The Rehab Runway: From the Treatment Room to the Track

A runner goes from 40 km to 44 km in a week. That is a 10% increase. But what if all four extra kilometres were added to one long run?

In Episode 22 of The Rehab Runway, I look at what the research actually says about the 10% rule, including a trial that tested a programme based on the rule and a newer study of more than 5,000 runners that examined spikes in individual run distance.

We then move from percentages to decisions: what has the runner tolerated recently, which training dial are we changing, how novel is the next session, and what did their symptoms and recovery tell us after the last one?

In this episode:

• Why 10% is a useful prompt, not a safe/unsafe threshold
• How weekly totals can hide a large change in the longest run
• What the single-session study found, and what it cannot prove
• A calf-injury return-to-running example
• Seven questions I use to plan the next exposure

Free Running Load Review for clinicians: https://www.healthhp.com.au/running-load-review

Full show notes and research: https://www.healthhp.com.au/the-rehab-runway/the-10-percent-rule-is-flawed

Want help putting this into practice in your own training? I offer personalised run coaching, with a plan built around your goals, training history and how you respond. Learn more or apply: https://www.healthhp.com.au/run-coaching

Two runners complete 50 km in a week. Did they experience the same training load?

That total does not tell us how many runs they completed, how closely those runs were spaced, whether one session dominated the week, or how much speedwork, elevation or racing was involved.

In Episode 21 of The Rehab Runway, Luke Nelson looks beyond weekly mileage to explore the training story around a running injury. He explains external and internal load, compares two very different 50 km weeks, and walks through seven areas he reviews with runners: frequency, density, volume, the longest run, intensity, elevation and racing.

We also discuss why the symptom timeline matters, how recent capacity changes the meaning of a familiar session, and what a retrospective load review can and cannot tell us about injury causation.

Free resource for clinicians: Download The Running Load Review to help structure your next training history:
https://www.healthhp.com.au/running-load-review

Full show notes and research links:
https://www.healthhp.com.au/the-rehab-runway/training-load-more-than-weekly-mileage

Want help putting this into practice in your own training? I offer personalised run coaching, with a plan built around your goals, training history and how you respond.

Learn more or apply: https://www.healthhp.com.au/run-coaching

How Fast Can You Run a Marathon? Making Sense of Marathon Predictions

🏃 Your half marathon result, watch, and favourite calculator might all suggest different marathon times. Which should you trust?

In this episode of The Rehab Runway, I explore what marathon predictions can tell us, where they fall short, and how runners and coaches can use them to choose a realistic race target.

We cover:

⏱️ Predicting marathon performance from a 5 km, 10 km or half marathon

🧮 Riegel, Jack Daniels’ VDOT and the Valencia prediction model

🫁 VO₂max, lactate threshold and running economy

🔋 Durability: what changes as fatigue builds

⌚ How much confidence to place in smartwatch predictions

📈 Training history, long runs and intensity distribution

☀️ How heat, elevation, fuelling and pacing influence the result

A predicted time is a starting point. The next question is whether your preparation and race-day conditions support it.

🎙️ Hosted by Luke Nelson, Sports & Exercise Chiropractor and running coach.

🔗 To show notes here: https://www.healthhp.com.au/the-rehab-runway/how-fast-can-you-run-a-marathon

📖 Read the accompanying blog: https://www.healthhp.com.au/post/how-accurate-is-your-marathon-prediction

Femoral bone stress injuries can be difficult to diagnose, challenging to manage and, particularly at the femoral neck, potentially serious if missed.

In this episode of The Rehab Runway, Luke Nelson is joined by physical therapist and running coach Nathan Carlson to discuss the diagnosis and management of femoral neck and femoral shaft bone stress injuries in runners.

They cover:

• How femoral neck and shaft bone stress injuries typically present
• Key clinical findings that should raise suspicion
• The role of MRI
• Compression-sided vs tension-sided femoral neck injuries
• When surgical review should be considered
• Early unloading and weight-bearing decisions
• Strength training and progressive rehabilitation
• Criteria for introducing plyometrics
• Return-to-run progression
• Progressing from easy running back to full training
• When blood tests should be considered
• When to order a DXA scan
• Screening for low energy availability and other contributors to bone health

A major focus of the episode is looking beyond the injury itself and asking why the runner developed the bone stress injury in the first place.

