1 00:00:00,520 --> 00:00:03,120 This episode of The Doctors Running Podcast is sponsored by 2 00:00:03,120 --> 00:00:04,360 her friends at Running Warehouse. 3 00:00:04,640 --> 00:00:07,160 Make sure you head over to their YouTube page to catch the second 4 00:00:07,160 --> 00:00:09,880 episode of their new series Test Run, where they put the team 5 00:00:09,880 --> 00:00:12,400 through a series of challenges to help showcase what kind of 6 00:00:12,400 --> 00:00:14,400 activities each shoe is best suited for. 7 00:00:15,000 --> 00:00:17,040 Their latest episode is all about versatility. 8 00:00:17,280 --> 00:00:19,520 Connor and the team brought out some fan favorite trainers of 9 00:00:19,520 --> 00:00:22,480 the past year including The Socket Endorphin Speed A6, Nova 10 00:00:22,480 --> 00:00:25,640 Blast Three, Poca Clifton 9 and New Balance Rebel V3 to see 11 00:00:25,640 --> 00:00:28,150 where each shoe excelled. Check out the results of their 12 00:00:28,150 --> 00:00:30,590 test by heading over to Running Warehouses channel on YouTube 13 00:00:30,590 --> 00:00:39,270 today. Hello everyone and welcome to 14 00:00:39,270 --> 00:00:41,990 the Docs Spring Podcast where we, a group of doctors to 15 00:00:41,990 --> 00:00:44,390 physical therapy discuss the art and science of running and the 16 00:00:44,390 --> 00:00:47,470 stuff that we put on our feet. Today at the round table we have 17 00:00:47,470 --> 00:00:50,990 myself, Nathan, I'll be hosting and we have Doctor David Salas 18 00:00:50,990 --> 00:00:54,110 who is joining me. We have a really fun episode 19 00:00:54,110 --> 00:00:58,430 today, but if this episode goes from having both of us here to 20 00:00:58,430 --> 00:01:02,510 becoming a David Solo episode. The reason why is because I got 21 00:01:02,510 --> 00:01:07,710 up at 4:00 AM while 340 or whatever to catch the US Today 22 00:01:07,710 --> 00:01:10,550 is the day where they played in the round of 16, the US women's 23 00:01:10,550 --> 00:01:14,430 soccer. So I am totally spent. 24 00:01:14,430 --> 00:01:16,630 I'm just so tired from getting up that early. 25 00:01:17,430 --> 00:01:20,350 So if this becomes a David Solo episode, you know I just fell 26 00:01:20,350 --> 00:01:24,150 asleep at the wheel here. But outside of that, we have a 27 00:01:24,150 --> 00:01:26,350 really actually a fun episode today. 28 00:01:26,470 --> 00:01:30,390 We are dipping into the mailbag and we wanted to hear what your 29 00:01:30,390 --> 00:01:33,710 questions were surrounding hamstrings and hamstring 30 00:01:33,710 --> 00:01:35,590 injuries. So that is going to be the topic 31 00:01:35,590 --> 00:01:39,110 of today And that kind of leads us into our subjective, we 32 00:01:39,110 --> 00:01:42,070 really got a lot of questions. We won't be able to probably hit 33 00:01:42,070 --> 00:01:45,270 all the questions we got. So our next subjective is what 34 00:01:45,270 --> 00:01:49,350 is the next condition or tissue or whatever that you want to 35 00:01:49,350 --> 00:01:51,790 hear us talk about. So we've talked about some in 36 00:01:51,790 --> 00:01:54,710 the past like planner fascia and Achilles. 37 00:01:54,830 --> 00:01:57,190 We can always hit those again. But what do you want to hear 38 00:01:57,190 --> 00:01:59,150 from us? That's our subjective for the 39 00:01:59,150 --> 00:02:01,910 day. All right. 40 00:02:02,390 --> 00:02:04,630 Are you ready to just jump right in, David, or do you have any 41 00:02:04,630 --> 00:02:07,750 updates? No, I think we can jump right 42 00:02:07,750 --> 00:02:09,600 in. Great, let's do it. 43 00:02:09,759 --> 00:02:12,360 Actually, let's not. I was gonna also say this is a 44 00:02:12,360 --> 00:02:15,280 great, this is actually a pretty crazy summer for our team family 45 00:02:15,280 --> 00:02:17,640 wise. So as you all know like David 46 00:02:17,640 --> 00:02:22,520 got married a couple weeks ago now and Matt as we as we record 47 00:02:22,520 --> 00:02:26,040 tonight like at any moment his wife could go into labor to have 48 00:02:26,040 --> 00:02:29,290 their first baby. So hang with us as we go through 49 00:02:29,290 --> 00:02:33,610 a lot of crazy transitions. As a team, we are working hard 50 00:02:33,610 --> 00:02:37,090 to make sure that we help or continue to crank out material 51 00:02:37,090 --> 00:02:39,170 for you. All that is useful and 52 00:02:39,170 --> 00:02:41,730 beneficial and hopefully at least a little entertaining as 53 00:02:41,730 --> 00:02:44,400 well. But now with that said, let's 54 00:02:44,400 --> 00:02:46,520 jump into the episode. So again, we dipped in the 55 00:02:46,520 --> 00:02:49,680 mailbag, we got all your questions about hamstrings, 56 00:02:49,680 --> 00:02:52,440 hamstring injuries, hamstring injury prevention, 57 00:02:52,600 --> 00:02:55,600 rehabilitation and let's just start with this one because I 58 00:02:55,600 --> 00:02:58,240 think it will kind of give us an opportunity to just talk about 59 00:02:58,240 --> 00:03:04,080 what the hamstrings are. So this is from Sealy Sealy, Ft 60 00:03:04,080 --> 00:03:07,600 Run. You got a better guess on that? 61 00:03:07,600 --> 00:03:11,840 I'm so sorry, but it says no matter what I do or who I see to 62 00:03:11,840 --> 00:03:14,600 try and fix it, it's always nagging. 63 00:03:14,920 --> 00:03:17,200 Why? So I feel like we obviously 64 00:03:17,200 --> 00:03:20,320 can't answer this question. But David, what are some things 65 00:03:20,320 --> 00:03:23,280 about the hamstring that that make it what it is, make it a 66 00:03:23,280 --> 00:03:25,560 common running injury? Let's use this as a platform to 67 00:03:25,560 --> 00:03:27,360 talk about what's going on with the hamstring. 68 00:03:28,200 --> 00:03:31,840 Yeah, so the hamstring is so dynamic of a muscle. 69 00:03:31,840 --> 00:03:34,640 I mean, we're talking about a multi joint muscle. 70 00:03:35,160 --> 00:03:39,800 They basically it runs from the issued tuberosity, meaning right 71 00:03:39,840 --> 00:03:43,480 at the sit bone there right on the bottom of that pelvis. 72 00:03:43,480 --> 00:03:45,800 It goes straight down your leg. And it's actually a group of 73 00:03:45,800 --> 00:03:47,440 muscles. We refer to it as one all the 74 00:03:47,440 --> 00:03:49,040 time, but it's actually three different muscles. 75 00:03:49,640 --> 00:03:53,320 And when you look at the well, let's just go to anatomy first 76 00:03:53,320 --> 00:03:56,960 actually. So biceps femoris goes down from 77 00:03:56,960 --> 00:03:59,560 that tuberosity down the lateral side, meaning the outside of 78 00:03:59,560 --> 00:04:01,440 your leg attaches to the head of the fibula. 79 00:04:01,970 --> 00:04:05,610 And then the semimembranosis and semi tendinosis go from that 80 00:04:05,610 --> 00:04:09,210 issue of tuberosity down immediately and then attach to 81 00:04:09,210 --> 00:04:12,450 the inside of that knee or just distal to that. 82 00:04:12,450 --> 00:04:14,490 One of them goes to a group called the peasant serene. 83 00:04:14,490 --> 00:04:16,730 The other one kind of blends in as well. 84 00:04:17,250 --> 00:04:21,810 What its job is to do in isolation is to bend the knee. 85 00:04:21,810 --> 00:04:24,890 Essentially it's knee flexion, but it does so much more than 86 00:04:24,890 --> 00:04:28,610 that dynamically and because it has that high attachment 87 00:04:28,610 --> 00:04:32,660 basically up in your butt there. When anytime you extend your leg 88 00:04:32,660 --> 00:04:35,700 out in front of you, whether it's walking, running, it's one 89 00:04:35,700 --> 00:04:38,940 of the main mechanisms that helps control your leg speed 90 00:04:38,940 --> 00:04:41,940 going forward so that you can prep your next step so that you 91 00:04:41,940 --> 00:04:43,940 can snap down onto the ground and push off. 92 00:04:44,700 --> 00:04:46,940 That's a very functional translation of it. 93 00:04:47,140 --> 00:04:50,860 However, it also does help with that initial lift and like the 94 00:04:50,860 --> 00:04:53,340 kicking up of the leg as well. So this is something that's on 95 00:04:53,340 --> 00:04:56,540 all of the time and there's a couple of different mechanisms 96 00:04:56,540 --> 00:04:58,830 as well. To help with that as well, your 97 00:04:58,830 --> 00:05:00,910 adductors on the inside of your groin can help out the 98 00:05:00,910 --> 00:05:03,790 hamstrings a little bit. And it's also, it's working 99 00:05:03,790 --> 00:05:05,990 together with everything. I mean everything from your core 100 00:05:05,990 --> 00:05:08,470 and back muscles to your hip flexors on the front side, 101 00:05:08,470 --> 00:05:12,030 everything kind of has to work alongside with each other in 102 00:05:12,030 --> 00:05:16,470 order to get the job done. And so it one of the reasons why 103 00:05:16,830 --> 00:05:21,590 hamstring injuries or niggles like like things going up and 104 00:05:21,590 --> 00:05:24,830 down over the course of time, it's not surprising because of 105 00:05:24,830 --> 00:05:28,980 how much it does and. That's not just running, that's 106 00:05:28,980 --> 00:05:34,340 living life as well. And so it's it's very, very 107 00:05:34,340 --> 00:05:38,780 tough to answer that question because it can do so many things 108 00:05:38,780 --> 00:05:41,180 and it's on all of the time. I mean, I can't tell you how 109 00:05:41,180 --> 00:05:43,740 many times I've had someone where maybe they had a proximal 110 00:05:43,740 --> 00:05:48,500 hamstring injury and their complaints shift away from, 111 00:05:48,780 --> 00:05:52,180 well, I can't run to like I'm having a hard time going 112 00:05:52,180 --> 00:05:54,300 upstairs. Like every time I sit down or I 113 00:05:54,300 --> 00:05:57,980 drive, I extend my leg out like. Certain like daily things start 114 00:05:57,980 --> 00:06:01,860 to get lost. And so when we look at 115 00:06:01,860 --> 00:06:05,340 hamstrings, I think the biggest thing initially is to look at 116 00:06:05,340 --> 00:06:07,220 irritability. How sensitive is this thing 117 00:06:07,220 --> 00:06:10,180 right now and what can we do with it outside of a pain 118 00:06:10,180 --> 00:06:13,740 sphere? And see if we could just make 119 00:06:13,740 --> 00:06:15,380 that bubble just a little tighter, a little tighter, a 120 00:06:15,380 --> 00:06:17,300 little tighter, Make it more functional, make it stronger, 121 00:06:17,300 --> 00:06:20,700 make it all the above, you know, coordination, propriception, all 122 00:06:20,700 --> 00:06:24,860 that stuff and and just create a better. 