1
00:00:08,160 --> 00:00:10,960
Hello, everybody, and welcome to
the Doctors of Running Podcast, 

2
00:00:10,960 --> 00:00:13,866
where we, a group of doctors of 
physical therapy, discuss the 

3
00:00:13,866 --> 00:00:16,739
art and science of running and 
the stuff that we put on our 

4
00:00:16,739 --> 00:00:18,616
feet. 
Today at the roundtable we have 

5
00:00:18,616 --> 00:00:21,094
the founder of Doctors of 
Running, Dr. Matthew Klein. 

6
00:00:21,094 --> 00:00:24,560
We have Dr. David Salas and 
myself, I'm Nathan Brown. 

7
00:00:24,560 --> 00:00:28,498
And as always, we're so thankful
for Rabbit apparel for helping 

8
00:00:28,498 --> 00:00:31,359
power this podcast and being our
lead sponsor. 

9
00:00:31,359 --> 00:00:33,999
They've been, I'm gonna talk 
about it maybe in a little bit, 

10
00:00:33,999 --> 00:00:36,821
but they've been sending us some
great stuff as the weather 

11
00:00:36,821 --> 00:00:40,000
starts to change that is just 
very much appreciated. 

12
00:00:40,079 --> 00:00:43,813
But if you're looking to check 
out more of what Rabbit is 

13
00:00:43,813 --> 00:00:45,962
doing, you can go to 
runinrabbit. com. 

14
00:00:45,962 --> 00:00:47,938
You can check out all their 
stuff. 

15
00:00:47,938 --> 00:00:50,194
They got tops, bottoms, whatever
you might need. 

16
00:00:50,194 --> 00:00:53,034
They've got accessories they 
have you know, gloves, hats, all

17
00:00:53,034 --> 00:00:56,613
that kind of stuff. 
And you can use the code, it's 

18
00:00:56,613 --> 00:00:59,509
simple that for the month of 
November, D-O-R-10. 

19
00:00:59,509 --> 00:01:01,679
That's it. 
That's the whole thing. 

20
00:01:01,679 --> 00:01:05,519
You can use that for 10% off 
your first order. 

21
00:01:05,519 --> 00:01:08,587
So today, what we're gonna do 
once we get to our main segment 

22
00:01:08,587 --> 00:01:11,063
is we're actually gonna be 
talking about specific injuries 

23
00:01:11,063 --> 00:01:14,767
that we have personally been 
working through and talking 

24
00:01:14,767 --> 00:01:17,534
about footwear considerations as
we've worked through these 

25
00:01:17,534 --> 00:01:19,569
injuries. 
Some of these injuries are more 

26
00:01:19,569 --> 00:01:21,599
in the moment, acute happening 
right now. 

27
00:01:21,600 --> 00:01:23,816
Some of them are things we've 
been dealing with for a long 

28
00:01:23,816 --> 00:01:25,770
time. 
We're going to revisit those and

29
00:01:25,770 --> 00:01:29,305
hopefully give you some tools to
think about how you can use 

30
00:01:29,305 --> 00:01:33,215
footwear and other just rehab 
considerations and should I run 

31
00:01:33,215 --> 00:01:35,840
considerations relating to 
different types of injuries 

32
00:01:35,920 --> 00:01:38,538
because what we've all been 
dealing with has been slightly 

33
00:01:38,538 --> 00:01:40,427
different. 
But before that, we always want 

34
00:01:40,427 --> 00:01:43,137
to do our in-for-testing segment
where we talk about different 

35
00:01:43,137 --> 00:01:45,299
shoes and different apparel that
we have been testing. 

36
00:01:45,299 --> 00:01:47,840
And so, Matt, I'm going to kick 
it to you first. 

37
00:01:47,840 --> 00:01:51,477
What have you been running in 
and getting time in? 

