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
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/
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.
Femmi: https://tinyurl.com/c7r732bs
Esther: https://www.instagram.com/estherkeown/?hl=en
Claire: https://www.instagram.com/claire_bades/?hl=en
Takeaways
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/
Pro version Heidi AI Scribe (time saver) Link: https://scribe.heidihealth.com/?via=SMP
Support the show: https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink
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
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
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:
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
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.
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.
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.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