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2 episodes with tom goom
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2 episodes with tom goom
Back pain affects millions of people across the UK. But a new study suggests running may be able to help chronic lower back back pain. It comes off the back of some previous research showing that running doesn't seem to harm the back and may actually be good for spine health. Running physio Tom Goom discusses these studies and offers some general advice for any runners currently suffering from back pain. The NHS has lots of advice on back pain and its possible causes: nhs.uk/conditions/back-pain/ This podcast and its content is not intended to replace medical assessment and advice. If you have an injury, we recommend seeing a qualified health professional. Learn more about your ad choices. Visit megaphone.fm/adchoices
Running physio Tom Goom gives an expert guide to recovering after a big race. Listen in for advice on making smart decisions in the aftermath of a big race, and how best to capitalise on your hard-earned fitness.For more expert advice on injury and recovery, visit To's website: running-physio.com Hosted on Acast. See acast.com/privacy for more information.
In this episode of the Physiotutors podcast, Tom Goom, also known as the Running Physio, provides valuable insights into medial tibial stress syndrome (MTSS) and its management. He discusses the pathophysiology of MTSS, Risk factors, and emphasizes the importance of gradual training progression and proper footwear selection to prevent MTSS. Tom also shares his approach to assessing and treating MTSS, focusing on finding a pain-free level of loading, incorporating strength training, and carefully guiding patients through a structured return to running program. It's a value-packed episode so tune in to master your approach to treating shin splints. This episode is sponsored by Lindy.ai - your A.I. medical scribe. Try Lindy for free by going to lindy.ai/physiotutors and receive 1 week of unlimited patient notes. Content 00:00 Intro 01:06 What is MTSS? 02:19 Risk Factors 03:34 Typical Patient 04:20 Specific Training Errors 05:40 Influence of Footwear 06:58 Forefoot Running 08:40 Red Flag Diagnoses 12:08 MTSS DIagnosis 13:06 Assessing the Patient 15:45 Muscle Testing 17:18 Sponsored Segment 18:55 Other Strength Parameters 21:05 Running Analysis/Technique 26:15 Treatment 29:29 Strengthening Exercises 31:58 What about Tibialis Anterior? 33:12 How to manage a flare-up? 35:25 Return to running 38:02 Different Mx for Different Sports 40:20 Duration of MTSS 41:35 Adjunct Treatments 43:30 Can MTSS become a Fracture? 44:25 Tom's closing remarks 46:25 Outro Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now Follow our Podcast on: Spotify | Apple Podcasts
How can you treat patients who experience knee pain and swelling during and after running? If you suspect their symptoms are caused by a meniscal injury, how can you rehab and return these patients to running without surgery? In this Physio Edge: Running repairs podcast with Tom Goom, you'll explore meniscal injuries in runners, recent research on runners with meniscal tears, and how to provide effective non-surgical management. You'll discover: Initial steps for managing pain and swelling in affected runners. Techniques to restore and maintain range of movement. Strategies for rebuilding strength in key muscle groups. Approaches to improve impact control and tolerance, preparing runners for a gradual return to their sport. When to manage these patients non-surgically, and when to refer for a surgical opinion. Tom explores the physical aspects of recovery, along with the impact of general health, weight management, and gait retraining on knee health. With a realistic timeline for recovery and a focus on individualised treatment plans, this podcast is a must-listen for therapists who treat runners.
Some injuries that go away quickly; others stick around and have a tendency to return – usually at the most inopportune moment. But what can you do about a persistent running injury? Leading running physio Tom Goom offers his expert advice on this subject in an episode that will be enjoyed be anyone who's battling a stubborn injury.Find Tom Goom online: running-physio.com @running.physio Hosted on Acast. See acast.com/privacy for more information.
Join David Pope (APA Titled Musculoskeletal and Sports & Exercise Physio) and Zoe Russell (Specialist Sports Physiotherapist, FACP; APA Titled Musculoskeletal Physio) in the Physio Edge podcast as they explore how to assess, treat, and manage patients suffering from ACL injuries or suspected ACL injuries. You'll discover how to assess a patient with a suspected ACL injury, and criteria you can use to identify whether a patient may be suited to non-surgical management or is likely to require surgery. You'll also understand when immediate or delayed surgery is the best option, and how to guide patients through the decision-making process and different phases of rehab. Listen in to provide your ACL injury patients with the best treatment options. Free Achilles tendinopathy video series with Tom Goom available now Links Improve your musculoskeletal and sports injury assessment & treatment results with a free trial Clinical Edge membership Free Achilles tendinopathy video series with Tom Goom David Pope at Clinical Edge Download and subscribe to the podcast on iTunes Download the podcast in Overcast Listen to the podcast on Spotify Zoe Russell on Twitter David Pope on Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge
Click here for details on the PHT Monthly MembershipThis episode delves into the relationship between nutrition and tendon health, inspired by a systematic review and insights from running physio Tom Goom.Key Points Discussed:Collagen Synthesis: Importance in tendon health and adaptation.Systematic Review Findings: Evaluating the impact of nutrition on tendon health.Alcohol Consumption: Its role in tendon health and the risks associated with it.Collagen Supplements: Potential benefits and the need for further research.Nutritional Advice from Fran Taylor: Professional insights on diet and tendinopathy management.Load Management in Rehab: Strategies for effective tendon rehabilitation.Conclusion: This episode offers valuable insights into how nutrition can impact tendon health, supported by scientific research and expert opinions. It emphasizes the importance of a balanced diet, the potential role of supplements, and the need for careful management in tendon rehabilitation.Timestamps:[00:00] Introduction to the episode's topic: Nutrition's impact on tendon health.[00:53] Background on the episode's inspiration and mention of Tom Goom's runners workshop.[01:17] Discussion of a systematic review on nutrition and tendon health.[02:13] Explanation of collagen synthesis in tendon health.[03:09] Objective of the systematic review and its methodology.[04:08] Importance of evaluating the quality of studies in a systematic review.[05:05] Overview of the findings from the systematic review.[06:03] Discussion on the combination of nutrients for tendon health.[07:01] Findings on alcohol consumption and tendon health.[08:54] Impact of collagen supplements on tendinopathy.[10:17] Limitations in the conclusions drawn from the studies.[11:41] Insights from nutritionist Fran Taylor on diet, supplements, and tendinopathy.[15:05] Additional recommendations for managing tendinopathy.[21:19] Summary and final thoughts on tendon rehab and nutrition.Book a free 20-min physio chat hereClick here to learn more about the PHT video course & to receive your 50% discountIf you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online
The hamstring plays a critical role in the running gait, but it's also a likely candidate for injury. Leading running physio Tom Goom (running-physio.com) has a particular specialism in the hamstring, and comes on the show to tell us how runners can strengthen and/or heal their hammies. Hosted on Acast. See acast.com/privacy for more information.
Runner's knee (or patellofemoral pain syndrome) is one of the most common running ailments. It's characterised by a dull pain around the front of the knee and can get worse quickly if not addressed. On this episode of the Runner's World podcast, leading running physio Tom Goom (running-physio.com) offers his expert advice on how to identify, recover from, and avoid runner's knee. Hosted on Acast. See acast.com/privacy for more information.
On this episode, leading running phyio Tom Goom (running-physio.com) tells you all you need to know about your achilles: how to strengthen it, what to do if it's causing you pain, and the kind of running likely to aggravate it. Think of this episode as your one-stop shop for expert achilles advice. Hosted on Acast. See acast.com/privacy for more information.
How can you successfully treat hip pain and instability associated with your patients' hip dysplasia? Find out the eight critical steps to excellent results with hip dysplasia in this podcast, which is part 3 in this three-part podcast series with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Free video series: Achilles Tendinopathy from start to finish line! with Tom Goom In this free Masterclass "Achilles tendinopathy: Assessment & rehab from start to finish line" presented by Tom Goom and hosted by Clinical Edge, you'll discover: 3 common conditions that cause Achilles pain. How to assess patients with Achilles pain to get a clear diagnosis, and know where to start treatment. Rehab exercises that will help your patients overcome their Achilles pain. How to successfully return your patients to running or sport, and achieve their goals, without stirring up their pain. CLICK HERE to register for your free access to this three-part video series with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Links associated with this episode: Free Achilles tendinopathy videos Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Physio Edge podcast 154 - Part 1 of 3 - Hip dysplasia key signs & symptoms with Tom Goom Physio Edge podcast 156 - Part 2 of 3 - 3 Types of hip dysplasia and How0 to identify them Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: CLICK HERE to download the article associated with this podcast Wilkin GP, Ibrahim MM, Smit KM, Beaulé PE. A contemporary definition of hip dysplasia and structural instability: toward a comprehensive classification for acetabular dysplasia. The Journal of arthroplasty. 2017 Sep 1;32(9):S20-7. Chapters: 05:36 - Step 1: Assessment 07:10 - Step 2: Investigations 08:35 - Step 3: Patient education 10:07 - Step 4: Settling symptoms 16:25 - Step 5: Strength 18:15 - Step 6: Control and proprioception 20:08 - Step 7: Co-existing pathology 21:09 - Step 8: General health 22:32 - Key points
Hip dysplasia is a commonly missed cause of hip and groin pain. In this podcast, which is part 2 in the 3 part series with Tom Goom (Running Physio), you'll discover three types of hip dysplasia that will cause different symptoms and need different treatment (based on Wilkins et al. 2017), how to identify each type, and common exercises and a treatment approach that may be stirring up your patients hip and groin pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Free Achilles tendinopathy videos Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Physio Edge podcast 154 - Part 1 of 3 - Hip dysplasia key signs & symptoms with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: CLICK HERE to download the article associated with this podcast Wilkin GP, Ibrahim MM, Smit KM, Beaulé PE. A contemporary definition of hip dysplasia and structural instability: toward a comprehensive classification for acetabular dysplasia. The Journal of arthroplasty. 2017 Sep 1;32(9):S20-7. Chapters: 03:12 - Signs & symptoms 06:05 - Assessment 08:05 - 3 types of hip dysplasia 08:28 - Anterior instability 09:58 - Posterior instability 11:42 - Lateral/global instability 13:29 - Key takeaways
Hip dysplasia is a commonly missed cause of hip and groin pain, catching, clicking, locking or popping, resulting from lack of coverage of the femoral head by the acetabulum. How can you identify hip dysplasia in your hip or groin pain patients, and avoid misdiagnosing it as iliopsoas or adductor related groin pain? What signs and symptoms will your patients reveal in their subjective history that'll help you identify this condition? Find out the key signs and symptoms of hip dysplasia in this podcast with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: CLICK HERE to download the article associated with this podcast Jacobsen JS, Søballe K, Thorborg K, Bolvig L, Storgaard Jakobsen S, Hölmich P, Mechlenburg I. Patient-reported outcome and muscle–tendon pain after periacetabular osteotomy are related: 1-year follow-up in 82 patients with hip dysplasia. Acta orthopaedica. 2019 Jan 2;90(1):40-5. Nunley RM, Prather H, Hunt D, Schoenecker PL, Clohisy JC. Clinical presentation of symptomatic acetabular dysplasia in skeletally mature patients. JBJS. 2011 May 4;93(Supplement_2):17-21. O'Brien MJ, Jacobsen JS, Semciw AI, Mechlenburg I, Tønning LU, Stewart CJ, Heerey J, Kemp JL. Physical impairments in Adults with Developmental Dysplasia of the Hip (DDH) undergoing Periacetabular osteotomy (PAO): A Systematic Review and Meta-Analysis. International Journal of Sports Physical Therapy. 2022 Oct 1;17(6):988-1001. Reiman MP, Décary S, Mathew B, Reiman CK. Accuracy of clinical and imaging tests for the diagnosis of hip dysplasia and instability: a systematic review. journal of orthopaedic & sports physical therapy. 2019 Feb;49(2):87-97. Chapters: 03:43 - Who develops hip dysplasia? 06:35 - Objective tests 09:11 - Hip dysplasia vs gluteal tendinopathy 10:45 - Hip dysplasia vs femoral neck stress structure 14:13 - Key takeaways
After injury or surgery, a lot of runners are told to stop running for different reasons. How can you answer patients that ask if they need to give up running for good? When should patients consider permanently stopping running? Find out in this podcast with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Chapters: 03:25 - Stop running permanently 8:15 - Safe to continue running? 10:05 - Post ACL surgery 11:22 - Knee OA 13:27 - Running rehab plan 16:44 - Key takeaways
Will strength training help your patients reduce their risk of running injury and improve their running performance? Find out what the latest research reveals in this Physio Edge Track record: Running repairs podcast with Tom Goom (Running Physio), as you discover: The latest research on whether strength training reduces running injury risk. Which runners are more likely to develop a running injury, and which runners more successfully avoid running injury. How to get runners to “buy in” and perform a strength program, when they're short on time and motivation. 3 key exercises your runners can do to improve their performance and reduce their running injury risk. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Article associated with this episode: CLICK HERE to download the article associated with this podcast Desai P, Jungmalm J, Börjesson M, Karlsson J, Grau S. Effectiveness of an 18-week general strength and foam-rolling intervention on running-related injuries in recreational runners. Scandinavian Journal of Medicine & Science in Sports. 2023 Jan 11 Chapters: 02:22 - Research study 04:39 - Results 07:47 - Training program
Marathon runners often come to us with pain, but also they need to build up their mileage in preparation for one of the most challenging events in endurance sport. They're trying to do more when their body may be telling them they need to be doing less. How do we manage their symptoms, and guide them up to the marathon itself? Find out in this podcast with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge 00:02:40 - Marathon training phases 00:09:08 - Training priority 00:11:41 - Manageable goals 00:12:27 - Discussing risks 00:13:59 - Short and simple rehab 00:15:23 - Hands-on treatment 00:17:17 - Case study
Is it time to turn your back on running? With the search term 'backwards running' becoming ever more popular, it seems more of use are putting our running into reverse gear. Converts say it bulletproofs their knees, but what evidence currently exists as to its benefits? Running physio Tom Goom (running-physio.com) sifts through the latest studies to give us an expert opinion on the pros and cons of backwards running. Hosted on Acast. See acast.com/privacy for more information.
