Fix My Running

On this episode of The Adaptive Zone, we speak to expert Professor Peter Malliares about tendinopathy, a condition characterized by persistent pain around the tendon and dysfunctional disability. We'll learn why an individualized approach is necessary and uncover the various factors that contribute to tendinopathy. 

We'll also hear about the various treatments available to patients, including taping, manual therapy, shockwave therapy, and injections, and why evidence shows that exercise is the most effective option. 

Finally, we'll dive into the controversial topic of injecting steroids around or directly into the tendon and the risks associated with these procedures. Join us as we break down this complex problem and learn the most effective ways to tackle tendinopathy to promote recovery and long-term health.

Professor Peter Malliares has been a physiotherapist since 1998 and is considered a foremost expert in tendon pain. He is currently based in Melbourne where he works as a clinician as well as a professor at Monash University, where he conducts research focused on lower limb tendinopathy.

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Chapters

00:00 Introduction

01:43 Understanding Tendinopathy: Pain, dysfunction, and pathology explained

03:54 The Nuance of Diagnosing

08:38 Localized Pain: Key to Identifying Patella Tendonitis

15:53 Key Treatments for Tendinopathy

22:22 Patellar Tendonitis: A Multifactorial Problem

26:58 Individualized Education and Exercise for Pain Management

33:04 Treating Tendinitis: Injections and Shockwave Reviewed

38:59  Debating the Safety of Steroid Injections Near Tendons

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This is one of the most common questions I get from runners. So today I’m going to take a deeper dive into Zone 2 running. We’ll talk about what Zone 2 running is, why it’s important and how to make sure you’re doing it right so that you can improve your race performance.

Zone 2 usually refers to a running intensity that focuses on developing the aerobic system. Runners often refer to this as the “aerobic base” and training that focuses on it as “base building”.

Zone 2 running is easy; while running, you should be able to speak clearly, in full sentences. It’s a running intensity that you could sustain for a long time.

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“I had to quit running because it’s bad for my knees” - Millions of people

If I had a dime for every time I’d heard that! I don’t actually know how much a dime is, being English and all.

Let's dig into the evidence, definitions and context of knee arthritis as it relates to running. Featuring a couple of rants about unhelpful terminology and phrases related to running injuries.

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Running with Power Meters has exploded in popularity in the last few years. Taking the baton from their cycling counterparts, elite runners have begun to embrace "power" as a key metric to guide their training.

As the cost of running power meters comes down, it's time for recreational runners to get in on the act. Many runners are noticing that "watts" is already displayed on their Garmin or Apple watch. Others have invested in foot pods from Stryd. Now the question is, how do we use power to improve our training.

My guest today is Steve Palladino. He is head coach at Palladino Power Project and an expert on running with power. Today, he is going to give us the 101 lecture on why running with power meters is the future.

Click to jump to that part of the video…

I was giving a talk at a running club a couple of weeks ago about strength training for runners. I asked the group to raise their hand if they were doing regular strength training. Only a few hands went up. Then I asked them to raise their hand if they had heard that strength training was good for runners.

All the hands went up.

This is real progress, it was only a few years ago that runners believed strength training was not only unhelpful, but that it would actually make them slower. This perspective has really shifted in the last few years. Nowadays, most runners understand that strength training will improve their performance and help them avoid injuries.

However, as I said, when I asked them who was actually doing it, only a few hands went up. In my opinion, this is a fairly representative sample of the running community at large. We now believe that strength training is a good thing to do, but not that many of us are actually doing it.

So today, I hope to do my little bit to help turn the tide. I’m going to outline how you can get into strength training. This week. I’ll go through a really simple workout that you can do to get the best bang for your buck out of your strength training. You can do it at home in less than an hour per week. All you’re going to need are a couple of heavy dumbbells.

If you want to know how much water you should drink when running, you’ll need to know how much you sweat. Sweat rates vary from runner to runner. Some people sweat as little as 200ml of fluid per hour, whereas others can sweat as much as 3 litres per hour!

To complicate things, sweat rates can vary significantly within the same runner. If you’re running in -30°C you will sweat far less than you will in +30°C. You will also sweat far more when running at race-pace than at your easy-pace.

As you can see, trying to give generic advice on how much water you should drink when running is a fool's errand. So what we really need is a strategy to work out how much water you need. To work that out, we need to get a picture of how much fluid you lose when you’re running.

Most runners have heard that slow running will help improve their performance. However, time and time again I see runners going too fast on their slow runs. This means they're always a bit tired, so they have to go slower on their fast runs. So they end up doing most of their runs at a kind of moderate-intensity pace. Missing out on many of the training benefits experienced at lower and higher intensities.

Today's guest is going to help us understand the training benefits of slow running and give us some practical tips to help us execute our slow workouts correctly. Dr. Tyler Eng is a Physical Therapist and Running Coach. He helps frustrated runners conquer chronic injuries so they can run for life. He is also the owner and Head Coach at MoveSpace PT.

Runners often use gels and sports drinks to fuel their long runs. In my experience, they typically take 1 gel per hour (at the most). Frankly, this is not enough. That would be 20-25 grams of carbohydrate. If you want to fuel your long run properly, you need more like 30-60 grams of carbohydrate. That’s more like 2-3 gels.

To put it more clearly, most runners be fuelling with 2-3 times as much carbohdrate on their runs. No wonder runners are always bonking! In this episode, Endurance Specialist Dietician, Stephanie Small, walks us through exacly how much you need to consume to fuel your runs. More importantly, she tells you exactly how to do it!

Stephanie also explains what to eat before, during and after your runs to enhance recovery. As well as telling you how to calculculate how many calories and macros you actually need to properly fuel your training…spolier alert, it’s more than you think!

Get a notepad ready for this one!

Discussed in this episode

If you'd like a pdf walkthrough of the "Project 2023" goal-setting method, email me the word "pdf" and I'll send it to you: [email protected]

If you set your goals using this method, I'd love to hear them, just email me at that same address.

I'd also love to connect with you on Instagram, give me a follow @matthewboydphysio

Happy New Year Everyone!

Leaking urine when running is way more common than it should be. Every week I meet a runner in the clinic with this problem. The degree to which urinary incontinence with exercise has been normalized is really disheartening. This is a significant medical problem. It is NOT normal and it CAN be treated.

If you, or someone you know, is having trouble with leaking when running you are going to be so pleased you listened to this episode. Emma Brockwell is a Pelvic Health Physiotherapist and an expert on urinary incontinence with running. She also happens to be an avid runner herself!

This problem is massively underreported and under-treated. If you know someone with this problem, please do share this episode with them. You might just change their life.