38
00:01:51,477 --> 00:01:53,751
Yeah. 
So the newest thing that I was 

39
00:01:53,751 --> 00:01:57,024
pretty excited to test out is 
the Altra Torin ST, which from 

40
00:01:57,024 --> 00:02:00,749
what I understand is actually 
replacing the Paradigm from what

41
00:02:00,749 --> 00:02:04,099
I'm hearing. 
So now I've got the Flow ST and 

42
00:02:04,099 --> 00:02:06,968
then the Torin ST. 
This is the zero drop, one of 

43
00:02:06,968 --> 00:02:09,620
the two of them. 
So as I'll talk about my thing 

44
00:02:09,620 --> 00:02:12,160
in a second because I can't 
quite handle zero drop. 

45
00:02:12,159 --> 00:02:14,800
There is a heel lift in here and
it makes it much more runnable. 

46
00:02:14,800 --> 00:02:17,788
One thing that was interesting 
to me is there is a decent 

47
00:02:17,788 --> 00:02:20,710
amount of posterior flare here, 
although what's nice is the foam

48
00:02:20,710 --> 00:02:23,941
and there's such a great bevel 
that it doesn't actually get in 

49
00:02:23,941 --> 00:02:26,160
the way. 
The only challenge is the shoe 

50
00:02:26,160 --> 00:02:28,400
is very stiff, and I didn't 
expect that. 

51
00:02:28,400 --> 00:02:31,760
So landing farther forward 
actually hasn't felt as good. 

52
00:02:31,759 --> 00:02:34,367
Landing with more rear foot and 
kind of rolling through has felt

53
00:02:34,367 --> 00:02:36,320
a little bit better. 
So still breaking it in. 

54
00:02:36,319 --> 00:02:38,719
I've got about 20 miles on it 
thus far. 

55
00:02:38,719 --> 00:02:41,840
Kind of more of the newer Altra 
fit where it's not the really 

56
00:02:41,840 --> 00:02:44,160
wide fit that you'd expect. 
I think Andrea would hate this. 

57
00:02:44,159 --> 00:02:46,724
This is more of that kind of 
like slightly snug, little bit 

58
00:02:46,724 --> 00:02:49,280
lower volume fit that still has 
a lot of toe box room. 

59
00:02:49,280 --> 00:02:52,969
So loved walking in this. 
Probably wasn't supposed to do 

60
00:02:52,969 --> 00:02:56,335
this, but I wore these during 
our interviews for George Fox 

61
00:02:56,335 --> 00:02:58,135
and my director's like, oh sweet
shoes. 

62
00:02:58,135 --> 00:03:00,960
I'm like, okay, cool. 
I get a check, a pass for that. 

63
00:03:01,200 --> 00:03:02,960
But really comfortable for 
all-day wear. 

64
00:03:02,960 --> 00:03:06,675
So I think a lot of people are 
going to prefer these for like 

65
00:03:06,675 --> 00:03:08,000
walking, standing, things like 
that. 

66
00:03:08,000 --> 00:03:09,860
Runners, you're going to have to
be able to go. 

67
00:03:09,860 --> 00:03:12,080
Are you okay with a little shoe 
that's a little bit stiffer? 

68
00:03:12,960 --> 00:03:15,018
But enjoying them decently so 
far. 

69
00:03:15,018 --> 00:03:17,760
The midsole's a lot firmer than 
I expected. 

70
00:03:17,759 --> 00:03:21,919
So maybe not quite a top five 
stability shoe of the year, but 

71
00:03:21,919 --> 00:03:24,760
definitely significant medial 
stability from the guide rail on

72
00:03:24,760 --> 00:03:26,632
the medial side. 
So that's great. 

73
00:03:26,632 --> 00:03:29,439
The other stuff is stuff that 
already is there. 

74
00:03:29,439 --> 00:03:35,200
So I'm up to 80, 90 miles on the
Forever Run Nitro 3 from Puma. 

75
00:03:35,200 --> 00:03:38,508
I will say I had this thought as
it's breaking in more and more 

76
00:03:38,508 --> 00:03:40,160
that those that like the Tempest
2. 

77
00:03:40,159 --> 00:03:42,140
Not if you have your hands on 
the three, it's totally 

78
00:03:42,140 --> 00:03:43,880
different. 
Tempest 2 is a little bit 

79
00:03:43,880 --> 00:03:46,480
heavier, firmer, and a little 
bit lighter on the stability. 