How can you settle symptoms and make progress with patients, when pain is a significant barrier to performing the rehab that will help them get back to the things they want to do? Discover the five step process in this podcast with Tom Goom (Running Physio) to settle patients symptoms, overcome this barrier of pain, and help patients make progress with their rehab. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Chapters 03:05 - Screen for serious pathology 04:13 - Analgesic review 05:13 - Discuss the pain 06:09 - Identify and modify aggravating factors 07:58 - Reduce irritation 15:48 - Key takeaways
We have a very exciting podcast today where we chat about all things running and pregnancy!We are joined today by three Hong Kong based running ladies, first up for the introduction is Katy, a British physio therapist who specialises in pre and postnatal care and specifically the pelvic floor, she shares some valuable tips and advice for those new or mums to be. We then have two new trail running mums Sayaka and Elsa who have had babies in the last two years and they run with UGlow a Hong Kong based running team. They chat to us all about their experience with staying active whilst pregnant and their postnatal experiences. We had an honest and candid chat all about expectactions vs reality with becoming a mum + how it honestly was for them mentally and physically, they also share some great personal advice with you!This is a beautiful conversation from the heart and one not to miss!The resources shared in the podcast below:Return to run guidelines by Tom Goom, Grainne Donnelly and Emma Brockwell, https://absolute.physio/wp-content/uploads/2019/09/returning-to-running-postnatal-guidelines.pdftherunnerphysio.com@physiomumuk
In this episode, Rhonda and Dayna share our top tips when you're feeling the itch to return to running postpartum, such as:1️⃣ The research shows that it might be beneficial to wait until the 3-month mark to return to impact movements like running, jumping and skipping.2️⃣ Check in with a pelvic floor physiotherapist and/ or postpartum fitness coach if you have the means to assess your pelvic floor strength, tone and coordination.3️⃣ It might be a good idea to start with strength training (especially single leg exercises) to build the stability and capacity of your tissues.4️⃣ It might be a good idea to start with a run/walk combo and gradually increase your time and distance spent running to give your body time to adapt.5️⃣ It might be helpful to slowly ease back into impact movements (i.e. hopping, jump squats, jumping lunges) to prepare your body for running.
YouTube video of this episode Online Running Technique Analysis Discussed in this episode... 00:00:00 Introduction 00:01:54 What does the evidence say? 00:03:11 Overstriding 00:04:23 Vertical Oscillation 00:05:40 Knock Knees and Dropped Pelvis 00:07:17 What is good running form? 00:07:55 Cadence 00:10:43 How to fix your running form Cool stuff mentioned in the show... 00:14:44 Top 4 Running Form Tips based on Evidence | with Tom Goom, Physiotherapist 00:15:09 Online Running Technique Analysis More from Matthew Boyd Physio Free Online Course Running Fundamentals Subscribe to The Adaptive Zone Podcast Subscribe to The Adaptive Zone YouTube Channel Facebook @matthewboydphysio Instagram @matthewboydphysio Work with Matthew Boyd Physio Running Technique Analysis Running Coaching Running Injury Physiotherapy --- Send in a voice message: https://anchor.fm/theadaptivezone/message
What strategies can you recommend to your patients that are recovering from injury or increasing their training to help improve physical recovery? Athletes often use various recovery strategies such as ice baths, compression stockings, massage and more to improve their recovery, but are they actually effective? What key strategies are evidence-based and useful? Patients experiencing pain or a flareup may feel distressed or anxious. What mental recovery strategies can your patients use to help with these feelings of distress or anxiety? Find out in this podcast with Tom Goom (Running Physio), as you discover the key recovery strategies for physical and mental health. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge
Patients with anterior knee pain may have pain with activities that load the patellofemoral joint (PFJ), such as squatting, going up or down stairs, and running. When is it important to offload patients PFJ during your rehab, to help settle their symptoms? How can you design a rehab program to improve your patients' knee pain? Find out in this podcast with Tom Goom (Running Physio) as you discover how to effectively offload and treat patellofemoral joint pain, exercises to include in rehab, and activities and exercises to reduce during your initial phases of treatment. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Article associated with this episode: Hart HF, Patterson BE, Crossley KM, Culvenor AG, Khan MC, King MG, Sritharan P. May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis. British Journal of Sports Medicine. 2022 Feb 3.
Can shockwave improve pain and function in Achilles tendinopathy patients that fail to improve with rehab? Find out in this podcast as Tom Goom (Running Physio) reveals whether the latest research supports the use of shockwave in Achilles tendinopathy patients, and how to successfully return patients to running and rehab. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Tricky tendons - Your free video guide to tendinopathy treatment with Tom Goom. Discover a new, effective approach to treatment of tricky tendinopathy presentations, and lesser known tendinopathies with this free video series presented by Tom Goom (Running Physio) and hosted by Clinical Edge. Tom will reveal the secrets to successfully treat tendon pain, and get your patients back to running and sport quickly and easily, without stirring up their pain. Get your free access to this video series now. CLICK HERE for your access to three free videos with Tom Goom CLICK HERE for your access to three free videos with Tom Goom Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available. Links associated with this episode: Discover the simple secrets to successfully treat tendon pain in this free three part video series with Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Article associated with this episode: CLICK HERE to download the article associated with this podcast Abdelkader NA, Helmy MN, Fayaz NA, Saweeres ES. Short-and intermediate-term results of extracorporeal shockwave therapy for noninsertional Achilles tendinopathy. Foot & Ankle International. 2021 Jun;42(6):788-97.
Calf strains are common in runners, footballers, dancers and other athletes. Discover how to assess, differentially diagnose and tailor your treatment of calf strains using the latest evidence in this podcast with Tom Goom (Running Physio). Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Your comprehensive guide to ITB assessment & treatment with Tom Goom If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB). What causes ITB syndrome? How can you assess, diagnose and successfully treat it? CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering: Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid. Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now. Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients. CLICK HERE to get immediate access to this free ITB video series with Tom Goom. Lateral hip pain assessment, diagnosis & treatment video series To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available. Links associated with this episode: Successfully treat ITB pain with this free three part video series with Tom Goom. Improve your lateral hip pain assessment, diagnosis & treatment skills with 3 free videos presented by Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Article associated with this episode: CLICK HERE to download the article associated with this podcast The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians. Green et al., 2022
Calcaneal bony stress injuries or fractures are often misdiagnosed and incorrectly treated as insertional Achilles tendinopathy or plantar heel pain, leading to worsening pain and poor recovery. In this podcast with Tom Goom (Running Physio), hosted by Clinical Edge, discover how to accurately assess and effectively treat patients with calcaneal bony stress injuries or fractures. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Your comprehensive guide to ITB assessment & treatment with Tom Goom If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB). What causes ITB syndrome? How can you assess, diagnose and successfully treat it? CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering: Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid. Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now. Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients. CLICK HERE to get immediate access to this free ITB video series with Tom Goom. Lateral hip pain assessment, diagnosis & treatment video series To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available. Links associated with this episode: Successfully treat ITB pain with this free three part video series with Tom Goom. Improve your lateral hip pain assessment, diagnosis & treatment skills with 3 free videos presented by Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge Article associated with this episode: CLICK HERE to download the article associated with this podcast Italiano J, Bitterman AD. Diagnosis and Management of Calcaneal Stress Fractures. Radiologic Technology. 2021 Nov 1;93(2):177-94.
There is certainly no shortage of "advice" out there about running form. If your social media habits are anything like mine, you can't scroll down your feed more than two or three times without seeing some video or image depicting "bad running form" or "good running form" or some sort of transition between the two. Heck, I've put up quite a number of these posts myself! BUT! What does the evidence say? What aspects of running form have been shown to influence running performance? What about injury rates? These are very important factors to consider before you start messing around with your running technique. Today we are joined by the one and only Tom Goom, aka The Running Physio. Many of you will be familiar with Tom, over the last decade he has gained quite a reputation for his ability to translate running injury research into easy-to-digest messages. Tom teaches clinicians all over the world through his Running Repairs Courses and has written for Running Fitness, Men's Running UK, the British Journal of Sports Medicine and the Journal of Orthopaedic and Sports Physical Therapy. His website, Running-Physio.com is the go-to resource for clinicians and runners who want to know what the science actually says about running injury management. To put it simply, there is no one better positioned to give us a "thousand-foot view" on running form research. You will leave this episode with some very clear takeaways about what is important (and not important) when it comes to running technique. Click here to check out the full show notes Discussed in this episode Biomechanical factors that influence running form in terms of performance: Overstriding Hip Adduction Forward Trunk Lean Cadence (step rate) How Tom approaches running form analysis How Tom approaches running form modification Follow Tom Twitter: @tomgoom Facebook: @RunningPhysio Website: Running-Physio.com Courses: The Running Repairs Course (in-person or online) Cool stuff mentioned in the show Tom's Physio Edge Podcast Episode: Running Injuries - What are the most important factors? A group discussion with Tom Goom, Greg Lehman & Dr Christian Barton Chapters 00:00 Who is Tom Goom? 04:00 Tip #1 | Avoid leaning forward 12:15 Tip #2 | Avoid knock knee running 19:40 Tip #3 | Avoid overstriding 28:43 What about arm swing? 32:51 Tip #4 | Increase your running cadence 41:26 Can we reduce injuries through technique? Follow Me Instagram: @matthewboydphysio Facebook: @matthewboydphysio Twitter: @mboydphysio YouTube: Matthew Boyd Would you like your running or triathlon questions featured in a future episode? Just click here to leave me a voicemail. Music By The Passion HiFi --- Send in a voice message: https://anchor.fm/theadaptivezone/message
When patients have a running injury, such as knee pain or Achilles tendinopathy, do we need to include strength training in their rehab? Discover when strength training is an important part of comprehensive running injury rehab in this podcast with Tom Goom (Running Physio), and explore: Whether strength is important in runners. Whether patients that are stronger are less likely to develop running injuries. Why recent research found higher levels of strength in recently injured runners compared to uninjured runners. When we need to improve patients' strength in running injury rehab. Can strength training reduce the risk of running injuries? How strength training fits into a comprehensive rehab program. When strength is relevant to pain and pathology. When rehab does NOT need to include strength training. How to know what to focus on during rehab. Which patients don't require exercises or strength training. How to identify when strength goals are a barrier to recovery and return to running. Additional benefits of strength training, beyond improved strength. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Your comprehensive guide to ITB assessment & treatment with Tom Goom If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB). What causes ITB syndrome? How can you assess, diagnose and successfully treat it? CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering: Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid. Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now. Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients. CLICK HERE to get immediate access to this free ITB video series with Tom Goom. Lateral hip pain assessment, diagnosis & treatment video series To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Links associated with this episode: Successfully treat ITB pain with this free three part video series with Tom Goom. Improve your lateral hip pain assessment, diagnosis & treatment skills with 3 free videos presented by Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge
When your patient with Achilles tendon pain isn't progressing as well as you hoped, could Plantaris be implicated in their pain? Find out in this latest Physio Edge Track record: Running repairs podcast with Tom Goom, where you'll discover: Plantaris anatomy and relationship to the Achilles tendon. Common symptoms when Plantaris is causing Achilles tendon pain. How to differentiate Achilles tendinopathy from Plantaris involvement. Why patients with Plantaris involvement may not progress with a tendon loading program. How to adjust treatment when you suspect Plantaris involvement. When Plantaris patients can return to running and hill running. Additional medical and surgical management when Plantaris conservative treatment doesn't resolve symptoms. Enjoy this new podcast with Tom Goom now to improve your treatment of Achilles tendon pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Your comprehensive guide to ITB assessment & treatment with Tom Goom If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB). What causes ITB syndrome? How can you assess, diagnose and successfully treat it? CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering: Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid. Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now. Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients. CLICK HERE to get immediate access to this free ITB video series with Tom Goom. Lateral hip pain assessment, diagnosis & treatment video series To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs Links associated with this episode: Successfully treat ITB pain with this free three part video series with Tom Goom. Improve your lateral hip pain assessment, diagnosis & treatment skills with 3 free videos presented by Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge
What do foam rolling and stretching do to the ITB? Are they effective in the treatment of ITB syndrome? Find out in this podcast with Tom Goom (Running Physio). Your comprehensive guide to ITB assessment & treatment with Tom Goom If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB). What causes ITB syndrome? How can you assess, diagnose and successfully treat it? CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering: Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid. Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now. Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients. CLICK HERE to get immediate access to this free ITB video series with Tom Goom. Lateral hip pain assessment, diagnosis & treatment video series To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom Links associated with this episode: Successfully treat ITB pain with this free three part video series with Tom Goom. Improve your lateral hip pain assessment, diagnosis & treatment skills with 3 free videos presented by Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge
Stress fractures and bone stress injuries in running patients need to be identified early, to allow recovery before the injury worsens and requires extensive time away from running. When should you suspect a stress fracture or a bone stress injury (BSI) in your running patients? Find out in the podcast with Tom Goom (Running Physio), and explore: How to identify stress fractures & BSI's in your patients. Which patients are at greater risk of developing BSI or stress fractures? Features in your patient history, including past & medical history, onset & aggravating factors that increase your suspicion of a stress fracture. Which BSI's are “high risk”? Common training errors that lead to a stress fracture. What tests can be performed in your objective assessment to help diagnose stress fractures? How to differentiate tendon pain from bone stress injuries Will bruising or swelling appear with bone stress fractures? How palpation can help your diagnosis Why common assessment tests are often painfree in bone stress injuries. When imaging is important. Which imaging modalities to request when you suspect a stress fracture or BSI. Improve your identification and assessment of stress fractures and bone stress injuries now with this podcast. Your comprehensive guide to ITB assessment & treatment with Tom Goom If you treat runners, walkers, cyclists or rowers you'll regularly see patients with lateral knee pain from an irritated iliotibial band (ITB). What causes ITB syndrome? How can you assess, diagnose and successfully treat it? CLICK HERE to get immediate access to a free three part video series that will help you successfully treat ITB pain, covering: Video 1 - Discover what causes ITBS, how to explain it to your patients, and 2 treatments you NEED to avoid. Video 2 - How to quickly & accurately assess ITBS, other potential diagnoses, and a common ITB test you can stop doing now. Video 3 - How to successfully treat ITBS. You'll explore practical demonstrations of exercises, gait retraining, load management and treatment you can use to get great results with your ITB patients. CLICK HERE to get immediate access to this free ITB video series with Tom Goom. Lateral hip pain assessment, diagnosis & treatment video series To improve your lateral hip pain assessment, diagnosis & treatment skills, CLICK HERE for your access to 3 free videos presented by Tom Goom Links associated with this episode: Successfully treat ITB pain with this free three part video series with Tom Goom. Improve your lateral hip pain assessment, diagnosis & treatment skills with 3 free videos presented by Tom Goom Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Tom live on Facebook & ask your shoulder related questions every Friday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Tom Goom on Twitter Tom Goom's website David Pope - Twitter David Pope & why I started Clinical Edge Review the podcast on iTunes Infographics by Clinical Edge
