinicians approach tendon rehabilitation by integrating biological, psychological, and social factors into treatment.

Follow Jack's research and updates:
 X (Twitter): @Mest_Jack
Facebook: Jack Mest Physio
Paper summary: https://www.jospt.org/do/10.2519/jospt.blog.2026017/full/ 

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Andy Blow is the founder of Precision Hydration and a former elite triathlete. In today's episode, we delve into the misconceptions around sweat & hydration advice and how to individually tailor a fueling strategy to help your performance.

Andy also answers your questions around cramping, running in cold conditions, gels for a sensitive stomach and if hydrating days before a race is necessary. 

Check out precisionhydration.com for electrolytes and fuelling products.

Click here to book in a free 1 on 1 chat with the precision hydration team.

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In this month’s research roundup, Brodie reviews three new papers examining super shoes (advanced footwear technology) and their impact on running economy and performance.

Across a large review, a meta-analysis, and a randomized crossover trial, the consistent finding was a ~2.5–3% improvement in running economy when using carbon-plated, high-stack, high-rebound foam shoes. Importantly, benefits weren’t limited to elites. Even at slower speeds (7.5–12 km/h), recreational runners showed meaningful reductions in oxygen cost, translating to roughly a 1% improvement in marathon performance — about three minutes for a four-hour runner.

The key insight is that it’s not just the carbon plate doing the work. The performance gains appear to come from a synergy between plate stiffness, PEBA-style high-rebound foams, rocker geometry, and stack height. The shoes don’t “create” energy — they reduce energy loss, particularly around the big toe joint and during stance. Interestingly, comfort didn’t correlate with better economy, and biomechanical changes were smaller than many expected.

From a practical standpoint, super shoes offer real performance advantages, but gradual integration is essential. Altered loading patterns and increased stiffness may raise injury risk if introduced abruptly, with case reports highlighting midfoot stress reactions. Rotate them in carefully, monitor symptoms, and be aware that high-rebound foams can degrade over time, reducing their metabolic benefit.

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In this episode, Brodie dives into a long-awaited research review examining whether active cool downs actually do what we’ve been told they do.

You’ve probably heard that cooling down helps “flush lactic acid,” reduce soreness, prevent injury, and speed up recovery.

But what does the evidence say?

This episode breaks down a comprehensive narrative review titled “Do we need a cool down after exercise?” and explores the physiological, psychological, performance, and injury-related effects of active cool downs compared to passive recovery

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In this episode, Brodie breaks down a newly published review paper that takes a deep dive into what’s actually happening inside painful tendons — far beyond the usual “overuse” explanation. You’ll learn how healthy tendons are structured, what changes at a microscopic level when tendinopathy develops, and why pain severity often doesn’t match what shows up on scans. The episode explores how factors like load management, low-grade inflammation, oxidative stress, ageing tendon cells, and overall metabolic health all interact to influence tendon pain and recovery.

Brodie also discusses what this emerging science means for real-world rehab — including why rest alone doesn’t work, why exercises sometimes stall progress, and why a more holistic approach is often needed. The episode finishes by looking ahead at future treatment directions, from improved diagnostics to regenerative and molecular therapies, while grounding everything in practical takeaways runners can apply right now. If you’re dealing with persistent tendon pain — especially proximal hamstring or Achilles tendinopathy — this episode will help you understand why recovery can be slow and what actually gives you the best chance of long-term success. 

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In this rerun episode, we dive deep into foot strength, control, and coordination with one of the world’s leading authorities on running biomechanics, Jay Dicharry.

Jay is a physical therapist, biomechanical researcher, and author of Running Rewired and Anatomy for Runners. He’s also the creator of the MOBO Board and has analysed thousands of runners’ gait patterns across elite labs in the US.

This conversation breaks down why foot strength is so often misunderstood, why simple exercises like towel scrunches fall short, and how runners can build durable, efficient feet that translate directly to better running performance and fewer injuries.

