1 00:00:00,320 --> 00:00:02,960 We're excited to share this week the launch of our new Doctors of 2 00:00:02,960 --> 00:00:04,440 Running Page at Running Warehouse. 3 00:00:04,920 --> 00:00:07,960 Ever want to tackle trails like David, Crush Hills like Matt, 4 00:00:08,119 --> 00:00:10,480 survive the cold like Nathan, or race like Andrea? 5 00:00:10,800 --> 00:00:13,040 Now's your chance. Head over to Running Warehouse 6 00:00:13,040 --> 00:00:15,480 to find all of our team's favorite apparel, nutrition, and 7 00:00:15,480 --> 00:00:17,040 more. Visit the link in our 8 00:00:17,040 --> 00:00:19,440 description to see the page today and make sure to check out 9 00:00:19,440 --> 00:00:21,320 Running Warehouse for all your running needs. 10 00:00:28,480 --> 00:00:31,160 Hello everyone and welcome to the Doctors of Running Podcast 11 00:00:31,160 --> 00:00:33,720 where we, a group of doctors of physical therapy, discuss the 12 00:00:33,760 --> 00:00:36,000 art and science of running and the stuff that we put on our 13 00:00:36,000 --> 00:00:39,120 feet today at the Round Table. I have Doctor Matthew Klein with 14 00:00:39,120 --> 00:00:41,920 me and I'll be hosting and basically interviewing him 15 00:00:41,920 --> 00:00:44,480 today. I'm Nathan Brown and we get to 16 00:00:44,480 --> 00:00:48,520 take some time to discuss two studies that Matt has just 17 00:00:48,520 --> 00:00:50,600 submitted for publication. So we are going to give an 18 00:00:50,600 --> 00:00:53,960 update on his dissertation work which pertains to Masters, 19 00:00:53,960 --> 00:00:55,680 Runners and Achilles Tendinopathy. 20 00:00:55,840 --> 00:00:59,640 So it's a very pertinent topic to in our way of understanding 21 00:01:00,120 --> 00:01:02,840 how we change as runners as we age. 22 00:01:03,240 --> 00:01:06,080 So we are going to ask our subjective in a second. 23 00:01:06,080 --> 00:01:10,760 But before I do that, if you could, if you want to be in the 24 00:01:10,760 --> 00:01:13,520 running to win another $100.00 gift card from running 25 00:01:13,520 --> 00:01:16,200 Warehouse, thank you to them for providing these to kind of 26 00:01:16,320 --> 00:01:17,760 connect with you all in this way. 27 00:01:17,760 --> 00:01:22,400 If you want to be entered to win a gift card for that after you 28 00:01:22,400 --> 00:01:25,960 leave her, you know please. If you If you can, please go and 29 00:01:25,960 --> 00:01:28,680 leave a review of this podcast wherever you listen to it. 30 00:01:28,680 --> 00:01:32,200 Subscribe on YouTube and then on the video that releases for this 31 00:01:32,200 --> 00:01:36,080 podcast, which drops on Sundays, you can just comment and answer 32 00:01:36,080 --> 00:01:40,200 the subjective and that will enter you to win the $100.00 33 00:01:40,200 --> 00:01:42,120 gift card from Running Warehouse. 34 00:01:43,000 --> 00:01:46,000 So subjective for the day as it relates to the research we're 35 00:01:46,000 --> 00:01:48,360 talking about, is when you think about where you're at as a 36 00:01:48,360 --> 00:01:51,520 runner now, whether you are a teenager or you're in your 20s, 37 00:01:51,520 --> 00:01:55,880 thirties, 40s, even if you're in your 50s, sixties, 70s, what are 38 00:01:55,880 --> 00:01:59,560 your long term running goals? When you think 20 years down the 39 00:01:59,560 --> 00:02:03,280 road, what do you hope to be doing in your 60s, seventies, 40 00:02:03,360 --> 00:02:07,240 80s as a runner? Or if you're only, you know 15, 41 00:02:07,240 --> 00:02:10,080 what do you hope to be doing at 35 as a runner? 42 00:02:10,080 --> 00:02:13,680 So think about your future self and where you hope to be and 43 00:02:13,680 --> 00:02:17,640 tell us what are some like long term goals that you've had for 44 00:02:17,640 --> 00:02:19,320 yourself. So Matt, when you think about 45 00:02:19,320 --> 00:02:21,520 that, what is, what are some of your goals? 46 00:02:22,640 --> 00:02:24,760 I think this one's been there for a while and maybe this kind 47 00:02:24,760 --> 00:02:26,640 of influenced some of my dissertation work, but I just 48 00:02:26,640 --> 00:02:27,960 want to be a good masters runner. 49 00:02:28,000 --> 00:02:31,920 Like I had was very lucky to get to do some competition in my 50 00:02:31,920 --> 00:02:36,800 like 20s and so both in the NC double AD three and then got to 51 00:02:36,800 --> 00:02:39,240 do some fun stuff like compete in some some decent sized 52 00:02:39,240 --> 00:02:42,760 marathons and things like that. But what has really interested 53 00:02:42,760 --> 00:02:45,560 in me is going and getting really competitive on like even 54 00:02:45,560 --> 00:02:47,760 a regional or national level as a masters runner. 55 00:02:47,760 --> 00:02:51,240 So it's really training hard, not really worried about what's 56 00:02:51,240 --> 00:02:53,640 happening right at this minute, but thinking how do I keep 57 00:02:53,640 --> 00:02:57,400 building for the long term. And so I know this is actually 58 00:02:57,400 --> 00:02:59,880 part of getting into my stuff. People argue, oh, being a master 59 00:02:59,880 --> 00:03:02,720 starts at 35. Like, I don't know, I don't 60 00:03:02,720 --> 00:03:05,120 think so things change. But my definition is start 61 00:03:05,120 --> 00:03:08,760 getting, you know, 404550 and above, looking at how do you 62 00:03:08,760 --> 00:03:14,000 optimize our functions starting then, but at that point, but 63 00:03:14,000 --> 00:03:16,360 starting now. So yes, being a competitive 64 00:03:16,360 --> 00:03:19,200 master's owner is really my big goal. 65 00:03:19,200 --> 00:03:22,640 You want to be like nationally competitive as I love. 66 00:03:22,640 --> 00:03:25,640 It Yeah, I know it's possible, but that's what I really want to 67 00:03:25,640 --> 00:03:26,560 do. That's great. 68 00:03:26,760 --> 00:03:28,240 Mine are a little less ambitious. 69 00:03:28,240 --> 00:03:31,600 I just want to be able to like when I think about myself 70 00:03:31,600 --> 00:03:34,120 running now compared to when I'm running in 20 years. 71 00:03:34,360 --> 00:03:38,000 I actually hope that I'm a I'm a stronger runner than than I am 72 00:03:38,000 --> 00:03:39,280 now. And I think the way that I would 73 00:03:39,280 --> 00:03:43,120 define that is I'm just having years of healthy running where I 74 00:03:43,120 --> 00:03:46,400 don't have to take time off like due to these types of injuries I 75 00:03:46,400 --> 00:03:51,120 had last year. So I think your work and all the 76 00:03:51,120 --> 00:03:53,880 other stuff, looking into musculoskeletal changes as we 77 00:03:53,880 --> 00:03:57,320 age and what sort of things we need to do to keep some of those 78 00:03:57,320 --> 00:04:00,000 at Bay or whatever. That's what I'm interested in 79 00:04:00,000 --> 00:04:03,240 because I just want to be able to go run a 50 Ki, want to be 80 00:04:03,240 --> 00:04:07,240 kind of an ultra person in my dreams like as a as kind of a 81 00:04:07,240 --> 00:04:11,880 40s, fifties, year old. I want to go and just enjoy, not 82 00:04:11,880 --> 00:04:15,280 not a fast one, just be go out and be able to do a 50. 83 00:04:15,280 --> 00:04:18,760 Miller just sounds super fun in a weird kind of way. 84 00:04:18,839 --> 00:04:22,240 So that's that's where I want to be is just healthy and robust. 85 00:04:22,240 --> 00:04:25,760 I just want a robust musculoskeletal system so that I 86 00:04:25,760 --> 00:04:28,720 can just go and run whatever I want to run, and even if it's 87 00:04:28,720 --> 00:04:31,640 slower, that doesn't really. That's not really my my aim, 88 00:04:31,640 --> 00:04:34,400 it's just durability is what I want. 89 00:04:35,040 --> 00:04:37,280 You know what we should do is remember when Regina ran the 90 00:04:37,280 --> 00:04:39,120 100K and we all came out like you came out? 91 00:04:39,120 --> 00:04:41,080 We had a blast. For those of you, don't Regina 92 00:04:41,080 --> 00:04:43,440 ran the My wife ran the US 100K championships. 93 00:04:43,440 --> 00:04:44,800 What is that? Is it almost two years ago? 94 00:04:44,800 --> 00:04:47,160 Oh, a three even, Maybe. Yeah. 95 00:04:47,560 --> 00:04:49,960 So we, Nathan and I got to see each other for the first time at 96 00:04:49,960 --> 00:04:52,720 a like in person a long time. So we're cheering our Regina, 97 00:04:52,720 --> 00:04:57,000 she's running 100K on on 10K loops and Nathan and I just kept 98 00:04:57,000 --> 00:04:58,800 running together. We were shooting content, so 99 00:04:58,800 --> 00:05:02,840 it'd be so fun if we got you run the 100K not that longer, much 100 00:05:02,840 --> 00:05:05,040 longer, and the whole team is there to support you. 101 00:05:05,040 --> 00:05:05,960 That would be really. Really. 102 00:05:05,960 --> 00:05:07,760 That would be super cool. Yeah. 103 00:05:07,760 --> 00:05:10,160 So now I'm putting that, I'm putting that in your head going, 104 00:05:10,160 --> 00:05:13,160 hey, we're going to do that as a team and support you to do that. 105 00:05:13,160 --> 00:05:15,680 That's my 20 year goal. I have a friend running it. 106 00:05:15,880 --> 00:05:18,120 It's coming up in a couple weeks from when we're recording this. 107 00:05:18,120 --> 00:05:21,520 He's, he's going to be running it this year, so I'm excited for 108 00:05:21,520 --> 00:05:23,080 him. Cool. 109 00:05:23,080 --> 00:05:26,240 Well, let's let's start talking about your dissertation research 110 00:05:26,440 --> 00:05:29,160 first. I just want you to give a brief, 111 00:05:29,760 --> 00:05:32,560 kind of some brief context for what is the stage of your 112 00:05:32,560 --> 00:05:35,440 research and where is it in cyberspace? 113 00:05:35,440 --> 00:05:36,880 Where? Where's your research at? 114 00:05:37,600 --> 00:05:41,120 Yeah, so I am still in my PhD, so I'm in the. 115 00:05:41,280 --> 00:05:45,120 I'm the finishing up my dissertation, so I've written 116 00:05:45,120 --> 00:05:48,240 the first like basically all the chapters except the final one. 117 00:05:48,440 --> 00:05:51,000 And the final one is essentially A conclusion and discussion 118 00:05:51,000 --> 00:05:53,360 about what everything that I've seen and found. 119 00:05:53,680 --> 00:05:57,320 The origin behind this is there was a lot of different versions 120 00:05:57,320 --> 00:05:58,520 of what I thought I wanted to do. 121 00:05:58,520 --> 00:06:01,480 And then I kind of came upon this because I found that there 122 00:06:01,480 --> 00:06:03,920 was a gap in the literature regarding Master droners, 123 00:06:03,920 --> 00:06:06,240 especially regarding Achilles tennopathy because the more 124 00:06:06,720 --> 00:06:08,680 research I was doing, I was going, all right, So what do I 125 00:06:08,680 --> 00:06:10,880 want to do? I really like working with older 126 00:06:10,880 --> 00:06:13,000 runners. I like seeing how the body 127 00:06:13,000 --> 00:06:15,360 changes with age and how do we optimize that because people 128 00:06:15,360 --> 00:06:18,160 tend to think that that's like as you get older it's an end 129 00:06:18,400 --> 00:06:20,920 instead of the way that kind of some of the what's we're 130 00:06:20,920 --> 00:06:22,880 starting to realize is no, it's just a new opportunity. 