In this episode, we have Tom Goom with us again to join us with our running injuries and running rehab talk this March. Today we will be talking about acknowledging types of persistent pain in our athletes or runners. He talks about the bigger picture on persistent pain and its other connections, differentiate this persistent pain versus series of acute flare ups, where we should focus the treatment, and navigating injured athletes return to their sport and many more. Key Takeaways we mustn't lose sight of the bigger picture. And actually, I think sometimes we do need to acknowledge that it is more of a persistent pain state, and not necessarily a series of flare ups of acute injury. Gritting your teeth and pushing on through isn't always the right answer… we do need to know when we need to back off a little bit. Focus on getting you well and ready to race rather than rushing you to get through a particular event when you've got a whole life of running ahead of you. Try and see if you can recognize when you are looking at a more persistent pain state and to try and really get to know that person and the bigger picture and what's driving that Suggested Keywords: Pain, athletes, running, persistent, bigger picture, acute injury, symptoms. More about Tom Goom Tom is physiotherapist and international speaker with a passion for running injury management. He has gained a worldwide audience with his website running-physio.com and has become known as The Running Physio as a result! Tom remains an active clinician committed to providing high quality, evidence-based care. Social media handles: Twitter: @tomgoom Instagram: @running.physio Website: Running-physio.com Resources: Running Injury and Rehab Webinar NetHealth Webinar Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts: https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify: https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927 Read the Full Transcript Here: Speaker 1 (00:01): Hey, Tom, welcome back to the podcast. I'm excited to have you on today. Speaker 2 (00:06): Thanks for having me back. I really enjoyed it. Last time we took proximal hamstring. Didn't we last time it was a good chat Speaker 1 (00:13): We did. And now this time you are part of the month of March and this month we're talking all about running injuries and running rehab. So what we're going to talk about today is persistent pain in these athletes. And I know this is something that you're seeing more and more of. So let's dive in what let's talk about as physical therapists or physiotherapists. Do you feel that we're acknowledging these types of persistent pain in our athletes or in our runners? Or are we just thinking, Oh, well, you know, they have this tendinopathy or this strain and it's just keeps recurring. It's just like a, it gets better and then becomes an acute injury again or this back pain. Oh, same thing. It, it kind of goes away and comes back. So what, what is your opinion on that? Are we acknowledging persistent pain in these athletic populations? Speaker 2 (01:20): Yeah, that's a good question. I think maybe we D we do look at it a bit more, like you're saying, we just kind of see it as a sort of repeated acute injury may be large rather than seeing it as a persistent pain problem. And I think that's because in part, when we see people with persistent pain, part of our, of our advice and our management is for them to be active. So if you've got someone to come see seeing you, that is actually already sporty, they're already active that, you know, you kind of think, well, what else needs to be offered here? And I think sometimes we don't really think about the sort of psychosocial practice in sporty or active people, because they're not obviously fear avoidance, especially if they're keeping their sport going. So we, we tend to go down the route. That's perhaps a bit more biomedical isn't now we looked at biomechanics, we look at strength and conditioning and these all can be valuable, but we mustn't lose sight of the bigger picture. I don't actually think sometimes we do need to acknowledge that it is more of a persistent pain state and a, not necessarily a series of flare ups of acute injury. Speaker 1 (02:24): How do we differentiate this is persistent pain versus a series of acute flare ups. Speaker 2 (02:30): Yeah, I think there's going to be an overlap between those things. We know that people with persistent pain that isn't necessarily stable with change can change quite a lot. People go through periods of quite severe flare ups as well. I think it's about sort of looking at the bigger picture and looking at the connection between things like pain and load. So in, in an acute injury situation with something like tendinopathy, quite often, there is quite a clear load pain relationship. It hurts when I load it. It doesn't hurt when I don't, I'm in a more persistent pain state. We might actually see that that relationship becomes a lot more blurry that the pain may well flare up when load hasn't changed or the pain may remain present. When there isn't a great deal of loading going on. So we start to see a bit of a breakdown of that connection between load and pain. And perhaps you start to see other aspects influencing symptoms, you know, lack of sleep, stress, fear, et cetera. We see other sort of types of behavior creeping in there as well around maybe avoidance coming in. So now they are backing away from their sport. So I think that's something we need to have a lookout for particularly that lack of relationship between load and pain and then exaggerated pain response as well. Speaker 1 (03:48): And when we're looking at these more sporty athletic people are runners how do they differentiate from say maybe our non sporty or non-running population? Speaker 2 (04:01): I think that there will be some definitely some, you know, some crossover between different people in different groups. And I really would, you know, w I use the term athlete, but I, I have a really broad definition of that. Someone, someone who wants to be regularly sporty and active fits that category for me. So I'm not necessarily necessarily when I say athlete referring to an elite athlete, competing at a high level, this, this can be people that want to be running three or four times a week, that really comes in that category too. But I think they can have, you know, similar concerns to someone that's not sporty around pain and damage, for example. So they might have similar concerns there. They might both have quite high life load which is a term I quite like this, somebody mentioned in one of my courses recently. Speaker 2 (04:49): So, you know, this is where you've got lots of stress going on with, with work and family life this kind of Highlife load that plays upon your pain. And they may also both groups have poor recovery. So, you know, athletes may not be brilliant sleepers non-athletes may not be brilliant. Sleep is too, they might not get much downtime much emotional recovery. So there can be quite a lot of of overlap. I think perhaps where they differ is they may have quite different goals. So I think it's, I see Mike might have wanted to go back to running half marathons, marathons, ultra marathons, and beyond potentially. So that might be quite a different goal to non-athletes that want to be more functional with day to day activities or lower level activities, perhaps like walking distances and perhaps something that we do see in athletes. Speaker 2 (05:38): That can be different though. Again, we see this in non-athletes too, is they may be a bit more inclined to push through pain. Most of us that have done sports at any level will know that pain is quite often a normal part of sport. And to some degree we do have to work with it. If, if we stopped every time, something we we'd never really, really do sport for very long, but this isn't necessarily always the right approach, gritting your teeth and pushing on through. Isn't always the right answer. And it's not always obvious that that's the case, but sometimes actually we do need to know when we need to back off a little bit. I'm an athletes particularly really highly driven athletes may not be quite so good at recognizing when they need to back off. Speaker 1 (06:21): Yeah, that's for sure. Especially if, like you said, they've got this goal of, I want to run a half marathon and marathon or an ultra to be able to, to have to abandon that goal due to pain, persistent pain or injury is, can be very devastating. Right. So how do you, how do you navigate that with your athletes and with your runners, especially with a more persistent pain, how do you navigate that? Very, I would say very sensitive goal or topic with these, with these runners or athletes. Speaker 2 (06:58): Yeah. It's not, it's certainly not easy. I think it's it can be challenging. I think wherever possible, we want to try and invite them to review their expectations and goals. So that it's not necessarily us being prescriptive and saying, this isn't realistic, or you're not going to achieve this, but if we can help them have slightly more fluid expectations of themselves and slightly more realistic goals, the ideal world then is that they then come around to the idea that perhaps this marathon they've got on the horizon, if it's not realistic for them, that they can set a different goal with it. And th this is one of the things, again, sometimes with, with higher level athletes, certain personality types is that being, being able to persist is a good skill, a good good thing to have, you know, and you need it when you get to sort of modulating 19 in the marathon and your legs are heavy. Speaker 2 (07:50): And, you know, you've got to keep going to hit your target. Tom, you need that in the time. You've got to have that level of persistence. And, and for that to be at least a little bit rigid because you you've got to, if you're going to achieve that goal, you've got to keep going, but to keep going at a certain time. So at times that rigid persistence is useful, but if you apply that all the time when circumstances are changing and your expectations are rigid, it doesn't really work very well. So for example, with the situation's changed, you're now in quite a lot of pain, you're struggling with day-to-day activity. This marathon is, is a lot closer now than, than we would, would like it to be. Ideally we have to try and encourage them to be a bit more fluid there and say, okay, well perhaps what we need to do is change that goal a little bit. Speaker 2 (08:37): Let's push it a little bit further down the line, give ourselves a bit more time and helping them see the positives of that decision can help. So you all often say to them, well, you know, if we can, if we can move this, you know, a few months down the line or let's go for a half marathon or a 10 K, it's going to take the pressure off you. You're not going to feel like you're constantly chasing your tail because you're trying to catch up with the training. You're not able to do. You're going to be able to focus on the rehab side of things. You're not going to feel so much pressure, and we can really focus on getting you well and ready to race rather than rushing you to get through a particular event when you've got a whole life of running ahead of you. Speaker 1 (09:15): Fair, very fair. And, and I think that's great for clinicians to hear, because I think that wording is very sensitive to the, to your patient and also gives them the goal gives them that aspirational goal that they can eventually get to. So I think that wording was great. Thank you for that. Now here's a tough question. And, and I don't know all the answers to this one, but in your opinion, and in your experience, what do you feel may be driving persistent pain in these runners or athletes? Speaker 2 (09:53): Well, we had us, that's a good question. Isn't it? A million dollar question and I would acknowledge I don't, I certainly don't have all the answers with this, and I don't think the research does yet either because it's an area, you know persistent pain in athletes isn't brilliantly well researched. So I think there's a lot that we can, we can learn about this, but there's a few things that would, I think, would spring to mind here. So I think beliefs are important. So and this is, can be beliefs around what the pain means. And then they, you know, what the pain means is if it's, if it's a sign of damage if they think it means they need to stop their exercise altogether, how they feel their body's gonna respond to exercise when they have pain that continuing to run, for example, will that be more harmful for them? Speaker 2 (10:38): It can be around beliefs around training too. A lot of people will feel that unless they're pushing themselves a hundred percent in every session it's not worth doing. So that can be quite difficult then for them to pace themselves and modify their training because it kind of all or nothing really. I think one of the things that I'm realizing more and more over the years working with with people and athletes is if they are quite heavily reliant on the sport for their mental wellbeing, then that can have a bigger impact too, because they might be using that, that sport to help them with their mood or anxiety or depression. So if they can't do their sport, it increases the impact of the injury. And I think it increases the fear associated with that because they're losing this coping strategy, they're losing physical fitness, they start to worry about the future. Speaker 2 (11:27): And I think maybe that links in with pain science, because it increases the threat that this injury has, and that has the potential then to have a knock on effect in terms of the pain and increasing pain severity and things. And a lot of these things are interlinked. I think training behaviors go hand in hand with that, you know, tending to push yourself hard all the time, boom, or bust, things like that. I think there's also a lot of stuff that we might not necessarily, we see like negative messages from others. So other other athletes, sometimes coaches, health professionals, unfortunately I'm so pumped. Sometimes we can be responsible for that life. I've treated lots of runners. Who've been told that they should never run again, for example, by various different health professionals. So we need to be aware of that. I think Google might have a lot to answer for I don't, I'd love to know. I think you've been Dr. Google doc to goo exactly. I don't, I don't know many situations where someone's been worried about something and put it into Google and felt better. Speaker 2 (12:31): What you find is the worst case scenario from it, which does amplify, you know, it does amplify people's worries. And that's actually something as a clinician, I would check in with your patients about what what'd you do when you worried about this? Did you go and Google it? What'd you find when you Google it? How does it make you feel? Because quite often they'll find the worst case scenario and I feel a lot more worried. So we want to discourage them from doing that, come to us. If you've got questions about your care, that's what we're there for really. So there's a lot of things that also impact of the injury, perhaps not being fully addressed. So you know, looking beyond the kind of physical impact of the injury, but the loss of the social side of the sport, the loss of their identity around sport the effects, as we said, it might have on mental health. Speaker 2 (13:18): There's lots of other things that go alongside the injury that often don't get talked about. And if they're not addressed, I think they can amplify it as well. And then the final thought I would add to this is perhaps if not had really particularly appropriate rehab it may be, it's been very focused on pain and not really focused on function in maybe that it's not been progressive and it's not really looked to address their rehab needs, lots of stretching and foam rolling and, you know, ice and, but no real kind of planning and progression in that. Speaker 1 (13:50): Okay. So that leads me to the next question as clinicians, where should we be focusing our treatments? Good segue there. Speaker 2 (13:57): Yeah. I like the connection. You've done this before, I think. Yeah. Yeah. I think, I think he's got to start in the first session with trying to develop an understanding for that person, if we can help them to, to understand their injury. And it takes time to build on that, but really make that part of that first session and give them the opportunity to share their story in that first session and also to air their concerns. You know, I really think we want to make the focus of these treatment sessions on the patient and their needs, not necessarily a kind of a list of things we need to tick off to do in a session because there is actually research showing that quite often, people whose needs aren't really identified we can be quite dismissive as clinicians. So we want to get in there right in the early, early stages and say, you know, what would you really like to, to from, from your treatment? Speaker 2 (14:52): What are your concerns? What are you particularly worried about here? What would you really like us to help with? Because we can start with that. I think that helps us form a good, strong connection. We can really help them understand the injury and build on it from there. I think that alongside shared goal setting, I think big PA plan of I'm a big fan of collaborative working you know, so you're working towards their goals. How can we help them achieve those goals together? And again, get a good idea of those in the first sessions. And it is part of the reason I really love working with rhinos is because many of them have a goal. Even if it's just, they want to get back to running 5k, you know, great, brilliant. It's a measurable goal. We can start the planning towards that pretty much from, from session one. Speaker 2 (15:37): And then we do want to have some progressive rehab because they're all gonna be psychosocial factors. In many cases, we've talked about, you know, beliefs to address perhaps poor recovery load management to talk about that quite often, there are physical needs as well. So we need to address those if there's a lack of strength or control or range and address them in a progressive way, as opposed to just loads of stretching and rolling, and then we can start to do a graded return to sport when, when they feel like they're physically and psychologically ready to engage in that. Speaker 1 (16:10): And what are some, some examples that maybe you can give of the types of diagnoses or the types of patients that you're seeing coming to you with persistent pain, you don't have, we don't have to go into, you know, the specifics of how you treat XYZ, but what are some things that you might be seeing in your patients coming to you with persistent pain? Speaker 2 (16:36): So I, I do specialize to some degree in tendinopathy. So we will see a lot of patients with long-standing tendinopathy lots of patients with proximal hamstring tendinopathy, because that's particularly the area I've researched in. But it will say Achilles tendinopathy issues as well. See people with low back pain and hip pain as well, falling into this category people with persistent patellofemoral pain syndrome persistent bone stress injuries, like medial tibial stress syndrome. So it's do see quite a mix. And, and many of those will have been treated first and foremost in quite a kind of biomedical model. I think, Speaker 1 (17:16): Yeah, so I think I just wanted to ask, cause I think it's important that clinicians out there hear like, Oh wait, you can have a persistent tendinopathy problem. You know, you can have like, Oh, I, I wasn't aware. I thought, you know, after let's say proximal hamstring after a year of rehabbing, if that kind of comes back, Oh, it's probably just like a muscle strain. It's probably not that tendinopathy again or, or not again, but it continuation of that. Absolutely. Yeah. And Speaker 2 (17:50): To give you a clinical example then, because we talked a little bit about how the connection between load and pain can be blurry about how that may, we may see an exaggerated response. So to give you an example of that proximal, hamstring, tendinopathy patient that I've been working with who will not be able to sit for more than maybe 30 seconds because that will really cause a flare up in their symptoms. Now we can see then that's a, that's a really exaggerated pain response. And the average person sits for somewhere around six to seven hours a day. So not to be able to tolerate even 30 seconds of sitting because there's pressure around that that tendon is, is an exaggerated pain response. And that person's pain will fluctuate not necessarily in line with load. So there'll be days where her symptoms are much worse and she doesn't really know why it's not because she's run a long distance or done anything different. Speaker 2 (18:53): The fluctuations in activity levels might be small in the range of a few minutes here and there. And yet the pain response is really exaggerated. And again, I talked about sort