Despite a chaotic recording (blackouts, platform failures, and tradesmen mid-interview), the first 40 minutes in particular are packed with high-value, practical insights you can start using immediately.

🧠 What You’ll Learn in This Episode

Why foot strength actually matters for runners

• Why the foot is often the missing link between strength training and running injuries
• How poor foot control can contribute to injuries up the chain (calf, knee, hip, spine)
• Why runners haven’t seen injury rates drop despite better shoes and more research

Coordination comes before strength

• Why most runners don’t have a “strength” problem, but a coordination problem
• The difference between:
  • Coordination
  • Stability
  • Load
• Why skipping coordination leads to poor results—even with good exercises

Simple self-tests you can do today

• The Toe Yoga test (and what failing it actually means)
• The single-leg balance test to identify poor foot strategy
• How to tell if you’re cheating with your hip and trunk instead of using your foot

How to load the foot properly

• Why calf raises alone are not enough
• When runners are not ready for heel-off or calf-dominant exercises
• How to progress from:
  • Flat-foot control
  • → single-leg stability
  • → loaded exercises like split squats and single-leg deadlifts
• Why heavy single-leg lifts actually make sense for runners

Flat feet, high arches & foot “type”

• Why foot shape isn’t something you need to “fix”
• When foot structure matters—and when it doesn’t
• Why some runners with very flat feet run pain-free at elite levels

Orthotics: who actually needs them?

• Why Jay now prescribes very few orthotics
• The test that determines whether orthotics are necessary
• How long-term orthotic use can reduce intrinsic foot muscle activity
• How to safely wean off orthotics if appropriate (and why cold-turkey is a bad idea)

Minimalist shoes vs cushioned shoes

• Why barefoot running didn’t “fail” (and what it actually changed)
• Why minimalist shoes are a training tool, not a moral identity
• How shoe cushioning affects proprioception and running economy
• Why most runners benefit from a shoe quiver, not one “perfect” shoe

Common misconceptions Jay sees all the time

• “Running alone is enough to make me strong”
• “Everyone should transition to minimalist shoes”
• “Foot motion is dangerous”
• Why most running injuries are load management problems, not form flaws

🏃 Practical Takeaways for Runners

• Foot strength isn’t about doing more exercises—it’s about doing the right progression
• Master coordination before adding load
• Train your feet year-round, not just when injured
• Barefoot strength work improves learning and control
• Strong feet support better running economy, not just injury prevention

🔗 Resources Mentioned

• moboboard.com – Foot-specific strength and coordination exercises
• anathletesbody.com – Jay’s educational resources and programs

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In this month’s Latest Running Research episode, Brodie breaks down four newly published papers that challenge common assumptions about bone health, injury risk, shoe prescription, and recovery tools in runners. 

Across all four studies, a consistent theme emerges: what feels logical—or is heavily marketed—doesn’t always align with how the body actually adapts. From bone mineral density and stress injuries to shoe “matching” and foam rolling, this episode helps runners separate useful tools from over-inflated claims.  

🦴 Paper 1: Bone Mineral Density & Ground Reaction Forces 

This study explored whether the forces experienced during running are associated with bone mineral density (BMD)—and whether this relationship differs between male and female runners. 

Key Findings 

• Male runners with higher ground reaction forces tended to have higher bone mineral density at the spine, pelvis, femur, and tibia.
• These relationships were present at both self-selected and standardised running speeds.
• In female runners, no meaningful relationship was found between impact forces and bone mineral density.
• Female runners had consistently lower absolute bone density and impact forces than males.

Why This Matters

• Bone adapts to mechanical loading—but not equally across sexes.
• Running alone may provide enough stimulus for bone adaptation in males, but often not in females.
• Hormones, energy availability, muscle mass, and force production likely play a role.

Practical Takeaways

• Running mileage alone is not a reliable bone-building strategy for everyone.
• Female runners may benefit more from:
  • Heavy strength training
  • Jumping and sprinting
  • Multi-directional loading
• Bone health also depends on recovery and nutrition, not just impact.