123 00:06:25,680 --> 00:06:28,000 Platform better lever. In the most literal terms, it's 124 00:06:28,000 --> 00:06:32,360 a very long stringy tendon, hence the name string, so that 125 00:06:32,360 --> 00:06:34,760 it can work for you. And not to say that it's working 126 00:06:34,760 --> 00:06:37,040 against you, sometimes it's just working hard. 127 00:06:37,640 --> 00:06:42,360 Yeah, totally. And just to kind of reiterate or 128 00:06:42,360 --> 00:06:45,480 hit on a couple of other things, just so that as we say terms, 129 00:06:45,480 --> 00:06:49,230 they hopefully will come back and kind of make a little bit 130 00:06:49,230 --> 00:06:51,950 more sense. So as you said, as David had 131 00:06:51,950 --> 00:06:54,510 said, so this is a muscle that spans 2 joints. 132 00:06:54,510 --> 00:06:57,910 So it crosses the hip joint and it crosses the knee joint. 133 00:06:58,270 --> 00:07:01,710 So if you were to contract your, your hamstring muscles, the 134 00:07:01,710 --> 00:07:05,630 whole group, you would extend your hip and you would flex your 135 00:07:05,630 --> 00:07:07,730 knee. If you wanted to quote, UN 136 00:07:07,730 --> 00:07:10,750 quote, stretch your hamstrings or put it on tension, you would 137 00:07:10,750 --> 00:07:13,110 need to flex your hip or like bring your knee towards your 138 00:07:13,110 --> 00:07:15,150 chest and then straighten your knee out. 139 00:07:15,490 --> 00:07:18,530 Those those combinations of motions are what put the 140 00:07:18,530 --> 00:07:23,410 hamstring on slack or stretch And then as David said, it's a 141 00:07:23,410 --> 00:07:28,210 very involved muscle with running the highest, the highest 142 00:07:28,250 --> 00:07:31,370 activation of the hamstrings is as David said in that what we 143 00:07:31,370 --> 00:07:34,770 call terminal swing phase. So your leg that's in the air as 144 00:07:34,770 --> 00:07:38,720 it's swinging forward, the highest activation of those 145 00:07:38,720 --> 00:07:42,040 hamstrings is at that end part of the swing phase. 146 00:07:42,040 --> 00:07:44,720 Because if you didn't, your leg would just keep swinging until 147 00:07:44,720 --> 00:07:48,000 you did like a punter's kick, quite literally, because those 148 00:07:48,000 --> 00:07:51,440 muscles are what slow it down and then they spike even a 149 00:07:51,440 --> 00:07:54,920 little bit more once you land. So because they help with that 150 00:07:54,920 --> 00:07:57,760 absorption of the shock. So you're slowing the limb, it 151 00:07:57,760 --> 00:08:01,560 helps absorb the shock. That's its highest activation 152 00:08:01,560 --> 00:08:05,760 point, and then it recycles over and over and over and over 153 00:08:05,760 --> 00:08:07,360 again. The other thing that you'll 154 00:08:07,440 --> 00:08:10,120 we'll know about the hamstrings is we'll go into this later 155 00:08:10,120 --> 00:08:15,240 more, but speed does change how involved the hamstring is with 156 00:08:15,240 --> 00:08:18,080 the stride. So faster, more hamstring, 157 00:08:18,080 --> 00:08:21,240 slower, less hamstring. If you've ever raised a one mile 158 00:08:21,680 --> 00:08:24,400 and you haven't raised a mile in a while, or you raised to 5K and 159 00:08:24,400 --> 00:08:27,520 you haven't raised to 5K in a while, you probably like darn. 160 00:08:27,520 --> 00:08:30,280 My hamstrings are sore today, the next day or the day after 161 00:08:30,280 --> 00:08:35,200 because hamstring utilizations utilization at those higher 162 00:08:35,200 --> 00:08:39,340 speeds is higher. So I think the other piece that 163 00:08:39,340 --> 00:08:43,179 I wanted to bring up is nothing exists in isolation. 164 00:08:43,179 --> 00:08:46,300 The hamstrings within them and underneath them flow the sciatic 165 00:08:46,300 --> 00:08:49,220 nerve and a lot of other anatomical structures. 166 00:08:49,220 --> 00:08:52,660 So when you have pain in that region, there can be a lot of 167 00:08:52,660 --> 00:08:55,180 different causes for these things, which is why if you 168 00:08:55,180 --> 00:08:57,700 don't get the right thing treated, it can lead to 169 00:08:57,940 --> 00:09:02,170 prolonged issues. And as is most things, our 170 00:09:02,170 --> 00:09:06,450 understanding of what causes the pain and why pain exists or what 171 00:09:06,450 --> 00:09:09,370 is the actual like cellular changes, that's all under 172 00:09:09,370 --> 00:09:11,530 investigation. Still nothing is completely set 173 00:09:11,530 --> 00:09:13,730 in stone. We're learning a lot about our 174 00:09:13,730 --> 00:09:16,210 perception of pain and where that comes from and what's the 175 00:09:16,210 --> 00:09:19,130 actual, you know, source in the just because something 176 00:09:19,130 --> 00:09:21,850 anatomically looks weird at the cellular level doesn't mean that 177 00:09:21,850 --> 00:09:24,850 that's causing the pain. So I would just to premise this 178 00:09:24,850 --> 00:09:29,170 whole thing, This is not going to be obviously a lecture, like 179 00:09:29,170 --> 00:09:31,330 a doctoral level lecture around this stuff. 180 00:09:31,330 --> 00:09:33,890 We're trying to give tangible things, but it's also not 181 00:09:33,890 --> 00:09:36,970 everything's figured out. So we will obviously won't have 182 00:09:36,970 --> 00:09:39,050 all the answers. Nobody can really have all the 183 00:09:39,050 --> 00:09:41,730 answers. But we do want to try to address 184 00:09:41,730 --> 00:09:44,890 some of these questions and maybe hopefully help people with 185 00:09:44,890 --> 00:09:46,810 some some of their issues and pitfalls. 186 00:09:46,810 --> 00:09:50,050 But this is all just educational, not specific 187 00:09:50,210 --> 00:09:56,090 medical advice. The last thing I will add is we 188 00:09:56,090 --> 00:09:59,280 always talk about make sure that there is an involvement from the 189 00:09:59,280 --> 00:10:01,600 back when it comes to lower extremity injuries. 190 00:10:01,800 --> 00:10:07,120 The hamstring is a muscle that's innervated by levels L5, S 1, S 191 00:10:07,120 --> 00:10:12,120 2 and so that's a pretty common area for what we call lumbar 192 00:10:12,120 --> 00:10:14,360 radiculopathy. So a lot of times if people are 193 00:10:14,360 --> 00:10:19,200 having low back pain associated with leg pain, you might find 194 00:10:19,200 --> 00:10:21,920 that there's weakness associated and all these other things. 195 00:10:21,920 --> 00:10:24,480 So the back is also an important thing to be screening when you 196 00:10:24,480 --> 00:10:27,820 have pain in the back of the leg whether especially if you're a 197 00:10:27,820 --> 00:10:30,220 clinician, you should be checking that out with with your 198 00:10:30,220 --> 00:10:32,540 runners. All right. 199 00:10:33,740 --> 00:10:38,500 I think to DJ maybe giving a quick list of kind of just 200 00:10:38,500 --> 00:10:42,500 general types of locations of pain or types of injuries that 201 00:10:42,500 --> 00:10:46,540 we see in in hamstrings. Do you want to lay a couple out 202 00:10:46,540 --> 00:10:50,180 for everybody? Yeah, so there's a couple 203 00:10:50,180 --> 00:10:53,340 different things that can happen at the hamstring and. 204 00:10:54,070 --> 00:10:56,630 We talked about it a little bit with the nuances. 205 00:10:56,630 --> 00:11:00,430 Anatomically, there's just a lot going on and this is a really 206 00:11:00,430 --> 00:11:02,390 long muscle. I mean, it's going from like 207 00:11:02,390 --> 00:11:05,990 you're bumped all the way down to the like, distal part of your 208 00:11:05,990 --> 00:11:08,670 knee, top of the shin there on the backside. 209 00:11:09,230 --> 00:11:14,070 And so usually when we refer to hamstring injuries, they're 210 00:11:14,590 --> 00:11:16,950 they're almost always either proximal or distal. 211 00:11:18,510 --> 00:11:21,630 Proximal meaning closer up to like this centerpiece of your 212 00:11:21,630 --> 00:11:24,590 spine there, so that would be essentially high up in the butt 213 00:11:24,590 --> 00:11:27,710 there. Usually you feel it when your 214 00:11:27,710 --> 00:11:30,950 leg reaches out in front of you or tries to decelerate your leg, 215 00:11:30,950 --> 00:11:32,350 like we were talking about earlier. 