80
00:03:46,480 --> 00:03:48,080
This is a very light stability 
shoe. 

81
00:03:48,080 --> 00:03:51,296
It really reminds me of the 
Tempest 3, just not quite as 

82
00:03:51,296 --> 00:03:53,981
like responsive, but a little 
bit better rolling, two, not 

83
00:03:53,981 --> 00:03:55,878
three. 
So if you're looking for a 

84
00:03:55,878 --> 00:03:58,310
Tempest alternative, this 
actually might be a really good 

85
00:03:58,310 --> 00:04:00,384
option just with a better 
fitting upper. 

86
00:04:00,384 --> 00:04:04,170
Still have the Mount to Coast 
C1, which I'm sure David might 

87
00:04:04,170 --> 00:04:06,304
mention here. 
Get another shoe, it's really 

88
00:04:06,304 --> 00:04:08,296
nice. 
Not the fastest thing, but it 

89
00:04:08,296 --> 00:04:11,296
rolls super well and long runs. 
Feel awesome in the shoe. 

90
00:04:11,296 --> 00:04:12,850
Durability has been killer as 
usual. 

91
00:04:12,850 --> 00:04:15,440
I think I've got almost 50 miles
of my pair. 

92
00:04:15,439 --> 00:04:18,373
It's crushing it. 
I will say the six millimeter 

93
00:04:18,373 --> 00:04:22,331
drop does feel much lower. 
I do need to use a heel lift and

94
00:04:22,331 --> 00:04:24,921
it feels a lot better. 
But overall, really solid the 

95
00:04:24,921 --> 00:04:27,182
first time. 
This is Mount to Coast fit, true

96
00:04:27,182 --> 00:04:30,214
to size. 
And the last one, I think this 

97
00:04:30,214 --> 00:04:34,556
thing with the heel lift is my 
favorite racing shoe of the 

98
00:04:34,556 --> 00:04:36,000
year. 
What is this? 

99
00:04:36,079 --> 00:04:38,959
I've got this is the TYR 
Valkyrie Elite 2. 

100
00:04:38,959 --> 00:04:42,479
I am really enjoying this thing.
This is my left shoe. 

101
00:04:42,479 --> 00:04:45,497
Heels still intact. 
I've got a little over 50 miles 

102
00:04:45,497 --> 00:04:48,428
on this thing. 
I just love running all kinds of

103
00:04:48,428 --> 00:04:51,400
fast stuff in this. 
I love really fast things. 

104
00:04:51,400 --> 00:04:54,640
I love threshold stuff. 
Fits broken in really nicely. 

105
00:04:54,639 --> 00:04:57,391
Love the fact that there's no 
heel counter. 

106
00:04:57,391 --> 00:05:01,175
And even back here, this flexes 
so nicely around the Achilles 

107
00:05:01,175 --> 00:05:03,549
tendon. 
Do I wish it was full ground 

108
00:05:03,549 --> 00:05:04,129
contact? 
Yes. 

109
00:05:04,129 --> 00:05:06,443
Has that gone like feeling has 
gone away? 

110
00:05:06,443 --> 00:05:07,599
Yes. 
Really nice midsole. 

111
00:05:07,600 --> 00:05:09,950
Yeah, definitely. 
I'm gonna, hopefully in the next

112
00:05:09,950 --> 00:05:13,466
couple weeks, as I usually work 
on Saturdays, I'm gonna try to 

113
00:05:13,466 --> 00:05:16,532
do a Thanksgiving turkey trot in
this and get a final racing 

114
00:05:16,532 --> 00:05:18,548
verdict. 
But TYR, you did a really good 

115
00:05:18,548 --> 00:05:20,075
job. 
I'm very impressed. 

116
00:05:20,075 --> 00:05:23,050
That's awesome. 
And that's what I got. 

117
00:05:23,050 --> 00:05:27,120
Yeah, I really do any shoe. 
I like that the TYR Valkyrie, 

118
00:05:27,120 --> 00:05:29,039
really, too. 
I like it until I don't. 