131 00:06:22,880 --> 00:06:25,600 You just have to be aware of some of the changes you need to 132 00:06:25,600 --> 00:06:28,280 make and but you can still optimize things on incredible 133 00:06:28,280 --> 00:06:29,840 levels. Don't it's not an it's not the 134 00:06:29,920 --> 00:06:32,040 end. It's a new a new beginning. 135 00:06:32,040 --> 00:06:34,240 If anything, just realize you got a you have a new a changing 136 00:06:34,240 --> 00:06:36,680 body. The problem is there's not a lot 137 00:06:36,680 --> 00:06:38,840 of research on this. There's some stuff going, OK, 138 00:06:38,840 --> 00:06:40,920 here's the most common injuries. So we knew that. 139 00:06:41,000 --> 00:06:43,560 I and I saw the literature as saying that injuries change as 140 00:06:43,560 --> 00:06:45,720 we get older. When you're younger, you get a 141 00:06:45,720 --> 00:06:48,640 lot of stuff surrounding the knee like patellitenopathy, 142 00:06:48,840 --> 00:06:52,960 kilise and like IT band stuff. Like there's a kind of a top 143 00:06:52,960 --> 00:06:56,640 couple injuries and it's really focused kind of more like around 144 00:06:56,640 --> 00:06:58,600 the knee joint and and that kind of stuff. 145 00:06:58,600 --> 00:07:02,600 But as we get older it switches and Achilles synopathy was the 146 00:07:02,600 --> 00:07:06,240 number one thing followed by hamstring issues and calf issues 147 00:07:06,680 --> 00:07:08,520 and there was no explanation of the research. 148 00:07:08,520 --> 00:07:10,640 I'm like that's interesting. Those are really important for 149 00:07:10,640 --> 00:07:13,960 speed, for function. And I saw a correlate like like 150 00:07:13,960 --> 00:07:16,200 a correlation between like I'm treating all these masters and 151 00:07:16,200 --> 00:07:20,000 it's like Achilles, calf, hamstring over and over and I'm 152 00:07:20,000 --> 00:07:24,800 like I'm treating individuals. But what why, what's happening? 153 00:07:24,800 --> 00:07:27,920 What's what's going on. So that was the push to start 154 00:07:27,920 --> 00:07:31,360 this and so where this is now in terms of like cyberspace stuff, 155 00:07:31,360 --> 00:07:33,520 stuff like that. My the systematic review I did 156 00:07:33,520 --> 00:07:37,440 which was my lit review kind of my semi introduction chapter is 157 00:07:37,440 --> 00:07:39,560 published out there. It isn't published in the 158 00:07:39,560 --> 00:07:42,040 Journal of Sports Mechanics. So if you would like that there 159 00:07:42,040 --> 00:07:44,480 is a paywall because I didn't want to spend for those of you 160 00:07:44,480 --> 00:07:46,640 don't know like behind the curtain if you want to make your 161 00:07:46,640 --> 00:07:49,080 stuff Open Access, you have to pay like thousands of dollars 162 00:07:49,080 --> 00:07:51,640 and I'm like no, just e-mail me and I'll, I'll give it to you 163 00:07:51,640 --> 00:07:54,600 for free. It's just FYI like I get charged 164 00:07:54,600 --> 00:07:56,640 with some, I have the PDF, I'll just give it to you. 165 00:07:58,440 --> 00:08:01,920 So that is published and that's that's public domain right now. 166 00:08:02,280 --> 00:08:05,760 The second part that was kind of my intro to go what's happening 167 00:08:05,960 --> 00:08:08,840 in younger athletes compared to masters runners. 168 00:08:09,280 --> 00:08:12,280 And what I found is there wasn't actually that much different 169 00:08:12,280 --> 00:08:14,840 than kind of what we suspected like the knee joint really 170 00:08:14,840 --> 00:08:17,320 didn't change as we got older. It's like you know, bio 171 00:08:17,320 --> 00:08:20,560 mechanics weren't changing. It was like fairly similar. 172 00:08:21,200 --> 00:08:24,040 What was changing was something around the ankle and the hip 173 00:08:24,040 --> 00:08:27,000 that there there was changes in like plantar, flexion kind of 174 00:08:27,000 --> 00:08:29,400 moments and powers and things were getting different. 175 00:08:29,400 --> 00:08:31,480 Something's happening at the ankle and there was also some 176 00:08:31,480 --> 00:08:35,120 stuff happening at the hip where stride length was changing. 177 00:08:35,120 --> 00:08:37,400 Like it was starting to it's shorten. 178 00:08:37,559 --> 00:08:40,320 But for some reason people were actually extending their hip 179 00:08:40,320 --> 00:08:41,559 more. And it's like that doesn't make 180 00:08:41,559 --> 00:08:43,919 any sense. Like what's what's going, how is 181 00:08:43,919 --> 00:08:47,040 the knee not changing if that. So it was good information but 182 00:08:47,040 --> 00:08:48,840 was like, I don't know what this means. 183 00:08:48,840 --> 00:08:52,600 So why don't we actually go get healthy masters runners and 184 00:08:52,600 --> 00:08:54,800 those with Achilles tonopping to see like what are the actual 185 00:08:54,800 --> 00:08:57,080 changes between those who are healthy and those are not. 186 00:08:57,080 --> 00:08:59,880 I thought that'd be the best way to see what kind of deficits are 187 00:08:59,880 --> 00:09:01,640 showing up. Now be aware I'm going to say 188 00:09:01,640 --> 00:09:03,840 this a couple times this is observational research. 189 00:09:04,160 --> 00:09:06,960 You cannot make conclusions like I can go do this intervention 190 00:09:06,960 --> 00:09:10,120 now it's we're this is just the beginning of a lifetime of cut 191 00:09:10,120 --> 00:09:12,920 looking into this. So the study was looking at 192 00:09:15,200 --> 00:09:18,320 Masters runners over 50 because I really wanted to make sure 193 00:09:18,320 --> 00:09:19,280 we're getting into the time port. 194 00:09:19,280 --> 00:09:22,840 We were truly seeing changes. And then masters runners who 195 00:09:22,840 --> 00:09:24,920 were healthy and those who had Achilles stenopathy. 196 00:09:24,920 --> 00:09:28,640 And I was having them run, do a single leg hop because I want to 197 00:09:28,640 --> 00:09:31,000 look at power. And then I also put them on 198 00:09:31,000 --> 00:09:33,680 what's called an isokinetic dynamometer, which is the gold 199 00:09:33,680 --> 00:09:36,800 standard to test strength. And I was looking at the 200 00:09:36,800 --> 00:09:40,760 strength mechanic, bio mechanics of the hip and the ankle, 201 00:09:40,760 --> 00:09:43,760 specifically hip extensors and the ankle plantar flexors or 202 00:09:43,760 --> 00:09:46,760 calves throughout all this stuff. 203 00:09:46,760 --> 00:09:50,200 And so those I've separated those into two studies. 204 00:09:50,200 --> 00:09:53,240 I have a ton more data that I after PhD, I'm going to 205 00:09:53,240 --> 00:09:55,480 hopefully put some stuff together and have some more 206 00:09:55,480 --> 00:09:57,920 answers. But the two major studies was 207 00:09:58,160 --> 00:10:02,280 running versus the strength testing and then the single leg 208 00:10:02,280 --> 00:10:04,440 hopping because I was going, what are running mechanics look 209 00:10:04,440 --> 00:10:06,080 like and does that relate to their strength? 210 00:10:06,680 --> 00:10:09,320 And then single leg hopping, 'cause I want to know, I suspect 211 00:10:09,320 --> 00:10:12,680 that power is playing a really big thing and power is how 212 00:10:12,680 --> 00:10:15,920 quickly can you produce force is going all right, I feel like 213 00:10:15,920 --> 00:10:16,960 there's going to be something there. 214 00:10:16,960 --> 00:10:19,360 So those two studies, they are both submitted to the Journal of 215 00:10:19,360 --> 00:10:22,400 Sports Bio Mechanics. One is with the editor and one's 216 00:10:22,560 --> 00:10:25,800 waiting the the Super long process in the queue. 217 00:10:25,840 --> 00:10:28,680 Yeah, so. Well, Congrats. 218 00:10:28,680 --> 00:10:31,520 I know that's a big process to just get things ready. 219 00:10:31,520 --> 00:10:35,680 And you know, for those who have gone through a dissertation 220 00:10:35,680 --> 00:10:39,280 process, you have experienced all of the iterations you get to 221 00:10:39,280 --> 00:10:43,520 go through. You get a lot of helpful and 222 00:10:43,520 --> 00:10:46,920 critical feedback on your stuff. Like it's a it's it's one of 223 00:10:46,920 --> 00:10:49,640 those things where you put your heart and soul into like really 224 00:10:49,640 --> 00:10:53,480 trying to curate and understand and interpret data. 225 00:10:53,760 --> 00:10:58,640 And then you get somebody who, whether it feels like it or not, 226 00:10:58,640 --> 00:11:00,880 lovingly says to you, this sucks. 227 00:11:00,920 --> 00:11:03,080 Do it different. And and then you have to like, 228 00:11:03,080 --> 00:11:06,160 say, OK, this isn't me, this was me trying something, but my 229 00:11:06,160 --> 00:11:07,480 identity is not wrapped up in that. 230 00:11:07,600 --> 00:11:09,000 So let's go back. And it's not. 231 00:11:09,000 --> 00:11:10,240 Supposed to be. It's not supposed. 232 00:11:10,280 --> 00:11:12,520 It's not supposed to be. But if he comes because he's fed 233 00:11:13,360 --> 00:11:15,720 hundreds of thousands of hours trying to run, this is it. 234 00:11:15,720 --> 00:11:17,680 This is the go at note, we're going to do another revision. 235 00:11:17,680 --> 00:11:19,400 This is version 20 of this. Yeah. 236 00:11:19,640 --> 00:11:23,360 So again, just all that to say, Congrats on getting there. 237 00:11:23,520 --> 00:11:26,080 And now I think what would be really interesting for us to do 238 00:11:26,080 --> 00:11:28,800 is to talk about those two different research questions you 239 00:11:28,800 --> 00:11:31,000 asked. And so if you could actually 240 00:11:31,000 --> 00:11:32,400 before this, I just thought of this. 241 00:11:32,560 --> 00:11:38,000 So I'm this is not a sponsor by the way, but this shell, it's 242 00:11:38,000 --> 00:11:41,000 from PATH projects. It's the Graves PX shell. 243 00:11:41,720 --> 00:11:44,520 It's awesome. It's like a water resistant one 244 00:11:44,520 --> 00:11:46,320 and I've gotten a number of runs in. 245 00:11:46,320 --> 00:11:49,120 It's been rainy around here. Well, we got like 6 inches. 246 00:11:49,120 --> 00:11:51,320 Well, we were supposed to get 6 inches of snow, but it was much 247 00:11:51,320 --> 00:11:53,240 less than that. But it was a big snowy weekend 248 00:11:53,520 --> 00:11:54,800 anyway. But we've gotten a lot of rain 249 00:11:54,800 --> 00:11:56,000 too. This thing's dope. 250 00:11:56,680 --> 00:11:58,760 So good. Highly recommend. 251 00:11:58,840 --> 00:12:01,640 Again, not a sponsor. There's your little brain break 252 00:12:01,680 --> 00:12:05,160 now going back in because we're going to go deep into research 253 00:12:05,160 --> 00:12:06,560 and statistics and all this stuff. 254 00:12:06,560 --> 00:12:10,720 So can you bring us into that first study on running and the 255 00:12:10,720 --> 00:12:12,800 correlation between running and strength measures? 256 00:12:12,960 --> 00:12:15,280 And maybe just talk a little bit about what your research 257 00:12:15,280 --> 00:12:18,440 question was And then kind of a little bit more about the 258 00:12:18,440 --> 00:12:22,000 methods, what did you measure? What equipment gave you that 259 00:12:22,000 --> 00:12:22,800 data? That kind of thing. 