216 00:11:32,990 --> 00:11:36,150 But you can't have it distally as well and distally meaning 217 00:11:36,150 --> 00:11:39,430 further away from you. That can be on the inside of the 218 00:11:39,430 --> 00:11:40,710 knee. That can be on the outside of 219 00:11:40,710 --> 00:11:45,520 the knee, probably more outside. Is more common than the inside, 220 00:11:45,520 --> 00:11:48,240 just because of stability and other things going on. 221 00:11:48,240 --> 00:11:51,480 You have internal rotation of your femur when you land. 222 00:11:51,480 --> 00:11:53,240 It's part of the shock absorbing mechanism. 223 00:11:53,240 --> 00:11:55,600 Sometimes it just gets a little bit irritated of rubbing on the 224 00:11:55,600 --> 00:11:59,520 outside of the knee or someone's really quad dominant and they 225 00:11:59,520 --> 00:12:02,720 have other things going on for the IT band and whatnot, but 226 00:12:04,160 --> 00:12:06,000 usually that'd be proximal, distal. 227 00:12:06,280 --> 00:12:10,600 Sometimes you can get muscle belly, you know genuine pain as 228 00:12:10,600 --> 00:12:13,160 well, whether it's weightlifting isom like. 229 00:12:13,560 --> 00:12:17,280 Isolated exercises, a bunch of knee flexion exercises or even 230 00:12:17,280 --> 00:12:22,320 just straight like bridges with rollouts or things like that 231 00:12:22,320 --> 00:12:24,760 where you're trying to isolate and really work those hamstrings 232 00:12:24,760 --> 00:12:29,320 and they get sore. Sometimes you'll get proximal 233 00:12:29,320 --> 00:12:32,640 that becomes belly where it kind of starts up high and then as it 234 00:12:32,640 --> 00:12:35,120 gets a little bit more irritated, they'll feel it down 235 00:12:35,120 --> 00:12:37,370 the leg. And then like you mentioned 236 00:12:37,370 --> 00:12:40,330 earlier, this could not be a hamstring thing at all. 237 00:12:40,330 --> 00:12:43,450 This could be something spinal where maybe there's a disc bulge 238 00:12:43,490 --> 00:12:47,250 or some stenotic changes happening or some kind of 239 00:12:47,250 --> 00:12:51,090 neurological involvement that's decreasing strength or 240 00:12:51,090 --> 00:12:53,770 increasing, you know, just neurologic tension where like 241 00:12:53,770 --> 00:12:55,850 everything around, it's just kind of gripping around that 242 00:12:55,850 --> 00:12:59,690 hamstring a little bit more. So it feels tighter because it's 243 00:12:59,770 --> 00:13:03,130 holding on to it more, you know where it's not maybe it's not 244 00:13:03,130 --> 00:13:07,900 truly quote UN quote tight, but. It's guarded, so there's a lot 245 00:13:07,900 --> 00:13:10,260 of different things that can go into hamstrings. 246 00:13:10,260 --> 00:13:14,100 And I mean, we said it before, but it's so dynamic of a muscle 247 00:13:14,100 --> 00:13:17,180 and it's so long of a muscle. There's just so many things that 248 00:13:17,660 --> 00:13:21,740 can go into it. Yeah, I I like to categorize 249 00:13:21,740 --> 00:13:25,100 them and basically is an issue with the tendon, is it an issue 250 00:13:25,100 --> 00:13:27,780 with the muscle belly or is it an issue with the muscular 251 00:13:27,780 --> 00:13:30,740 tendon as junction where the muscle kind of transitioned into 252 00:13:30,740 --> 00:13:33,220 being a tendon and then the tendon attaches to the bone? 253 00:13:33,680 --> 00:13:36,480 And the tendon issues can either, as you said, be proximal 254 00:13:36,480 --> 00:13:39,200 up by your sit bone or distill down by your knee. 255 00:13:39,240 --> 00:13:41,680 And then the everything in between is kind of from the 256 00:13:41,680 --> 00:13:43,520 muscle belly. The muscle belly stuff is 257 00:13:43,520 --> 00:13:46,080 typically like an acute injury from like. 258 00:13:46,080 --> 00:13:48,760 Something sprinting, yeah. Yeah, so like that. 259 00:13:48,760 --> 00:13:53,320 That's we often on this podcast end up talking a little bit more 260 00:13:53,320 --> 00:13:57,960 about distance running pretty much anything 800 and up. 261 00:13:59,120 --> 00:14:03,120 But you know, that is a reality where the muscle belly stuff is 262 00:14:03,120 --> 00:14:05,400 probably gonna. To sit more in that sprinting, 263 00:14:05,400 --> 00:14:07,440 which could happen in a kick for an 800 too. 264 00:14:07,600 --> 00:14:09,880 So I mean, I've. Pulled up a little bit, Kick in 265 00:14:09,880 --> 00:14:13,240 before. Yeah, you're 15105 K It's 266 00:14:13,240 --> 00:14:14,680 happened. That's good. 267 00:14:15,040 --> 00:14:16,960 That's good. That's a good thing. 268 00:14:16,960 --> 00:14:17,760 That's. Great. 269 00:14:17,920 --> 00:14:19,760 It's a great thing. You're so fast. 270 00:14:19,760 --> 00:14:22,120 Shouldn't be pulling up in the last fifty of the race, but. 271 00:14:22,160 --> 00:14:24,800 Hamstring, hamstring tears are great because it means you're 272 00:14:24,800 --> 00:14:28,400 running fast enough, right? All right. 273 00:14:28,400 --> 00:14:30,320 So let's move on to our next question. 274 00:14:30,320 --> 00:14:33,520 So we had multiple questions on one of these topics that you 275 00:14:33,520 --> 00:14:35,800 just kind of laid out there, David, and that's proximal 276 00:14:35,800 --> 00:14:38,200 hamstring tendinopathy. So here's kind of the questions 277 00:14:38,520 --> 00:14:41,280 Ebgb's asks. What can be done for rehab and 278 00:14:41,280 --> 00:14:45,200 management of proximal hamstring tendonitis and then Fox in socks 279 00:14:45,200 --> 00:14:50,470 in box with no asks? What do you recommend for 280 00:14:50,470 --> 00:14:52,710 insertional hamstring tendinopathy? 281 00:14:52,710 --> 00:14:55,950 And we're assuming that insertional means inserting into 282 00:14:55,950 --> 00:14:58,870 the bone proximately up by the sit bone. 283 00:14:58,870 --> 00:15:01,270 So I've been doing a little bit of work on this. 284 00:15:01,270 --> 00:15:03,830 I have a couple athletes who've been dealing with proximal 285 00:15:03,830 --> 00:15:06,710 hamstring tendinopathy. So there's a really great 286 00:15:06,710 --> 00:15:10,670 article by a guy named Tom Gum. He's actually running physio if 287 00:15:10,670 --> 00:15:12,830 you want to like, look him up, but he's an awesome 288 00:15:12,830 --> 00:15:15,910 physiotherapist, has a lot of continued education for runners 289 00:15:15,910 --> 00:15:18,510 if you are a PT and you want to do a core. 290 00:15:18,590 --> 00:15:21,510 Course, he has what's called the running Repairs course. 291 00:15:21,510 --> 00:15:23,870 It's an online CEU that you can do. 292 00:15:24,110 --> 00:15:28,830 I think it's really good stuff and he's got a really great 293 00:15:28,830 --> 00:15:32,150 clinical commentary that came out a bit ago about runners with 294 00:15:32,150 --> 00:15:35,200 proximal hamstring tendinopathy. And I think the big thing about 295 00:15:35,200 --> 00:15:38,640 proximal hamstring tendinopathy, just remember it's at that point 296 00:15:38,640 --> 00:15:41,520 where it's inserting into your sit bone, you're often going to 297 00:15:41,520 --> 00:15:43,880 get kind of like what feels like deep buttock pain. 298 00:15:43,880 --> 00:15:46,520 Sometimes it feels like it radiates up into the buttock a 299 00:15:46,520 --> 00:15:49,040 little bit more, sometimes it radiates down the leg a little 300 00:15:49,040 --> 00:15:51,960 bit. And oftentimes the people feel 301 00:15:51,960 --> 00:15:54,880 pain at that point where there's the highest hamstring 302 00:15:54,880 --> 00:15:58,120 activation, which is right either as or right after that 303 00:15:58,120 --> 00:16:00,480 foot is hitting the ground. Remember, your hamstring is 304 00:16:00,640 --> 00:16:03,680 contracting to slow your limb down and then it helps a little 305 00:16:03,680 --> 00:16:05,040 bit with. That shock absorption. 306 00:16:05,280 --> 00:16:07,440 And that's the point where people who have proximal 307 00:16:08,160 --> 00:16:13,640 hamstring tendinopathy tend to feel their symptoms and it's 308 00:16:13,680 --> 00:16:17,200 actually a real bugger to treat. And part of that is because the 309 00:16:17,200 --> 00:16:23,040 issue is not only the activation of the hamstring, but it's also 310 00:16:23,040 --> 00:16:26,880 the compression of that tendon. So if you can, picture yourself 311 00:16:26,880 --> 00:16:28,480 bringing your knee to your chest. 312 00:16:28,870 --> 00:16:31,910 And you have, you know, the tendon sticking into a bone. 313 00:16:31,950 --> 00:16:35,190 That tendon gets stretched but also compressed and like bent 314 00:16:35,230 --> 00:16:38,790 over that sit bone. And so one of the issues with 315 00:16:38,790 --> 00:16:40,350 this is that you not only need to. 316 00:16:41,660 --> 00:16:44,740 Moderate the amount of of loading that goes to the tendon 317 00:16:44,740 --> 00:16:47,140 from a force production perspective, you have to limit 318 00:16:47,140 --> 00:16:49,940 the amount of compression and the way that you can do that 319 00:16:49,940 --> 00:16:52,540 from a rehab perspective is limiting the amount of hip 320 00:16:52,540 --> 00:16:54,980 flexion or bringing your knee towards your chest when you're 321 00:16:54,980 --> 00:16:59,660 doing different activities. So if you're for example, for 322 00:16:59,660 --> 00:17:02,540 some people, skipping a step might be painful, but a single 323 00:17:02,540 --> 00:17:05,339 step as you're going upstairs might not, and that's because 324 00:17:05,339 --> 00:17:07,420 you're going into less less hip flexion. 