119
00:05:29,040 --> 00:05:32,836
And so I think like I just 
really have to grade my efforts 

120
00:05:32,836 --> 00:05:35,824
when I'm in those. 
And like, but I could totally 

121
00:05:35,824 --> 00:05:39,472
see someone ripping a race in 
that like do comparable to other

122
00:05:39,472 --> 00:05:42,339
super shoes. 
Do we know speaking of TYR when 

123
00:05:42,339 --> 00:05:44,827
the Maverick was it V2 is coming
out? 

124
00:05:44,827 --> 00:05:47,343
I'm really curious. 
If somebody knows and from TYR, 

125
00:05:47,343 --> 00:05:50,584
hey, I'm really interested. 
You all have put out some great 

126
00:05:50,584 --> 00:05:53,698
stuff between the Maverick with 
the anatomic toe boxes was 

127
00:05:53,698 --> 00:05:56,467
really great. 
There was this racing shoe, like

128
00:05:56,467 --> 00:05:58,973
I want to see more. 
I'm curious. 

129
00:05:58,973 --> 00:06:01,120
So no pressure. 
Anyway, I'm done. 

130
00:06:01,280 --> 00:06:04,520
That's a big statement. 
It's hard to get Matthew Klein 

131
00:06:04,520 --> 00:06:07,434
excited about like a brand new 
line of footwear. 

132
00:06:07,434 --> 00:06:10,695
That's cool. 
So like what do I got in 

133
00:06:10,695 --> 00:06:11,441
testing? 
Yeah. 

134
00:06:11,441 --> 00:06:12,187
Yeah. 
Yeah. 

135
00:06:12,187 --> 00:06:14,121
Yeah. 
I was gonna say if anyone's been

136
00:06:14,121 --> 00:06:16,792
tuning into the podcast, I'm not
running, but I had some stuff 

137
00:06:16,792 --> 00:06:19,695
that just came in. 
But yeah, Mount to Coast C1. 

138
00:06:19,695 --> 00:06:22,710
I've been running in that. 
Really, really love it. 

139
00:06:22,710 --> 00:06:26,200
So much so that I'll probably be
talking about it as we come to 

140
00:06:26,200 --> 00:06:29,544
the end of the year. 
But as far as shoes that have 

141
00:06:29,544 --> 00:06:32,560
come in that I'm excited to run 
in when I am running again. 

142
00:06:32,800 --> 00:06:35,256
If you tune into the last 
podcast, you know, or if you 

143
00:06:35,256 --> 00:06:38,808
follow me on socials, you know. 
But if you don't know, I took a 

144
00:06:38,808 --> 00:06:42,589
pretty hard fall last Sunday, so
one week from today we record on

145
00:06:42,589 --> 00:06:45,406
Sundays. 
And thankfully I did not break 

146
00:06:45,406 --> 00:06:47,932
my ankle. 
But we weren't sure. 

147
00:06:47,932 --> 00:06:50,879
You know, as of Sunday night 
still. 

148
00:06:50,879 --> 00:06:54,369
So thankfully didn't break it, 
and I'm working through a lot of

149
00:06:54,369 --> 00:06:57,195
that, but it still hurts and 
it's getting better though. 

150
00:06:57,195 --> 00:06:59,840
I'm out of the boot and I'm I'm 
moving around. 

151
00:06:59,840 --> 00:07:03,760
But as far as like shoes that 
are going to be tested, we have 

152
00:07:03,760 --> 00:07:08,205
the Mount to Coast M1, which is 
like I was just so sad when this

153
00:07:08,205 --> 00:07:11,759
box came because I was so 
excited to run in this shoe. 