260 00:12:23,600 --> 00:12:25,560 Let me be careful because I made that mistake and I didn't, I 261 00:12:25,560 --> 00:12:28,520 didn't necessarily correlate the running and the strength stuff. 262 00:12:28,520 --> 00:12:30,840 I mean, I did actually, but it's not part of the public. 263 00:12:30,840 --> 00:12:33,560 There's a ton of stuff that I calculated that I'll share that 264 00:12:33,560 --> 00:12:35,840 didn't end up getting in there because like it was, it was not 265 00:12:35,840 --> 00:12:39,200 significant enough to actually be worth talking about at least. 266 00:12:39,520 --> 00:12:41,920 Yeah, that's that's for those who don't know a lot of the 267 00:12:41,920 --> 00:12:43,440 research. There's tons of stuff out there 268 00:12:43,440 --> 00:12:45,520 that's not significant. They just don't tell you because 269 00:12:46,200 --> 00:12:48,560 unfortunately a lot of times some of the feedback you get 270 00:12:48,600 --> 00:12:50,880 from journals and then your mentors learn this is like, 271 00:12:50,880 --> 00:12:53,880 well, if it's not worth, if it's not significant, like try not to 272 00:12:53,880 --> 00:12:56,520 report it and it's like, Oh well, I feel like that's still 273 00:12:56,520 --> 00:13:00,400 important, but that's off topic. So I did actually correlate it, 274 00:13:00,400 --> 00:13:01,800 which was a is a different story. 275 00:13:02,520 --> 00:13:06,080 It was just looking at the the strength measures and submaximal 276 00:13:06,080 --> 00:13:08,000 running mechanics. And I want to clarify that just 277 00:13:08,000 --> 00:13:11,480 going, you know, these two groups have this, their shared 278 00:13:11,480 --> 00:13:13,280 similarity is that they both run. 279 00:13:13,280 --> 00:13:14,760 It would make sense to look at running. 280 00:13:15,080 --> 00:13:17,760 And I my hypothesis was I suspect that there's going to be 281 00:13:17,920 --> 00:13:21,640 some differences in how much dorsiflexion they have, how much 282 00:13:21,640 --> 00:13:23,760 hip extension they have while running. 283 00:13:24,000 --> 00:13:25,880 And I expect to see different bio mechanics. 284 00:13:25,880 --> 00:13:29,920 Like I expect to see different moments which are like forces 285 00:13:29,920 --> 00:13:33,000 essentially that are generated by muscles at at the hip and the 286 00:13:33,000 --> 00:13:35,360 ankle. I'm expecting them to be less at 287 00:13:35,360 --> 00:13:40,240 the hip and more at the ankle. I'm expecting the those with 288 00:13:40,240 --> 00:13:44,080 Achilles tendinopathy to have less hip extensor strength and 289 00:13:44,080 --> 00:13:46,960 less calf strength because I think that that's going to put 290 00:13:46,960 --> 00:13:48,560 more stress on the Achilles tendon. 291 00:13:48,560 --> 00:13:50,560 So those are my hypothesis about going right. 292 00:13:50,840 --> 00:13:53,800 I'm expecting basically see like less of everything up higher, 293 00:13:53,920 --> 00:13:55,800 especially when it comes to strength, but the one thing I'm 294 00:13:56,080 --> 00:14:00,000 expecting to see more of is increase moments or forces at 295 00:14:00,000 --> 00:14:02,400 the ankle because I think that's going to stress the Achilles 296 00:14:02,400 --> 00:14:04,360 more. So just to just to reiterate and 297 00:14:04,360 --> 00:14:07,120 make sure I'm understanding what you did, you had what you did is 298 00:14:07,120 --> 00:14:09,920 you're really comparing these two groups in both of these two 299 00:14:09,920 --> 00:14:10,960 areas. Observational. 300 00:14:10,960 --> 00:14:14,240 You're comparing the healthy and the Achilles tendinopathy group 301 00:14:14,520 --> 00:14:17,240 in their strength metrics, and you're also comparing them 302 00:14:17,240 --> 00:14:19,480 between each other with the running mechanics. 303 00:14:19,520 --> 00:14:23,840 And you thought that you would see less strength output in the 304 00:14:24,280 --> 00:14:26,960 Achilles tendinopathy group. And you also thought that you 305 00:14:26,960 --> 00:14:29,120 would see a difference in mechanics between the two 306 00:14:29,120 --> 00:14:31,280 groups. But you also thought that both 307 00:14:31,280 --> 00:14:34,760 groups would show increased workload at the ankle during 308 00:14:34,760 --> 00:14:36,960 running. Or were you saying you just you 309 00:14:36,960 --> 00:14:39,160 thought you'd say that Justin, the Achilles tendinopathy group? 310 00:14:39,160 --> 00:14:41,160 Justin, the Achilles Tendinopathy group is what I 311 00:14:41,160 --> 00:14:44,640 thought and again to admit to again how I did this is the the 312 00:14:44,640 --> 00:14:46,520 running. I talked about how I measured 313 00:14:46,520 --> 00:14:48,040 its strength, which is pretty consistent. 314 00:14:48,040 --> 00:14:50,200 The gold standard for looking at strength is isoconnect 315 00:14:50,200 --> 00:14:52,040 dynamometers. You ever seen what's called a 316 00:14:52,040 --> 00:14:54,520 Biodex or Humac norm? You kind of sit on the thing and 317 00:14:54,520 --> 00:14:56,920 you got the lever that kind of get to push your limb back and 318 00:14:56,920 --> 00:14:59,400 forth. That's what I used for the 319 00:14:59,400 --> 00:15:01,760 running by mechanics. We had a 3D motion capture 320 00:15:01,760 --> 00:15:05,080 system and force plates. So they would the the runners 321 00:15:05,080 --> 00:15:08,320 would go across these force plates and we'd also measure how 322 00:15:08,320 --> 00:15:11,040 they're moving their Max joint angles and things like that. 323 00:15:11,480 --> 00:15:13,520 Great. So tell us, tell us a little 324 00:15:13,520 --> 00:15:15,400 bit, let's start on the strength side of things. 325 00:15:15,400 --> 00:15:17,640 How did that, how did those numbers shake out? 326 00:15:17,640 --> 00:15:21,600 What did you what did you learn? So what I learned was there was 327 00:15:21,600 --> 00:15:24,680 actually no difference in ankle plantar flexion strength or calf 328 00:15:24,680 --> 00:15:28,040 strength between the groups. It was exactly the same even 329 00:15:28,040 --> 00:15:31,360 across the board like look there was very little variability is 330 00:15:31,360 --> 00:15:34,280 fairly consistent upon groups. It really wasn't that different. 331 00:15:34,960 --> 00:15:39,640 The hip strength values were pretty were were slightly less. 332 00:15:39,640 --> 00:15:43,160 It was still significant, so it was reportable, but it was less 333 00:15:43,480 --> 00:15:45,800 in the Achilles tendinopathy group. 334 00:15:45,800 --> 00:15:50,520 So they had less hip, less hip extensor strength, but no 335 00:15:50,520 --> 00:15:52,960 differences in calf or plantar flexor strength. 336 00:15:53,160 --> 00:15:56,120 OK. And did that surprise you? 337 00:15:57,000 --> 00:16:00,200 Yeah, it really did because I would have assumed and you know, 338 00:16:00,200 --> 00:16:02,840 it makes me think is, yeah, I tell my students all the time, 339 00:16:02,840 --> 00:16:05,520 don't assume, yeah, there's weakness because there's 340 00:16:05,520 --> 00:16:07,040 pathology. That was an incorrect 341 00:16:07,040 --> 00:16:08,360 assumption. I mean, that's what we do. 342 00:16:08,360 --> 00:16:11,440 It's scientific method, right. But yeah, there was not a 343 00:16:11,440 --> 00:16:13,800 difference in cap strength, which I was expecting there to 344 00:16:13,800 --> 00:16:17,560 be less because there actually has been some literature that 345 00:16:17,560 --> 00:16:19,760 suggested that there that cap strength can be weaker. 346 00:16:19,760 --> 00:16:22,520 But there is also alternative research that suggests there 347 00:16:22,520 --> 00:16:25,600 isn't actually weakness, and there's even a small little bit 348 00:16:25,600 --> 00:16:28,080 that says those with Achilles stenopathy can actually 349 00:16:28,080 --> 00:16:31,560 sometimes have more calf strength, and so there's some 350 00:16:31,560 --> 00:16:34,040 variability there. So this group, this group of 351 00:16:34,040 --> 00:16:36,800 masters are those I specifically looked at, did not have any 352 00:16:36,800 --> 00:16:38,880 differences in calf strength. It was only the hip that was 353 00:16:38,880 --> 00:16:39,640 decreased. Great. 354 00:16:39,640 --> 00:16:41,320 And that was for hip extensor strength, yeah. 355 00:16:41,360 --> 00:16:44,680 Did you measure any other directions or any other muscle 356 00:16:44,680 --> 00:16:45,920 groups? Did you look at like knee 357 00:16:45,920 --> 00:16:48,280 flexion and? Let me clarify. 358 00:16:48,280 --> 00:16:51,600 I did not look at hip flexion. I did not look at knee extension 359 00:16:51,600 --> 00:16:53,840 because those things had not been found to be different. 360 00:16:54,520 --> 00:16:56,600 I did look at for the ankle and the hip. 361 00:16:56,600 --> 00:17:01,360 I looked at concentric and eccentric strength and it was 362 00:17:01,400 --> 00:17:03,160 the hip. The hip extension, both 363 00:17:03,160 --> 00:17:05,280 concentric and eccentric strength were decreased. 364 00:17:05,440 --> 00:17:09,119 For ankle plantar flexion, both concentric and eccentric were 365 00:17:09,119 --> 00:17:10,240 not different. OK. 366 00:17:10,839 --> 00:17:13,880 So why kind of what's your why behind this? 367 00:17:13,880 --> 00:17:17,079 Like why do you think you saw those findings that you saw, you 368 00:17:17,079 --> 00:17:20,520 know, why do you think that they maybe didn't have decreased 369 00:17:20,520 --> 00:17:23,640 strength in the in the calf kind of what what do you take from 370 00:17:23,640 --> 00:17:25,040 that? Yeah, you want to know the real 371 00:17:25,040 --> 00:17:27,040 like first answer that I have. No idea it. 372 00:17:27,760 --> 00:17:30,480 Was like, I don't know, man. Like what the what the. 373 00:17:31,280 --> 00:17:35,640 No. But I I think by itself it 374 00:17:35,640 --> 00:17:37,880 doesn't tell a full story. This is the challenging part 375 00:17:37,880 --> 00:17:39,800 about research. And I learned this very quickly 376 00:17:40,000 --> 00:17:42,200 with doing this stuff. And you'll see kind of how 377 00:17:42,440 --> 00:17:44,640 there's some things that match and there's some things that 378 00:17:44,640 --> 00:17:46,640 don't match at all. And I still have questions about 379 00:17:46,640 --> 00:17:50,800 that, but that's how you continue research my, my thought 380 00:17:50,800 --> 00:17:53,520 my my further hypothesis has to be tested as I'm going, all 381 00:17:53,520 --> 00:17:56,600 right. So what I'm assumption is, is 382 00:17:56,600 --> 00:17:59,040 they don't, it's not obviously decreased strength at the calf 383 00:17:59,080 --> 00:18:02,560 even though there, there may be some other biomechanical factors 384 00:18:02,560 --> 00:18:06,920 there. But clearly the issue is calf 385 00:18:06,920 --> 00:18:08,360 strength. They can still protect, they're 386 00:18:08,360 --> 00:18:10,720 they're still able to generate enough force to do it. 387 00:18:11,240 --> 00:18:13,320 But then that made me realize, and when I looked in the 388 00:18:13,320 --> 00:18:16,720 literature is actually, if you go look at the literature, cap 389 00:18:16,720 --> 00:18:20,640 strength is not a consistent method and a consistent metric 390 00:18:20,640 --> 00:18:23,240 to really look at tendinopathies in the Achilles. 