🦴 Paper 2: Biomechanics & Bone Stress Injuries
 
This scoping review examined biomechanical factors associated with bone stress injuries (BSIs) across multiple running populations.
 
Key Findings:

• The strongest prospective risk factors for BSIs were:
  • Greater vertical centre-of-mass movement (“bounce”)
  • Lower cadence
• Every ~0.5 cm increase in vertical motion was linked to a 14–17% higher injury risk.
• Each additional step per minute was associated with a 3–5% reduction in risk.
• Site-specific mechanics varied by injury location (tibia, metatarsals, navicular).

Why This Matters

• Excessive vertical motion and low cadence consistently increase bone stress.
• Many commonly blamed factors (e.g. loading rate) are less reliable predictors.
• Some biomechanical findings may reflect post-injury adaptations, not causes.

Practical Takeaways

• Small cadence increases (5–10 steps/min) may meaningfully reduce bone stress.
• Reducing unnecessary “bounce” can be protective.
• Gait changes should be gradual and load-aware.
• Biomechanics is only one piece—training load, sleep, nutrition, and bone health interact

👟 Paper 3: Shoe Recommendations & Gait Analysis
 
This single-blinded randomised trial tested whether shoes recommended based on gait analysis actually change how runners move—or simply change how they feel.
 
Key Findings

• Shoes labelled as “gait-matched” were rated:
  • More comfortable
  • Higher performing
  • Lower injury risk
• Despite this, both shoes were identical models with different colours.
• No differences were found in:
  • Running mechanics
  • Foot strike
  • Tibial acceleration

Why This Matters

• Expectations and expert recommendations strongly influence perception.
• Gait analysis can act as a placebo-like effect.
• Feeling better does not necessarily mean moving differently—or safer.

Practical Takeaways

• Comfort matters—but it does not guarantee injury protection.
• Be cautious of claims that a shoe “fixes” your gait.
• If a shoe feels good and supports consistent training, it can still be useful—but not for biomechanical reasons.
• Long-term injury risk is driven more by load management than shoe category

 
🧠 Paper 4: Foam Rolling & the Knowledge-to-Action Gap
 
To close the episode, Brodie discusses a paper examining whether practitioner beliefs about foam rolling align with scientific evidence.
 
Key Findings

• Strongest evidence supports foam rolling for:
  • Short-term increases in range of motion
  • Temporary pain reduction
  • Acute increases in local blood flow
• Little to no evidence supports:
  • Performance enhancement
  • Injury prevention
  • Long-term structural changes to muscle or fascia
• Only 2 of 15 practitioner beliefs aligned with the evidence.
• Knowledge gaps existed across professions and countries.

Why This Matters

• Foam rolling isn’t useless—but its benefits are often overstated.
• The issue isn’t the tool—it’s how it’s explained and justified.
• Poor science communication fuels unrealistic expectations.

Practical Takeaways

• Use foam rolling as a short-term symptom-management tool, not a fix.
• It won’t replace strength training, load management, or recovery.
• If it helps you feel better and train consistently, that still has value

🔑 Episode Take-Home Message
 
Across bone health, injury risk, footwear, and recovery tools, the evidence consistently shows that adaptation is driven by load, context, and recovery—not quick fixes or marketing claims.

Understanding what actually matters allows runners to train smarter, reduce injury risk, and focus on interventions that truly move the needle.
 

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For years, chronic tendinopathy has been treated as a tendon problem — load it, strengthen it, remodel it. But what if, for some runners, the tendon itself isn’t the main driver of pain anymore?

In this episode, Brodie breaks down a new 2026 systematic review that may reshape how we think about stubborn, long-standing tendon pain. The paper explores whether nerve ingrowth and abnormal blood vessels around tendons — not degeneration of the tendon tissue itself — may be the real pain source in chronic cases.