154
00:07:11,920 --> 00:07:14,464
This was like the shoe that I 
was like I've been getting in 

155
00:07:14,464 --> 00:07:17,325
the trails more lately too. 
And then I was like, of course, 

156
00:07:17,325 --> 00:07:20,822
I fall like right before this 
shoe comes in, but it's meant to

157
00:07:20,822 --> 00:07:25,280
be their ultramarathon trail 
racing shoe. 38 heel, 34 

158
00:07:25,280 --> 00:07:29,760
forefoot, like 9.7 ounces, super
critical midsole, Vibram 

159
00:07:29,760 --> 00:07:32,672
Megagrip. 
Like this thing's meant to to be

160
00:07:32,672 --> 00:07:35,395
the shoe, right? 
It's meant to be the long haul 

161
00:07:35,395 --> 00:07:38,080
shoe that you can train and race
in for long distances. 

162
00:07:38,079 --> 00:07:40,825
I put my left foot in it, it 
feels really nice. 

163
00:07:40,825 --> 00:07:44,311
You know, it reminds me a lot of
like the Cloud Ultra Pro from 

164
00:07:44,311 --> 00:07:44,872
On. 
Yeah. 

165
00:07:44,872 --> 00:07:47,360
Especially even the bevel is 
like super similar. 

166
00:07:47,360 --> 00:07:50,847
Like it's just like this wide, 
large, rounded bevel, and the 

167
00:07:50,847 --> 00:07:54,639
geometry is like a lot of it has
reminiscence to that shoe. 

168
00:07:54,639 --> 00:07:58,360
Which I really liked that shoe. 
So hopefully I can get some 

169
00:07:58,360 --> 00:08:01,876
miles on this soon. 
And it retails, I believe, at 

170
00:08:01,876 --> 00:08:05,666
195 or 190. 
So if it was comparable to the 

171
00:08:05,666 --> 00:08:08,319
On shoe, it'd be noticeably 
cheaper too. 

172
00:08:08,319 --> 00:08:10,924
Can you show me the bottom of 
it? 

173
00:08:10,924 --> 00:08:12,224
Yeah. 
It's Vibram, right? 

174
00:08:12,224 --> 00:08:15,920
Vibram Megagrip, yeah. 
And it's wider it's wider in the

175
00:08:15,920 --> 00:08:19,120
midfoot than the the On shoe, 
which is nice too. 

176
00:08:19,120 --> 00:08:21,360
Because that's that was my one 
thing. 

177
00:08:21,360 --> 00:08:24,220
It's like for really long stuff.
It was just a little narrow, so 

178
00:08:24,220 --> 00:08:26,639
I kind of like I see like seeing
the width there. 

179
00:08:26,639 --> 00:08:28,907
That's cool. 
Yeah, so super excited about 

180
00:08:28,907 --> 00:08:31,819
this one. 
I think it's gonna be a hit. 

181
00:08:31,819 --> 00:08:35,280
I just yeah, I just gotta run. 
And the other ones, I'll make 

182
00:08:35,280 --> 00:08:37,679
this one quick because we talked
about on the last podcast, but 

183
00:08:37,679 --> 00:08:41,860
we've got the Easy Chaser from 
Rabbit and the Pace Chaser from 

184
00:08:41,860 --> 00:08:44,502
Rabbit. 
So Easy Chaser foam feels super 

185
00:08:44,502 --> 00:08:46,776
promising. 
I think the upper could use a 

186
00:08:46,776 --> 00:08:50,019
little bit of work, it's kind of
lower volume, a little bit 

187
00:08:50,019 --> 00:08:52,864
thicker material, and then it 
just tapers really quickly in 

188
00:08:52,864 --> 00:08:55,168
the forefoot. 
And so like if I can feel it, I 

189
00:08:55,168 --> 00:08:57,664
know other people are going to 
feel it because I usually am not

190
00:08:57,664 --> 00:09:00,088
bothered by that. 
So but I wasn't bothered with it

191
00:09:00,088 --> 00:09:02,720
in the days that I wore it 
before I fell. 

192
00:09:03,120 --> 00:09:06,555
So as far as like standing and 
walking, I have yet to run in 

193
00:09:06,555 --> 00:09:08,776
it. 
I was gonna run in it the next 

194
00:09:08,776 --> 00:09:10,752
day after I fell, but hey, oh 
well. 

195
00:09:10,752 --> 00:09:14,220
So we'll get back on it soon. 
That's meant for easy day miles.