Full show notes:
https://www.healthhp.com.au/the-rehab-runway/femoral-bone-stress-injuries

Nathan Carlson / Running MateInstagram: https://www.instagram.com/runningmatekc/Website: https://runningmatekc.com/

Luke Nelson / The Rehab RunwayInstagram: https://www.instagram.com/sportschiroluke/Website: https://www.healthhp.com.au/

Beyond the Calf Raise: Foot & Ankle Function in the Runner | Romain Tourillon

The foot and ankle are the runner's only point of contact with the ground, yet they're often reduced to calf raises, ankle mobility and a handful of intrinsic foot exercises. But are we missing the bigger picture?

In this episode of The Rehab Runway, I sit down with physiotherapist, researcher and strength & conditioning coach Romain Tourillon to explore how his research has reshaped our understanding of foot and ankle function in runners.

We discuss the concepts of the absorbing foot and propulsive foot, the role of intrinsic and extrinsic foot muscles, foot stiffness, first-ray loading, MTP function, and why many traditional foot strengthening exercises may not be providing enough stimulus.

We then shift our attention to the calf, where Romain discusses his multidimensional framework for assessment and rehabilitation. We discuss maximal strength, capacity, explosive strength and reactive strength, why seated and standing calf testing provide different information, how he developed his calf-capacity circuits, and how clinicians can better translate strength gains into improved running performance.

Whether you're a clinician, coach or runner, this episode offers a fresh perspective on one of the most important yet misunderstood regions of the body.

In this episode, we cover:

• Romain's PhD and how it changed his understanding of foot function

• The roles of the intrinsic and extrinsic foot muscles

• The absorbing foot and the propulsive foot

• Foot stiffness, force transmission and first-ray loading

• Assessing foot and ankle function

• The five dimensions of calf function

• Seated versus standing calf strength testing

• Why calf strength doesn't always transfer to running

• Calf capacity and the development of the calf-capacity circuits

• Sequencing rehabilitation from strength to reactive function

• Common mistakes clinicians make when assessing and rehabilitating the foot and calf

If you enjoyed this episode, please follow The Rehab Runway, leave a rating or review, and share it with a colleague or runner who would benefit from a different way of thinking about foot and ankle rehabilitation.

🌐 ⁠Shownotes

https://www.healthhp.com.au/the-rehab-runway/episode-18-beyond-the-calf-raise

Guest: Romain Tourillon, Sports Physiotherapist

Instagram: @romain.tourillon

LinkedIn: Romain Tourillon

Link to Romain’s Calf course: Complex Calf Course 

🎙️ Subscribe to The Rehab Runway for more evidence-based conversations on running injuries, rehabilitation and performance.

🌐 ⁠https://www.healthhp.com.au/the-rehab-runway⁠

📱 Follow Luke Nelson: Instagram: @sportschiroluke

ibial bone stress injuries are one of the most frustrating injuries a runner can face. They can derail training for months, recur if managed poorly, and are often mistaken for "shin splints" in the early stages.

In this episode of The Rehab Runway, I’m joined by physiotherapist Beau Tyrrell to unpack what every runner and clinician needs to know about tibial bone stress injuries.

We discuss what is actually happening within the bone, why these injuries develop, and how to differentiate a tibial bone stress injury from medial tibial stress syndrome (MTSS). Beau also explains the role of imaging, MRI grading, and why recognising these injuries early can significantly improve outcomes.

The conversation then shifts to rehabilitation, covering relative unloading, strength training, cross-training, impact progressions, and the criteria Beau uses before returning a runner to training. We also explore common rehabilitation mistakes, recurrence risk, RED-S, training load, and practical strategies to reduce the likelihood of future bone stress injuries.

Whether you're a runner dealing with persistent shin pain or a clinician working with injured runners, this episode is packed with practical, evidence-informed advice.