We unpack the emerging research, explain each intervention in plain language, and discuss who this may (and may not) apply to — especially runners stuck in repeated rehab cycles despite “doing everything right.”

This is early, evolving science. But it’s a fascinating glimpse into where chronic tendon treatment may be heading next.

What You’ll Learn in This Episode

• Why some chronic tendon pain may be neuropathic (nerve-driven) rather than structural
• How abnormal blood vessels and nerves grow into painful tendons over time
• Why traditional loading programs sometimes stop working in very chronic cases
• What “neural modification” treatments aim to do — and why they’re gaining interest
• The six intervention categories reviewed in the paper (explained simply)
• How strong (or limited) the current evidence actually is
• Where this research fits alongside exercise-based rehab, not against it

Interventions Reviewed (Plain-English Overview)

1. High-Volume Injections (HVIGI / HVDI)

Large volumes of fluid are injected around the tendon (not into it) under ultrasound guidance to mechanically disrupt abnormal blood vessels and pain-sensitive nerves.

Key takeaway:
Consistent short- to medium-term pain and function improvements, especially in people who had failed exercise-based rehab.

2. Sclerosing Polidocanol Injections

A chemical agent is injected directly into abnormal blood vessels to deliberately close them down, cutting off blood supply to pain-producing nerves.

Key takeaway:
Moderate to strong pain reductions in very chronic cases, with outcomes comparable to surgery in some studies.

3. Radiofrequency Microtenotomy

A minimally invasive procedure using controlled heat to disrupt nerve ingrowth and abnormal vessels at the tendon–paratenon interface.

Key takeaway:
Very strong results in a small cohort, but higher risk and limited evidence so far.

4. Minimally Invasive Paratenon Release

Scar-like adhesions between the tendon and surrounding tissue are mechanically released to restore tendon movement and reduce nerve irritation.

Key takeaway:
Large pain reductions and high rates of pain-free outcomes in non-insertional Achilles tendinopathy.

5. Electrocoagulation Therapy

Electrical energy is used to seal off abnormal blood vessels surrounding the tendon under ultrasound guidance.

Key takeaway:
Promising early results, but evidence limited to one small study.

6. Surgical Interventions (Open & Endoscopic)

Surgery physically separates the tendon from irritated surrounding tissue and removes abnormal vessels and nerves.

Key takeaway:
Effective for some, but invasive, with longer recovery and higher risk.

The Big Picture Takeaway

Across very different procedures, outcomes were surprisingly similar.

That points to a common mechanism:
 👉 Modifying the neural (nerve-driven) pain environment around the tendon, rather than “fixing” tendon structure itself.

This doesn’t replace exercise-based rehab — but it may explain why a subset of runners with long-standing, highly sensitive tendinopathy stop responding to load alone.

This research is best viewed as a future direction, not a replacement for good rehab principles.

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Chronic plantar fasciitis can quietly strip away your confidence, your identity as a runner, and eventually your belief that running is even possible again.

In today’s episode, Jon shares his seven-year battle with stubborn plantar fasciitis—and how he went from barely being able to walk in the morning to completing trail marathons at age 59.

This is not a story about a magic treatment or a quick fix. It’s about patience, progressive strength, smarter recovery, and changing the way you think about pain. If you’ve tried everything and feel like you’re running out of options, this conversation will resonate deeply.

What We Cover in This Episode

Jon’s long road with plantar fasciitis

• How his symptoms started, disappeared, then returned worse than ever
• Why years of rest, stretching, and passive treatments didn’t solve the problem
• What “first-step pain” taught him about whether he was improving or regressing

Why many plantar fasciitis treatments fail

• Over-stretching and aggressive rehab that actually delayed healing
• Why ticking “strength training” off the list too early is a common mistake
• The difference between doing exercises and loading tissue correctly

The turning point

• The mindset shift that stopped the injury from controlling his life
• How slow, progressive calf strengthening rebuilt tissue capacity
• Why learning not to catastrophize flare-ups changed everything