196
00:09:14,220 --> 00:09:17,410
Foam is super soft. 
It does have a bounce to it. 

197
00:09:17,410 --> 00:09:19,440
Like it's it's a nice feeling 
foam. 

198
00:09:19,680 --> 00:09:21,816
And yeah, it's exactly the name 
Easy Chaser. 

199
00:09:21,816 --> 00:09:23,680
It's meant to just chase Easy 
Miles. 

200
00:09:24,000 --> 00:09:26,946
Pace Chaser, ATPU-based midsole,
carbon-plated, performance 

201
00:09:26,946 --> 00:09:30,870
trainer. 
You know, that's kind of what it

202
00:09:30,870 --> 00:09:34,090
is. 
Now this one, the upper and the 

203
00:09:34,090 --> 00:09:37,666
forefoot and the midfoot are 
fine, but with the heel, it just

204
00:09:37,666 --> 00:09:40,750
fits really snug. 
And if you're watching this, you

205
00:09:40,750 --> 00:09:44,392
can see it just moves anteriorly
pretty aggressively, and that 

206
00:09:44,392 --> 00:09:48,920
fit on the heel is pretty tight.
Like I can feel it pushing on my

207
00:09:48,920 --> 00:09:51,548
Achilles a little bit. 
Thankfully, I didn't have any 

208
00:09:51,548 --> 00:09:53,400
issues. 
I actually have taken this to 

209
00:09:53,400 --> 00:09:57,040
the track and the shoe does rip.
Like it's an it's a nice shoe. 

210
00:09:57,039 --> 00:09:59,667
But the it's gonna be 
problematic for some people. 

211
00:09:59,667 --> 00:10:02,000
And I know it was for Klein. 
Yep. 

212
00:10:02,000 --> 00:10:04,935
And even though it's flexible 
back here, it's still reinforced

213
00:10:04,935 --> 00:10:08,454
enough to where it just pushes 
into it still has enough 

214
00:10:08,454 --> 00:10:11,156
structure to do it. 
But yeah, what's up? 

215
00:10:11,156 --> 00:10:13,852
I have taken a chainsaw to my 
pair. 

216
00:10:13,852 --> 00:10:15,200
Oh that's right. 
Yeah. 

217
00:10:15,200 --> 00:10:18,863
So I buzzed down that little 
like extra internal piece and 

218
00:10:18,863 --> 00:10:22,467
still getting some pressure so 
the next step is I'm gonna buzz 

219
00:10:22,467 --> 00:10:25,776
the like top quarter of the heel
in half and see if it'll split 

220
00:10:25,776 --> 00:10:28,591
up my Achilles tendon because I 
the midsole feels very nice and 

221
00:10:28,591 --> 00:10:31,360
I really want to test it, but my
Achilles tendon is doing very 

222
00:10:31,360 --> 00:10:34,240
well and I don't want to 
irritate it too much. 

223
00:10:34,240 --> 00:10:35,680
So Two B D. 
Yeah. 

224
00:10:35,680 --> 00:10:36,832
T B D. 
Sorry. 

225
00:10:36,832 --> 00:10:39,424
Two B T. 
Two B D T B D. 

226
00:10:39,424 --> 00:10:41,224
I can't. 
T B D talk. 

227
00:10:41,224 --> 00:10:44,580
Promising foam. 
Miss of a miss of a fit in an 

228
00:10:44,580 --> 00:10:47,020
upper. 
I think the other thing I wanted

229
00:10:47,020 --> 00:10:51,689
to add to that. 
Well, I was gonna add for the 

230
00:10:51,689 --> 00:10:55,861
for the chaser, I was gonna take
it out for my workout this past 

231
00:10:55,861 --> 00:10:59,622
week and I took it out just to 
like trial it first because it 

232
00:10:59,622 --> 00:11:03,146
was a little bit of a longer 
workout and the overlays on the 

233
00:11:03,146 --> 00:11:06,765
forefoot they kind of like span 
vertical not vertically but like

234
00:11:06,765 --> 00:11:11,095
long along the length of the 
yeah along the length of it, I 

235
00:11:11,095 --> 00:11:13,439
could feel those pushing into my
toes. 