391 00:18:23,240 --> 00:18:27,200 It's actually when you get velocity involved in power where 392 00:18:27,200 --> 00:18:29,680 it actually becomes much more significant. 393 00:18:30,040 --> 00:18:32,360 And we'll get that, yeah. We'll get that to that in a 394 00:18:32,360 --> 00:18:34,200 second. And I was like that didn't make 395 00:18:34,200 --> 00:18:36,640 sense to me until I really looked at the data in the second 396 00:18:36,640 --> 00:18:39,280 study. So I'm like OK, this there 397 00:18:39,280 --> 00:18:41,680 that's consistent with kind of what some of the stuff that I 398 00:18:41,680 --> 00:18:45,120 found later going, yes, power more maximal efforts tend to be 399 00:18:45,120 --> 00:18:49,040 a little bit better at that. And if you just look at all out 400 00:18:49,040 --> 00:18:51,640 strength metrics that's like it's like looking at quantity 401 00:18:51,640 --> 00:18:54,160 versus quality. The quantity isn't always 402 00:18:54,160 --> 00:18:57,120 different. How it's being generated is a 403 00:18:57,120 --> 00:18:59,080 little bit more of the story. And so that's what I started 404 00:18:59,080 --> 00:19:02,920 realizing The hip strength being different is interesting to me 405 00:19:03,160 --> 00:19:08,280 because I mean, there is evidence that the less force you 406 00:19:08,280 --> 00:19:11,400 generate at like the hip, the more so that happens to the 407 00:19:11,400 --> 00:19:14,640 ankle and vice versa. However, it's like, well, you're 408 00:19:14,880 --> 00:19:18,240 generating, there's less going on at the hip, but the ankle is 409 00:19:18,240 --> 00:19:20,640 the same. And actually, I do have data on 410 00:19:20,640 --> 00:19:22,160 the knee. The knee is also the same too. 411 00:19:22,160 --> 00:19:23,760 So it's like, wait? Yeah. 412 00:19:23,760 --> 00:19:28,080 So to to dig into that for a second, you know, you have this 413 00:19:28,080 --> 00:19:30,800 concept where you have this decreased force production at 414 00:19:30,800 --> 00:19:34,240 the hip, you have similar force productions at the ankle and 415 00:19:34,240 --> 00:19:36,680 then you also compared running mechanics and you just kind of 416 00:19:36,680 --> 00:19:40,480 started to refer to at the hip. There was less going on in the 417 00:19:40,480 --> 00:19:42,920 Achilles group. Can you just go into that a 418 00:19:42,920 --> 00:19:45,080 little bit? Yeah, so that the bio mechanics. 419 00:19:45,080 --> 00:19:46,920 Yes, yes. Yeah, I guess so. 420 00:19:46,920 --> 00:19:49,320 Here's where it gets weird. The bio mechanics really weren't 421 00:19:49,480 --> 00:19:50,880 any different. Between the groups. 422 00:19:51,240 --> 00:19:53,640 Between the groups, peak motions were not different. 423 00:19:53,640 --> 00:19:57,280 So peak stride like hip extension wasn't different, 424 00:19:57,560 --> 00:20:00,000 ankle motions were not different. 425 00:20:00,000 --> 00:20:02,640 And I was looking primarily in the sagittal plane because 426 00:20:02,640 --> 00:20:05,160 recent evidence has suggested that some of the frontal plane 427 00:20:05,160 --> 00:20:07,880 stuff actually may not play, is not as consistent as we would 428 00:20:07,880 --> 00:20:10,240 have liked. Like one of the ideas was the IU 429 00:20:10,240 --> 00:20:12,320 pronate more, there's more twisting of the Achilles. 430 00:20:12,520 --> 00:20:14,560 And there's actually been some evidence to think that actually 431 00:20:14,560 --> 00:20:17,960 may not be a thing. And so it was like, all right, 432 00:20:17,960 --> 00:20:20,320 the only consistent thing was we're seeing Sagittal plane. 433 00:20:20,840 --> 00:20:24,160 You know, like front to back, it wasn't different and the moments 434 00:20:24,440 --> 00:20:27,000 were also not different at the ankle or the hip. 435 00:20:27,000 --> 00:20:30,760 So it's like, wait, hip like strength values are different, 436 00:20:30,760 --> 00:20:34,160 but the forces being generated during submaximal running, which 437 00:20:34,160 --> 00:20:36,840 is just running an easy pace, which may have been where the 438 00:20:36,840 --> 00:20:39,920 issue was, wasn't any different. So when you have go out for a 439 00:20:39,920 --> 00:20:45,040 jog, the mechanics really, at least the quantitative mechanics 440 00:20:45,480 --> 00:20:48,400 weren't that different. Interesting and it's. 441 00:20:48,400 --> 00:20:50,920 Very interesting. Did this, did your study in 442 00:20:50,920 --> 00:20:53,280 terms of all of I know you collected tons of different 443 00:20:53,280 --> 00:20:58,320 data, did your, did you look at duty cycle in this study looking 444 00:20:58,320 --> 00:21:00,480 at like the amount of time on the ground versus time in the 445 00:21:00,480 --> 00:21:01,400 air? No. 446 00:21:01,680 --> 00:21:06,160 So that I have that information, I have yet to pull that out and 447 00:21:06,160 --> 00:21:09,080 one of the one of the reasons I did that is because a pH. 448 00:21:09,080 --> 00:21:11,240 D does have some limitations. You have to be a little bit 449 00:21:11,240 --> 00:21:12,760 cautious with what you report on. 450 00:21:13,280 --> 00:21:16,480 The easiest things to report on a pH D is looking at like Max 451 00:21:16,480 --> 00:21:20,920 value, so like ISO kinetic, like Max strength right or peak joint 452 00:21:20,920 --> 00:21:23,720 ankles or peak moments. Some of the things like duty 453 00:21:23,720 --> 00:21:25,640 cycles, things like that you have to be a little bit careful 454 00:21:25,640 --> 00:21:28,360 with because at the end of the day you're trying to get this 455 00:21:28,360 --> 00:21:31,080 thing like finished and your committee is going to, you know, 456 00:21:31,080 --> 00:21:33,480 tear your new one. If it's not so though, that data 457 00:21:33,480 --> 00:21:36,320 is there. I have not looked at it or 458 00:21:36,320 --> 00:21:37,840 parsed it out yet. Great. 459 00:21:38,000 --> 00:21:40,840 I have two questions for you or one comment and a question. 460 00:21:40,840 --> 00:21:43,320 The comment is the reason I asked about duty cycle is Malazo 461 00:21:43,320 --> 00:21:46,640 just came out with another study that looks at injury rates in 462 00:21:46,640 --> 00:21:50,040 relation to duty cycle. So there's there's more stuff 463 00:21:50,040 --> 00:21:51,880 kind of coming out in that realm, which I think is 464 00:21:51,880 --> 00:21:55,240 interesting. The second thing which is more 465 00:21:55,240 --> 00:21:58,880 of a question is now it's escaping my brain. 466 00:21:59,840 --> 00:22:03,120 This is how my life works. Just forget things, that's OK. 467 00:22:03,400 --> 00:22:04,600 I do that all the time right now. 468 00:22:06,280 --> 00:22:08,200 It just goes being. A being a parent and trying to 469 00:22:08,200 --> 00:22:10,360 do a second doctorate degree, which we're both doing, is what 470 00:22:10,360 --> 00:22:11,200 is this? What happens? 471 00:22:11,360 --> 00:22:13,680 It is, yeah. Tap out. 472 00:22:14,120 --> 00:22:18,240 Well, let's let's move forward then because I I can't, I can't 473 00:22:18,240 --> 00:22:20,080 think of it. Oh, this is what I was going to 474 00:22:20,080 --> 00:22:21,280 ask. Can you explain? 475 00:22:21,280 --> 00:22:23,000 You've used the word moment a lot. 476 00:22:23,000 --> 00:22:26,880 So you've talked about joint angles and Max hip flexion and 477 00:22:26,880 --> 00:22:29,000 all these or hip extension and these joint angles. 478 00:22:29,120 --> 00:22:31,520 Can you just explain what a moment is? 479 00:22:31,720 --> 00:22:35,800 Just that people understand who may not have a like APT degree. 480 00:22:36,240 --> 00:22:39,160 Yeah, that's fine. So normally we talk about forces 481 00:22:39,160 --> 00:22:42,200 like good forces are usually in a single plane of motion, right. 482 00:22:42,200 --> 00:22:45,440 Like if I'm landing on the ground, like a like a vertical 483 00:22:45,440 --> 00:22:47,240 ground reaction force. It's like how much force is 484 00:22:47,240 --> 00:22:50,360 coming straight back up when you're talking about joints. 485 00:22:50,600 --> 00:22:53,520 Joints don't really do do that same thing. 486 00:22:53,520 --> 00:22:55,800 They're not it's it's usually much more rotational. 487 00:22:55,800 --> 00:22:58,920 So a moment is looking at more kind of that rotational force 488 00:22:58,920 --> 00:23:01,440 and there's, there's internal moments, there's external things 489 00:23:01,440 --> 00:23:04,640 that create an inside and outside and it just essentially 490 00:23:04,640 --> 00:23:08,200 means like a joint or almost like like a rotate, like a more 491 00:23:08,200 --> 00:23:10,880 of a rotational force, so to speak. 492 00:23:11,120 --> 00:23:13,040 Great. And you can have like summations 493 00:23:13,040 --> 00:23:14,520 and stuff like that. And I'm going to be totally 494 00:23:14,520 --> 00:23:16,840 honest with you that it took me like multiple years to finally 495 00:23:16,840 --> 00:23:19,720 really understand what a moment is and half the time ago, did I 496 00:23:19,840 --> 00:23:23,120 say that right. So yeah, this basically just 497 00:23:23,120 --> 00:23:25,480 means like kind of like joint or rotational force essentially, 498 00:23:25,480 --> 00:23:28,240 but not quite torque. Yeah, it's different. 499 00:23:28,280 --> 00:23:29,800 Yep, great. Thank you. 500 00:23:30,200 --> 00:23:32,120 So let's move on to study #2 then. 501 00:23:32,120 --> 00:23:34,360 So let's, let's talk about, So you have this first one where 502 00:23:34,360 --> 00:23:36,440 you took these two groups. In between them you compared 503 00:23:36,440 --> 00:23:39,800 their strength numbers where you basically found that there was a 504 00:23:39,800 --> 00:23:43,200 slight decrease in hip extensor strength output or force 505 00:23:43,200 --> 00:23:45,760 production output, but everything at the ankle was 506 00:23:45,760 --> 00:23:47,880 defined. Then you looked at mechanics and 507 00:23:47,880 --> 00:23:50,120 everything between those two groups looked the same whether 508 00:23:50,120 --> 00:23:51,960 they had Achilles tendinopathy or not. 509 00:23:52,560 --> 00:23:54,480 And then now you did this study #2. 510 00:23:54,480 --> 00:23:57,200 So bring us into the second study that you have in for 511 00:23:57,200 --> 00:23:59,520 publication. And I will clarify that for 512 00:23:59,520 --> 00:24:01,280 those who are listening, who actually participate in the 513 00:24:01,280 --> 00:24:04,200 study and you know how long it took to do each one of these it 514 00:24:04,240 --> 00:24:06,840 this was all done at once. So we did the running mechanics 515 00:24:07,200 --> 00:24:10,280 did the hopping and then did the I used to take denim opt to be 516 00:24:10,280 --> 00:24:11,760 like I'm a little sore the next day. 517 00:24:11,760 --> 00:24:13,800 I'm like yeah you just did like a two hour workout. 518 00:24:13,800 --> 00:24:18,160 So you know, so this the, the second study was looking at 519 00:24:18,160 --> 00:24:20,400 single leg horizontal hop mechanics. 