In this episode, we cover:

• What a tibial bone stress injury actually is• Tibial bone stress injury vs MTSS ("shin splints")• Clinical assessment and red flags• When MRI is indicated and how useful MRI grading really is• Relative unloading vs complete rest• Strength training and bone adaptation• Cross-training during rehabilitation• Progressive impact loading• Return-to-running criteria• RED-S and low energy availability• Preventing recurrence and managing training load

🌐 ⁠Shownotes

https://www.healthhp.com.au/the-rehab-runway/episode-17-tibial-bone-stress-injuries

Guest

Beau Tyrrell, Sports Physiotherapist

Instagram: @stressfracturephysio

🎙️ Subscribe to The Rehab Runway for more evidence-based conversations on running injuries, rehabilitation and performance.

🌐 https://www.healthhp.com.au/the-rehab-runway

📱 Follow Luke Nelson:
Instagram: @sportschiroluke

Women’s safety in running is not just a women’s issue. It is a running community issue.

In this episode of The Rehab Runway, I’m joined by running coaches Isobel Tait from Peak Endurance and Emma-Rose from Run Joy Melbourne to discuss women’s safety in running, why it affects participation and training, and what all of us can do to help create safer running spaces.

The conversation was prompted by recent discussion around women’s safety while running, along with the Run My Way survey from the Office of Sport and Transport for NSW. The survey found that 95% of women said safety influences their running habits, 70% of women had felt unsafe on a run, and 50% of women had experienced harassment while running.

We discuss the extra mental load many women carry before and during a run, including route choice, timing, headphones, location sharing, running alone, group running and whether to acknowledge strangers.

But this conversation is not just about giving women more strategies to stay safe. We also talk about what men can do, what coaches need to consider, and how run clubs can create safer, more inclusive running environments.

In this episode, we cover:

Why women’s safety in running needs to be discussed more openly

How safety concerns shape when, where and how women run

What the Run My Way survey tells us about the safety gap in running

Why feeling unsafe is not limited to physical assault

How harassment, intimidation, unwanted comments and being followed can affect running experiences

Practical strategies women may use to feel safer

What male runners need to understand

How men can give space, respect non-engagement and call out poor behaviour

Why safety should be considered when prescribing training

What run clubs can do to create safer running environments

Why women’s safety in running is a shared responsibility

Content note: This episode discusses women’s safety while running, including harassment, intimidation and assault. We do not go into graphic detail, but some listeners may find parts of the conversation distressing. Please listen in a way that feels right for you.

Show notes:

https://www.healthhp.com.au/the-rehab-runway/womens-safety-in-running

Guest links:

Isobel Tait
Peak Endurance
Instagram: @peakendurancecoaching

Emma-Rose
Run Joy Melbourne
Instagram: @run_joy_melbourne

Episode Description

Most runners think injuries happen because of training errors.

Too much mileage. Too much intensity. Not enough strength work.

But what if the real issue isn't just training load?

In this episode of The Rehab Runway, Luke explores the often-overlooked role of stress in running injuries. From work deadlines and poor sleep to travel, life events and emotional stress, we discuss how non-training stressors can influence recovery, performance and injury risk.

Luke also shares reflections from his own recent knee injury and why looking beyond mileage may have changed the way he thinks about injury prevention and rehabilitation.

In this episode, you'll learn:

• Why injury risk is about total load, not just training load

• How stress can reduce your capacity to tolerate running

• Why some injuries seem to occur during "easy" training weeks

• The concept of delayed injury responses and accumulated stress

• How stress influences recovery, pain and decision-making

• What research tells us about stress and injury risk in athletes

• The pros and cons of using wearables such as Garmin, WHOOP and Oura Ring

• Practical strategies runners can use during high-stress periods

Whether you're a runner trying to stay healthy, a coach managing athletes, or a clinician working in sports medicine, this episode will help you think differently about injury risk and recovery.

🎓 Clinician Education

Luke's next MAT Running Course will be held on 22 November, covering runner assessment, load management, strength training, gait analysis and return-to-run planning. https://www.healthhp.com.au/mat-running-course⁠

🎙️ The Rehab Runway
From the Treatment Room to the Track. Where evidence meets experience in running rehab and performance.

🔗 Connect with Luke:
Instagram: @sportschiroluke
Website: https://www.healthhp.com.au
Training & Education: https://www.healthhp.com.au/mat-running-course

Research discussed & full show notes here

🎙️ Strength Training for Runners: What Actually Matters?