236
00:11:13,759 --> 00:11:17,490
So and I know I'm more sensitive
than than some people when it 

237
00:11:17,490 --> 00:11:20,640
comes to uppers, but I could 
feel the thickness of those. 

238
00:11:20,960 --> 00:11:23,689
Now that I'm putting my hand in 
there. 

239
00:11:23,689 --> 00:11:27,440
I think they can refine that, 
the foam feels really promising.

240
00:11:27,440 --> 00:11:30,080
I think that they could just 
shift the geometry, get rid of 

241
00:11:30,080 --> 00:11:32,500
the cutout, but then that 
thickness of that upper those 

242
00:11:32,500 --> 00:11:36,130
overlays are just too much. 
And then the the heels tough. 

243
00:11:36,130 --> 00:11:39,530
The heels tough. 
I did not realize it was that 

244
00:11:39,530 --> 00:11:42,005
thick. 
I I didn't feel that when I was 

245
00:11:42,005 --> 00:11:44,480
wearing it. 
The fit was fine for me there. 

246
00:11:44,480 --> 00:11:46,862
But geez, that is thick. 
Yeah. 

247
00:11:46,862 --> 00:11:51,616
That's like I mean that's like a
palpable like almost like a 

248
00:11:51,616 --> 00:11:54,320
little rod or something. 
They're moving the right 

249
00:11:54,320 --> 00:11:56,667
direction though. 
Like if we think about their 

250
00:11:56,667 --> 00:11:59,646
first shoe and their first trail
shoe, like they're starting 

251
00:11:59,646 --> 00:12:01,356
they're starting to turn the 
knob. 

252
00:12:01,356 --> 00:12:04,420
It's just not there yet. 
Yeah, but it it is nice. 

253
00:12:04,420 --> 00:12:07,200
I feel like foam, plate, even 
the traction was good. 

254
00:12:07,200 --> 00:12:11,262
You know, I felt like for the 
most part, it was really 

255
00:12:11,262 --> 00:12:13,364
promising. 
I just think it's the for me, 

256
00:12:13,364 --> 00:12:15,876
it's the heel, but yeah, for you
it's the forefoot. 

257
00:12:15,876 --> 00:12:18,161
So upper in general. 
And the heel. 

258
00:12:18,161 --> 00:12:21,628
And the heel. 
For me it's both, but that's all

259
00:12:21,628 --> 00:12:22,320
right. 
Yeah. 

260
00:12:22,320 --> 00:12:26,024
But that's that's what I got, 
you know, in-for-testing. 

261
00:12:26,024 --> 00:12:28,079
Nate. 
I have one shoe. 

262
00:12:28,080 --> 00:12:31,455
It's not a running shoe, it's a 
hiking shoe. 

263
00:12:31,455 --> 00:12:35,200
So this is the Hoka Speed Goat 7
Hike GTX. 

264
00:12:35,200 --> 00:12:39,356
So it's kind of a mid and like 
mid-height. 

265
00:12:39,356 --> 00:12:43,270
I really like it. 
I I sometimes struggle with 

266
00:12:43,270 --> 00:12:47,400
mid-height shoes just because 
they can depending on how your 

267
00:12:47,400 --> 00:12:50,670
like shin sits, you just get 
pressure on either the inside or

268
00:12:50,670 --> 00:12:53,490
the outside. 
But this one is really thin and 

269
00:12:53,490 --> 00:12:57,884
really flexible and has a little
bit of a like a stretch padding 

270
00:12:57,884 --> 00:13:00,000
to it. 
So that's really nice. 

271
00:13:00,000 --> 00:13:03,864
This for me is a shoe that I'm 
excited for to have as we are 

272
00:13:03,864 --> 00:13:05,920
getting closer and closer to 
snow and slush. 

273
00:13:05,920 --> 00:13:09,313
Like this is a gonna be a great 
commuter shoe, even for me. 

274
00:13:09,313 --> 00:13:11,919
So like I've used what is the 
transport they've had. 