325 00:17:07,950 --> 00:17:11,190 If you're running faster as you're bringing your leg forward 326 00:17:11,190 --> 00:17:14,030 and if your knee is coming higher, that's more hip flexion, 327 00:17:14,030 --> 00:17:16,349 you might get more compression of the tendon during that 328 00:17:16,349 --> 00:17:19,109 deceleration phase. So there's a lot of things that 329 00:17:19,109 --> 00:17:22,910 can lead to increased irritation that are very minute changes. 330 00:17:22,910 --> 00:17:27,069 So running at 8 versus A7 versus a 6 minute per mile might be the 331 00:17:27,069 --> 00:17:30,150 thing that flares it back up as you're trying to get in on your 332 00:17:30,150 --> 00:17:33,710 rehab. There's kind of, you know the 333 00:17:33,790 --> 00:17:35,630 the name of the game is Load management. 334 00:17:36,940 --> 00:17:40,260 You have to do the right up type of loading, but you can't do no 335 00:17:40,260 --> 00:17:43,300 loading at all if you just rest. This is one of those things that 336 00:17:43,300 --> 00:17:45,660 isn't going to get better on a cellular level. 337 00:17:45,660 --> 00:17:49,220 It has to do with real. Ultimately there's changes in 338 00:17:49,220 --> 00:17:50,620 like what's called ground substance. 339 00:17:50,970 --> 00:17:54,090 But it comes to changes in what's called collagen and it 340 00:17:54,090 --> 00:17:56,650 means that you have to give it the right load to train it to go 341 00:17:56,650 --> 00:18:00,330 back to the proper orientation, which we know in the Achilles 342 00:18:00,330 --> 00:18:02,010 tendon can take about nine months. 343 00:18:02,210 --> 00:18:04,730 So we don't know exactly what that looks like in the 344 00:18:04,730 --> 00:18:06,010 hamstring. It's a little bit more 345 00:18:06,010 --> 00:18:10,250 squirrelly in terms of our ability to see it when we're 346 00:18:10,250 --> 00:18:12,890 doing research when it comes to like diagnostic ultrasound. 347 00:18:13,440 --> 00:18:15,800 But a lot of those principles probably still apply where this 348 00:18:15,800 --> 00:18:19,360 is a long term process. You can't hope for changes in 349 00:18:19,360 --> 00:18:21,400 two weeks. You can't hope for changes in 350 00:18:21,400 --> 00:18:23,440 six weeks. You can't hope for changes in 351 00:18:23,440 --> 00:18:26,560 eight weeks. You got to think like 3-6, nine 352 00:18:26,560 --> 00:18:30,560 months of a rehab process, which on the front end, if you have 353 00:18:30,560 --> 00:18:32,320 that in your head, that can be really helpful. 354 00:18:32,600 --> 00:18:34,960 That also means you just have to be super patient when it comes 355 00:18:34,960 --> 00:18:38,200 to running because like I said, if you try to go too fast too 356 00:18:38,200 --> 00:18:41,680 soon, it might be the one thing that just flares it back up and 357 00:18:41,680 --> 00:18:45,640 just sets you back a little bit. That does not mean that it's the 358 00:18:45,640 --> 00:18:47,920 end, you don't have to start completely over, but it's just 359 00:18:47,920 --> 00:18:51,000 one of those Rd. bumps where you just have to be OK being patient 360 00:18:51,280 --> 00:18:54,360 and then being smart with the types of exercises that you're 361 00:18:54,360 --> 00:18:57,800 doing. So when it I I I can't go into 362 00:18:58,040 --> 00:19:01,600 like all the details, but I will give a couple more kind of 363 00:19:01,600 --> 00:19:04,280 tidbits on like progressing yourself through if you're 364 00:19:04,280 --> 00:19:07,680 having pain, just like sitting on a chair if you're having pain 365 00:19:07,680 --> 00:19:10,360 just with walking or just with stairs, I would say you're 366 00:19:10,360 --> 00:19:12,360 probably in a more high irritability state. 367 00:19:13,320 --> 00:19:17,200 Which means that your loading exercises should be ones that 368 00:19:17,280 --> 00:19:19,200 aren't putting compression through the tendon. 369 00:19:19,280 --> 00:19:22,480 And that means, as I just said, like keeping your hip fully 370 00:19:22,480 --> 00:19:24,760 extended or straight. You don't want your hip bent. 371 00:19:25,080 --> 00:19:30,120 So the only way to do exercises without kind of moving into 372 00:19:30,120 --> 00:19:34,160 flexion are isometrics. So isometric bridges, if you 373 00:19:34,160 --> 00:19:36,680 have like a row, I think it's called a Roman chair, that's 374 00:19:36,680 --> 00:19:39,360 what I call them, where you can kind of like put your heels in 375 00:19:39,360 --> 00:19:41,680 and kind of bend forward. You can just hold your body at 376 00:19:41,680 --> 00:19:45,240 like a, you know, at an incline and just do single leg holds. 377 00:19:45,960 --> 00:19:48,400 We actually have. We actually have some exercises 378 00:19:48,400 --> 00:19:51,240 posted on our Instagram about proximal hamstring tenopathy 379 00:19:51,240 --> 00:19:54,440 going through or through three or four phases of rehab. 380 00:19:54,950 --> 00:19:58,110 But you got to start really easy with these long isometric holds. 381 00:19:58,190 --> 00:20:01,310 That helps with pain modulation, that helps with starting to that 382 00:20:01,310 --> 00:20:03,390 process. And once your pain comes down 383 00:20:03,390 --> 00:20:05,710 enough, that's where you start to add in hip flexion. 384 00:20:05,710 --> 00:20:07,350 That's where you start to put your feet on the ground. 385 00:20:07,350 --> 00:20:10,270 That's where you start to add in mini squats, maybe some lunges, 386 00:20:10,870 --> 00:20:12,670 There's a there's all these different kinds. 387 00:20:12,670 --> 00:20:14,550 There's no magic exercise. It's all about the right 388 00:20:14,550 --> 00:20:18,190 exercise at the right time. But you can't just push through 389 00:20:18,190 --> 00:20:21,750 pain with this either. Pain is a bit of a sign for you 390 00:20:21,750 --> 00:20:24,670 as you progress and it's recommended right now not to go 391 00:20:24,670 --> 00:20:27,750 more than about a two out of 10 on kind of a zero to 10 pain 392 00:20:27,750 --> 00:20:31,070 scale, which I I usually say is like a dull ache. 393 00:20:31,990 --> 00:20:34,990 If it comes to that, like noticeable ache or starting to 394 00:20:34,990 --> 00:20:39,190 be on like if you would actually define it as pain versus just 395 00:20:39,190 --> 00:20:43,150 like achiness, that's too much. It's got to stay a little bit 396 00:20:43,150 --> 00:20:46,750 low and it's got to stay low during the exercise and 24 hours 397 00:20:46,750 --> 00:20:51,640 after the exercise. One really nice way to know is 398 00:20:52,080 --> 00:20:55,000 if the exercise that you're doing are too much is you can 399 00:20:55,000 --> 00:21:00,040 pick a movement like a single leg bridge and you can do one in 400 00:21:00,040 --> 00:21:03,360 the morning and you rate it on a scale of zero to 10, How painful 401 00:21:03,360 --> 00:21:06,120 is it to do that thing? Then you do your activities for 402 00:21:06,120 --> 00:21:08,440 that day. The next morning you do the same 403 00:21:08,440 --> 00:21:10,480 bridge in the same position at the same time. 404 00:21:10,760 --> 00:21:14,270 And then you say, was it a zero out of 10, two out of 10, four 405 00:21:14,270 --> 00:21:16,910 out of 10, whatever it is? And you watch your trends. 406 00:21:16,910 --> 00:21:18,790 If your trends are getting worse, you know your activity is 407 00:21:18,790 --> 00:21:20,030 too much. They're staying the same. 408 00:21:20,030 --> 00:21:22,350 You're in a pretty good spot depending on how high that that 409 00:21:22,350 --> 00:21:23,910 level is. If they're coming down, 410 00:21:23,910 --> 00:21:25,630 obviously you're heading the right direction. 411 00:21:26,430 --> 00:21:30,270 So I just word vomited for way too long. 412 00:21:30,310 --> 00:21:32,990 David, what do you want to talk about with proximal hamstring 413 00:21:32,990 --> 00:21:35,750 tendinopathy? No, I think you hit it great. 414 00:21:35,750 --> 00:21:38,870 I mean, there is a couple things that go through my head 415 00:21:38,870 --> 00:21:41,640 immediately. One of them was irritability and 416 00:21:41,640 --> 00:21:44,440 then one is pain modulation and you kind of covered that pretty 417 00:21:44,440 --> 00:21:46,920 well. And looking into the range of 418 00:21:46,920 --> 00:21:49,960 motion like okay, what are we comfortable doing, you know, And 419 00:21:49,960 --> 00:21:52,840 it's like if we can't hip, like we can't flex the hip and extend 420 00:21:52,840 --> 00:21:56,120 her leg, well then why would we do those exercises if it's just 421 00:21:56,120 --> 00:21:58,680 going to piss it off, to be frank. 422 00:21:58,840 --> 00:22:02,920 And so I think it's great. You know, working in a straight 423 00:22:02,920 --> 00:22:06,720 leg position, you can still work a lot of coordinated things and 424 00:22:07,120 --> 00:22:11,120 get a lot of great work done. Without doing you know these 425 00:22:11,120 --> 00:22:16,080 drop lunges or Rdl's or well actually an RDL depending on the 426 00:22:16,080 --> 00:22:19,160 person, again right, looking at the individual. 