Strength training that actually worked

• The calf exercises that gave the biggest return on investment
• How he progressed from double-leg to single-leg loading safely
• Rep ranges, frequency, and why patience mattered more than intensity

Recovery beyond rehab

• How improving sleep quality accelerated his progress
• Nutrition changes that supported training and recovery
• Why recovery became non-negotiable as he got older

Where Jon is now

• Running pain-free most days after years of struggle
• Completing half marathons, mountain runs, and a self-supported trail marathon
• How he’s approaching goals differently to stay healthy long-term

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Matt is a repeat guest from the Doctors of running and a running shoe fanatic!

Our discussion on today's episode starts with shoe expiry dates. Matt gives his opinion on when it is time to buy new running shoes and what variables play a role in running shoe wear and tear.

Next, we explore the different features of a shoe that you need to consider when buying a new pair. Matt discusses comfort, flexibility, stability, upper, drop, weight and many other features.

Matt also shares his recommendations on shoe brands for beginner runners, performance-minded runners and his take on maximalist versus minimalist.

Follow Matt's work by visiting the doctors of running website, youtube,  podcast and insta.

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In this month’s Latest Running Research episode, Brodie breaks down three high-impact studies that every runner should know about—covering sleep quality and injury risk, what actually gets injured during marathon running, and how strength training can improve running economy. If your goals are to run faster, stay injury-free, and train smarter in 2025, this episode delivers clear, evidence-based insights without the fluff.

We start with a standout prospective study tracking runners over six months, showing that poor sleep quality—not sleep quantity—significantly increases injury risk. Each one-point drop in perceived sleep quality increased injury risk by 36%, while rising fatigue and muscle soreness emerged as early warning signs in the 1–2 weeks before injury. The takeaway is clear: sleep quality, recovery monitoring, and subjective signals like soreness and fatigue deserve far more attention than most runners give them.

Next, we zoom out and examine a comprehensive review of marathon-related injuries, separating race-day injuries from training injuries and identifying the most commonly affected areas (thigh, knee, calf, foot, and ankle). The paper highlights both modifiable risk factors (training load, recovery, alcohol use, footwear transitions) and non-modifiable risks (age, sex, prior injury), offering valuable context for runners preparing for longer events or returning from injury.

Finally, the episode explores new research on strength training and running economy, focusing on how combining heavy resistance work with plyometrics (“complex training”) can meaningfully improve efficiency. The findings reinforce that strength training isn’t just for injury prevention—it directly improves how much energy you burn at a given pace, making it a powerful performance tool when programmed correctly.

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In this reflective end-of-year episode, Brodie pulls back the curtain on his own training highs, mistakes, injuries, and breakthroughs to help you make 2026 your smartest running year yet. Drawing from a full year of HYROX preparation, calf and hamstring setbacks, strength gains, sleep struggles, and race-day lessons, he breaks down what actually worked, what didn’t, and—most importantly—why. 

This isn’t just about racing faster; it’s about learning how to adapt, manage load, avoid repeating injury cycles, and build resilience over the long term. Whether you’re training for a marathon, HYROX, or simply trying to stay consistent and injury-free, this episode will prompt honest self-reflection and give you practical ideas you can immediately apply to your own running journey 

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In this Ask Me Anything episode, Brodie answers three high-value listener questions on marathon prep, goal setting, and tapering. He breaks down when to prioritise distance vs time for long runs, how to structure challenging yet realistic running goals, and the key differences between tapering for a half marathon versus a full marathon. The discussion includes practical guidance drawn from coaching insights, research, and Brodie’s own clinical experience supporting runners around the world.

Key Topics Covered

1. Long Runs: Distance vs Time
Brodie explains how to balance training plans that prescribe long distances with the reality of being on your feet for extended periods. He outlines the tipping point where diminishing returns can compromise recovery and how to use duration caps or split-day mileage to stay on track.