Strength training has become one of the most talked-about topics in running performance and injury prevention. But despite the growing body of research, many runners are still left wondering what they should actually be doing in the gym, how often they should be doing it, and whether it will truly make them a better runner.

In this episode of The Rehab Runway, I’m joined by physiotherapist, strength and conditioning coach, researcher and podcaster Kate Baldwin to unpack what the evidence really tells us about strength training for runners.

We explore why strength training appears to improve running economy and performance, the concept of the interference effect, and whether runners should really be worried that lifting weights will negatively affect their endurance training.

Kate also shares insights from her PhD research into concurrent training in endurance athletes, including how strength and endurance training can be effectively integrated, the minimum effective dose of strength training, and why consistency often matters more than complexity.

We also discuss:
🏋️‍♂️ How much strength training runners actually need
🏃 Running economy and durability
⚡ The role of strength training in performance
📈 Practical programming considerations
🔋 Recovery and balancing gym work with running
🧠 Common misconceptions around strength training for endurance athletes

Whether you're a runner, coach or clinician, this episode is packed with practical, evidence-informed takeaways you can apply immediately.

⁠Full show notes here

📲 Follow Kate Baldwin on Instagram:
@thedistancedr

🌐 Connect with Luke Nelson
Instagram: ⁠@sportschiroluke⁠
Website: ⁠https://www.healthhp.com.au/⁠

🎧 Enjoying the podcast?
Please consider following, rating, and sharing The Rehab Runway. It helps us continue bringing evidence-informed conversations to runners and health professionals around the world.

🎙️ Running Durability Explained: Why You Fall Apart Late in a Run

Why do some runners completely fade late in races while others seem to hold pace deep into fatigue?

In this episode of The Rehab Runway, I’m joined by sports physiologist, researcher, strength coach, and endurance coach Michele Zanini to unpack one of the most talked about emerging concepts in endurance performance: durability.

We explore what durability actually means, how it differs from VO₂ max, lactate threshold, and running economy, and why the physiology you start a race with may not be the physiology you finish with.

Michele shares insights from his recent research examining how prolonged running changes running economy, thresholds, and fatigue resistance, along with what may separate runners who maintain performance late in races from those who completely unravel.

We also dive into:
• how durability is currently measured in research
• practical ways coaches and clinicians may assess it in the field
• the role of long runs and training volume
• whether strength training can improve durability
• and how fueling, pacing, and fatigue all interact during prolonged performance

Whether you’re a runner preparing for your next marathon or a clinician working with endurance athletes, this episode offers a fascinating look into what may be one of the missing links in long-distance performance.

🎯 Key Takeaways

• Durability refers to the ability to resist physiological deterioration during prolonged exercise
• Running economy, VO₂ max, and lactate threshold can all worsen as fatigue builds
• Two runners with similar “fresh” physiology may perform very differently late in races
• Long runs and higher training volumes may improve running economy durability
• Strength and plyometric training may help preserve performance under fatigue
• Late-race breakdown is not always just a fueling or pacing issue
• Durability may become an important future performance marker in endurance sport

Full show notes here

📚 Research Discussed

• Zanini, M., Jones, A.M. and Nybo, L. (2025) ‘Viewpoint: Durability, fatigability, repeatability, and resilience in endurance sports: definitions, distinctions, and implications’, Journal of Applied Physiology.
• Zanini, M., Folland, J.P. and Blagrove, R.C. (2025) ‘Regular long runs and higher training volumes are associated with better running economy durability in performance matched well-trained male runners’, Medicine & Science in Sports & Exercise.
• Zanini, M., Folland, J.P., Wu, H. and Blagrove, R.C. (2025) ‘Strength training improves running economy durability and fatigued high-intensity performance in well-trained male runners’, Medicine & Science in Sports & Exercise.

🌐 Connect with Michele Zanini

Instagram: @michele.zanini

ResearchGate: Michele Zanini
LinkedIn: Michele Zanini

🌐 Connect with Luke Nelson

Instagram: @sportschiroluke
Website: https://www.healthhp.com.au/

🎧 Enjoying the podcast?

Please consider following, rating, and sharing The Rehab Runway. It helps us continue bringing evidence-informed conversations to runners and health professionals around the world.