520 00:24:20,400 --> 00:24:23,800 And the reason I was looking at that is I knew from previous 521 00:24:23,800 --> 00:24:26,280 evidence that the single leg horizontal hop meaning like 522 00:24:26,280 --> 00:24:29,080 you're you're not jumping straight up, you're jumping 523 00:24:29,080 --> 00:24:33,760 forward as far as you can. When you jump forward, much more 524 00:24:33,760 --> 00:24:36,720 of the propulsive force comes from the hip and the ankle. 525 00:24:36,720 --> 00:24:39,280 The knee does not contribute very much until you land. 526 00:24:39,640 --> 00:24:42,480 And So what I was seeing in my systematic review is it looked 527 00:24:42,480 --> 00:24:45,520 like more of the deficits and changes that happen as we get 528 00:24:45,520 --> 00:24:48,360 older was happening during the propulsive phase. 529 00:24:48,360 --> 00:24:53,000 And my my theory was something's happening there that if I can 530 00:24:53,000 --> 00:24:56,440 piece out together that I think might be might may be 531 00:24:56,440 --> 00:24:59,560 contributing to some of the the risk factors for Achilles 532 00:24:59,560 --> 00:25:00,960 centenopathy. So I chose to say like 533 00:25:00,960 --> 00:25:05,000 horizontal hop, which is also a great measure of power where 534 00:25:05,000 --> 00:25:07,600 it's like, you know, submaximal running mechanics, even ice, 535 00:25:07,600 --> 00:25:10,360 kinetic dynamometry. It's really hard to get accurate 536 00:25:10,360 --> 00:25:13,200 measures of power. How fast somebody could generate 537 00:25:13,200 --> 00:25:16,840 force out of that stuff. So I thought this be a great 538 00:25:16,840 --> 00:25:19,760 test to use because it's very well validated, it's clinically 539 00:25:19,760 --> 00:25:22,120 relevant, and I thought, great, let's let's do this. 540 00:25:22,400 --> 00:25:26,480 So I had the masters runners stand on one force plate and hop 541 00:25:26,520 --> 00:25:31,080 as far as they could to another force plate and land, even 542 00:25:31,080 --> 00:25:33,240 though I wasn't actually looking at how they landed, that they 543 00:25:33,240 --> 00:25:37,480 just needed them to land safely and was looking at how they 544 00:25:37,480 --> 00:25:39,920 propelled themselves off the plate. 545 00:25:39,920 --> 00:25:41,520 And single leg, correct. You may have said that. 546 00:25:41,560 --> 00:25:43,000 Single leg, yeah. Single leg great. 547 00:25:43,200 --> 00:25:46,720 Because that that would be I I felt like most relevant to 548 00:25:46,720 --> 00:25:48,600 running mechanics. Totally, yeah. 549 00:25:48,880 --> 00:25:50,440 Yeah. So tell us a little bit about 550 00:25:50,440 --> 00:25:53,720 what you found with it then. Yeah, this was a little bit more 551 00:25:54,000 --> 00:25:57,440 consistent where there were actually there was decreased 552 00:25:57,440 --> 00:26:01,480 power at both the hip. I just say positive power 553 00:26:01,480 --> 00:26:05,240 meaning you're generating the force rather than negative or 554 00:26:05,240 --> 00:26:08,120 eccentric power is where you're landing and having to shock 555 00:26:08,120 --> 00:26:09,920 absorb really quick. So I was just looking at 556 00:26:09,920 --> 00:26:13,840 propulsion or positive power, but there was less hip positive 557 00:26:13,840 --> 00:26:16,760 power, hip extensor positive power and ankle plantar flexion 558 00:26:16,760 --> 00:26:19,360 positive power in the the Achilles Tendinopathy Group. 559 00:26:20,240 --> 00:26:23,480 I also still looked at those same moments and there was 560 00:26:23,480 --> 00:26:28,720 decreased hit moments, but there was not decreased ankle moments. 561 00:26:28,760 --> 00:26:31,520 What does that tell you? So what's interesting there is 562 00:26:31,520 --> 00:26:34,200 that power when we typically calculate that from a bio 563 00:26:34,200 --> 00:26:37,080 mechanic standpoint, you actually use some of the moments 564 00:26:37,080 --> 00:26:38,920 to calculate you use some of the forces, right? 565 00:26:39,120 --> 00:26:43,040 So it's force, but then it's force in relationship to 566 00:26:43,040 --> 00:26:45,560 velocity. So I thought I was looking at 567 00:26:45,560 --> 00:26:49,240 that going well at the ankle where the this pathology is 568 00:26:49,240 --> 00:26:52,880 primarily happening. If the the amount, the moment or 569 00:26:52,880 --> 00:26:56,640 the amount of force isn't different, the velocity has to 570 00:26:56,640 --> 00:26:59,720 be the thing that's different. Now as I got called out for, I 571 00:26:59,720 --> 00:27:02,280 do have that data, I just have to pull it out correctly, but I 572 00:27:02,280 --> 00:27:04,560 haven't because there's only so much you can report on a study, 573 00:27:04,560 --> 00:27:08,040 but that's I highly suspect the how quickly things were. 574 00:27:08,040 --> 00:27:11,480 If I look at velocity that might be different, but that's 575 00:27:11,480 --> 00:27:13,720 interesting. It was both at the ankle and the 576 00:27:13,720 --> 00:27:16,040 hip. So the single leg hop study was 577 00:27:16,040 --> 00:27:19,680 much more in line with what I thought was going to happen. 578 00:27:19,800 --> 00:27:24,120 It just took a more truly maximal power test to pull this 579 00:27:24,120 --> 00:27:26,080 out. And what I realized looking back 580 00:27:26,080 --> 00:27:29,680 to the first study is going, I should have had them like Sprint 581 00:27:29,680 --> 00:27:32,000 across the plate. But unfortunately it was not a 582 00:27:32,000 --> 00:27:33,480 treadmill base. It's people have done this 583 00:27:33,480 --> 00:27:35,000 before. Sometimes you can do like bio 584 00:27:35,000 --> 00:27:37,920 mechanics on a treadmill at APU. We just have the force plates in 585 00:27:37,920 --> 00:27:40,200 the ground, so I did like only a couple meters for them to run 586 00:27:40,200 --> 00:27:43,080 across. So sprinting at that level has 587 00:27:43,080 --> 00:27:44,280 not been found to be very accurate. 588 00:27:44,280 --> 00:27:45,600 So I was kind of limited with that. 589 00:27:46,160 --> 00:27:49,000 So I suspect like I need to look at more maximal stuff. 590 00:27:49,040 --> 00:27:51,800 And I think this relates more because a lot of them, not all 591 00:27:51,800 --> 00:27:54,440 but a lot of the masters that I'm working with, they're not 592 00:27:54,440 --> 00:27:56,480 running at sub maximal efforts all the time. 593 00:27:56,680 --> 00:27:58,760 But if you do that, maybe you don't get as injured. 594 00:27:58,800 --> 00:28:01,360 All of these, the people that I tested, regardless of their 595 00:28:01,360 --> 00:28:04,280 ability, were all people that still competed. 596 00:28:04,360 --> 00:28:07,120 And they were still people that you know, they go run easy one 597 00:28:07,120 --> 00:28:09,120 day and then they might have a workout or if it's not 598 00:28:09,120 --> 00:28:12,600 structured they go run fast one day for what for them and then 599 00:28:12,600 --> 00:28:14,640 run ease another day and kind of gets around. 600 00:28:14,640 --> 00:28:18,240 So it's like well, if the sub maximal running mechanics aren't 601 00:28:18,240 --> 00:28:20,840 different and have to be very careful what I'm about to say 602 00:28:20,840 --> 00:28:24,560 because I didn't actually test maximal running mechanics and 603 00:28:24,560 --> 00:28:28,120 there is no evidence that has ever linked hopping to running 604 00:28:29,160 --> 00:28:31,360 which is another study I might be working on. 605 00:28:33,200 --> 00:28:36,320 Don't, please don't instill that I have to be careful as going. 606 00:28:36,320 --> 00:28:40,360 My my suspicion is that during normal submaximal efforts you're 607 00:28:40,360 --> 00:28:42,680 not probably going to see as much stuff, But when you try to 608 00:28:42,680 --> 00:28:45,800 run faster or generate. Sorry, when when you try to 609 00:28:45,800 --> 00:28:48,960 generate more maximal efforts, not necessarily running, because 610 00:28:48,960 --> 00:28:51,840 we don't know that for sure, there's going to be differences 611 00:28:51,840 --> 00:28:55,760 and that may potentially put the tendon more at risk. 612 00:28:55,760 --> 00:28:59,680 Because I suspect what to really use the calf, you have to be 613 00:28:59,680 --> 00:29:04,840 able to absorb like, so the calf will help the tendon optimally 614 00:29:04,840 --> 00:29:09,000 absorb energy, but then to release it, you actually have to 615 00:29:09,000 --> 00:29:12,320 move that thing fast enough to actually efficiently release it. 616 00:29:13,080 --> 00:29:15,600 And if you're not moving fast enough, I think that energy 617 00:29:15,600 --> 00:29:17,640 doesn't have anywhere to go and you're going to end up working 618 00:29:17,640 --> 00:29:20,440 harder to push forward. And that puts more stress to the 619 00:29:20,440 --> 00:29:22,160 tendon. At least that's my theory that 620 00:29:22,160 --> 00:29:24,800 I'm working on. Yeah, I think that's super 621 00:29:24,800 --> 00:29:28,680 interesting. And you know, I, I, I think 622 00:29:28,680 --> 00:29:32,080 you've already laid out the limitations of this sort of 623 00:29:32,080 --> 00:29:36,200 research observational, yeah. When can you just repeat that 624 00:29:36,200 --> 00:29:39,680 one more time in terms of what sort of conclusions can we draw 625 00:29:39,680 --> 00:29:41,560 from this, from the studies itself? 626 00:29:41,560 --> 00:29:44,240 I think I have some more like practical questions for you 627 00:29:44,240 --> 00:29:46,000 based on how you conceptualize this. 628 00:29:46,000 --> 00:29:48,800 But this that lies outside of the purview of the study itself. 629 00:29:48,800 --> 00:29:52,240 So can you just repeat kind of where are your conclusions with 630 00:29:52,240 --> 00:29:54,280 what are your conclusions with both of these studies? 631 00:29:54,840 --> 00:29:56,680 This is good practice for my dissertation defense. 632 00:29:56,720 --> 00:29:59,840 There we go. So the the the first study, the 633 00:29:59,840 --> 00:30:05,120 conclusions were that there are hip strength, maximal strength 634 00:30:05,840 --> 00:30:10,160 deficits at the hip but not at the ankle, and that when running 635 00:30:10,160 --> 00:30:14,080 at submaximal paces, there's no difference between those who do 636 00:30:14,080 --> 00:30:15,920 and do not have Achilles tendon problems. 637 00:30:15,920 --> 00:30:19,560 So you cannot tell differences across the board. 638 00:30:19,720 --> 00:30:23,120 Looking at running mechanics in those who do and don't have 639 00:30:23,120 --> 00:30:27,280 this, the second study suggested that you can better visualize 640 00:30:27,280 --> 00:30:30,680 the deficits in those who have Achilles stenopathy if you use a 641 00:30:30,680 --> 00:30:33,560 single leg hop test, a maximal test. 642 00:30:33,880 --> 00:30:36,880 And what you might might find in this group is that there is 643 00:30:36,880 --> 00:30:41,080 decreased power at both the hip and the ankle and there's 644 00:30:41,080 --> 00:30:46,600 decreased forces at the hip. What that necessarily means we 645 00:30:46,600 --> 00:30:49,760 can postulate, but because this is an observation, research, 646 00:30:49,760 --> 00:30:52,320 meaning we're just watching and taking and data, we're not doing 647 00:30:52,320 --> 00:30:55,760 an intervention, I cannot make a conclusion about what treatments 648 00:30:55,760 --> 00:30:58,520 need to be done. I cannot make any conclusion 649 00:30:58,520 --> 00:31:02,200 about is this like, you know, chicken or the egg kind. 650 00:31:02,200 --> 00:31:03,480 Of thing let me my next question. 