2. Setting Challenging but Realistic Goals
Using a structured process—including performance history, rate of improvement, race timelines, and A/B/C goal setting—Brodie shares a framework for developing goals that stretch you without leading to burnout. He also discusses staying true to your plan when friends’ ambitious goals don’t align with your needs.

3. Tapering for Half vs Full Marathons
Brodie breaks down how tapering differs across race distances, why marathon tapers commonly run two weeks while half-marathon tapers may require only a few days, and which variables should remain constant (like intensity) to keep your legs feeling springy and race-ready.

Takeaways

• Cap long runs around 3–3.5 hours if distance pushes you excessively beyond that, to protect recovery.
• Use A/B/C goals and clear timelines to stay grounded and motivated.
• Tapering strategies must match the physiological demands of the race:
  • Marathons require a longer, structured taper.
  • Half marathons may only need a shorter, flexible taper period while maintaining intensity.
• Goal clarity, challenge, commitment, feedback, and simplicity are the pillars of effective goal design.

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This episode is all about turning setbacks into strategy. Brodie joins the show to unpack why injuries are rarely random and how every niggle, flare-up, or full-blown setback carries valuable information about your training, lifestyle, and recovery habits. We explore the big levers that influence injury risk, including sleep, stress, nutrition, footwear changes, and emotional pressure, as well as the subtle patterns runners often miss. Brodie breaks down how to identify training errors, uncover weak links, and understand the early warning signs your body gives long before an injury fully appears.

You’ll learn how to approach your running like an ongoing experiment, how to track the right data, and how to use self-awareness to build a more durable, resilient runner’s body. From understanding your personal injury patterns to applying smarter safeguards in your training plan, this conversation teaches you how to turn any injury into long-term progress. Whether you’re currently sidelined or simply want to avoid repeating past mistakes, this episode gives you the mindset and tools to come back stronger than before.

Check out the Strength Running Podcast here

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Predicting Future Injuries & Early Detection with Prof. Eric Hegedus

In today’s rerun episode, Brodie sits down once again with Professor Eric Hegedus—physical therapist, clinician, researcher, and one of the podcast’s favourite returning guests. Eric previously joined us in Episode 186 to dive into return-to-running principles. Today, he’s back to explore one of the hardest and most misunderstood topics in running science:

Can we actually predict running injuries?
If so, how? And what should runners do with that information?

Using insights from his 3-year prospective cohort study, Eric walks us through what physical performance tests can and cannot tell us about injury risk—and why simple movement screens like single-leg squats may be more powerful than we ever realised.

We also dive into psychosocial risk factors, early warning signs, modern wearable data, and why injury prediction research is evolving rapidly.

What This Episode Covers

• Why Eric designed a study to challenge the Functional Movement Screen (FMS)
• The 15 bodyweight performance tests studied across 360 athletes
• Which movement patterns actually mattered for overuse injuries
• The shocking finding: when motor control was considered, past injury stopped predicting future injury
• Why weak glute medius and poor ankle mobility show up repeatedly in injured runners
• How poor movement gives you “less wiggle room” before overload
• Why injury prediction today is no longer just movement → injury, but a multifactorial real-time model
• The four early warning signs of an upcoming injury episode
• Practical takeaways all runners can apply immediately

Key Insights & Takeaways

1. Movement Quality Matters More Than We Thought

Eric’s research found that poor single-leg or double-leg squat control was strongly associated with future overuse injuries—even more than past injury history.
When movement quality was poor, “past injury” no longer predicted new injury. This indicates:

• Poor motor control = major vulnerability
• Runners with poor control have less buffer when workloads fluctuate
• Runners who move well have a much larger margin for error

Symptoms of poor control during squats include:

• Knees collapsing inward
• Trunk rotating
• Heels lifting
• Using the spine instead of hips/knees to descend

These often reflect:

• Weak glute medius
• Poor ankle mobility
• Poor neuromuscular coordination after prior injury

2. The Tests That Truly Matter

Eric’s study grouped bodyweight tests into:

• Active motion
• Motor control
• Hip stability
• Flexibility
• Power

But the only category that consistently correlated with overuse injury was:

Motor Control: quality of double-leg and single-leg squat

These tests are simple, take 20 seconds, and anyone can self-assess in front of a mirror.