427 00:22:20,760 --> 00:22:25,000 But it's it's just using the information you have in front of 428 00:22:25,000 --> 00:22:29,000 you and creating a plan that works for the individual and and 429 00:22:29,000 --> 00:22:31,480 feels productive. And it's like if you're able to 430 00:22:31,480 --> 00:22:34,880 get work done and your nervous system's okay with it, that 431 00:22:34,880 --> 00:22:38,850 helps tremendously with pain. Like the brain starts to trust 432 00:22:38,850 --> 00:22:41,250 it again and that nervous system starts to calm down. 433 00:22:41,250 --> 00:22:46,130 You'd be surprised like how many times something's been like just 434 00:22:46,130 --> 00:22:48,330 a little guarded. And then the 2nd that the brain 435 00:22:48,330 --> 00:22:51,650 feels like it's OK, everything lets go and all of a sudden 436 00:22:51,650 --> 00:22:53,970 there's like the limitations fall off and it's that's not the 437 00:22:53,970 --> 00:22:56,730 case for everybody. But sometimes someone kind of 438 00:22:56,730 --> 00:23:00,170 needs that permission from themself to like go into that 439 00:23:00,570 --> 00:23:03,930 next area of activity. And sometimes it does take 440 00:23:03,930 --> 00:23:05,850 taking a step or two back initially. 441 00:23:06,280 --> 00:23:09,880 To realize that and be like, oh wait, I am okay, okay and then 442 00:23:09,880 --> 00:23:12,800 it's fine. That's not the case with all 443 00:23:12,800 --> 00:23:14,840 things, right? I mean, when we talk about 444 00:23:14,840 --> 00:23:17,200 tendinopathy is usually these things have been around for a 445 00:23:17,200 --> 00:23:20,080 while. So we talked about it earlier. 446 00:23:20,080 --> 00:23:24,800 But having these kind of more longer vision approaches and 447 00:23:24,800 --> 00:23:27,320 knowing that there might be some ebbs and flows depending on the 448 00:23:27,320 --> 00:23:30,400 type of work that you're putting in, mileage, speed, whatever. 449 00:23:31,040 --> 00:23:35,720 But I think. Also being comfortable with the 450 00:23:35,720 --> 00:23:39,640 ebbs and flows and having a psychological readiness for that 451 00:23:39,640 --> 00:23:45,280 can be so helpful, 100%, yeah. Because then it, I think, as you 452 00:23:45,280 --> 00:23:50,120 just talked about the influence of how we approach the reality 453 00:23:50,120 --> 00:23:54,040 of discomfort can really influence how we experience that 454 00:23:54,040 --> 00:23:57,900 over time. And it's both a warning sign to 455 00:23:57,900 --> 00:24:02,300 us in terms of what our body can tolerate, but also a normal part 456 00:24:02,300 --> 00:24:04,820 of the adaptation process. If you're going to go through 457 00:24:04,820 --> 00:24:06,460 loading. The important part about 458 00:24:06,460 --> 00:24:09,860 exercise in my mind too, is if you have a proximal hamstring 459 00:24:09,860 --> 00:24:14,380 issue and you either limit your running run differently or don't 460 00:24:14,380 --> 00:24:17,260 run at all, you don't want to lose the overall capacity of 461 00:24:17,260 --> 00:24:19,180 that muscle. So you want to do as much, you 462 00:24:19,180 --> 00:24:22,620 know, loading and strengthening as you can without aggravating 463 00:24:22,620 --> 00:24:27,100 that tendon so that you maintain all of the strength and power 464 00:24:27,100 --> 00:24:29,140 that was there before. And I think that's what's missed 465 00:24:29,140 --> 00:24:32,660 a lot too in in rehab programs. If you do end up working with 466 00:24:32,660 --> 00:24:36,820 the PT is you get to a really good functional spot with pretty 467 00:24:36,820 --> 00:24:38,700 much everything even like easy running. 468 00:24:38,940 --> 00:24:42,180 But your rehab protocol either because insurance runs this out 469 00:24:42,180 --> 00:24:45,460 or you you can't keep going to PT from a time standpoint. 470 00:24:45,700 --> 00:24:49,660 We miss out on the power training and hamstrings are very 471 00:24:49,660 --> 00:24:52,340 powerful muscles, like they're made-up of a lot of type 2 472 00:24:52,340 --> 00:24:56,060 fibers. They are quick, fast twitch and 473 00:24:56,060 --> 00:25:00,100 so they fire when we go fast and if we don't train that during a 474 00:25:00,100 --> 00:25:03,820 rehab process that could re aggravate once you really go 475 00:25:03,820 --> 00:25:06,860 back. So that that's just another 476 00:25:06,860 --> 00:25:10,500 consideration for why strengthening is so important. 477 00:25:12,610 --> 00:25:16,050 All right, so we have another question here. 478 00:25:17,130 --> 00:25:21,610 It's from Genie Runner and they're asking how do zero drop 479 00:25:21,610 --> 00:25:25,290 shoes play a role in hamstring recruitment? 480 00:25:25,290 --> 00:25:29,530 Also, how would a carbon fiber plated shoe impact hamstring 481 00:25:29,530 --> 00:25:33,850 recruitment or roll? So David, why don't you take 482 00:25:33,850 --> 00:25:35,730 this one away? We're talking about kind of two 483 00:25:35,730 --> 00:25:38,410 parts of the spectrum. Well, zero drop can still, I 484 00:25:38,410 --> 00:25:40,370 mean kind of a carbon inflated shoe in a rocker. 485 00:25:40,370 --> 00:25:42,130 Yeah, you can. But yeah. 486 00:25:42,650 --> 00:25:44,250 But yeah, why don't you talk about that? 487 00:25:44,250 --> 00:25:47,650 There's a lot there. Yeah, I think a lot of it comes 488 00:25:47,650 --> 00:25:51,610 down to the design of the shoe. Not all zero drop shoes are made 489 00:25:51,610 --> 00:25:55,890 exactly the same. I think when we look at what a 490 00:25:55,890 --> 00:26:00,570 zero drop shoe used to be, it'd be similar to the Company 0, 491 00:26:00,570 --> 00:26:03,090 ironically. You know, these very low to the 492 00:26:03,090 --> 00:26:08,290 ground, highly flexible shoes, kind of wide tow bar. 493 00:26:08,330 --> 00:26:11,970 Well, they don't always have wide tow box, but that's kind of 494 00:26:11,970 --> 00:26:14,530 like the natural like oh, this is what your foot's supposed to 495 00:26:14,530 --> 00:26:21,290 do type philosophy. With that in mind, I think of it 496 00:26:21,290 --> 00:26:26,170 very similar as well to the very low profile bracing flats, 497 00:26:26,170 --> 00:26:28,930 things like that, where there's a lot of flexibility up front 498 00:26:29,410 --> 00:26:32,560 usually. Your legs going to be flying a 499 00:26:32,560 --> 00:26:35,120 little bit more. So if you're trying to run fast 500 00:26:35,120 --> 00:26:38,960 and push. So I would probably say on that 501 00:26:38,960 --> 00:26:42,000 ecentric component when that legs advancing, you're probably 502 00:26:42,000 --> 00:26:44,240 going to notice it a little bit more and then on the landing and 503 00:26:44,240 --> 00:26:46,440 the pushing off, you're going to notice it a lot more in your 504 00:26:46,440 --> 00:26:48,960 calves. So that could be potentially 505 00:26:48,960 --> 00:26:53,200 more like middle muscle belly to distal hamstring because of the 506 00:26:53,200 --> 00:26:56,440 kind of like landing stabilizing and having to like lift early. 507 00:26:57,090 --> 00:27:00,090 But what you can also say the same thing about these high 508 00:27:00,090 --> 00:27:04,930 stack rocker shoes as well. But I would say I'd probably go 509 00:27:04,930 --> 00:27:07,370 more on the proximal hamstring side of things, especially since 510 00:27:07,370 --> 00:27:10,450 a lot of these shoes are taken load away from the calves and so 511 00:27:10,450 --> 00:27:13,250 everything's shifting up. Your rocker is kind of shifting 512 00:27:13,250 --> 00:27:15,970 you and pitching you forward a little quicker, your heels 513 00:27:15,970 --> 00:27:20,050 raising a little bit quicker, so. 514 00:27:20,450 --> 00:27:24,170 I noticed myself, at least anecdotally between the two, I 515 00:27:24,170 --> 00:27:27,770 probably would notice a flatter geometry more distally and a 516 00:27:27,770 --> 00:27:32,530 highly rockered high stack shoe more proximately just on load 517 00:27:32,530 --> 00:27:35,170 management and what's a little bit sore following certain 518 00:27:35,170 --> 00:27:36,570 efforts. Yeah, I'd. 519 00:27:36,810 --> 00:27:39,930 I would agree with you on those. There's obviously no like 520 00:27:40,010 --> 00:27:43,050 randomized controlled trials on this exactly. 521 00:27:43,090 --> 00:27:46,290 Yeah. But you know, so it's kind of 522 00:27:46,290 --> 00:27:48,930 anybody's, it's anybody's guess. But from a biomechanical 523 00:27:48,930 --> 00:27:53,210 perspective, those high stacked rockered carbon plated shoes 524 00:27:53,210 --> 00:27:56,250 shift load away from the ankle, up towards the hamstring, up 525 00:27:56,250 --> 00:27:59,130 towards the hip specifically. Which is why I think as you were 526 00:27:59,130 --> 00:28:00,850 saying more proximately with some of those. 527 00:28:01,050 --> 00:28:04,170 Whereas with the zero drop shoe, if it's more of that kind of 528 00:28:04,170 --> 00:28:07,130 traditional flexible, zero traditional is the wrong word. 529 00:28:07,130 --> 00:28:11,130 But the minimalist type shoe that would say hey, we're still 530 00:28:11,130 --> 00:28:13,530 using a lot of our calf which means a lot of like load 531 00:28:13,530 --> 00:28:15,090 sharing. So if it was going to be 532 00:28:15,090 --> 00:28:18,580 involved with the hamstring, it may be, you know, more mid 533 00:28:18,580 --> 00:28:20,140 belly, more distal, could be proximal. 534 00:28:20,140 --> 00:28:23,260 I feel like that's a little more like dependent on the runner 535 00:28:23,260 --> 00:28:25,340 than it is the shoe. Whereas I think we know enough 536 00:28:25,340 --> 00:28:28,180 about these kind of like rocker shoes that it does shift load 537 00:28:28,180 --> 00:28:31,060 away from the ankle. And we know that whereas this 538 00:28:31,060 --> 00:28:34,100 other one's kind of like could be for me, nothing could be for 539 00:28:34,100 --> 00:28:36,220 you the worst thing in the world for your hamstring. 