651 00:31:03,480 --> 00:31:06,240 Come first, right? Or did the, I don't know that. 652 00:31:06,240 --> 00:31:08,800 And so the one of the big question remains is are these 653 00:31:08,800 --> 00:31:12,520 changes that happened after the pathology or did they contribute 654 00:31:12,520 --> 00:31:13,760 before? We don't know. 655 00:31:13,800 --> 00:31:16,760 So we just know that this seems to be present at this time 656 00:31:16,760 --> 00:31:19,160 point. And that is something that that 657 00:31:19,160 --> 00:31:22,080 I think clinically when I, when I'm working with people and PTS 658 00:31:22,080 --> 00:31:26,520 that are working with people, you'll inevitably in a 659 00:31:26,520 --> 00:31:29,440 conversation with a patient that you're working with or a client, 660 00:31:29,440 --> 00:31:31,640 they're going to ask, so why did this happen? 661 00:31:31,920 --> 00:31:34,840 And I think that sometimes we can take these studies and try 662 00:31:34,840 --> 00:31:38,680 to say one way or another, but reality is we we really don't 663 00:31:38,680 --> 00:31:40,360 know. Again, just to tease it out 664 00:31:40,360 --> 00:31:42,880 again and just to make it explicit again, we don't know 665 00:31:42,880 --> 00:31:47,320 whether the power production through that forward hop test 666 00:31:47,320 --> 00:31:52,240 was due to the existence of their Achilles tendinopathy or 667 00:31:53,200 --> 00:31:57,520 if it was, they had that power deficit and therefore it led to 668 00:31:57,760 --> 00:32:00,000 the tendinopathy. We don't know. 669 00:32:00,080 --> 00:32:02,240 And that's usually the case when it comes. 670 00:32:02,680 --> 00:32:04,440 Yes. And that's the case when we have 671 00:32:04,440 --> 00:32:07,560 people in with us because we don't have the data before their 672 00:32:07,560 --> 00:32:10,200 injury. And so I guess my next question 673 00:32:10,200 --> 00:32:14,760 for you now starts to move away from the studies themselves and 674 00:32:14,760 --> 00:32:18,440 more how you conceptualize either whether you're a runner 675 00:32:18,440 --> 00:32:21,840 yourself or if you're APT who works with runners and you're 676 00:32:21,840 --> 00:32:23,640 trying to tease some of the stuff stuff out. 677 00:32:24,120 --> 00:32:26,080 I think some of the questions I have in my head once some of 678 00:32:26,080 --> 00:32:28,840 them revolve around like how would you in a clinic that 679 00:32:28,840 --> 00:32:31,160 doesn't have a force plate measure power? 680 00:32:31,880 --> 00:32:36,520 And the other one is what sort of things are worth either doing 681 00:32:36,520 --> 00:32:42,840 or measuring as you age to kind of work on this power side of 682 00:32:42,840 --> 00:32:44,080 things? Yeah. 683 00:32:44,560 --> 00:32:47,200 So my answer for the first one about what's what, what 684 00:32:47,200 --> 00:32:49,440 clinically relevant tests do you think we can use? 685 00:32:49,800 --> 00:32:53,520 One of them is I I don't know at this, I mean it's good still to 686 00:32:53,520 --> 00:32:56,960 do, but I wouldn't put as much emphasis on the running motion 687 00:32:56,960 --> 00:32:59,840 analysis, seeing going OK, that wasn't that didn't seem the 688 00:32:59,840 --> 00:33:01,600 thing that really generated the biggest difference. 689 00:33:01,600 --> 00:33:03,640 Some people might have some things that contribute and 690 00:33:03,640 --> 00:33:06,040 that's totally fine. But a lot of the things that I 691 00:33:06,040 --> 00:33:08,480 would be looking at in this population, the reason why I 692 00:33:08,520 --> 00:33:12,440 picked this was, as you get older, one of the things we lose 693 00:33:12,440 --> 00:33:15,840 most significantly unless you lose work on it is power. 694 00:33:16,400 --> 00:33:20,240 You lose muscle mass, you actually lose more strength, 695 00:33:20,360 --> 00:33:22,760 relatively amount of muscle mass, you lose and you lose more 696 00:33:22,760 --> 00:33:25,600 power relative to your strength. So this is something very 697 00:33:25,600 --> 00:33:28,560 important, no matter what sport or activity or even if you're 698 00:33:28,560 --> 00:33:33,000 not athletic, what you're doing as an aging individual, you lose 699 00:33:33,000 --> 00:33:35,360 power more than anything. And the problem with that is 700 00:33:35,360 --> 00:33:37,640 that that is most predictive of function. 701 00:33:37,680 --> 00:33:41,160 Like the biggest preventative factor for falls is actually how 702 00:33:41,160 --> 00:33:43,960 much power you have because you could react quickly, right? 703 00:33:43,960 --> 00:33:47,400 So it's also like in terms of getting a lot of our activities 704 00:33:47,400 --> 00:33:49,760 to daily living, we don't talk about they require power getting 705 00:33:49,760 --> 00:33:53,440 upstairs getting out of a seat like to do that optimally takes 706 00:33:53,440 --> 00:33:56,440 not just how much strength you have, but can you generate it 707 00:33:56,440 --> 00:34:01,200 quickly to to do these things. So I I honestly think that some 708 00:34:01,200 --> 00:34:05,240 of this very simple like single M power test, like the single 709 00:34:05,240 --> 00:34:07,280 leg hop test is a great test to do. 710 00:34:07,280 --> 00:34:10,320 Put some tape down go, hey, how far can you hop on one leg 711 00:34:10,600 --> 00:34:13,040 versus the other or like how far can you hop? 712 00:34:13,040 --> 00:34:17,080 Does it even look qualitatively good because if you want to run 713 00:34:17,080 --> 00:34:20,400 and you run fast, running is a series of single leg hops 714 00:34:20,400 --> 00:34:23,480 essentially and you're having to generate force much faster than 715 00:34:23,480 --> 00:34:25,400 you were doing it while running or while walking. 716 00:34:25,400 --> 00:34:30,000 So you do need a level of of power to do these activities. 717 00:34:30,000 --> 00:34:32,600 So I think some of the clinical relevant tests like the physical 718 00:34:32,600 --> 00:34:35,159 performance test, so the single leg hot single leg horizontal 719 00:34:35,159 --> 00:34:38,360 hop test, if that's not safe enough, doing some of the double 720 00:34:38,360 --> 00:34:41,360 limb jumps or things like that which you just need a piece of 721 00:34:41,360 --> 00:34:44,639 tape and a tape measure, it's a measure, are really good tests 722 00:34:44,639 --> 00:34:46,239 that I think are worth looking at. 723 00:34:46,520 --> 00:34:49,960 Do you, did you see in your review any when you were think 724 00:34:49,960 --> 00:34:51,840 choosing your test that you're going to do? 725 00:34:51,840 --> 00:34:53,719 Did they? Are there any correlation 726 00:34:53,719 --> 00:34:57,160 studies between force plate power output and distance in 727 00:34:57,160 --> 00:35:00,880 that horizontal hop test? I don't think that's a great 728 00:35:00,880 --> 00:35:03,160 question. I don't think anybody has done 729 00:35:03,160 --> 00:35:05,400 that great. Study, let's do that because if 730 00:35:05,400 --> 00:35:08,160 we can, if it does, then Dang, then you don't have to buy a 731 00:35:08,160 --> 00:35:10,520 force plate and you can just be like how far can you do this? 732 00:35:11,320 --> 00:35:14,080 And then we could correlate you know kind of like how there's, 733 00:35:14,120 --> 00:35:17,160 there's studies for strength that have worked to understand 734 00:35:17,160 --> 00:35:20,240 what's the relationship between a three Rep Max knee extension 735 00:35:20,440 --> 00:35:24,560 and an isokinetic knee extension test just to know like and and 736 00:35:24,560 --> 00:35:28,280 usually so not that people care about this, but like a three Rep 737 00:35:28,280 --> 00:35:32,120 Max test is going to overestimate your limb symmetry 738 00:35:32,240 --> 00:35:34,600 as compared to an isokinetic test. 739 00:35:34,680 --> 00:35:37,560 So therefore clinically as a clinician I make sure that 740 00:35:37,720 --> 00:35:41,080 instead of returning to sport at 90% quad strength, I return to 741 00:35:41,080 --> 00:35:46,200 sport at 95% quad strength if I'm using a like a three Rep Max 742 00:35:46,200 --> 00:35:48,960 knee extension. So in the same way I think that 743 00:35:48,960 --> 00:35:52,960 would be an interesting thing to learn is like do we have, can we 744 00:35:52,960 --> 00:35:57,840 get some data to correlate what you know and we just get like 745 00:35:57,840 --> 00:36:01,600 hundreds of people to do this and see if see if we see if we 746 00:36:01,600 --> 00:36:04,440 get the same or different that'd be a helpful clinical study. 747 00:36:05,280 --> 00:36:07,800 If I mean if it showed that it was correlated. 748 00:36:07,800 --> 00:36:10,600 If it's not, then we know it's not and then we can have more 749 00:36:10,600 --> 00:36:13,120 accurate interpretation of our findings, but cool. 750 00:36:14,600 --> 00:36:15,960 Yeah, we got to put that on the docket. 751 00:36:16,040 --> 00:36:17,120 Yeah, Let's put it on the docket. 752 00:36:18,560 --> 00:36:26,320 And then when it comes to what you think as a runner who is, I 753 00:36:26,320 --> 00:36:31,640 mean, we're both in our mid 30s. What sort of things do you think 754 00:36:31,640 --> 00:36:34,640 are valuable to work on? And again, this is outside of 755 00:36:34,640 --> 00:36:37,320 the purview of the conclusions of your study, but with 756 00:36:37,320 --> 00:36:40,440 everything that you know, what what do you think is smart to 757 00:36:40,440 --> 00:36:42,000 do? I think the number one thing 758 00:36:42,000 --> 00:36:43,840 that I've seen and I I talked about this on the previous 759 00:36:43,840 --> 00:36:47,400 podcast is you're going to do plenty of running but really 760 00:36:47,400 --> 00:36:50,880 working on high level strength training. 761 00:36:50,880 --> 00:36:53,400 And I'm not saying go do this for like 10 hours a day. 762 00:36:53,400 --> 00:36:56,000 I'm saying even for a few minutes like once or twice a 763 00:36:56,000 --> 00:36:59,720 week working on kind of more intense strength training is 764 00:36:59,720 --> 00:37:01,640 really important. I said talked about the same 765 00:37:01,640 --> 00:37:03,760 thing with Rich Willie, about like you know, building bone 766 00:37:03,760 --> 00:37:05,800 density right. And you see the same thing as 767 00:37:05,800 --> 00:37:08,520 you age that we lose strength. That's something really 768 00:37:08,520 --> 00:37:11,720 important to can do work on because by itself running is not 769 00:37:11,720 --> 00:37:14,560 a great way to improve strength. It will definitely improve. 