3. Early Warning Signs of an Injury (Clear Red Flags)

Eric highlights four factors runners should monitor weekly:

• Fatigue
• Stress levels
• Sleep quality
• Muscle soreness

When all four trend in the wrong direction, an injury is often imminent.

4. Wearables Are Changing Injury Prediction

Unlike old studies that tested athletes once per year, modern tech (Garmin, Whoop, Oura, etc.) collects real-time data—giving much stronger prediction models.

Right now, Eric estimates we can predict injury with:

👉 30–50% confidence
Already far better than the past, and improving rapidly.

5. Runners Must See Themselves as Whole Humans

Mechanical load alone doesn't explain injuries. Psychological and lifestyle factors matter just as much:

• Travel
• Stress
• Poor sleep
• Relationship/social strain
• High soreness
• Reduced recovery behaviors

Ignoring these variables leads runners into repeated injury cycles.

🧠 Practical Tips for Runners

• Film yourself doing a single-leg and double-leg squat → check knee control, trunk alignment, ankle mobility
• Avoid running when fatigued, highly stressed, poorly slept, or extremely sore
• Build glute medius strength (side planks, hip abduction variations)
• Improve ankle mobility if squats improve with heels elevated
• Consider cross-training to break unidirectional overload
• Take easy days without guilt—they prevent injury, not reflect weakness
• Look at yourself as a whole athlete: body + mind + lifestyle

📚 Related Research Mentioned

• Hegedus et al. Physical performance tests predict injury in NCAA athletes
• Chris Bramah: Hip drop & knee mechanics associated with running injury
  (Referenced within conversation)

👤 About Today’s Guest: Prof. Eric Hegedus

Eric Hegedus is a professor, clinician, researcher, and highly respected physiotherapist whose body of work spans biomechanics, injury risk, and clinical reasoning. His research is widely used globally in sports rehabilitation and athlete screening.

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In this month’s Latest Research episode, we break down five new papers added to the Run Smarter Research Library — including big updates on trail running performance, dynamic stretching, running stability, and emerging tendon therapies like ozone, collagen, and PRP.

Whether you're a trail runner, road runner, or someone dealing with a stubborn tendon injury, this episode arms you with the latest insights to train smarter and reduce injury risk.

In This Episode

Trail Running: What Predicts Performance & Injury Risk?

Paper: Analysis of Factors Influencing Injuries and Performance in Trail Running
Key insights:

• Higher weekly volume, more elevation gain, more interval training, and structured recovery → lower injury risk
• Sleep + passive recovery (massage, mobility, sauna, cold plunges) strongly linked to better performance
• Taller runners had slightly higher injury risk
• Prepared tissue = safer tissue
• More training is protective — but only when recovery is adequate

Dynamic Stretching: Does It Improve Neuromuscular Readiness?

Paper: Acute Effects of Dynamic Stretching on Knee Joint Position Sense and Dynamic Balance in Recreational Runners
Key insights:

• A 5-minute dynamic warm-up improved:
  • Joint position sense
  • Single-leg balance
  • Neuromuscular “readiness”
• Runners were more accurate with limb positioning and more stable on Y-Balance Test

Dynamic Stability & Running Economy: Why Variability Helps

Paper: Runners with Lower Dynamic Stability Exhibit Better Running Economy
Key insights:

• More step-to-step variability (“controlled chaos”) = better running economy
• Stability didn’t change with speed → suggests an individual running “trait”
• Efficient runners aren’t rigid — they allow micro-adjustments

Ozone Therapy for Tendinopathy — An Emerging Option?