of beliefs and things go going into, you know, going into this area. And when we talk to this particular person about her beliefs, you can see she's very concerned that sitting damages the tendon and therefore that adds to the threat value associated with the city. She's very fearful of sitting when you ask her to do it, you can see she's really reluctant, but also we need to acknowledge why it really hurts. It's really hard for a long time. So there should be no judgment and our pie, we should be reckless. Yeah. This is really difficult. This is having a huge impact on this person's life. Can't if you can't sit down and even to have a cup of tea or to watch a move at the end of a long day, what should we eat dinner? Like that's big. So I think we have to recognize that as a persistent pain picture and with aspects of tendinopathy in there that we can manage, but just seeing it, like you say, as, Oh, it's just another flare up of the proximal hamstring tendon. We were missing that bigger picture, I'd say. Speaker 1 (20:01): Yeah. And that was a great example. Thanks for that. And now, you know, when we talk about running, we talk about athletes. So one thing they all want to do is they want to return to their sport. So can you talk to us a little bit about how we navigate that, how we prepare these people to return to their sport and what that, what that sport may look like? Speaker 2 (20:24): Yeah. I think, I think maybe we start, if we can, by seeing if we can reduce irritability a bit where possible. So if we think back to that lady, I was talking about Verrier to boost symptoms at the moment. So if I go straight into a greater return to running, I think that's probably going to be a little bit too much to start with. So in many situations we may we say, okay, let's see what we can do to reduce the symptoms and irritability helping someone understand their pain and that it's not a sign of damage can help helping them work out a list of things that may help to reduce their pain. Maybe particular exercises that help simple things like, you know, using heat or ice if necessary, but trying to give them strategies and work with them. So they've got a little bit of a list of things that can turn that, that pain volume down a little bit, and we're placing them in a bit more control, reducing that threat value. Speaker 2 (21:17): And then we can start to work towards that graded return to sport. And again, if we want to plan together because we really want the person to be in the driving seat and us maybe just helping, you know, being a bit of a satnav along the way to keep them on track. So we've had this recently really lovely runner I've been working with who in the first session said to me you know, what she'd like to do is first of all, build some strength then increase her cardio fitness by bringing in a bit of cycling and swimming. Then she wanted to bring in some, some impact and some plyometric exercises before doing a graded return to running. And I thought immediately, brilliant, this is fantastic. This person has a great plan. Speaker 1 (21:57): And they find this woman, Speaker 2 (22:00): I met wonderful one, and this, this is someone with a lot of experience in sport. Who's also studied a sport of science, so knows the topic really well, but that's a fantastic plan. Let's go with that plan and just help the person with their plan there. So, and we might follow quite a similar plan to that for, for patients. You know, we try and calm things down where we can, we build some strength to try and address some of their physical needs. We bring in some cardiovascular exercise to build some fitness up. We start to introduce impact because it can build impact tolerance, but it also is often a a way of developing some power. So perhaps some plyometric exercise to restore power, which is often neglected in rehab. And then we start to do a graded return to running and that's then where we got to try and work with them around their goals and also work with them around pain. And that can be a bit of a barrier. Speaker 1 (22:53): Yeah. And so how much pain is acceptable? How much is too much? Yeah. Speaker 2 (22:59): Like our pain scales you know, sort of scoring pain out of 10. And I, I would say there's actually quite a few studies that have done that quite successfully. So I think there's some value in that. But what we've talked about with these pain groups is that the connection between load and pain, isn't very clear and the pain response is exaggerated. So if we're guided purely by pain, we are going to struggle a little bit, I would say with these patients. So I would tend to say that the patient needs to decide what they feel is acceptable, and we provide some, some guidance. And we need to try, and if we can look at longer term trends, then now patients quite understandably might get very focused on day-to-day pain fluctuations, but it's actually more the long-term in pain over the, over the weeks and months that we're a little bit more interested in. Speaker 2 (23:49): And we also perhaps need to recognize that there are almost two slightly separate goals here, improving function and improving pain. If you're seeing improvements in function and pain, hasn't changed, that's still a win because you're doing more. In fact, that's quite good when, because you're doing more and your pain doesn't get worse, but patients often won't see that as a win because understandably they may want that pain to go away, but we can often folks first will say, okay, well, let's start with what you feel is a manageable level of exercise. Let's work with it consistently. First of all, and then gradually build as long as you feel the pain is, is an acceptable level. And sometimes what we tend to see then is over time, they're able to do more and more, and then gradually that pain does subside because they're able to do more. Speaker 2 (24:39): They're more confident they're starting to get their life back. The threat value of the pain is starting to go down, but that takes quite a long time. So I think quite often, wherever possible, placed the focus a bit more in function and just save the patient a few phone that feel that it's manageable. It's acceptable. This is fine. If it's too much, if it's not manageable, we'll dial it down a little bit, but we want, if we can to stay consistent with exercise, because otherwise we're going to have a lot of beam, bus tear will build you up and stop they'll drop and stop. We want to just see, can we keep you ticking along, even if it's at quite a low level Speaker 1 (25:13): And do you have your patients keep a log or a journal or some way so that they can see, Oh, I was doing this. I started with Tom on March 1st and here it's April 1st. And this is what I was able to do Marsh. Now this is what I can do in April. My pain's around the same, but look at how much more I can do, or maybe my pains a little less. Or do you, how do you keep track of all that? Do you give that to the patient to help them with their own sort of locus of control? And are you using the pain scale? Are you saying well, what is your pain March 1st? Let's compare that to April 1st. Let's compare that to March 1st. Speaker 2 (26:01): Yeah. I would try and see if we can monitor that goal activity because it's important to be able to see that they're improving and they're progressing towards their goal. If you've got quite a specific goal, like running a 5k in order to get that, you've give it a C you know, how, how far you're able to run. And that's the simplest question. How far can you run now? But that can be it could be steps for day. If someone's wanting to build up their walking, it could be minutes rather than miles with any activity, really. So I think it's a good idea to try and monitor what people are doing. I do, I do use the pain scale a little bit. It depends on, on how comfortable the person is with it, whether they like using that. I tend to perhaps make it a little bit more simple and just say, is your pain mild, moderate, or severe sort of break it down into those into those three sort of different categories, really. Speaker 2 (26:58): But the thing is with pain is there's so many different aspects of it. Are we talking about average pain day to day? We talking about peak pain. What did the pain get up to is it's at its highest, we're talking about pain frequency. So how often you've had that pain during the day, are we talking about pain distress, which I think is almost a separate thing. How distressing are you finding that pain? So if you're especially worried about it, that pain often will be more distressing, even if the severity isn't necessarily higher. Do you see what I mean? So I think, I think where possible we focus on the golf function and we, we try and take that focus off pain a little bit because as well, you know, if patients are monitoring it every day, that drawing that focus on pain every day, and they're asking ourselves, how much does it hurt? Speaker 2 (27:47): Even some patients have no one used the term morning MRI. I used to get up in the morning and do it, do a sort of stretching test on his Achilles. That was what he called his morning MRI to test the Achilles out and see how he thought it would be that day. We don't really want to do that. To be honest, we want to focus on what your valued activities let's really try and bring them back in, build those up and keep a kind of a little casual, casual notice of pain, let pain tell us if it's too much, if it's breaking through, into your attention and in telling you it's too much, that's probably when we need to act, if you're looking for it, if you're, if you're kind of really questioning, is it worse today? I'm less concerned about it. Speaker 1 (28:26): Got it. Yeah. So you don't want them to, you don't want your patients to be waking up and be like, wait, do I feel, do I feel more pain today? Weight you're you're well aware that you have pain. Speaker 2 (28:38): Yes. Yeah, absolutely. I think that calling is focusing on the pain as well. It's quite, it's quite a normal thing to do. I think we've kind of pathologized it a little bit. But I think actually it's understandable for people to do that. There's another layer of context around the pain and what it might mean and what that might mean for your, for your future. So I'll give you an example from myself. So I have I have psoriasis and I have nail bed changes with psoriasis and that increases the likelihood of you developing cirrhotic arthritis. So a couple of weeks ago and surfing on Twitter and someone posts a link to a research paper that says new studies shows link between nail bed changes and severities, psoriatic arthritis. And I start thinking, yeah, my fingers are a bit sore today, you know, and that's one of the areas where you can get psoriasis, arthritis, changes in the joints and the fingers. Speaker 2 (29:41): And then I throw it comes back a little bit later that day and for a few more days afterwards, and now I'm sort of noticing like achy thumbs hands are a bit stiff in the morning. And if I allow myself to keep focusing on that and measuring that and worrying about that, it would be understandable that that could become really quite a worry for me, because then you think, well, is it cirrhotic arthritis? That's been, that's known to actually affect the joint and perhaps even damage the joint. And if I've got nail bed changes, that means it can be very severe. And what impact would that have on my life? And these are all just normal things that we have as, as people, as health professionals that know quite a bit about pain. So I think we can acknowledge for someone who's not a health professional. Speaker 2 (30:25): There's probably a lot of that going on, particularly the pain's been there a long time and pains is a real nuisance because it can, you can kind of like stop worrying about it. And then, then you have the pain and it kind of reminds you and goes on about you and that can start worrying prices over again. So it is hard. And I think sometimes it's health professionals, we think like, well, I talked to them about their pain and I reassured them that pain doesn't damage tech. But that if you think that that is enough to wipe out that concern, we are. Yeah, but we may need to be consistent with that message several times. And we might need to encounter that worry coming up several times and to try and help someone contextualize their symptoms and to see that not what they're fearing, but what really is going on. Speaker 2 (31:18): And to look at a bit the now of how symptoms are. So with my hands, you know, I don't have any of the classic signs of cirrhotic arthritis. I don't have swelling. I don't have a loss of joint range. I've actually been tested for psoriatic arthritis and it was negative. So it was trying to contextualize it and see the reality is I've just turned 40 and I've got slightly stiff fingers. That's the reality. So let's focus on the now and what is real for you now and not what you fear might be coming up in the future. Speaker 1 (31:47): Yeah. And that's something that I say to myself every time I wake up and my neck's a little stiffer sore, you know, my upper back feels a little sore instead of my, what I used to do is, Oh, okay. I better not go to work today. I better just relax. Let me get a heating pad. Let me just, I don't want to do anything. I should probably just lay down. And these are all the things I used to do. And so now when I wake up or if I do have a flare up of neck pain or something like that, now I'll just say, okay, I know nothing is seriously damaged. I have the MRIs to prove it multiple. And you know, these are just things that I have to continually say to myself. And I think I'm pretty well versed in, in the science behind pain and, and even working with people with persistent pain. I mean, I do it every, but even for myself, I have to continuously sort of recite these mantras to myself in order for me to get through the day when I have a little bit more discomfort or pain. So the struggle is there, you know, and I think imparting that and telling that to your patients, especially your runners with persistent pain. I think that can be very powerful. Speaker 2 (33:07): Yeah, absolutely. And, and recognizing, as I said, the bigger picture of knowing the person and, and the things that make them make up them as a person. And if they are, for example, running to their mental wellbeing, what, what, what is the, the thing that, that they're running to help? And how does that link to their pain? Are they running to help anxiety? In which case are they someone who is perhaps going to struggle with negative thoughts about chain, and they're going to be drawn into ruminating about those negative thoughts about pain, and they're going to be looking for reassurance that those thoughts, you know, jumping on Dr. Google, I'm finding actually it makes it worse because they see all the negative outcomes they're afraid of laid out on a web page. So if they are someone with, with that, then they, they may need more, more help with that. They may need to, you know, you may need to work with a mental health professional to help them work with those thoughts and to find ways perhaps to not get drawn into that ruminating pattern and to look for other coping strategies, we show it to them. The long-term can be useful because they're less reliant and upon the sport, because they actually learn perhaps a slightly different relationship with that, with their thoughts and from that, then can help that their mental wellbeing. Speaker 1 (34:22): Yes. I agree with that. And Nelson, before we kind of wrap things up is there anything that we missed or that maybe we flew by a little too quickly that you want to elaborate on? And if not, what would be your best advice to a clinician that is working with AF that is working with people with or athletes with persistent pain problems? Speaker 2 (34:54): I think in terms of things we might have missed, I just would say that there's a, there's a nice paper from Halon as torn in 2017 that's well worth a look, which is, is actually looking at things a little bit more in terms of pain in athletes. And there's, there's quite a nice quote in that that I'll just briefly read now if that's the case. So they say even low level inflammation, for example, linked to sleep deprivation, ongoing stress and load exceeding the tissues capacity can reduce the athlete's mechanical nociceptive threshold sufficiently to make normal mechanical demands of sport painful. So that sort of Lincoln into this bigger picture stuff saying here, actually, if we're not recovering enough, or the load is excessive on the tissues, it's actually going to have an effect potentially on sensitivity know nociceptive threshold. Speaker 2 (35:49): So this is where it's quite important for us to see the bigger picture. They also say in that paper that the, the link between tissue change and pain is thought to reduce over time. So if you've got someone with very persistent symptoms, years' worth of pain, you should already perhaps be suspecting that this is probably not just going to be driven by the tissues. I mean, when is there ever a situation where pain is, but, you know, it's probably going to be a bigger picture here that we need to identify. And I think that's probably one of the key messages to take from what we've talked about. Hey, really, you know, you, you start right with the first question is perhaps just to, to try and see if you can recognize when you are looking at a more persistent pain state and to try and really get to know that person and the bigger picture, and what's driving that because then I think you're going to get better results with them and then try and see if we can work gradually towards their goals and just keep them on track with it and give it time. Speaker 2 (36:45): It will take time, you know, this, the patients I'm seeing, we're looking at at least six months, probably a year of working together because there's so much to work through. I think we sometimes say, Oh, we reassured them about their pain. Give them some exercises away. They go, it's not really like that. You know, it's going to be lots of ups and downs. We're going to have to stick with them for a while and just keep chipping away, but you can get some really good results with people and you can get them back to the sport that they, that they love. And that can be a really, really big thing for them. Speaker 1 (37:13): Yeah. that's a great way to to end our conversation here. One, one question, what was the, who's the author of the paper from 2017? Speaker 2 (37:26): I think it's Hamline at all. I believe it was in the but I can find a link to it for you to put in the, in the show notes, if you would. Speaker 1 (37:36): Perfect. That would be great. And I will look it up as well. But thank you for that. Now before we finish our conversation, where can people find you? If they have questions? Speaker 2 (37:48): Yeah. Come and say hello on on Twitter, I'm at Tom goo or an Instagram ad running dot physic. Also I've got my website, which is running-physio.com. So yeah, come and say hello, ask questions and things. So it's good to chat. Speaker 1 (38:03): Perfect. And last question. What advice would you give to your younger self knowing where you are now? And I know we've, you said this before is, and I have to say something different. Now you get a chance to give yourself a second piece of advice. Speaker 2 (38:16): Oh, good question. Oh now that I'm thought 14 spending a bit on top, I'd, I'd say really enjoy your hair while it's there. Yeah. now I don't know, in all seriousness, I think I would probably sort of say you know, really make sure that you kind of value value, that things are important in life friends and the family, you know, always, always try and put those things first because ultimately they're, they're the things that are most important for us. And I think a lot of people already know that and I've learned it, especially during COVID, but I think there's a lot to be said about, you know, focusing on family and friends and things first you can still have a very fulfilling career and things, but I think that that's the important, the important stuff. That's what makes, makes life great. Really Speaker 1 (39:08): Excellent advice. Well, Tom, thank you so much for coming on to the podcast again and sharing all this great information with us. I really appreciate your time. Thanks for having me back here. And it's been really good pleasure, pleasure, and everyone. Thank you so much for listening. Have a great week and stay healthy, wealthy and smart.