540 00:28:37,300 --> 00:28:39,820 That's an exaggeration, but that's kind of the point is it 541 00:28:39,820 --> 00:28:43,780 could be anywhere on the spectrum and I guess in my 542 00:28:43,780 --> 00:28:46,060 opinion, just because we don't have anything out there to show 543 00:28:46,060 --> 00:28:50,060 exactly what's going on there. Right, Good. 544 00:28:50,060 --> 00:28:53,460 And this question was actually from somebody who was recently 545 00:28:53,460 --> 00:28:56,900 on our podcast. It was an episode that Andrea 546 00:28:56,900 --> 00:29:01,020 did and interviewed her on the topic of back pain and scoliosis 547 00:29:01,060 --> 00:29:04,620 as it relates to runners. This is Doctor Jeannie Halloran. 548 00:29:04,620 --> 00:29:08,860 So check out that episode. Really interesting stuff there 549 00:29:08,860 --> 00:29:12,540 that can be applied beyond just scoliosis and just understanding 550 00:29:12,540 --> 00:29:15,710 kind of the role of our pelvis and her spine and running when 551 00:29:15,710 --> 00:29:19,830 it comes to pelvis in running. That really actually is an 552 00:29:19,830 --> 00:29:22,390 influence with hamstring stuff and we haven't touched on that 553 00:29:22,390 --> 00:29:26,510 yet, right? So let's use this next question 554 00:29:26,510 --> 00:29:28,750 and it'll flow right in perfectly with that. 555 00:29:28,750 --> 00:29:34,470 So Warren's Ong is asking at what state stage of running with 556 00:29:34,470 --> 00:29:37,670 the proximal or distal tendinopathy hurt the most. 557 00:29:37,670 --> 00:29:40,510 So kind of asking at what point in that cycle might it hurt the 558 00:29:40,510 --> 00:29:42,430 most? Do you have any thoughts on 559 00:29:42,430 --> 00:29:43,150 that? Yeah. 560 00:29:43,150 --> 00:29:44,670 I mean, we talked about it a little bit already. 561 00:29:44,670 --> 00:29:47,470 But as that leg advances forward, you're probably going 562 00:29:47,470 --> 00:29:49,110 to feel it a little bit more proximately. 563 00:29:50,270 --> 00:29:52,630 As it lands, you're probably going to feel a little bit more 564 00:29:52,630 --> 00:29:54,990 distally just from a shock absorption closest to the 565 00:29:54,990 --> 00:29:58,990 ground, like everything's going to rotating and coming down with 566 00:29:58,990 --> 00:30:03,950 you as you're landing. In relation to the pelvis or 567 00:30:04,070 --> 00:30:07,190 just just in general, there just in general did I didn't say 568 00:30:07,190 --> 00:30:08,830 pelvis, but. OK. 569 00:30:11,350 --> 00:30:15,510 Because I think the the most likely spot for either the 570 00:30:15,510 --> 00:30:19,030 proximal or distal to be felt is that terminal swing early stance 571 00:30:19,030 --> 00:30:21,190 phase. It just depends on for you what 572 00:30:21,190 --> 00:30:25,190 was the weak link and why. But I do think when we think 573 00:30:25,190 --> 00:30:29,390 about the pelvis, when you if you tuck your tailbone 574 00:30:29,390 --> 00:30:34,200 underneath you, OK, that's going to like posterior tilt of your 575 00:30:34,200 --> 00:30:36,000 pelvis, that shortens your hamstring. 576 00:30:36,320 --> 00:30:39,000 If you anteriorly tilt your pelvis, that lengthens the 577 00:30:39,000 --> 00:30:41,520 hamstring. So if you're a runner who has a 578 00:30:41,520 --> 00:30:45,960 very anterior tilt in your lumbar spine, that will bring 579 00:30:45,960 --> 00:30:49,760 your pelvis into again that anterior tilt Lord on a curve of 580 00:30:49,760 --> 00:30:51,720 your spine. All these can be OK things. 581 00:30:52,320 --> 00:30:55,240 But that will put more stretch on your hamstring as your limb 582 00:30:55,240 --> 00:30:57,400 advances. So if you're an over strider and 583 00:30:57,400 --> 00:31:01,240 you are extending your knee all the way and you're in this 584 00:31:01,240 --> 00:31:05,560 anterior tilt that because your other leg is in terminal stance 585 00:31:05,560 --> 00:31:07,840 phase, which is where your hips are going to go into that 586 00:31:07,840 --> 00:31:12,160 anterior tilt anyway, you have to recognize that that could be 587 00:31:12,160 --> 00:31:15,280 leading to a lot of strain through that hamstring. 588 00:31:15,480 --> 00:31:18,240 So anterior tilt of your palace put excess stress and if you're 589 00:31:18,240 --> 00:31:21,800 overstriding with an extended knee, that's that's kind of a 590 00:31:21,800 --> 00:31:24,240 recipe for high, high strain through the hamstrings. 591 00:31:25,180 --> 00:31:29,300 And that could be again a reason why if somebody has that they 592 00:31:29,300 --> 00:31:31,660 might feel a little bit more proximately than they do 593 00:31:31,660 --> 00:31:35,020 distally just because that will lead to increased compression at 594 00:31:35,020 --> 00:31:38,820 that sit bone joint. The other part is when it comes 595 00:31:38,820 --> 00:31:41,900 to mechanics, when I'm doing running analysis with people, 596 00:31:41,900 --> 00:31:43,940 one of the things that we look at is landing position. 597 00:31:44,140 --> 00:31:47,580 I care a lot about, care a lot depending on the person, care a 598 00:31:47,580 --> 00:31:50,620 lot about where the foot is landing and what it does the 599 00:31:50,620 --> 00:31:52,340 limb look like. I care less if they're landing 600 00:31:52,340 --> 00:31:56,360 on their toe or their 4 foot, their heel, their rear foot, 601 00:31:56,360 --> 00:31:58,040 whatever. But if they land with a 602 00:31:58,040 --> 00:32:00,680 completely extended knee, that tells me a lot more about the 603 00:32:00,680 --> 00:32:03,920 demand on the hamstring than if they land with about 20 degrees 604 00:32:03,920 --> 00:32:07,200 of knee flexion. Very different loading profile 605 00:32:07,320 --> 00:32:10,600 shows also a different amount of like potentially neuromuscular 606 00:32:10,600 --> 00:32:13,000 control, because if their limb is just moving to a straight 607 00:32:13,000 --> 00:32:15,280 extension of their knee, fully straight, that means they're not 608 00:32:15,280 --> 00:32:19,400 slowly slowing down the limb of of their their tibia, they're 609 00:32:19,400 --> 00:32:21,880 not slowing that down. So that could be a part of the 610 00:32:21,880 --> 00:32:25,160 training is how do you learn how to advance your limb without 611 00:32:25,160 --> 00:32:27,880 letting your your foot just swing straight into full 612 00:32:27,880 --> 00:32:32,000 extension. And for folks who are having 613 00:32:32,000 --> 00:32:36,480 some distal stuff, I often see a fully extended knee as they're 614 00:32:36,480 --> 00:32:38,760 as they're landing just because there's less control around the 615 00:32:38,760 --> 00:32:42,080 knee joint and and that could be a factor for them as well. 616 00:32:43,280 --> 00:32:47,680 So this next question is from Shipwreck Trent and they're 617 00:32:47,680 --> 00:32:52,480 asking does overstretching contribute to hamstring injury? 618 00:32:52,840 --> 00:32:56,360 So the way I conceptualize this question was like not stretching 619 00:32:56,360 --> 00:32:59,640 during running, but just like stretching as a warm up or as a 620 00:32:59,640 --> 00:33:03,440 cool down and doing kind of like a tripod pose or whatever it is 621 00:33:03,440 --> 00:33:05,280 for a stretch. So do you have any thoughts on 622 00:33:05,280 --> 00:33:07,960 that, David? Yeah, I think inherently, just 623 00:33:07,960 --> 00:33:11,720 looking at the question, I'll tell people, mobility isn't 624 00:33:11,720 --> 00:33:14,720 necessarily the enemy. If you're really flexible and 625 00:33:14,720 --> 00:33:17,960 you have this crazy range of motion and can put your feet 626 00:33:17,960 --> 00:33:20,080 over your head, there's nothing wrong with that. 627 00:33:20,640 --> 00:33:23,480 The question is whether or not we can control it through the 628 00:33:23,480 --> 00:33:25,520 range of motion you want to control it through. 629 00:33:25,960 --> 00:33:29,600 Now, if you're a very dynamic gymnast and need that range of 630 00:33:29,600 --> 00:33:31,920 motion, well, you better be able to control that leg through that 631 00:33:31,920 --> 00:33:33,200 range or you're going to hurt yourself. 632 00:33:33,900 --> 00:33:37,380 And the same applies to running and things like that. 633 00:33:37,380 --> 00:33:42,020 Now, if we're looking at it from a force output standpoint and 634 00:33:42,020 --> 00:33:46,900 you're doing a lot of stretching statically before before 635 00:33:46,900 --> 00:33:49,820 exercising intensely, there is research out there that does 636 00:33:49,820 --> 00:33:52,740 show that that does decrease your force output when you are 637 00:33:52,740 --> 00:33:55,900 trying to do something with a high amount of load on the other 638 00:33:55,900 --> 00:33:58,560 end of it. And so that's why they usually 639 00:33:58,560 --> 00:34:02,520 don't recommend, you know, these long static stretching sessions 640 00:34:02,520 --> 00:34:07,160 before a heavyweight lifting or a speed workout or things like 641 00:34:07,160 --> 00:34:08,920 that. And then it's like almost the 642 00:34:08,920 --> 00:34:11,600 opposite with dynamic stretching, you know, getting a 643 00:34:11,600 --> 00:34:14,040 warm up in, getting the pliability of the muscle, the 644 00:34:14,040 --> 00:34:17,440 tendon, get it used to kind of extending out a little bit and 645 00:34:17,440 --> 00:34:20,280 get it primed at both in the neuromuscular stand. 