Paper: Oxygen–Ozone Therapy in Tendinopathy Management
Key insights:

• May reduce pain, improve function, and support collagen regeneration
• Early evidence only; protocols vary
• Appears promising as an adjunct, not a standalone treatment

Porcine Collagen Injections for Proximal Hamstring Tendinopathy

Paper: Porcine Collagen Injection Therapy Affects Proximal Hamstring Tendinopathy in Athletes
Key insights:

• Return to sport:
  • Collagen + rehab: 57 days
  • Rehab only: 72 days
• Greater functional improvements in the collagen group
• Still small, preliminary studies

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In this special episode, Brodie releases a previously patron-only AMA, answering a wide range of listener questions across injury rehab, running technique, strength training, and recovery tools. Even if you don’t struggle with these issues now, the principles and reasoning in Brodie’s answers provide invaluable insight into smarter training decisions for every runner.

🦴 1. Training With Stress Fractures Below the Ankle

Brodie breaks down why not all stress fractures are equal and why their location, grade, and healing stage matter.
He explains:

• The difference between high-risk vs low-risk stress fractures
• Why navicular fractures heal slowly due to poor blood supply
• The importance of pain-free loading (during, after, and next day)
• How to rebuild fitness without stressing the foot: swimming, pool running, upper body strength, knee extensions, seated hamstring curls
• A staged return to loading:
  1. Offloaded cardio + upper body strength
  2. Seated cycling with low resistance
  3. Rowing + progressive cycling loads
  4. Standing lower-limb strength work (squats, lunges, calf raises)
  5. Elliptical and increasing time-on-feet tolerance
  6. Jump progressions → walk/jog program

Brodie even maps out a sample weekly schedule for mixed cross-training and strength while rehabbing.

🏃‍♀️ 2. “Understriding” Explained (Gait Analysis Breakdown)

A listener asks if it's possible to understride because her gait report showed “reduced overstride bilaterally.”

Brodie explains:

• What overstriding actually is
• Why you must contact slightly in front of your centre of mass
• Why a high cadence (e.g., 188 spm) naturally prevents overstriding
• Why “closer to centre of mass than average” is not a problem if you feel stable and upright
• Why there's usually no need to change your technique if you're not braking excessively or injuring yourself

Great mini-lesson on biomechanics, cadence, and efficient landing mechanics.

🏋️‍♀️ 3. Is One Set Enough in Strength Training?

A unique question: Can I just do one set of an exercise and move on?

Brodie dives into:

• What’s required to trigger true adaptation
• Why one set rarely provides enough consistent stimulus
• Why variety is good—but too much can “spread your progress thin”
• How to work around boredom or repetition fatigue using:
  • Supersets
  • Circuits
  • Alternating upper/lower body between sets
• His recommended “big three” for runners:
  • Squats
  • Deadlifts / Lunges / Step-ups
  • Calf raises
• How minimal effective dosing still works if done consistently and progressively

Practical, realistic strength advice every recreational runner can apply.

🧦 4. Do Compression Socks Actually Help Twingy Calves?

Brodie reviews the latest meta-analysis on compression garments and their effects on recovery:

• Stronger evidence for resistance training recovery
• No significant recovery effects following running
• Small benefits for next-day cycling performance

His advice:

• If compression feels nice, it’s fine to use as a short-term comfort tool
• BUT: don’t rely on it—investigate the cause of recurring calf twinges
  • Training load balance
  • Speed work
  • Hills
  • Shoe heel-drop
  • Hydration and sodium status
• Follow the Recovery Pyramid (Shona Halson):
  1. Sleep, nutrition, hydration, stress
  2. Water immersion
  3. Active recovery
  4. Massage
  5. Cold/heat, cryo, infrared
  6. Top of pyramid: fads like foam rolling, massage guns, compression

🎧 Final Thoughts

This AMA covers a broad range of topics, but the theme is consistent:
 Use symptoms to guide load, progress logically, and focus on long-term habits rather than quick fixes.