Today Brodie reads through a 2016 paper published by Tom Goom, Peter Malliaras, Michael Reiman & Craig Purdam. The paper title is: Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management. Brodie discusses the assessment and diagnostic process with PHT and then dives into load management and the 4 stages of PHT rehab. Here is a link to the paper Click here to learn more about the PHT video course & to receive your 50% discount If you would like to learn more about having Brodie on your rehab team go to www.runsmarter.online Or book a free 20-min physio chat here
Joining us on this podcast to discuss this crucial topic are Dr Adam Gledhill, Dr Dale Forsdyke and Tom Goom. Adam is Course Director for Sport, Exercise and Health Sciences at Leeds Beckett University. He is also chair of the British Association of Sport and Exercise Science Division of Psychology. Dale is a Senior Lecturer in Sports Injury Management at York St John University, and Head of Science and Medicine at York City Tier 1 Regional Talent Club. Tom (probably known to many as ‘the running physio’) is a physiotherapist with over 15 years of experience who specialises in running injuries. He shares his knowledge with clinicians and runners around the world through his website Running-physio.com and very popular Running Repairs Course. In this podcast we cover: The inspiration behind the editorial and why is it such an important topic Patients’ basic psychological needs and how they relate back to rehab? A number of practical suggestions on how to enhance adherence. Links: ‘I’m asking you to believe—not in my ability to create change, but in yours’: four strategies to enhance patients’ rehabilitation adherence https://bjsm.bmj.com/content/early/2020/11/03/bjsports-2020-102245?hwshib2=authn%3A1611998232%3A20210129%253A76cf0ccf-1d2e-4e4c-8ced-6c1e1766754f%3A0%3A0%3A0%3AikkQGUelivZ4k1xUJsCLFQ%3D%3D Blog on the running-physio website https://www.running-physio.com/adherence/
Welcome to episode 51 of the Mountain Land Running Medicine Podcast! This month, we spoke with Tom Goom of The Physio Rooms in England. Tom graduated with BSc (Hons) in Physiotherapy from Oxford Brookes University in 2002. He is Clinical Lead at The Physio Rooms, a keen runner, and creator of Running-Physio.com. Tom’s work has gained a worldwide audience and been featured in the British Journal of Sports Medicine, Runner’s…
In this episode we’re speaking about pelvic health in women and returning to exercise after pregnancy and birth. For this interview, we’ve recruited two of the very best in this area; Advanced Physiotherapist in pelvic health Gráinne Donnelly and Specialist Women’s Health Physiotherapist Emma Brockwell.The pair together with Tom Goom wrote the highly cited return to running postpartum guidelines entitled: ‘Returning to running postnatal – guidelines for medical, health and fitness professionals’.Pelvic health issues affect many women at different stages of life including the 80% of women in the U.K. who will have a baby. Pregnancy and child birth can cause a number of pelvic health issues, such as incontinence of urine, pelvic organ prolapse and diastasis recti (abdominal separation) which we cover in this episode. We also talk about the importance of the pelvic floor muscle and why all women can benefit from doing exercises to strengthen this muscle whether they've had a baby or not!Both Emma and Gráinne are passionate about helping women overcome pelvic health issues, and raising awareness about such conditions which are common but not normal. They highlight that the vast majority of these issues can be treated effectively with physiotherapy, something that they find not a lot of women are aware of.They're also on a mission to improve the quality and consistency of information available to guide women back to normal life after having a baby. We talk about if you can’t see it, you can’t be it, when it comes to elite athletes returning to competition after pregnancy and stress the importance of physical activity for pregnant women. We also talk about why women need adequate time to repair, heal and recover after giving birth and before returning to any form of exercise.In 'Question Time' this week we answer a question around why some women may feel more anxious and overwhelmed (especially given the way of the world at the moment) in phase 4 of their cycle- the premenstrual window- and what people can do about it.Resources:Free access to returning to running postnatal guidelines: https://mailchi.mp/38feb9423b2d/returning-to-running-postnatal-guidelineDiastasis Rectus Abdominis Patient Handbook: https://absolutephysio.dpdcart.com/product/199837 https://www.pelvicroar.org/ and https://www.pelvicroar.org/rectus-diastasisSqueezy App: https://www.squeezyapp.com/ which has a link to the "find a physio" directory toohttps://www.activepregnancyfoundation.org/ https://www.umi-health.com/Grainne on Insta and FB @absolute.physio on Twitter: @ABSPhysio Grainne's website - www.absolute.physioEmma's webite - https://physiomum.co.uk/Emma on Instagram and FB: @physiomumuk and Twitter @emma_physiomum If you like what we do and you'd like to support our cause please consider becoming a Patron of the Female Athlete Podcast. Head to www.patreon.com/femaleathletepodcast -our huge thanks go to Hannah Welling for becoming a Patron this week.We would like to thank our title sponsor for series 2 -Pretty Athletic. Pretty Athletic is a unique skincare brand for active women who sweat. Visit wwww.prettyathletic.com to view the amazing range of products available and use discount code FEMALEATHLETEPOD for 20% off.
Love your Mac? Find your vacuum cleaner cumbersome? Despair at the booking system of your local leisure center? User experience design (or lack of) plays a significant part in whether you love or loathe the products and services you interact with. This week on the Good Practice podcast, Gemma and Ross D talk to Rhys Pendred, Emerald Work's Lead UX designer. We focussed on the what, why and how of user experience, discussing: What UX is UX fundamental principles How we might think about and improve the UX of our products / learning. Show notes For more from us, including access to our back catalogue of podcasts, visit emeraldworks.com. There, you'll also find details of our award winning performance support toolkit, our off-the-shelf e-learning, and our custom work. Rhys mentioned Jacob Neilson's "10 Usability Heuristics for User Interface Design". This article can be found online at https://www.nngroup.com/articles/ten-usability-heuristics/ If you'd like to find out more about UX in learning design, we would recommend listening to our previous podcast "Design thinking for instructional design" with Connie Malamed. You can find it here https://podcast.goodpractice.com/78-design-thinking-for-ld Rhys talked about Eddie Van Halen's quirky, brown M&Ms stipulation. This is mentioned in The Independent's Eddie Van Halen obituary. You can read the obituary at https://www.independent.ie/entertainment/music/obituary-eddie-van-halen-39608991.html Gemma referred to a piece of research on muscle loading. It was mentioned in Tom Goom's video "What muscles should runners strengthen". The video is found online at https://www.running-physio.com/muscles/ Connect with our speakers If you'd like to share your thoughts on this episode, connect with our speakers on Twitter / LinkedIn: Gemma Towersey @gemmatowersey Ross Dickie @RossDickieEW Rhys Pendred linkedin.com/in/rhys-pendred
Visit a massage therapist and chances are you will be told you have muscle knots and maybe even 'Trigger Points'. Much of the therapist's work will strive to 'undo' these knots, maybe using 'Trigger Point Therapy'. But how much evidence is there that these knots are responsible for pain. What effect does 'releasing' them have? As runners, can we benefit from such 'release'?Ep.52 of Run Chat Live Podcast brings you the undisputed forefather of putting evidence back into therapeutical care - Mr Paul Ingraham. If you are as yet aware of Paul Ingraham’s work via painscience.com, formerly known as saveyourself.ca, then buckle yourself in for an episode that is going to change your life. Though taste is obviously a personal thing, as far as writing style, humour & educational skills go, Paul Ingraham is still after many, many years one of Run Chat Live's TOP RECOMMENDATIONS for clinicians (and patients) looking to open the door to becoming more evidence based.* * * Check out Paul's Trigger Point Book at: * * * https://www.painscience.com/tutorials/trigger-points.php.com RUNCHATIVE INTERNATIONAL RUNNING CONFERENCE 2020Oct 29th & 30th - ONLINE!Simultaneous Translation into Spanish!10 fantastic speakers including:Matt Fitzgerald, Kevin Maggs, Ben Cormack, Tom Goom, Alice Sanvito, Claire Minshull, Trevor Prior, Emma Brockwell, Nick Knight & Jess Bruce, Mike James.INFO & TICKETS: https://www.therapistlearning.com/p/run-chat-live-2020 JOIN US FOR FUTURE EPISODES!Runchatlive episodes are recorded LIVE on Thursdays at 8pm (UK time) on our Facebook Page: www.Facebook.com/MattPhillipsRCL. Details of up and coming episodes are posted at www.runchatlive.com.If you prefer to watch or listen in your own time, here are some options:Video/audio on our website https://www.runchatlive.com/Video on our YouTube channel: https://www.youtube.com/c/runchatlivePodcast on your preferred podcast player e.g. Apple Podcasts (iTunes), Spotify, Stitcher, etc.
Despite the popularity of massage, many of the common assumptions of what is happening physiologically are poorly evidenced. In this episode of Runchatlive, internationally acclaimed massage therapist Alice Sanvito talks to us about what massage does & doesn’t do for runners, and how therapists can make it work better.We also discuss both therapists and runners can learn & evolve without feeling anger & frustration. Alice Sanvito is one of ten speakers presenting at this year's Runchatlive International Running Conference, Oct 29th & 30th Online. As one of just four therapists in the USA selected by Zhenya Kurashova Wine to be trained as instructors for the Kurashova Institute for the Study of Physical Medicine, Alice Sanvito has a great amount of experience in massage therapy, with a no nonsense science-based approach that makes her a leading figure in a number of online communities. Look out for her hashtag #shitmassagetherapistssay RUNCHATIVE INTERNATIONAL RUNNING CONFERENCE 2020Oct 29th & 30th - ONLINE!Simultaneous Translation into Spanish!10 fantastic speakers including:Matt Fitzgerald, Kevin Maggs, Ben Cormack, Tom Goom, Alice Sanvito, Claire Minshull, Trevor Prior, Emma Brockwell, Nick Knight & Jess Bruce, Mike James.INFO & TICKETS: http://rcl2020.eventbrite.co.uk/ JOIN US FOR FUTURE EPISODES!Runchatlive episodes are recorded LIVE on Thursdays at 8pm (UK time) on our Facebook Page: www.Facebook.com/MattPhillipsRCL. Details of up and coming episodes are posted at www.runchatlive.com.If you prefer to watch or listen in your own time, here are some options:Video/audio on our website https://www.runchatlive.com/Video on our YouTube channel: https://www.youtube.com/c/runchatlivePodcast on your preferred podcast player e.g. Apple Podcasts (iTunes), Spotify, Stitcher, etc.
In the previous episode of Runchatlive, we had the honor of talking with Dr. Benno Nigg - founder, creator & director of the Human Performance Laboratory, University of Calgary, a multi-disciplinary research center with approximately 200 researchers & assistants working in every aspect of the understanding of movement and exercise.In Episode 50, we are delighted to bring you Dr. Guillaume Millet, who from 2013 to 2018 worked at the Human Performance Laboratory directing the Neuromuscular Fatigue research team. Now back in France, Dr. Millet is Professor of Exercise Physiology in the Department of Kinesiology at Jean Monnet University, Saint-Étienne and the director of the LIBM laboratory (Inter-University Laboratory of Human Movement Biology).His general research area investigates the physiological, neurophysiological and biomechanical factors associated with fatigue, including that associated with extreme (ultra-endurance, hypoxia) exercise, and in this episode of Runchatlive talks about training & fatigue in Ultra Trail Running.We should add, Dr. Millet is himself no stranger to extreme exercise, with over 30 years experience competing in endurance sports including ultra-trail running, XC skiing and adventure races. The Ultra-Trail du Mont-Blanc® (UTMB) is widely regarded as one of the most difficult foot races in the world with a distance of approximately 106 miles and a total elevation gain of around 32,940 ft. - Dr. Millet has placed 3 times in the top 6. - - - - - - - - - - - - - - - - -RUNCHATIVE INTERNATIONAL RUNNING CONFERENCE 2020Oct 29th & 30th - ONLINE!Simultaneous Translation into Spanish!10 fantastic speakers including:Matt Fitzgerald, Kevin Maggs, Ben Cormack, Tom Goom, Alice Sanvito, Claire Minshull, Trevor Prior, Emma Brockwell, Nick Knight & Jess Bruce, Mike James.INFO & TICKETS: http://rcl2020.eventbrite.co.uk/- - - - - - - - - - - - - - - - - - - - JOIN US FOR FUTURE EPISODES!Runchatlive episodes are recorded LIVE on Thursdays at 8pm (UK time) on our Facebook Page: www.Facebook.com/MattPhillipsRCL. Details of up and coming episodes are posted at www.runchatlive.com.If you prefer to watch or listen in your own time, here are some options:Video/audio on our website https://www.runchatlive.com/Video on our YouTube channel: https://www.youtube.com/c/runchatlivePodcast on your preferred podcast player e.g. Apple Podcasts (iTunes), Spotify, Stitcher, etc.
Runchatlive Ep49: Benno Nigg 'The Science Of Modern Running Shoes'A true honour this episode to spend an hour chatting with special guest for Dr. Benno Nigg. Regarded by many as the important contributor to running related research over the past 40 years, Dr.Nigg is Founder & director of the Human Performance Laboratory at the University of Calgary, a multi-disciplinary Research Center concentrating on the study of the human body and its locomotion. He has received many awards and recognitions, including the Olympic Order, honorary degrees from the Universities of Salzburg and Innsbruck and an honorary professorship from the University of Shanghai.In this episode of Runchatlive, he will be discussing the SCIENCE behind modern running shoes. What role have shoes truly played in the performance explosion we have witnessed since Eliud Kipchoge became the first man to break two hours for the marathon. 2019 also brought us twice as many men running under 2:10 and twice as many women under 2:27 compared to 2016. Eight of the twelve fastest men’s marathons in history have been run in the last year. How much of a factor has this new breed of shoe played? And more importantly, what is it in the shoe that could have made this possible?With over 25,000 publications on human locomotion, in particular with relation to products such as orthoses, shoe insoles, sport shoes, surfaces and sport equipment, Dr. Nigg will be giving us an inside look at his latest study that appeared this August in the British Journal of Sports Medicine: 'The teeter-totter effect: A new mechanism to understand shoe-related improvements in long-distance running.'An incredible hour, thank you once again Dr. Benno Nigg for giving us his time. - - - - - - - - - -RUNCHATIVE INTERNATIONAL RUNNING CONFERENCE 2020Oct 29th & 30th - ONLINE!Simultaneous Translation into Spanish!10 fantastic speakers including:Matt Fitzgerald, Kevin Maggs, Ben Cormack, Tom Goom, Alice Sanvito, Claire Minshull, Trevor Prior, Emma Brockwell, Nick Knight & Jess Bruce, Mike James.INFO & TICKETS: http://rcl2020.eventbrite.co.uk/- - - - - - - - - - - - - - - - - - - - JOIN US FOR FUTURE EPISODES!Runchatlive episodes are recorded LIVE on Thursdays at 8pm (UK time) on our Facebook Page: www.Facebook.com/MattPhillipsRCL. Details of up and coming episodes are posted at www.runchatlive.com.If you prefer to watch or listen in your own time, here are some options:Video/audio on our website https://www.runchatlive.com/Video on our YouTube channel: https://www.youtube.com/c/runchatlivePodcast on your preferred podcast player e.g. Apple Podcasts (iTunes), Spotify, Stitcher, etc.