646 00:34:20,280 --> 00:34:21,760 Well, yeah. Nervous system and muscular 647 00:34:21,760 --> 00:34:24,040 neuromuscular. From that neuromuscular 648 00:34:24,040 --> 00:34:26,360 standpoint so that it knows that it's about to do something and 649 00:34:26,360 --> 00:34:31,840 it's ready to go do it. So stretching is so wide of a 650 00:34:31,840 --> 00:34:34,120 field. But if I'm hearing if I'm like 651 00:34:34,120 --> 00:34:37,880 reading it, at least the way I feel like I'm interpreting this, 652 00:34:38,040 --> 00:34:42,600 it sounds static based on the question and if it's before a 653 00:34:42,600 --> 00:34:45,800 high intensity effort then it probably would be detrimental 654 00:34:45,800 --> 00:34:47,719 from a force output standpoint. But. 655 00:34:48,590 --> 00:34:51,110 If you're doing it just throughout the day for your own 656 00:34:51,110 --> 00:34:54,270 Wellness, even afterwards, I haven't really seen anything 657 00:34:54,270 --> 00:34:57,350 detrimental there. And if you feel good and it 658 00:34:57,350 --> 00:35:00,070 helps get some blood flow to the area and you have nice mobility, 659 00:35:00,070 --> 00:35:02,670 then that's great. Yeah, when they look at 660 00:35:02,670 --> 00:35:06,150 hamstring injuries, it's not like stretching is a risk factor 661 00:35:06,150 --> 00:35:10,670 for hamstring injury. But that I think that if the 662 00:35:10,670 --> 00:35:13,430 question is about a healthy person just doing a lot of 663 00:35:13,430 --> 00:35:16,980 stretching, doing yoga, doing things for mobility, is that 664 00:35:16,980 --> 00:35:18,300 going to predispose you to a hand? 665 00:35:18,380 --> 00:35:20,900 Does that contribute to injury? Not necessarily. 666 00:35:20,900 --> 00:35:22,180 I think is what you were just saying. 667 00:35:22,180 --> 00:35:25,940 And I would agree with that, where I think it flips a little 668 00:35:25,940 --> 00:35:29,620 bit as if you're somebody with a more acute hamstring strain of 669 00:35:29,620 --> 00:35:34,590 some kind and then you stretch that, that would contribute to 670 00:35:34,590 --> 00:35:37,470 preventing healing. And the reason that this is 671 00:35:37,470 --> 00:35:41,630 important is because when you strain a muscle, hip flexors are 672 00:35:41,630 --> 00:35:44,590 a great example. Calves are an awesome example. 673 00:35:44,590 --> 00:35:46,630 Hamstrings are another amazing example. 674 00:35:46,830 --> 00:35:50,430 When you strain them, they feel tight, like that's what they'll 675 00:35:50,430 --> 00:35:51,990 feel like. So it'll be like the natural 676 00:35:51,990 --> 00:35:53,590 thing that you want to do is stretch. 677 00:35:54,270 --> 00:35:56,510 That stretching can prolong the healing process. 678 00:35:56,510 --> 00:35:59,270 So for an acute hamstring strain, they usually we 679 00:35:59,270 --> 00:36:03,230 recommend not stretching for at least three weeks, if not four 680 00:36:03,230 --> 00:36:06,310 to six depending depending on how severe your you know your 681 00:36:06,310 --> 00:36:08,150 injury is. You want to avoid that 682 00:36:08,150 --> 00:36:11,230 stretching because you think about it, if you had a rope and 683 00:36:11,230 --> 00:36:14,720 you were to fray that rope, it wouldn't get stronger by pulling 684 00:36:14,720 --> 00:36:17,040 on it more. You would have to give it time 685 00:36:17,040 --> 00:36:19,840 to, you know, readhere to itself, and then you can stretch 686 00:36:19,840 --> 00:36:22,080 it to get the length if you have a length deficit. 687 00:36:22,280 --> 00:36:25,920 So in that sense, yes, overstretching can contribute to 688 00:36:25,920 --> 00:36:28,040 hamstring issues, but that's only if you've had one in the 689 00:36:28,040 --> 00:36:30,040 first place that you're trying to rehabilitate. 690 00:36:31,160 --> 00:36:34,480 Otherwise, I think it's as you said, timing of your stretching 691 00:36:34,480 --> 00:36:38,840 isn't maybe important and it may not contribute necessarily, but 692 00:36:38,840 --> 00:36:42,520 it's also, you know, maybe not the most needed thing if you're 693 00:36:42,520 --> 00:36:45,000 trying to like pair out, what what do I need to do to stay 694 00:36:45,000 --> 00:36:47,200 healthy? Running hamstring stretching 695 00:36:47,200 --> 00:36:49,440 regularly probably doesn't top the list. 696 00:36:49,760 --> 00:36:53,520 And we're talking mainly here when we say acute strain, most 697 00:36:53,520 --> 00:36:58,840 likely sprinting it pulled us, might have a partial micro tear 698 00:36:58,840 --> 00:37:02,640 in there like you need to let that thing mend and you don't 699 00:37:02,640 --> 00:37:06,080 want to be yanking on it a bunch, not necessarily like I've 700 00:37:06,080 --> 00:37:08,980 been feeling this six months. Yes. 701 00:37:08,980 --> 00:37:10,980 And things are pulling on a little bit. 702 00:37:11,420 --> 00:37:14,300 And yeah, yes, exactly. I think the other group I would 703 00:37:14,300 --> 00:37:18,380 add in there are like the group where I just ran my first 5K and 704 00:37:18,380 --> 00:37:20,380 forever and my hamstrings feel so tight. 705 00:37:20,380 --> 00:37:23,060 Now that's not a really a time to stretch either. 706 00:37:23,060 --> 00:37:24,740 You've probably have a grade one. 707 00:37:25,060 --> 00:37:27,020 This is what happens when you do a hard effort. 708 00:37:27,900 --> 00:37:31,620 You you tear muscles, that's what you do, You break them 709 00:37:31,620 --> 00:37:32,820 down. And that's why recovery is so 710 00:37:32,820 --> 00:37:35,380 important because you get weaker during the workout and then 711 00:37:35,380 --> 00:37:38,290 stronger during the rest. So if you went and raced 712 00:37:38,290 --> 00:37:40,410 something and you're noticing your hamstrings feel quote UN 713 00:37:40,410 --> 00:37:42,850 quote tight, you probably don't want to stretch them for that 714 00:37:42,850 --> 00:37:44,530 week. Let them, let them feel tight 715 00:37:44,770 --> 00:37:48,210 and loosen them up by doing as you said, dynamic warmups. 716 00:37:48,210 --> 00:37:50,490 Go walk. Go do some like very light 717 00:37:50,490 --> 00:37:53,770 movement related exercise. Body weight stuff, skips. 718 00:37:53,930 --> 00:37:56,290 Yeah, skip, You know, high knees. 719 00:37:56,290 --> 00:37:57,370 But get it. Moving do. 720 00:37:58,090 --> 00:38:00,610 Something. Do some bridges whatever it is. 721 00:38:01,170 --> 00:38:05,530 Like their butt kicks. I mean, like, yeah, yeah, great. 722 00:38:06,340 --> 00:38:09,060 I know Casper the Friendly Ghost is feeling it a little bit right 723 00:38:09,060 --> 00:38:13,460 now. Yeah, yeah, our audio, for those 724 00:38:13,460 --> 00:38:16,300 who don't know, Casper, our audio engineer, He just had a 725 00:38:16,300 --> 00:38:17,900 5K. I feel like I'm using the 726 00:38:17,900 --> 00:38:22,460 example because it's him. Yeah, but he just raised his 727 00:38:22,460 --> 00:38:24,500 first 5K and he just did bridges now. 728 00:38:24,500 --> 00:38:26,140 He put it in the chat. It's amazing. 729 00:38:27,140 --> 00:38:31,260 He just ran a 5K, did a great job, did better than what his 730 00:38:31,260 --> 00:38:33,380 goal time was, and he's feeling it today. 731 00:38:33,380 --> 00:38:35,900 So we're actually just talking to him this whole time. 732 00:38:36,910 --> 00:38:40,430 All right, let's move on. We've we've hit a lot of these 733 00:38:40,430 --> 00:38:43,110 other questions because Nanny Coleman was talking about 734 00:38:43,110 --> 00:38:45,790 mechanical differences between the upper and and lower 735 00:38:45,790 --> 00:38:48,070 hamstring tendinopathy. We talked about that. 736 00:38:49,350 --> 00:38:52,270 We talked about where this proximal hamstring tendinopathy 737 00:38:52,270 --> 00:38:54,150 tends to be up in the the glutes. 738 00:38:54,150 --> 00:38:57,630 This is Eric Korup and they were asking is this kind of deep 739 00:38:57,630 --> 00:39:00,030 glute bum pain, insertional hamstring tendinopathy. 740 00:39:00,230 --> 00:39:05,230 They sometimes barely notice it. Maybe because it could be so 741 00:39:05,230 --> 00:39:06,710 many things. It could be that proximal 742 00:39:06,710 --> 00:39:09,590 hamstring issue. It could be something with, you 743 00:39:09,590 --> 00:39:11,590 know, the low back referring there. 744 00:39:11,590 --> 00:39:14,390 It could be one of the gluteal deep gluteal muscles. 745 00:39:14,390 --> 00:39:18,790 There's a lot of anatomy but that is where the pain comes in. 746 00:39:20,290 --> 00:39:23,370 So I think the the last big question that I want to ask you 747 00:39:23,370 --> 00:39:26,170 David and we've we've gotten this from a few people. 748 00:39:26,170 --> 00:39:29,250 It's for those who haven't had a hamstring issues and want to 749 00:39:29,250 --> 00:39:33,370 maintain healthy hamstrings. What recommendations do you have 750 00:39:33,370 --> 00:39:36,170 for for that group where they're like I haven't had an issue 751 00:39:36,170 --> 00:39:39,570 before, Are the things I should do I I always fret to use the 752 00:39:39,570 --> 00:39:43,290 word prevent these injuries, but what are your thoughts on that? 753 00:39:43,850 --> 00:39:47,210 Yeah, I mean, when we take a look at late stage rehab for 754 00:39:47,210 --> 00:39:49,490 hamstring strains, it's a lot of that stuff. 755 00:39:50,080 --> 00:39:53,880 Yes, keep your strength good, keep your pliability good. 756 00:39:53,880 --> 00:39:58,120 I mean whether it's plyometrics, dynamic stretching, I mean 757 00:39:58,120 --> 00:40:01,440 you'll never see me before a track workout and not doing any 758 00:40:01,440 --> 00:40:04,600 kind of drills like I will always be doing some skips. 