770 00:37:14,560 --> 00:37:18,080 Your aerobic capacity is there's some tissues like changes that 771 00:37:18,080 --> 00:37:20,400 will occur. But if you want to get better 772 00:37:20,400 --> 00:37:23,320 at, if you want to get stronger, you really need to do strength 773 00:37:23,320 --> 00:37:25,240 training. And it doesn't need to be to do 774 00:37:25,560 --> 00:37:29,680 50 hours of it a day. It's it's just like even like a 775 00:37:29,680 --> 00:37:33,080 couple minutes warming up doing some very simple stuff, a 776 00:37:33,080 --> 00:37:35,320 deadlift, A squat, something that's like heavy. 777 00:37:35,320 --> 00:37:38,920 Getting close to your Max and a couple reps of those is a really 778 00:37:38,920 --> 00:37:40,480 great way of doing strength stuff. 779 00:37:40,480 --> 00:37:44,000 And I think the same could be said with tendinopathies because 780 00:37:44,000 --> 00:37:47,800 they do tend to become a little bit more common as we get older. 781 00:37:48,120 --> 00:37:51,720 I think working on like, you know, heavy, slow resistance 782 00:37:51,720 --> 00:37:54,920 training is really, really important for some of the major 783 00:37:54,920 --> 00:37:58,800 tendons of lokgemity be a hamstring, quad and certainly 784 00:37:59,360 --> 00:38:02,800 Achilles. But the thing I would add that I 785 00:38:02,800 --> 00:38:05,680 learned is you also got to be working on power. 786 00:38:05,680 --> 00:38:08,720 Like, it's not just how much strength you can produce or 787 00:38:08,720 --> 00:38:11,240 force you can produce, it's how the quality of it. 788 00:38:11,600 --> 00:38:15,600 And anecdotally, qualitatively, a lot of the Masters owners I 789 00:38:15,600 --> 00:38:19,880 work with are going. I haven't hopped since I was in 790 00:38:19,880 --> 00:38:23,680 high school and I'm like, so there was a good note. 791 00:38:23,680 --> 00:38:27,400 I gave them at least one test trials, but how many trials it 792 00:38:27,400 --> 00:38:31,640 took them to actually complete, it varied greatly until we could 793 00:38:31,680 --> 00:38:35,400 actually get them to truly take off and stick a maximal test. 794 00:38:35,400 --> 00:38:37,200 And that took some time for them to figure out. 795 00:38:37,680 --> 00:38:41,840 So again, you're thinking as you get older, hey, my speed's 796 00:38:41,840 --> 00:38:43,520 decreasing, like all this stuff's decreasing. 797 00:38:43,520 --> 00:38:47,120 I'm having this I think again same thing as the as the 798 00:38:47,480 --> 00:38:52,560 strength training doing some careful less is more with this 799 00:38:52,560 --> 00:38:53,800 because this I like strength training. 800 00:38:53,800 --> 00:38:55,760 Power training is one of things like you can get away with that 801 00:38:55,760 --> 00:38:59,920 once a week because you don't realize how like jumping around 802 00:38:59,920 --> 00:39:02,960 can actually make you pretty sore and it is it's high benefit 803 00:39:02,960 --> 00:39:06,000 but it's also high risk. So it's you know less is more 804 00:39:06,240 --> 00:39:10,160 but I think doing some hopping and single leg stuff, single leg 805 00:39:10,160 --> 00:39:12,760 hopping would be really beneficial for people who are 806 00:39:12,760 --> 00:39:16,120 aging to work on and even with for the non runners I've worked 807 00:39:16,120 --> 00:39:19,680 with I have lots of I I love the geriatric population. 808 00:39:19,680 --> 00:39:22,560 I have lots of people in their late 70s and 80s who I'm like, 809 00:39:22,960 --> 00:39:25,680 we're going to do a box jump and it might be this tall, but we're 810 00:39:25,680 --> 00:39:27,600 going to still work on that. And you get people who start 811 00:39:27,600 --> 00:39:31,000 crying going, I haven't like, jumped like this and I don't 812 00:39:31,000 --> 00:39:33,920 know how in like 80 years. And it's like they actually. 813 00:39:33,920 --> 00:39:36,200 Crying because they're terrified or crying because they're 814 00:39:36,200 --> 00:39:37,280 pumped. They just didn't. 815 00:39:37,320 --> 00:39:39,560 They're pumped, yeah. Yeah. 816 00:39:39,640 --> 00:39:41,720 The second we're like pumped and like wow, I can't believe I did 817 00:39:41,720 --> 00:39:45,280 this. So the what I'm seeing 818 00:39:45,280 --> 00:39:49,720 overarching beyond what I'm looking at is that there is a 819 00:39:49,720 --> 00:39:54,200 way to age optimally and you don't have to do a crazy diet or 820 00:39:54,200 --> 00:39:57,440 crazy workout technique. You just need to have some basic 821 00:39:57,440 --> 00:40:00,040 things that you need to maintain that we typically don't do as we 822 00:40:00,040 --> 00:40:01,280 age. Like you work on all kinds of 823 00:40:01,280 --> 00:40:03,560 jumping and all kinds of fun stuff as a kid that you don't do 824 00:40:03,560 --> 00:40:05,640 as an adult, and it would be very helpful. 825 00:40:06,160 --> 00:40:09,040 Even in small dosages to continue to do that, recognizing 826 00:40:09,040 --> 00:40:12,640 that that is very important for your health no matter what age 827 00:40:12,640 --> 00:40:15,560 you are. And So what I hope from a career 828 00:40:15,560 --> 00:40:17,680 standpoint is kind of try to make that a little bit more 829 00:40:17,680 --> 00:40:21,160 known to go there are changes that are happening now. 830 00:40:21,160 --> 00:40:26,000 The question is no matter what or who you are, how do you help 831 00:40:26,840 --> 00:40:31,040 age well And so it's kind of my long pie in the sky version of 832 00:40:31,040 --> 00:40:33,840 what I'd like to do is that's my clinical, I thought of what you 833 00:40:33,840 --> 00:40:35,680 can work on. I think what could be fun is 834 00:40:35,680 --> 00:40:41,080 creating a library of a kind of progression of those two areas 835 00:40:41,080 --> 00:40:46,000 to like maximize your or to age well with our musculoskeletal 836 00:40:46,000 --> 00:40:49,160 systems and create that as like an opportunity for people to 837 00:40:49,160 --> 00:40:53,520 like I don't know like get in on on learning how to do that smart 838 00:40:53,520 --> 00:40:55,680 in a you know 16 week progression. 839 00:40:55,680 --> 00:40:58,960 We should, we should put that on our dream list for Dor to create 840 00:40:58,960 --> 00:41:02,000 something like that and kind of operationalize some of this 841 00:41:02,000 --> 00:41:05,240 stuff that you're learning. And I think that could be super 842 00:41:05,240 --> 00:41:09,040 fun to to think. There's been great evidence on 843 00:41:09,040 --> 00:41:11,600 those two things in terms of like strength training reducing 844 00:41:11,600 --> 00:41:13,880 injuries, power training improving performance. 845 00:41:13,880 --> 00:41:16,960 Like, you know imagine if 90% of runners just that was just like 846 00:41:17,080 --> 00:41:19,680 because you most people will do some kind of random stretching 847 00:41:19,680 --> 00:41:21,760 routine before they run. Like imagine if they just had a 848 00:41:22,000 --> 00:41:24,800 very brief thing they did after their run with that like 849 00:41:25,280 --> 00:41:27,840 injuries or decrease. You know, I know it's odd for 850 00:41:27,840 --> 00:41:30,080 two people be who two physical therapists to go, how do we 851 00:41:30,080 --> 00:41:31,920 decrease the number of people that have to come see us. 852 00:41:31,920 --> 00:41:34,800 But we're it's we're very lucky to be in a preventative 853 00:41:34,800 --> 00:41:36,960 professional room. We want you to be healthy. 854 00:41:36,960 --> 00:41:40,920 We want you to not need us because that's part of living 855 00:41:40,920 --> 00:41:43,000 well in prevention. So yeah, it'd be really cool. 856 00:41:43,360 --> 00:41:48,480 Absolutely in the the, so we have a pro bono clinic on campus 857 00:41:48,520 --> 00:41:51,840 and one of the things that I have the privilege of doing with 858 00:41:51,840 --> 00:41:55,000 our students is we work with the cross country and track team and 859 00:41:55,000 --> 00:41:59,240 ROTC and we bring them through a full running evaluation. 860 00:41:59,240 --> 00:42:04,080 So we do 3D analysis of their gait and then we do a full 861 00:42:04,080 --> 00:42:07,200 strength assessment using handheld dynamometry and then we 862 00:42:07,200 --> 00:42:10,120 do a functional movement assessment and we do a mobility 863 00:42:10,120 --> 00:42:13,760 assessment. So we look at hip, knee, ankle 864 00:42:13,800 --> 00:42:18,960 strength, hip, knee, ankle mobility, running mechanics and 865 00:42:18,960 --> 00:42:20,160 then we have some functional movements. 866 00:42:20,160 --> 00:42:23,120 One of our functional movements is a single leg forward hop or 867 00:42:23,120 --> 00:42:26,000 the horizontal hop. The second one of the other ones 868 00:42:26,000 --> 00:42:33,360 is a drop jump off of a box and it's amazing that even college 869 00:42:33,360 --> 00:42:36,120 runners have a really hard time hopping. 870 00:42:36,960 --> 00:42:41,400 They run a lot, but they don't have that kind of like power 871 00:42:42,520 --> 00:42:45,600 even though they're very, very fast and and you know, these 872 00:42:45,600 --> 00:42:50,240 are, you know it's AD 3 school, but but these guys and gals are 873 00:42:50,280 --> 00:42:55,040 running very quickly and hot and jumping's hard, jumping's really 874 00:42:55,040 --> 00:42:57,800 hard for them. So I think it's just an 875 00:42:57,800 --> 00:43:01,760 interesting observationally just to and it makes me glad that 876 00:43:01,760 --> 00:43:05,480 we're testing some of those things and we'll have to keep 877 00:43:05,480 --> 00:43:09,680 chatting about how to best learn from all of the stuff that we're 878 00:43:09,680 --> 00:43:12,120 doing in that lab as well because I think that there's a 879 00:43:12,120 --> 00:43:17,440 lot to lot to be discovered. So yeah, what other thoughts 880 00:43:17,480 --> 00:43:22,720 have you had in this process of of learning and kind of final 881 00:43:22,720 --> 00:43:25,720 wrap up thoughts? Yeah, I think one of the things 882 00:43:25,720 --> 00:43:30,600 I've learned is to not think linearly, if that makes sense, 883 00:43:30,600 --> 00:43:34,520 because a lot of the previous data on the stuff is like, oh, 884 00:43:34,520 --> 00:43:37,400 you know, you have like the the joint moments again, like, 885 00:43:37,400 --> 00:43:39,600 right. Like there's a certain amount 886 00:43:39,960 --> 00:43:42,480 that goes in low extremity. If they decrease somewhere, 887 00:43:42,640 --> 00:43:44,480 they're supposed to increase somewhere else. 888 00:43:44,480 --> 00:43:48,040 I actually didn't see that I saw them because as I mentioned, 889 00:43:48,360 --> 00:43:51,160 even though I didn't include the knee in the study, the knees 890 00:43:51,280 --> 00:43:53,640 weren't any different, right? They were the same too. 891 00:43:53,640 --> 00:43:55,320 They're the same, joint moments the same, all that. 892 00:43:55,320 --> 00:43:58,520 So I'm like, even during the hop, the hop, the power and 893 00:43:58,520 --> 00:44:03,880 moments weren't any different. I was like, OK, so you're 894 00:44:03,880 --> 00:44:05,600 decreasing at the hip and the ankle. 895 00:44:06,760 --> 00:44:09,400 Where's that stuff going? The thing is that I, I realized 896 00:44:09,400 --> 00:44:11,800 is I need to go back and I can probably figure this out, but I 897 00:44:11,800 --> 00:44:14,560 didn't actually measure how exactly how far they hopped. 