Today in the Run Culture Podcast I chat to Tom Goom the Running-Physio, from Brighton the UK! His website; www.running-physio.org has so many fantastic resources, blogs and videos for sore/injured runners! Tom, as you will hear is fully abreast all the latest running research! Today we focused on a wholistic look of running injury and pain. We talked about the importance of training structure, plans, the importance of easy days, knowing your body, the complexity of pain, fluid versus rigid expectations, harmonious versus obsessive passion, that running training is a behaviour and the complexities involved with behavioural change. We also touched on practical strength training and how Tom views running biomechanics.
Ep40: Tom Goom - 2002-2020 Changes In Running Injury PreventionTom Goom a.k.a. 'The Running Physio' is a physiotherapist based in Brighton, working out of the Physio Rooms. His 'Running Repairs Course' is internationally acclaimed, and he has now organised a 'Running Rehab, from Pain to Performance’ conference this April 24th in London, with speakers Alex Hutchinson, Ian Griffiths, Claire Minshull and Chris Napier. With this superb line-up, the conference is destined to be of huge value! Tickets available at https://www.running-physio.com/p2p/With this year marking Tom’s 18th year as a Physiotherapist, we decided to celebrate by taking a trip down memory lane and looking at ways in which the management & treatment of Running Injury & the optimization of Running Performance has changed since Tom started in 2002. The episode is literally FULL of fantastic advice and comforting testimony to the fact that as a therapist it is totally normal to have your beliefs & assumptions challenged by modern research, and your practice forced to evolve to keep in line with more modern concepts.We hope you enjoy the episode!----------------------------------RCL INTERNATIONAL RUNNING CONFERENCE 2020As announced in this episode, dates have now been released for the RCL International Running Conference 2020: Thursday October 29th & Friday October 30th in Brighton, UK.Details of the TEN speakers presenting across the two days will be released soon, as well as links to early bird tickets, so make sure you follow us on social media @runchatlive. Videos of last year's conference are still available at www.runchatlive.com as well as branded T-shirts.* * * * WANT TO SUPPORT THE PODCAST? * * * *The success of a podcast ultimately boils down to how much Apple advertises it, which is heavily based on ratings & reviews. A huge thanks to those of you who have left ratings and reviews!If you'd like to help us, do please take two minutes to leave a rating & review on Apple Podcasts or iTunes. iPhone users can do it from the app on your phone, android users need to go to iTunes on a laptop/pc. Thanks in advance! https://podcasts.apple.com/gb/podcast/runchatlive/id1446286174NEXT EPISODE:April 30th Thursday 8pm GMT:* * * TODD HARGROVE * * *Join us LIVE: www.facebook.com/MattPhillipsRCL
Gráinne Donnelly is back and we completely nerd out in this episode on all things transperineal ultrasound in assessing and treating pelvic floor dysfunction in women. From 2D to 4D, scope of practice and all the fun measures you can do. Enjoy our excitement that we just cannot contain. #nerds If you missed her last episode, head back to April 2019 to listen to her, Tom Goom and Emma Brockwell discuss their guidelines on return to running in postnatal women. Guidelines for reprocessing ultrasound transducers 2017 Bio from her website - Absolute Physio: Gráinne is an Advanced Physiotherapist in pelvic health. She graduated from the University of Ulster in 2008 with a Bachelor of Science Degree in Physiotherapy. She specialised in Pelvic, Obstetric and Gynaecological physiotherapy in 2010 undertaking extensive post-graduate training and completing the Postgraduate Certificate in Continence Practice at the University of Bradford in 2018. Gráinne is currently completing a Masters in Advancing Healthcare at the University of Ulster and is aiming to complete this in 2020. Alongside her private practice, she continues to work part-time in the NHS where she is the team lead for the pelvic health physiotherapy service across her local health trust. Gráinne became particularly interested in the assessment and treatment of Diastasis Recti due to its prevalence and associated implications with her clients. She also teaches health and fitness professionals about the assessment and management of Diastasis Recti. Gráinne co-authored the internationally recognised "Returning to running postnatal - guidelines for medical, health and fitness professionals managing this population" as well as publishing her conference presentation "Diastasis Rectus Abdominis - physiotherapy management" from the 2018 Pelvic, Obstetric and Gynaecological Physiotherapy Conference. Gráinne regularly presents at conferences around the UK and Ireland on topics related to pelvic health and well-being. She uses real-time ultrasound for pelvic health and is involved in training courses for physiotherapists. Grainne is the Chair for the Pelvic Obstetric and Gynaecological Physiotherapy Northern Ireland specialist interest group as well as a member of the Ulster Gynae Urology Society committee. Gráinne is also a fully certified PINC and STEEL cancer rehabilitation physiotherapist and co-founded a non-profit service in N. Ireland called SPARK Cancer Rehabilitation. She also co-founded WHITE Circle, an educational pelvic health platform to empower women to safeguard their pelvic health.
Are passive therapies making patients worse? Does stretching help? Where do the bio, psycho and social components fit into patient management? This week Tom Goom joins us to chat about how to avoid the common pitfalls all clinicians can make. Known to many in the SEM community as the ‘Running Physio’, Tom is a physiotherapist with over 15 years of experience who specialises in running injuries. He shares his knowledge with clinicians and runners around the world through his website Running-physio.com and very popular Running Repairs Course.
What are the keys to good running form? Is there a magical number for step rate? Should we all be changing the way we run? This week Tom Goom joins us to chat about gait retraining and its role in helping injured runners. Known to many in the SEM community as the ‘Running Physio’, Tom is a physiotherapist with over 15 years of experience who specialises in running injuries. He shares his knowledge with clinicians and runners around the world through his website Running-physio.com and very popular Running Repairs Course. In this 20-minute episode, Tom discusses the rationale for gait retraining, who needs it, how to assess the injured runner and his comprehensive gait retraining management plan.
When you love running or any other sport or activity, having to take time off with an injury is really frustrating. Your patients with an injury limiting their running will feel frustrated and be keen to keep running or get back to running as quickly as possible. We can make a huge difference in helping them return to running, but how do we do it? It would be pretty simple if we could hand all of our running injury patients a standard return to running table with a list of set running distances, and send them on their way to just follow the program. The trouble is, it doesn’t work that way in real life. Each of your patients will have different goals, and respond differently to rehab and increases in running, depending on their injury, irritability of their symptoms, their load tolerance, and a lot of factors. Since recipe-based approaches won’t work for a lot of patients, how can you tailor your rehab and guide your running injury patients through their return to running? In this podcast with Tom Goom, we’re going to help you return your patients to running as quickly as possible, know which factors you need to address in your rehab, and how to tailor your rehab to each of your patients. You will explore how to: Test whether your patient is ready to run Find your patients ‘run tolerance’ Incorporate your athlete’s goals into their rehab Use their pathology to guide return to running eg stress fractures or plantar fasciopathy Use irritability to guide your load progression Vary your treatment depending on the stage of their competitive season Address strength, range of movement, control, muscle mass, power and plyometric impairments in their rehab program Choose the number of exercises you use Balance risk and reward to meet patients goals Four key steps to return your patient to running Use impact tests when assessing whether your patient is ready to run Plan training structure and progression Monitor return to running Identify acceptable pain levels while increasing running We will take you through four real patient case study examples so you can apply the podcast in your clinical practice, including: Achilles tendon pain Medial tibial stress syndrome (MTSS)/Shin splints Calf pain High risk tibial stress fracture CLICK HERE to download your podcast handout Links associated with this episode: Free lateral hip pain video series with Tom Goom Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 084 Running injury treatment - tendinopathy, MTSS, total hip replacement & high BMI patients. Q&A with Tom Goom Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
Join these three amazing physios discuss the guidelines on returning to running after having a baby they developed in March 2019. Find out why 3 months postpartum is a better cut-off for consideration in returning to running and a summary of their key points. If you haven't read the guidelines, they are free and available HERE (guidelines)! Check out Tom Goom at www.running-physio.com Grainne Donnelly at www.absolute.physio Emma Brockwell at www.physiomum.co.uk
In this episode we welcomed a great panel of physiotherapists in Hamish Vickerman, Tom Goom, Neil Meigh and Kevin Nordanger to talk about how Podiatry and Physiotherapy can/should work together, the overlap between professions, the preconceived notions we have about each others professions and more.
How can you manage lower limb tendinopathy in your patients that like to run? Can runners with medial tibial stress syndrome (MTSS) continue to run? Can patients with high BMI or following total hip replacement run? Physiotherapists Tom Goom and David Pope answer your questions on how to assess and treat patients with running-related injuries in this Q&A conducted live, including: How can you manage post-run morning stiffness? What are the important aspects when managing load? How can you treat Achilles tendinopathy patients with decreasing tolerance to running and walking, and increasing pain? Differential diagnosis for Achilles pain Proximal hamstring tendinopathy What exercises can be used? Is a feeling of tightness normal, and how can this be addressed? Are stretches helpful? When can deadlifts and Romanian deadlifts (RDL's) be used? Patellar tendinopathy - how can you manage a runner that is not willing to decrease running volume even temporarily? Peroneal tendinopathy Running vs rest in female distance runners with chronic hamstring origin injuries Patellar tendinopathy Medial tibial stress syndrome (MTSS)/Shin splints treatment Working at marathons or running events - How can you help your runners with ITBS or PFP finish a race? Can runners return to running following total hip replacement? Is running harmful for patients with high body mass index (BMI) when they want to reduce weight? To improve your skills and results with low back pain patients, CLICK HERE for your free access to 3 videos with Tom Goom on "How to assess low back pain in runners and athletes" Links associated with this episode: Submit questions for the Physio Edge podcast Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 083 Running gait retraining, strengthening, glutes & ITB syndrome. Q&A with Tom Goom Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
What are the key components when assessing and treating runners? Should your treatment of running injuries focus on glutes? How can your runners schedule their training to improve recovery? Physiotherapists Tom Goom and David Pope answer your questions on how to assess and treat patients with running-related injuries, including: The key concepts when assessing and treating running injuries Gait retraining programs The best ways to change running technique Does gait retraining cause fatigue? Is gait retraining suitable in painfree runners? What are the most important elements to prevent injury in runners? Scheduling to improve recovery from injury. When should your runner run, and when should they rest? Can we increase leg stiffness when running? Does increasing leg stiffness reduce injury risk? Strengthening for runners Do glutes become underactive or "not fire properly"? Does improving glute strength improve running mechanics? Calf tears - how can you treat these? What tests can you perform for your runners calves? Do runners have "stiff hips", and does it matter? Can you help runners with meniscal tears? How can you treat ITB syndrome? Is barefoot running helpful or harmful? Should we run in only 1 shoe if we want to win a race? To improve your skills and results with low back pain patients, CLICK HERE for your free access to 3 videos with Tom Goom on "How to assess low back pain in runners and athletes" Links associated with this episode: Submit your running-injury related questions for the Physio Edge podcast Download and subscribe to the podcast on iTunes Twitter - @tomgoom Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Other episodes of interest: Physio Edge 082 Achilles tendinopathy treatment - the latest research with Dr Seth O'Neill Physio Edge 076 Footwear advice for running injuries with Tom Goom Physio Edge 075 Tendinopathy, imaging and diagnosis with Dr Sean Docking Physio Edge 068 Lower limb tendinopathy loading, running and rehab with Dr Peter Malliaras Physio Edge 042 Treatment of Plantaris & Achilles Tendinopathy with Dr Seth O'Neill Physio Edge 041 Plantaris Involvement In Achilles Tendinopathy With Dr Christoph Spang
This expert in Biomechanics and a member of the staff at the University of Montana is known as one of the best for a reason. He studies runners and runner injuries with patellofemoral pain, Achilles tendonitis, and tibial stress fractures and is known for helping assist clinicians with diagnosing and preventing common running injuries. Rich is a runner himself and ran cross country and track starting in high school. If you are interested in subjects such as the risk of injury, gait retraining (and can we even change gait longer term?), the helpfulness of wearables , strength training and the importance of recovery, this episode will be of special interest to you. We are back to the science you all love in this episode. Today’s Guest Dr. Richard Willy is an Assistant Professor in the School of Physical Therapy, University of Montana. He received his PhD in Biomechanics and Movement Science from the University of Delaware and his master of physical therapy from Ohio University. In addition to his research, Dr. Willy has been a clinician for 18 years specializing in treatment of the injured runner. What you will learn about: How runners who suffer tendon or stress fractures are significantly more at risk for additional tendon or stress fractures. Part comes from not changing training loads and making the same mistakes over again. How general overall life stress in our lives increases the risk of injury because it impacts sleep and recovery overall. Sleep quality really impacts the risk of stress fractures. How a Clinician can work with runners to change their biomechanics (stride, cadence, etc) and how much practice it takes in order to make those changes the norm for the runner. How the runner needs to become bodily aware of what the change should feel like. But, should you even bother to change your gait or is there something else you can do to make your body more durable and lower your injury risk that is more effective? The importance of cadence and whether there really is any magic to the oft touted 180 steps per minute. Can you trust the cadence reported by your running watch? How stress fractures may need a team of specialists to lower their risk, including Physical Therapists, Strength Coaches and Registered Dietitians. How runners lie to themselves about where they are physically in terms of their training volume. How we push too hard after a race to improve or try to return to “where we were” too quickly after injury. The largest risk is in the 3rd work after comeback because that is where the body really starts to break down from accumulated stresses. Strength training is instrumental in tendon health and durability. And it needs to be heavier weights, not low weight/high rep modes. Endurance training mitigates the tendency to increase muscle mass but instead helps focus the change on tendon health and strength vs bulking up muscles. Plyometrics can also help with tendon strength and stiffness but at the end of the day strength training gives a bigger bang for the buck. Hip strength is important but won’t change how you are moving. The process of getting stronger is what is more important and hip strengthening and quadriceps strength seems to best help protect the knees. Calf raises are also important as a large percentage of our overall propulsion comes from the calf. Wearables are a double edged sword that provide us with some useful info but we also get caught up in the social media aspects and trying to do too much based on our fitness levels because we are competing with our friends vs focusing on our readiness. Where a wearable can help is providing the data needed to review their running history and where something might have changed that caused an injury in terms of volume or terrain. Heart rate can help with keeping runs easier but as we get dehydrated our bodies have to increase the heart rate in order to push the blood volume so it can be a bit misleading. Chest straps are more reliable right now than wrist based still. Distance, cadence, vertical oscillation, all seem to be pretty accurate and others not so much. But clinically many of those measures don’t mean anything in terms of our running health. It is important to track things over time but as predictive measures we still really don’t know enough to make that data of much use. Inspirational Quotes: Mix things up. Don’t run the same pace or the same route or the same terrain all of the time. Do some speed sessions, trail runs, run with different groups to make your body adapt. Especially as we age, it it important to keep the breadth of running modes in your plans. Your perceived exertion is more important than any other measure. We don’t get faster running every run as a tempo run. Resources: Last week's episode with Chrissie Wellington Tina4Real Podcast Running for Real Superstars Community Support Tina through her Patreon Page Effort scale for training by feel Experts Rich mentioned to follow: Chris Napier Izzy Moore Alison Gruber Max Paquette Tom Goom Podcast episode with Max Paquette Podcast episode with Tom Goom Rich on Twitter Email rich: rich.willy@umontana.edu Buy a Running for Real T-shirt, Tank, or Hat Thank you to HOKA ONE ONE and Bodyhealth for sponsoring this episode of Running for Real. HOKA ONE ONE® is a running shoe unlike any other. The Bondi 6 was one of the first shoes HOKA ONE ONE® ever created and it’s become a fan-favorite for good reason. Just try it on today and experience the sweetest cushion. Become part of the family. It’s Time To Fly™.. 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On this episode of the Healthy Wealthy and Smart Podcast, Tom Goom joins me to discuss a gluteal tendinopathy case study. Tom has gained the nickname ‘Running Physio’ after years of combining his passion for physio and love for running together to specialise in management of running injury. He’s written widely on the topic with over 200 evidence-based articles for his own site, running-physio.com as well as contributing to the BJSM Blog, Runner’s World and the Telegraph. In 2016 he published a masterclass on proximal hamstring tendinopathy in the Journal of Orthopaedic and Sports Physical Therapy. He presents his Running Repairs Course in the UK, internationally and online, covering a range of topics from training load management to bone stress injuries, strength and conditioning and more. In this episode, we discuss: -Crafting the subjective portion of your evaluation -Objective measures at the impairment, activity and participation levels -Multimodal treatment approaches to manage gluteal tendinopathy -Intrinsic factors that affect tendon health -And so much more! Identifying what running really means to your patient will help guide your goals for therapy as Tom stresses, “I want to know about the impact the injury is having on them.” Modifying activity levels is an important aspect for your exercise prescription and you have to convey to your patients that, “It’s this kind of balancing act of risk versus reward.” It is important for clinicians to avoid iatrogenic language in their patient education and only, “Highlight the good things.“ Establish at the onset to, “Expect flair ups.” as managing patient expectations during their rehabilitation is key to long term success. Treating gluteal tendinopathy is both challenging and rewarding and Tom believes, “There’s an art to it as well as a science.” For more information on Tom: Tom is a physiotherapist with over 10 years of experience and a very keen runner! He graduated with a BSc (Hons) degree in 2002 and since then has worked in clinics in the UK and overseas. His career started in Winchester where he worked in the NHS and developed a specific interest in lower limb rehab and joined the physio team at a semi-professional football club. Following the Tsunami in 2004 Tom travelled to Sri Lanka and did voluntary physiotherapy work in a hospital, teaching local staff, treating patients and fundraising for new equipment. Tom returned to the UK in 2006 and started working in Brighton as a senior physiotherapist. His interest in rehab continued to grow and he ran lower limb and spinal rehab groups as well a chronic pain programme. Tom started RunningPhysio in March 2012 to help those training for marathons that spring, since then it’s developed into a resource used by runners all over the world. Tom has written for Running Fitness, Men’s Running UK, and the British Journal of Sports Medicine blog. His work has featured on Kinetic Revolution, Bartold Biomechanics and a host of online sports sites. A few words from Tom… I’m learning about running all the time, one thing I’ve found is that there are a lot of opinions out there! No 2 people will give you the same advice and I respect that. My plan with this site is to share my view on injury prevention and management when running. I welcome different views and ideas so please feel free to comment. I don’t claim to have all the answers but I hope people will find this site helpful. I’ve got a few miles under my belt and a few good PB’s – 39:30 for 10km and a 1:28 half marathon. In April 2013 I did my first marathon and loved it! I finished in 3:12:28 – full story here. I work at The Physio Rooms clinic in Brighton. For more information or to arrange an appointment see our Clinic Page. If you have any questions feel free to leave a comment or chat to me on Twitter via @tomgoom. Please note that due to very high numbers of comments and questions we aren’t able to reply to everyone Resources discussed on this show: Running Physio Website Running Physio Twitter Running Physio Facebook Tendon Health Questionnaire Pain Catastrophizing Scale Hudl Technique Plinsinga et al 2018: Psychological factors not strength deficits are associated with severity of gluteal tendinopathy: A cross‐sectional study Ganderton et al 2018: Gluteal Loading Versus Sham Exercises to Improve Pain and Dysfunction in Postmenopausal Women with Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial. Mellor et al 2018: Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes! Have a great week and stay Healthy Wealthy and Smart! Xo Karen