759 00:40:04,680 --> 00:40:06,360 I'll like. I mean it might be a little bit 760 00:40:06,360 --> 00:40:08,760 different on the day depending on what I'm feeling internally, 761 00:40:09,160 --> 00:40:12,520 but I will always be doing something and making sure that 762 00:40:12,520 --> 00:40:16,560 things are mobile, you know I. Try to be good about the 763 00:40:16,560 --> 00:40:19,040 strength training and other side of things as well, and just 764 00:40:19,040 --> 00:40:21,920 making sure that your body is a good machine that you can use. 765 00:40:22,480 --> 00:40:25,880 And if you keep it, you know, if you take care of it, it should 766 00:40:25,880 --> 00:40:29,000 take care of you. And that's not to say that 767 00:40:29,000 --> 00:40:31,160 people doing all the right things don't get hurt. 768 00:40:31,160 --> 00:40:33,840 It does happen. I'm sorry for the situation. 769 00:40:33,840 --> 00:40:38,280 It's happened to myself, you know, And you sometimes there's 770 00:40:38,280 --> 00:40:40,800 things outside of your control there and you just have to take 771 00:40:40,800 --> 00:40:44,080 things in your hands and do the best you can and get back out 772 00:40:44,080 --> 00:40:46,120 there. But if you're doing things well 773 00:40:46,520 --> 00:40:49,600 and things are going well, keep try to keep them going well. 774 00:40:49,760 --> 00:40:54,240 Like, yes, I wouldn't necessarily, unless you're doing 775 00:40:54,240 --> 00:40:57,240 absolutely nothing and just thinking about it, I probably 776 00:40:57,240 --> 00:41:00,360 wouldn't change too much. And even then, if you're not 777 00:41:00,360 --> 00:41:03,400 doing anything and you want to start doing something, ease into 778 00:41:03,400 --> 00:41:04,920 it. Because if you go and you 779 00:41:04,920 --> 00:41:07,280 overload your body in a different way on top of other 780 00:41:07,280 --> 00:41:09,560 things you're already doing, that's also asking for an 781 00:41:09,560 --> 00:41:13,130 injury. So just don't overextend 782 00:41:13,130 --> 00:41:17,250 yourself and gradually increase the load of whatever it is 783 00:41:17,250 --> 00:41:19,570 you're trying to do, whether it's get faster, it gets 784 00:41:19,570 --> 00:41:22,730 stronger, or just, you know, do things around the house. 785 00:41:22,890 --> 00:41:26,490 Yeah, I totally agree. I think that one of the best 786 00:41:26,490 --> 00:41:30,130 things we can do for just the global idea of trying to stay 787 00:41:30,130 --> 00:41:32,890 healthy when we run is to pre plan. 788 00:41:32,970 --> 00:41:37,850 So if you are not a 5K runner or one mile or whatever, and you 789 00:41:37,850 --> 00:41:40,290 want to go and do something faster, but you've just been 790 00:41:40,290 --> 00:41:43,140 running. Casually and recreationally and 791 00:41:43,140 --> 00:41:46,300 maybe some long distance stuff. Prepare your body for that 792 00:41:46,300 --> 00:41:47,980 before you start that training cycle. 793 00:41:47,980 --> 00:41:50,180 So like, if you want to train for if you know like, oh this 794 00:41:50,180 --> 00:41:53,060 summer, I think I want to do a 5K and I really, really want to 795 00:41:53,060 --> 00:41:55,970 run it hard. That that's winter and spring. 796 00:41:56,210 --> 00:41:58,690 You should be doing that late stage rehab, so you should do 797 00:41:58,690 --> 00:42:01,330 heavy strengthening. You should load those tendons a 798 00:42:01,330 --> 00:42:05,330 lot through ecentrics or heavy concentrics, either one, and 799 00:42:05,330 --> 00:42:08,210 then be hitting plyometric stuff so that you're getting that 800 00:42:08,210 --> 00:42:12,770 power and fast response to it. Because our muscles and tendons 801 00:42:12,770 --> 00:42:15,450 don't adapt to loads, we don't give them to give to them. 802 00:42:15,450 --> 00:42:18,890 So if we don't train plyometrics in that high speed velocity 803 00:42:18,890 --> 00:42:21,770 stuff, it won't really be ready for it when the time comes. 804 00:42:21,930 --> 00:42:25,710 So take your. Time when you're not in a heavy 805 00:42:25,710 --> 00:42:29,270 training cycle and do exercises that are specific to the demands 806 00:42:29,270 --> 00:42:30,630 that running will put on it later. 807 00:42:30,750 --> 00:42:33,270 Because running and doesn't really get us stronger. 808 00:42:33,550 --> 00:42:36,390 We have to get stronger to like do the running that we wanna do. 809 00:42:36,390 --> 00:42:39,630 So that'd be my biggest recommendation is pre plan and 810 00:42:39,630 --> 00:42:42,590 get a plan in place to do it I think when it comes to like. 811 00:42:43,300 --> 00:42:46,380 Gait retraining, I think you'd have to have something pretty 812 00:42:46,980 --> 00:42:49,860 pronounced on on kind of your running analysis. 813 00:42:49,860 --> 00:42:54,860 So I even though I have a 3D system like in our clinic and I 814 00:42:54,860 --> 00:42:58,660 use it all the time, I'm not changing somebody's running for 815 00:42:58,660 --> 00:43:02,260 something minor, you know, because even the evidence on 816 00:43:02,340 --> 00:43:04,300 injury prevention through GAIT retraining. 817 00:43:06,080 --> 00:43:08,120 It's getting there. There is some stuff there now, 818 00:43:08,440 --> 00:43:12,320 which is nice, but it would be if you were the person who has a 819 00:43:12,320 --> 00:43:16,080 lot of extension through your knee and you're really landing 820 00:43:16,080 --> 00:43:18,760 over striding. That would just be part of 821 00:43:19,040 --> 00:43:22,480 global injury prevention, not specifically hamstring. 822 00:43:22,480 --> 00:43:25,800 So I think that there is a space for assessing your running and 823 00:43:25,800 --> 00:43:27,840 kind of looking at it, but you'd have to have somebody who knows 824 00:43:27,840 --> 00:43:29,880 what they're talking about and not just make changes for the 825 00:43:29,880 --> 00:43:32,360 heck of it. All right. 826 00:43:32,520 --> 00:43:36,320 Final question of the night. David, this is for you. 827 00:43:37,080 --> 00:43:43,360 Is it Hammy Hamm i.e. Or Hammy HAMMY. 828 00:43:43,720 --> 00:43:45,680 Interesting, I wonder. He sent that one. 829 00:43:48,480 --> 00:43:49,680 That's a great question. It was. 830 00:43:50,200 --> 00:43:52,600 Doc Sabrent, David. It was the first question we 831 00:43:52,600 --> 00:43:57,400 got. You know, I'm from the i.e., the 832 00:43:57,400 --> 00:44:00,240 Inland Empire. I gotta go with Hammy i.e. 833 00:44:00,780 --> 00:44:04,260 What? No, no, this is an HAMMY 834 00:44:04,340 --> 00:44:08,540 situation. Or I mean, I think if it's 835 00:44:08,540 --> 00:44:12,820 similar actually to like the Tammy Tammy or the Sammy, Sammy, 836 00:44:12,940 --> 00:44:14,620 like which one's right? They're both right. 837 00:44:15,340 --> 00:44:16,780 I think you're wrong in this scenario. 838 00:44:19,980 --> 00:44:23,180 Maybe that's our new subjective. Is it hammy with an i.e. 839 00:44:23,180 --> 00:44:28,340 Or hammy with a Y, but then whammy is only with the Y I've 840 00:44:28,340 --> 00:44:31,500 never seen whammy with an i.e. No whammies. 841 00:44:31,500 --> 00:44:35,980 But then if you see that it's Ies right on all those. 842 00:44:36,300 --> 00:44:39,940 Yeah, it's true. Have you seen that game show? 843 00:44:39,940 --> 00:44:42,020 What's it called? No whammies. 844 00:44:42,020 --> 00:44:43,020 No whammies. No whammies. 845 00:44:43,140 --> 00:44:44,980 That one. Why would I watch a show called 846 00:44:44,980 --> 00:44:46,580 No Whammies, No Whammies, No Whammies? 847 00:44:46,620 --> 00:44:48,380 No, no, no. It's called something else. 848 00:44:49,660 --> 00:44:52,020 Gosh, what's it called? It's, but it's a game show and 849 00:44:52,020 --> 00:44:54,500 that's like when they hit the spinner, they're like, no 850 00:44:54,500 --> 00:44:56,340 whammies. Anyway, I can't think of it. 851 00:44:56,580 --> 00:44:58,940 Also, somebody help us out and tell us what that game show is. 852 00:44:59,500 --> 00:45:02,220 Anyway, thank you all for contributing questions about the 853 00:45:02,220 --> 00:45:04,740 hamstring. We had a fun time talking about 854 00:45:04,740 --> 00:45:08,260 this and again, we do have some resources of specific rehab 855 00:45:08,260 --> 00:45:10,700 exercises on our Instagram. You'll kind of have to dig a 856 00:45:10,700 --> 00:45:14,060 little bit. They are easy to find this. 857 00:45:14,060 --> 00:45:17,700 I feel like we're plugging this so but on my. 858 00:45:18,730 --> 00:45:21,130 The running lab that I kind of lead, it's called Pioneers 859 00:45:21,130 --> 00:45:23,890 Running Lab. We'll link these in the pod as 860 00:45:23,890 --> 00:45:25,610 well or in the in the description. 861 00:45:26,530 --> 00:45:30,050 But you know on Pinery's running lab, our Instagram, if you hit 862 00:45:30,050 --> 00:45:33,930 the exercises tab or highlight reels or whatever, it'll bring 863 00:45:33,930 --> 00:45:36,010 up some reels of of these exercises. 864 00:45:36,290 --> 00:45:39,890 And yes, Casper, our audio engineer in the clutch, it's 865 00:45:39,890 --> 00:45:41,850 called press your luck, that's the game show. 866 00:45:42,730 --> 00:45:45,370 Anyway, thank you all for joining us tonight. 867 00:45:45,840 --> 00:45:48,120 We just went off the rails for the last three minutes, so sorry 868 00:45:48,120 --> 00:45:51,040 for wasting your time and look forward to talking next time. 869 00:45:51,200 --> 00:45:52,200 Have a great night, everybody.