898 00:44:14,880 --> 00:44:17,200 But I think you can actually get that data, right? 899 00:44:18,680 --> 00:44:20,960 That would be a nice follow up to do because that's typically 900 00:44:20,960 --> 00:44:22,320 what you actually do with the single. 901 00:44:23,120 --> 00:44:25,440 Yeah, but you were getting the, but that's not what you were 902 00:44:25,440 --> 00:44:27,320 looking at. So that's the thing. 903 00:44:27,480 --> 00:44:30,480 Mechanical factors. So what I realized there's 904 00:44:30,480 --> 00:44:32,600 there's a lot of different ways to look at this and what you 905 00:44:32,600 --> 00:44:34,600 need to remember is you can't look linearly. 906 00:44:34,600 --> 00:44:38,120 Sometimes you have to look at multiple planes of of 907 00:44:38,120 --> 00:44:40,840 information to think about. This is like, OK, well strength 908 00:44:40,840 --> 00:44:42,160 isn't different, the moments are different. 909 00:44:42,400 --> 00:44:45,400 What if we look at the quality of those measures? 910 00:44:45,400 --> 00:44:48,200 And if I've learned anything, as I think, you know, you have to 911 00:44:48,200 --> 00:44:49,880 go down the path. And so we teach our students 912 00:44:49,880 --> 00:44:52,760 like don't jump to the last like, minute thing first, clear 913 00:44:52,760 --> 00:44:54,840 out the big stuff, right. How do they move? 914 00:44:55,080 --> 00:44:56,680 What's their basic level of strength? 915 00:44:56,680 --> 00:44:59,840 If that's clear, then you can start going to what are the 916 00:44:59,840 --> 00:45:01,640 quality of those, those movements, right. 917 00:45:01,640 --> 00:45:04,520 So movement, coordination, what's the quality of how you 918 00:45:04,520 --> 00:45:06,560 generate that force, how quickly you're doing it, how 919 00:45:06,560 --> 00:45:08,600 consistently you're doing it. And I think there's a lot of 920 00:45:08,600 --> 00:45:12,200 good stuff in that quality area that we're just beginning to 921 00:45:12,200 --> 00:45:16,400 learn that I'm super curious about, especially as we age 922 00:45:16,400 --> 00:45:18,880 going, hey, like how's that quality change? 923 00:45:18,880 --> 00:45:22,200 Because if we know how it changes, we have a better idea 924 00:45:22,200 --> 00:45:24,560 of how do we start designing interventions to see can we 925 00:45:24,560 --> 00:45:29,360 address those and can we start potentially slowing down some of 926 00:45:29,360 --> 00:45:31,840 those performance related changes that we see and start 927 00:45:31,840 --> 00:45:35,960 aging more optimally. And so it's some cool stuff, but 928 00:45:35,960 --> 00:45:39,560 honestly, way more questions than answers, which is exactly 929 00:45:39,560 --> 00:45:41,400 what this is supposed to do. Perfect. 930 00:45:41,400 --> 00:45:47,280 So, so here's my final question for you for the Night has just 931 00:45:47,280 --> 00:45:50,120 because this is the doctors running podcast, has any of this 932 00:45:50,120 --> 00:45:53,880 research and the study that you've been working on, has that 933 00:45:53,880 --> 00:45:58,240 changed how you consider shoe choice for people as we age? 934 00:45:59,000 --> 00:46:01,640 Yeah, it actually did. And there's no there was 935 00:46:01,640 --> 00:46:04,080 actually a study done not too long ago. 936 00:46:04,080 --> 00:46:06,720 I'm looking at masters runners and like the effect is super 937 00:46:06,720 --> 00:46:11,360 shoes and I I don't think they found that massive of a of a 938 00:46:11,360 --> 00:46:13,920 difference. But what it what made me think 939 00:46:13,920 --> 00:46:16,880 about this is doing OK Masters runners are typically losing 940 00:46:16,880 --> 00:46:19,800 power and there's a group obviously with Achilles 10 up 941 00:46:19,800 --> 00:46:24,080 they're losing a greater amount and it made me wonder about the 942 00:46:24,080 --> 00:46:26,800 use of super shoes in this population 'cause I know many, 943 00:46:26,880 --> 00:46:30,400 this is anecdotal, many, many people who are training full 944 00:46:30,400 --> 00:46:32,280 time in these shoes as masters do. 945 00:46:32,280 --> 00:46:34,560 I was like that I feel great. I'm going to use this all the 946 00:46:34,560 --> 00:46:36,680 time. Some of them are healthy, some 947 00:46:36,680 --> 00:46:38,400 of them are not. And the great thing about these 948 00:46:38,400 --> 00:46:42,440 shoes is that, yes, they they, they save your legs, right? 949 00:46:42,440 --> 00:46:45,800 They feel fun all the time. One of the challenges though is 950 00:46:45,800 --> 00:46:49,560 if there's an increased risk of pathology in this population, 951 00:46:49,560 --> 00:46:53,800 which I'm going to argue maybe there's a biomechanical reason 952 00:46:53,800 --> 00:46:56,800 and maybe there's not. Maybe that's a secondary thing 953 00:46:56,800 --> 00:46:58,440 that's not related to bio mechanics. 954 00:46:58,440 --> 00:47:02,640 And if there's not, you are taking away one of the things 955 00:47:02,640 --> 00:47:04,800 that actually helps the tendon get stronger. 956 00:47:04,800 --> 00:47:08,080 There's some early suggestion that some of these shoes 957 00:47:08,080 --> 00:47:11,120 decrease load through the tendons, but you need that load 958 00:47:11,120 --> 00:47:13,800 to help keep remodeling and keep it strong. 959 00:47:14,440 --> 00:47:17,720 So I would still highly suggest that even if you love these 960 00:47:17,720 --> 00:47:20,360 shoes, these are probably not something you should train in 961 00:47:20,360 --> 00:47:24,960 all the time, 'cause you may or may not be putting yourself at 962 00:47:24,960 --> 00:47:28,280 risk for the tendons not being remodeled and loaded the way you 963 00:47:28,280 --> 00:47:30,160 need. I don't have any evidence behind 964 00:47:30,160 --> 00:47:32,400 that. That's that's purely you know, 965 00:47:32,400 --> 00:47:35,080 me putting things together and asking questions and going huh 966 00:47:35,080 --> 00:47:36,640 I. Wonder. 967 00:47:37,240 --> 00:47:41,680 I wonder if maybe using these things all the time isn't the 968 00:47:41,680 --> 00:47:43,920 great greatest idea. I mean, we've already talked 969 00:47:43,920 --> 00:47:45,680 about this in the younger population. 970 00:47:46,040 --> 00:47:49,680 I think with older individuals the same thing might occur as 971 00:47:49,680 --> 00:47:52,440 you might have to deal with, you know, you got to be smart with 972 00:47:52,440 --> 00:47:53,720 your training, right. We're. 973 00:47:54,280 --> 00:47:58,680 So yeah, that was what made me think about that and asked like 974 00:47:58,680 --> 00:48:02,160 OK, so I don't think the shoot is the priority in terms of 975 00:48:02,160 --> 00:48:05,400 treating this. But I think still being a little 976 00:48:05,400 --> 00:48:08,920 cautious with your shoe choice might be helpful. 977 00:48:08,920 --> 00:48:11,880 Although if you're somebody that maybe you got this chronically, 978 00:48:12,320 --> 00:48:15,600 maybe a rocker shoe would be really good, maybe that you need 979 00:48:15,600 --> 00:48:17,520 to decrease stress there. But you also have to realize 980 00:48:17,520 --> 00:48:20,320 that stress is what helps things remodel. 981 00:48:21,160 --> 00:48:24,200 And so you being strategic with your choice is good and maybe 982 00:48:24,200 --> 00:48:26,800 not trying to go, oh, I can only do that I'm only running in this 983 00:48:26,800 --> 00:48:28,880 shoe. It's like, you know, where 984 00:48:29,480 --> 00:48:32,960 extremes don't generally work. It's much more kind of, there's 985 00:48:32,960 --> 00:48:35,560 a lot of minutia to it, understanding how and when to 986 00:48:35,560 --> 00:48:37,440 use things rather than yes or no. 987 00:48:37,920 --> 00:48:42,480 So that's kind of my air bubble, Air bubble thoughts on like 988 00:48:42,480 --> 00:48:44,680 what's what do I think shoe wise? 989 00:48:44,760 --> 00:48:46,600 Fantastic. Ironically, one of the most 990 00:48:46,600 --> 00:48:49,120 common questions is talking about like, you're supposed to 991 00:48:49,120 --> 00:48:51,440 be like, it would take about two hours and we'd be talking about 992 00:48:51,440 --> 00:48:53,160 shoes half the time going, oh, like doctors running. 993 00:48:53,160 --> 00:48:56,040 Like, what do you think of this? Like, oh, this is like, it's a 994 00:48:56,040 --> 00:48:56,880 great question. I don't know. 995 00:48:56,920 --> 00:48:59,920 Like, I'm not looking at that. So yeah, but we can talk about 996 00:48:59,920 --> 00:49:01,520 it. Yep, absolutely. 997 00:49:02,320 --> 00:49:05,480 Well, Matt, thanks again for sharing all of this and Congrats 998 00:49:05,480 --> 00:49:06,920 on the progress you've been making. 999 00:49:06,920 --> 00:49:10,800 It's a lot of work that you've put into it and excited to hear. 1000 00:49:11,200 --> 00:49:14,600 I mean, I'm excited that you're now at this point where you can 1001 00:49:14,880 --> 00:49:17,800 go towards defense and you can get done with the PhD. 1002 00:49:17,800 --> 00:49:22,880 And so congratulations there. We're all at DUR, super proud of 1003 00:49:23,000 --> 00:49:26,880 of you and your progress. It's just been really fun to be 1004 00:49:26,880 --> 00:49:30,760 with you on the journey and hoping the best for kind of 1005 00:49:30,760 --> 00:49:32,920 whatever is next. And now you have some freedom in 1006 00:49:32,920 --> 00:49:34,160 what you get to start looking at. 1007 00:49:34,160 --> 00:49:35,680 You get to just keep trying the journey. 1008 00:49:35,680 --> 00:49:38,360 So thanks for kind of laying your it's kind of like laying 1009 00:49:38,360 --> 00:49:40,480 your heart out there when you're taught it's, you know, we just 1010 00:49:40,480 --> 00:49:43,720 talked about research for 50 minutes, but really it's like 1011 00:49:43,720 --> 00:49:46,240 Matt's heart because he's put so much time into it. 1012 00:49:46,240 --> 00:49:49,680 So be nice to Matt, OK? But he's. 1013 00:49:49,680 --> 00:49:53,280 Broken my heart multiple times. No learning. 1014 00:49:53,600 --> 00:49:57,280 Appreciate, appreciate you sharing and really excited to 1015 00:49:57,280 --> 00:50:00,440 see what you, what you do next. If you want to keep following 1016 00:50:00,440 --> 00:50:02,440 what we're doing at Doctors of Running, you can always check 1017 00:50:02,440 --> 00:50:04,280 out our work at doctorsrunning.com. 1018 00:50:04,280 --> 00:50:08,440 You can also follow us on any of the social media platforms at 1019 00:50:08,440 --> 00:50:11,320 Doctors of Running and you can see all of the different types 1020 00:50:11,320 --> 00:50:15,560 of shoe reviews that we put out, but also research reviews and 1021 00:50:15,560 --> 00:50:17,760 things like that. So thanks for following up on 1022 00:50:17,760 --> 00:50:20,760 us, following us with all of this. 1023 00:50:21,000 --> 00:50:23,640 If you want to run the gift card, leave a review. 1024 00:50:23,720 --> 00:50:27,320 Head over to YouTube on Sunday and when this release is on 1025 00:50:27,320 --> 00:50:30,200 YouTube if you're listening on the audio and answer the 1026 00:50:30,200 --> 00:50:32,240 subjective question and we'll talk to you all soon.