There are a lot of myths around footwear, and your patients with running injuries will often blame an "incorrect shoe" choice for their injury, or believe that getting the "right shoe" will help resolve an injury. Are running shoes the cause of, and solution to running injuries? What advice should you give your patients when they ask that inevitable question "Do you think I need to get new shoes?", closely followed by "What shoe do you think I should run in?" In Physio Edge podcast episode 76 with Tom Goom, you will also discover: What footwear should your runners and injured runners wear? Footwear questions you need to ask your running injury patients Does footwear change gait patterns? Can footwear contribute to injury? What footwear may contribute to or help in your treatment of Achilles tendinopathy What is heel-toe drop and how is this important? Does footwear affect ground reaction forces, and how does this relate to bone stress injuries and plantar fasciopathy? Is minimalist or barefoot running helpful or harmful? Can runners safely transition to barefoot or minimalist running? Is footwear the key to resolving running injuries? Shoe prescription Recommendations when buying new shoes Footwear considerations for specific pathologies When should runners change their shoes? If you would love to get better results with running injuries, the podcast handout contains the key take-home messages for you. You can download it here. To complement this podcast and improve your treatment of runners, Tom Goom and I have created three awesome free Achilles tendinopathy rehab videos. This is a series of three evidence-based videos to help you master Achilles treatment. CLICK HERE to get your free access to these videos Links of Interest Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy Download and subscribe to the podcast on iTunes Download your free podcast handout on treatment of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Related posts Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Research associated with this episode Esculier et al. 2015. A consensus definition and rating scale for minimalist shoes. Fuller et al. 2017. Six week transition to minimalist shoes improves running economy and time-trial performance. Kong et al. 2009. Running in new and worn shoes: a comparison of three types of cushioning footwear. Mallisoux et al. 2015. Influence of heel to toe drop of standard cushioned running shoes on injury risk in leisure time runners: a randomised controlled trial with 6 month follow up. Nigg et al. 2015. Running shoe and running injuries: myth busting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’. Salzier et al. 2016. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity.
Tom may be a recovering cheese addict who occasionally has relapses (yes, we do go into this), but, primarily he has a passion for working with runners in his job as a physiotherapist in the UK, while running the very popular injury prevention (and rehab) blog, Running Physio. Tom gives us advice on how to sort through the overwhelming amount of information online to know which sources to trust, and how to decide on who is in your "team" who can help you when you need it. We should figure this out BEFORE issues arise, so when those injuries or setbacks do come up, we know exactly who to call, rather than doing a frantic google search for anyone who can help. Your team doesn't have to be in person, as evidence has found that Skype or online consultations can help runners in more ways than we would expect. Tom explains the three keys critical to staying healthy: If you try to make sure you plan your training and progress it slowly, include targeted strength work to improve performance, and focus on recovery by getting enough sleep, including planned recovery days. We discuss how to prepare for an appointment with a medicals professional. If you know what you want from the appointment, they will be better equipped to help you. If you are seeing someone and not getting better, Tom gives us the factors to consider before you seek a second opinion, but if you do need to see someone else, there is nothing wrong with that, maybe the person you are seeing does not have the correct skills for your particular injury. We cover how to know what to do if you don't want to risk taking extra days off and losing fitness when you don't have to, but you are not sure if the injury is completely healed. How to weigh up the risk of more pain and developing further injury vs the reward of training in that moment. Tom explains how the differences between types of pains are not actually telling us as much as we might think, but how your injury behaves during and after a run is actually more insightful. Believe it or not, shoes are less important than we think, but sometimes our shoes do put us at risk of injury, Tom explains how to choose the right shoes for you. Finally, we cover the negative effects of stress (any stress, not just running), how stress can slow healing by up to 60%, and affect how we respond to exercise, prevent or reduce gains in fitness, and increase pain perception. On all fronts, we all need to consider just how much our lifestyle could be the reason we are struggling with injuries. Today's episode is for you if you have ever been frustrated with an injury or felt overwhelmed with the amount of information out there about injuries. Tom gives us a realistic approach to break down the advice, and show us how to help ourselves get better faster, and prevent injuries in the future. Today's Guest Tom Goom One of the top physiotherapists in the UK, Tom has worked with runners of every level and speed at the Physio Room in Brighton. Tom is the creator of the very popular website, Running Physio where he blogs and shares information about how runners can remain injury free, and run stronger than ever. What You Will Learn About Why it is important for a physiotherapist (or physical therapist) to "get" runners, especially when we are injured How to find a medical professional you can trust when you need treatment and how to wade through the sea of information available online How to prepare for an appointment with a medical professional, what you need to do and why being prepared will help them treat you better What to do if you went to see a physic or physical therapist, but things are not improving, how to know when to seek a second opinion What features of injuries to look out for as a major warning sign to stop rather than keep running through How to pick the best shoes for you and your body (and no, it's not complicated!) Inspirational Quotes If you get them, you "get runners", I think that is actually really important because the more I ran, the more I realized its actually harder to rest than to run sometimes...I could really understand with people who came to me with running injuries who were not able to run, how much of an impact it had on them, how much they really missed it. There is nothing else that is quite the same, that has the same buzz associated with it, so when you don't have it, it is really difficult to replace it. If you are looking for someone specifically for treatment, then recommendations from fellow runners is a good way to go, perhaps recommendations from other health professionals. Any medical sites making massive claims, "we can fix everything, we can treat everything, we have these wonderful magical techniques", I would always tend to be a little bit skeptical about that, because often the people that know the most, are the people who are usually a little bit more careful about what they claim as they recognize how complex a lot of things are. Get it clear, what are the priorities, what are the important things that will actually make a difference? Because a lot of the time, when you get to those debates about things, you are looking at perhaps smaller stuff that isn't a important, and there are some thing that most experts in running would agree on. No amount of foam rolling is going to help you if you are training far above what your body can cope with. Before the appointment, really ask yourself, what do I want from this? What am I looking for? What questions do I have that I really want answered? Really that appointment should be about you and what you want from it...If you go in with a clear idea, you get what you want out of it. It's much harder to manage an injury if you don't really understand it. When you are not progressing with rehab, there are lots of different potential reasons for that, and it's trying to pick through that and work out what is the reason. Ultimately, what matters is that the runner gets the best outcome and it doesn't matter where that comes from, whether it is me or another professional, as long as they get the best outcome. I think health professionals nowadays should be very familiar with the fact that patients will have asked Dr Google, they will come in with an idea of what their problem is. I think really, as heath professionals, we shouldn't be too sensitive to that, and we should take the time to explain if we don't agree with what the patient thinks the problem is. If in doubt, get checked out. Running patterns only change a small amount. There is only a small amount of evidence that certain shoes will reduce risk of injury, so when you are looking at relatively small changes to shoes, it probably isn't going to make a massive impact, but it is also very unpredictable as different people respond differently to different shoes. A lot of us runners, we are quite driven people, and it is that drive that gets us off the couch and gets us running, whereas a lot of people don't have that same drive, but linked to that drive are other features that perhaps we can push ourselves quite hard and be hard to ourselves, perhaps be a little bit of a perfectionist, and that can be lead to injuries too as we push our bodies to more than what they are capable of doing. Being kind to yourself, and recognizing that your are only human, that can help let go of some of that guilt. Your injury risk is nearly doubled if you are sleeping less than 8 hours a night. Resources Mentioned Last week's interview with Devon Yanko Running Physio Strength Training for Runners program Tom's Skype consults for tendon injuries If you feel like you are not getting better Part 1 Mike Sullivan (Tina's chiropractor) Kyle Bowling Chiropractor (treated Tina's peroneal tendonitis) Mark Cucuzzella and Josh Emdur (about steady running consults) Athlete monitoring worksheets to print Adam Meakins (The Sports Physio) Dr. Rich Willy Christian Barton (complete sports care) Craig Purdam Pete Malliaras(Tendinopathy Blog) Tony the Fridge Thank you to my new running buddy VI and favorite recovery product BodyHealth for sponsoring this episode of Running for Real. VI is there to encourage you on tough days, congratulate you on the days you crush it, and remind you of your goals when you need it. You can enter to win your own VI by visiting GetVI.com/running4real When I was running 90 miles a week as a pro, I would take 5-10 BodyHealth Perfect Amino tablets every day without fail. They helped me recover faster, and feel better. Now they have Perfect Amino XP, which makes it even easier. Get 10% off at Bodyhealth.com using coupon code TINA10
Experiencing increasing calf pain with running can be an incredibly frustrating experience for your running patients, especially when it is severely limiting or stopping them from being able to run. You can have a lot of success in helping your runners overcome running related calf pain, and in episode 66 of the Physio Edge podcast, we give you practical strategies and exercises you can use in your treatment. Tom Goom and David Pope helped you explain the causes of calf pain to your running patients, differential diagnosis and red flags, and what you need to assess in episode 64 and episode 65, and in Episode 66 you will explore: How to strengthen the calf complex Strengthening for local ankle and foot muscles Benefits and how to incorporate strengthening for the kinetic chain Incorporating neural mobility into your treatment Adjusting and progressing training loads The role of gait retraining in the treatment of calf pain If you would love to get better results with calf pain in runners, the podcast handout contains the key takehome messages for you. You can download it here. To complement this podcast and improve your treatment of runners, Tom Goom and I have created three awesome free Achilles tendinopathy rehab videos. This is a series of three evidence-based videos to help you master Achilles treatment. CLICK HERE to get your free access to these videos Links of Interest Free Achilles tendinopathy rehabilitation in runners videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy Download and subscribe to the podcast on iTunes Download your free podcast handout on treatment of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Related posts Physio Edge 065 - Differential diagnosis of calf pain in runners with Tom Goom Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Research associated with this episode Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis Kerry et al. (2005). Mechanical calf pain in a 23-year-old male due to dynamic functional entrapment of the popliteal artery Scarvelis and Wells. (2006). Diagnosis and treatment of deep vein thrombosis
When your patients present with calf pain, do you have a clear understanding of the likely causes and potential differential diagnosis? Do they have any red flags that require urgent medical attention? What other issues besides a calf tear could be causing their calf pain? It's time to brush off those diagnostic skills, to understand the types of calf pain you can treat, and which patients you need to refer on immediately. In this podcast with Tom Goom and David Pope, we are going to break it down for you, so you are confident in assessing and diagnosing the different types of calf pain. You will understand: How to identify calf muscle pathology or tears When symptoms are due to neural irritation or pathology Different types of vascular pathology, including popliteal artery entrapment Red flags such as deep vein thrombosis (DVT) What information imaging can provide You can download a free handout containing a summary of the podcast info on differential diagnosis, which you can download here. Tom Goom and I are really excited to share three free evidence-based Achilles tendinopathy rehabilitation videos - to help you master the treatment of achilles tendinopathy. These will be out soon, so join us for these free masterclasses Links of Interest Free Achilles running rehab videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy Download and subscribe to the podcast on iTunes Download your free podcast handout on differential diagnosis of calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Related posts Physio Edge 064 What is causing calf pain in runners and how can you assess it with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Research associated with this episode Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis Kerry et al. (2005). Mechanical calf pain in a 23-year-old male due to dynamic functional entrapment of the popliteal artery Scarvelis and Wells. (2006). Diagnosis and treatment of deep vein thrombosis
One of the most popular blogposts of all time on Tom Goom's website running-physio.com is on how to manage calf tears in runners. Is this because it is a really common problem, or because Tom wrote such a great blogpost? It's a bit hard to tell, and most likely it's a bit of both, but it begs the question "Why is calf pain one of the issues so many runners face? " In episode 64 of the Physio Edge podcast, David Pope and Tom Goom discuss the latest research around calf pain in runners and what is actually going on. We want to give you all the tools you need to assess runners that present with calf pain, so we have included this in the episode as well. We also created a free handout with the info and assessment tests from this podcast, which you can download here. If you would like to up your game on calf pain, here are some of the highlights from the podcast: What is responsible for calf pain in runners? What are the common symptoms? What will imaging show (or not show)? What happened to chronic exertional compartment syndrome (CECS)? Does it still exist? What is biomechanical overload syndrome, and how is it different to CECS? Who are the most likely culprits to experience calf pain? How can you assess runners with calf pain? What tests should you perform? How can you perform a calf capacity test? Tom Goom and I are releasing free Achilles running rehab videos - a series of three evidence-based videos to get you great results with achilles tendinopathy. These will be out soon, so join us to master Achilles treatment Links of Interest Free Achilles running rehab videos with Tom Goom - a series of three evidence-based videos to get you great results with achilles tendinopathy Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries Download and subscribe to the podcast on iTunes Download your free podcast handout on calf pain in runners Tom Goom on Twitter Let David Pope know what you liked about this podcast on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Related posts Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Physio Edge 062 How to treat plantar fasciopathy in runners with Tom Goom Infographic - How to treat plantar fasciopathy in runners with Tom Goom Research associated with this episode Franklyn-Miller et al. 2012. Biomechanical overload syndrome: defining a new diagnosis Breen et al. 2015. Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: A case series
How can you treat plantar fasciopathy? How can you return your plantar fasciopathy patients to activity and running? When can they run without aggravating their pain? In episode 62 of the Physio Edge podcast, Tom Goom and David Pope help you discover exactly how you can get great treatment outcomes with plantar fasciopathy. You will discover: How can you treat plantar fasciopathy (PF)? How can you help reduce plantar fascia pain during the "pain-dominant" phase? How can you improve load capacity during the "load-dominant" phase? When do your patients need relative rest? What cross training options are suitable for runners with PF? When and how can you incorporate strengthening into your treatment? What other impairments should you address in your treatment? How do you adapt strengthening if your patients pain is irritable vs non-irritable Is stretching helpful? Should you include other treatment, eg taping, orthotics, gel heel cup When can your patients return to running? How long is the average recovery from PF? A PF case study with exercise progressions and return to running. Download Physio Edge podcast episode 62 now to find out all of this and more This podcast follows on from Physio Edge 060 Plantar fasciopathy in runners with Tom Goom and Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Links of Interest Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries Download and subscribe to the podcast on iTunes Download your free podcast handout on plantar fasciopathy in runners Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Related posts Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy in runners with Tom Goom Infographic - Plantar fasciopathy imaging & education with Tom Goom Physio Edge 061 How to assess & diagnose plantar fasciopathy in runners with Tom Goom Infographic - How to assess & diagnose plantar fasciopathy in runners with Tom Goom Research associated with this episode Rathleff et al. 2014. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.
Assessment and diagnosis is vital in planning your plantar fasciopathy treatment program, and successfully returning your patients to activity and running. Structures in the vicinity of the plantar fascia insertion may contribute to plantar heel pain, but require a very different treatment approach. How can you identify other structures that are involved? What questions do you need to ask in the history? How can you perform an examination, and what tests should you perform on patients with plantar fasciopathy? In episode 61 of the Physio Edge podcast, Tom Goom and David Pope help you discover exactly how you can assess and differentially diagnose plantar fasciopathy. You will discover: Plantar fasciopathy clinical presentation How to identify fat pad irritation Patterns of calcaneal and navicular bony stress injuries How you can identify nerve entrapment and radiculopathy Red flags such as spondyloarthropathy Questions to ask in your subjective that will guide your diagnosis and treatment How to perform an objective assessment Tests you need to perform Identifying impairments to address during rehabilitation When you should perform a running assessment Download Physio Edge podcast episode 61 now to find out all of this and more This podcast follows on from Physio Edge 060 Plantar fasciopathy in runners with Tom Goom Links of Interest Join the 21 day challenge to improve your exercise prescription skills, confidence and results with rehabilitation of running injuries Download and subscribe to the podcast on iTunes Download your free podcast handout on plantar fasciopathy in runners Enrol on the free 21 day challenge "21 days to better skills, confidence and results with runners Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Infographics by Clinical Edge Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Enrol on the free webinar "How to treat persistent pain, and use the latest pain education strategies in your treatment" with Mike Stewart Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy Research associated with this episode Rathleff et al. 2014. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Riel H, et al Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on
Plantar fasciopathy is one of the most common causes of foot pain in runners and non-athletes alike. Our understanding of plantar fasciopathy (PF) pathology and treatment has progressed significantly over recent years. In episode 60 of the Physio Edge podcast, Tom Goom and David Pope explore PF, what we know about it, and how you can explain the condition, treatment and recovery process to your patients. You will discover: What we know about plantar fasciopathy What pathology is present What information imaging provides Which forms of imaging are the most useful What are the risk factors for developing PF Which aspects of running may be related or contribute to developing PF? How can you explain PF the condition, treatment and recovery process to your patients Download this podcast now to find out all of this and more Links of Interest Download and subscribe to the podcast on iTunes Download your free podcast handout on plantar fasciopathy in runners Enrol on the free 21 day challenge "21 days to better skills, confidence and results with runners Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy Research associated with this episode Sullivan et al. 2015. Musculoskeletal and Activity-Related Factors Associated With Plantar Heel Pain Nielsen et al. 2013. Predictors of Running-Related Injuries Among 930 Novice Runners van Leeuwen, et al. 2015. Higher body mass index is associated with plantar fasciopathy/‘plantar fasciitis’: systematic review and meta-analysis of various clinical and imaging risk factors Riel H, et al Is ‘plantar heel pain’ a more appropriate term than ‘plantar fasciitis’? Time to move on
How can you identify the most important factors involved in your patients running injuries? During your rehabilitation of runners, which is most important to address - load, gait pattern, strength, foot strike, pelvic position, footwear, range of movement or other factors? I wanted to discuss and debate these issues with a number of Physiotherapists that treat and research running injuries, so I have a very different format for you on this episode of the Physio Edge podcast - a group podcast. On this podcast, we have Tom Goom, Greg Lehman and Dr Christian Barton all in one virtual room discussing and debating the merits of the various approaches to running injuries. In this episode of the Physio Edge podcast David Pope and the group discuss: When is it ok for your runners to continue running, and when do they need to stop Common myths around running retraining When is it important to change your patients foot strike? Which patient presentations and pathologies will be assisted with running retraining? How can you identify a suitable running load during rehab How can you incorporate running retraining into your rehab Which areas are important to running assessment How can you manage training load strength and conditioning When are plyometrics appropriate during rehabilitation Other factors that impact injury prognosis and duration What advice can you give new runners Which footwear should runners wear? Download this podcast now to find out all of this and more Links of Interest Download and subscribe to the podcast on iTunes Download your free podcast handout on running injuries Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership Tom Goom - Running Physio website - Tom on Twitter - Tom Goom's website & courses - Tom on Facebook Live Greg Lehman - Greg Lehman's website - Twitter - Facebook Dr Christian Barton - Twitter - LaTrobe Sport and Exercise Medicine Research Blog Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy Papers mentioned in this episode Is there an economical running technique? A review of modifiable biomechanical factors affecting running economy Influence of step length and landing pattern on patellofemoral joint kinetics during running The training-injury prevention paradox: should athletes be training smarter and harder? Optimizing strength training for running and cycling endurance performance: A review A negative life event impairs psychosocial stress, recovery and running economy of runner Running shoes and running injuries: mythbusting and a proposal for two new paradigms: preferred movement path and comfort filter The effectiveness of exercise interventions to prevent sports injuries: a syatematic review and meta-analysis of randomized controlled trials Chronic psychological stress impairs recovery of muscular function and somatic sensations over a 96-hour period Frontal plane kinematics of the hip during running: Are they related to hip anatomy and strength? High eccentric hip abduction strength reduces the risk of developing patellofemoral pain among novice runners initiating a self structured running program: a 1 year observational study
Your athletes workload consists of the amount of running, training and matches performed. Their current workload can be compared to previous workload to identify periods where they may be at risk of injury or setting back their rehabilitation (Gabbett 2016). Balancing your athletes workload during rehabilitation and afterwards is vital to allow recovery from injury, improved performance while avoiding further injury. What do you need to monitor, and how can you monitor workload in an easy and efficient manner? Find out in this episode of the Physio Edge podcast with Tom Goom and David Pope. You will also discover: What is athlete monitoring? What is the aim? What do we want to monitor? What are external training loads? What are internal training loads? How might we monitor athletes? What do we do with the data we get? Download this podcast now to find out all of this and more Links of Interest Download and subscribe to the podcast on iTunes Download your free podcast handout on athlete monitoring Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy Reference: Gabbett, TJ. The training—injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med 2016;50:273-280
Helping our running patients recover and return to running following injury is our primary rehab priority, however we may also have the opportunity to help improve their running performance. Runners are often motivated by improving their speed, performance and times, and incorporating these goals into their rehab can increase motivation and exercise compliance. How then can we help our patients to improve their performance when returning from an injury? Find out in this episode of the Physio Edge podcast with Tom Goom. You will also discover: Why consider performance? How might we assess performance in a more scientific way? What are the benefits of performance tests? How can we link it to other aspects e.g. gait analysis? How does performance influence training structure and progression? How do we optimise performance in injured athletes? Links of Interest Download and subscribe to the podcast on iTunes Download your free podcast handout on advanced performance tests & optimising performance in runners Enrol on the free webinar "How to perform a running assessment" with Dr Rich Willy Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership Tom Goom's website & courses Tom on Facebook Live Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy
Identifying how much running each of your patients can perform (their load capacity) during their rehabilitation is a skill. This podcast will help you develop your load management skills, and know how much running your individual patients should perform at each stage of their rehabilitation. In this podcast with Tom Goom, you will discover: What is load capacity? How do we identify your patient’s running capacity? How are your patient’s progressing in their rehabilitation, relative to where they want to be? How can you identify what your patients goals are, so that you can help tie this into a rehab program? What questions can you ask your patients to assess load capacity and identify the right amount of load? What objective tests can you use to help identify your patient’s load capacity? How should you adapt your testing with different pathology? What tests can you perform to identify your patient’s load capacity if your patient has an Achilles Tendinopathy? What measures can we use to identify your patient’s running performance? This podcast is the first in a series of podcasts over the next few months with Tom Goom, where we will help to develop your assessment and treatment skills, while improving your results with runners. Links of Interest Download and subscribe to the podcast on iTunes Download your free podcast handout on load capacity in runners Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy Tom Goom on Twitter Connect with David Pope on Twitter Review the podcast on iTunes Like the podcast on Facebook Get your free trial Clinical Edge membership Tom Goom’s website & courses Tom on Facebook Live Enrol on the free webinar “How to perform a running assessment” with Dr Rich Willy Related articles Cook J, Docking S. “Rehabilitation will increase the ‘capacity’ of your …insert musculoskeletal tissue here….” Defining ‘tissue capacity’: a core concept for clinicians. BJSM 2015
The rotator cuff and rotator cuff tendons are often involved in shoulder pain, and targeted with our treatment. Dr Chris Littlewood is a Physio and senior research fellow at the University of Sheffield, and spends a large portion of his time studying and treating shoulder pain, including rotator cuff tendinopathy. In this episode, Chris and I discuss how to identify rotator cuff tendinopathy and other types of shoulder pain, and how you can direct your treatment for rotator cuff tendinopathy. We also explore: Other sources of shoulder pain Clues that the cervical spine could be referring pain to the shoulder Unstable shoulder Red flags When to image the shoulder When bursal thickness or effusion is or isn’t a problem Shoulder assessment Stiff painful shoulders Treatment for rotator cuff tendinopathy Improving exercise adherence When to perform special orthopaedic tests Injections Surgery Is there really a rotator cuff exercise, compared to a scapular muscle exercise? Do exercises isolate the rotator cuff? Download your free handout “Rotator cuff tendinopathy” Links of interest Webinar with Dr Chris Littlewood Download the handout from this podcast Webinar with Tom Goom on Bone stress injuries Cervical spine assessment & treatment online course Clinical Edge Clinical Edge free trial David Pope on Twitter David on Facebook Live video
Proximal hamstring tendinopathy (PHT) occurs in athletes, runners, weightlifters, and other athletes, as well as more sedentary patients, causing pain at the hamstring origin and limiting your patients ability to sit, run and continue to be active. There are a number of structures that can contribute to pain in this area, and in this podcast, Tom Goom and David Pope discuss how to clearly identify PHT and differentiate it from lumbar spine referred pain, hip pain, sciatic nerve pain and other conditions. Tom recently released an article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management with Peter Malliaras, Mike Reiman and Craig Purdam. We explore this article, and the research around PHT, and cover in detail: Subjective clues to guide you towards diagnosis Aggravating factors and 24 hour pain patterns Differential diagnosis Lumbar spine pain How the lumbar spine could contribute to development of PHT Hip pain SIJ pain Sciatic nerve pain Development of PHT Central sensitisation Diagnostic tests for PHT Hamstring tests Other assessment tests Functional tests The value of palpation Tests for involvement of the rest of the kinetic chain Running assessment/gait analysis Testing load tolerance Biopsychosocial aspects of tendon recovery Other advice for patients Whether stretching is helpful When your patient can return to running Cross training Does manual therapy have a role in the treatment of PHT? Starting treatment (Stage 1) When and how to progress rehabilitation (Stage 2) Further rehabilitation progressions (Stage 3) Advanced exercise progressions for high load sports Exercises you can incorporate during the various stages How long recovery will take Links Free webinar with Tom Goom Download the free handout summary of this podcast Tom’s website - Running Physio Tom on Twitter Running Repairs courses with Tom Article in JOSPT on Proximal Hamstring Tendinopathy: clinical aspects of assessment and management JOSPT Peter Malliaras Mike Reiman Craig Purdam VISA-H Become a Clinical Edge member to access Tom’s webinar and other great online education
Putting big mouths and big ideas behind microphones. The Physio Matters Podcast is a feature of Chews Health's third core value ‘We
In the second episode of The NAF Physio Podcast, Adam talks with Tom Goom aka The Running Physio about babies, blogs, twitter and superman, and of course about running, and runners injuries, from the common calf strain to anterior knee pain, we talk about the role of isolated and functional exercises for runners, as well as the controversial topic of running gait mechanics: Should we try to address them and how?
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