275
00:13:11,920 --> 00:13:14,426
There's some like 
transport-esque elements to this

276
00:13:14,426 --> 00:13:18,000
shoe, just a little bit 
obviously beefed up with you 

277
00:13:18,000 --> 00:13:22,214
know the lugs on the bottom and 
the Vibram Megagrip and it's 

278
00:13:22,214 --> 00:13:26,170
really nice though because it's 
Gore-Tex, but it's I forget what

279
00:13:26,170 --> 00:13:28,390
they call it. 
Invisible Invisible Fit. 

280
00:13:28,390 --> 00:13:32,508
Yeah, so it's super thin. 
Like it's not this hefty, thick 

281
00:13:32,508 --> 00:13:34,776
thing. 
It's really lightweight, like it

282
00:13:34,776 --> 00:13:39,280
still feels like a light shoe. 
So I'm I'm I've been using it 

283
00:13:39,280 --> 00:13:42,480
already just out for fall 
activities and hiking, but I'm 

284
00:13:42,480 --> 00:13:46,232
excited for it for winter and 
some commuting stuff. 

285
00:13:46,232 --> 00:13:47,120
Yeah. 
Yeah. 

286
00:13:47,120 --> 00:13:50,950
Have have you tried the Teva 
Hurricane or Trail Setter 

287
00:13:50,950 --> 00:13:54,659
Hurricane Trail Setter GTX? 
Yeah, yeah, that one's super 

288
00:13:54,659 --> 00:13:56,679
nice too. 
Yeah, the mid. 

289
00:13:56,679 --> 00:13:58,293
Yeah. 
Or the low. 

290
00:13:58,293 --> 00:14:01,920
But the the mid is also 
invisible fit Gore-Tex. 

291
00:14:01,920 --> 00:14:02,835
Yes. 
And yeah. 

292
00:14:02,835 --> 00:14:05,580
It's good. 
So I'd be curious to hear your 

293
00:14:05,580 --> 00:14:07,931
thoughts between the two. 
Yeah, especially because they're

294
00:14:07,931 --> 00:14:11,076
like the same parent company. 
So it's like more of how are 

295
00:14:11,076 --> 00:14:13,346
they differentiated? 
I should spend more time on 

296
00:14:13,346 --> 00:14:17,239
comparing those in my mind. 
The other thing that I thought I

297
00:14:17,239 --> 00:14:20,599
could do as we transition to 
cold weather is give a couple 

298
00:14:20,599 --> 00:14:23,728
highlights of things that I like
to use for like cold weather 

299
00:14:23,728 --> 00:14:25,280
running. 
We're down in the 30s. 

300
00:14:25,279 --> 00:14:29,415
We've hit 20s a couple times at 
the time that I'm running. 

301
00:14:29,415 --> 00:14:31,479
And the dark. 
What'd you say? 

302
00:14:31,479 --> 00:14:33,199
Not cold. 
Not cold yet. 

303
00:14:33,200 --> 00:14:34,428
We're getting there. 
Yeah. 

304
00:14:34,428 --> 00:14:36,880
If we can hit that temperature, 
not cold. 

305
00:14:37,120 --> 00:14:39,680
I mean to be we've been in the 
30s, we haven't got twenties. 

306
00:14:41,200 --> 00:14:44,400
We've also in the northwest have
gotten into the like mid-30s. 

307
00:14:44,399 --> 00:14:46,778
Like my car was frozen the other
day, and I wasn't prepared for 

308
00:14:46,778 --> 00:14:48,672
that. 
I'm like, ah man, I was like 

309
00:14:48,672 --> 00:14:51,356
already rushing to Providence. 
And then it's not my car is 

310
00:14:51,356 --> 00:14:52,976
frozen. 
I'm like, I need to order. 

311
00:14:52,976 --> 00:14:54,808
I don't know where my ice 
scraper is. 

312
00:14:54,808 --> 00:14:56,640
I need to probably order a new 
one. 

313
00:14:56,639 --> 00:14:59,580
So he has out there with a towel
scraping going, do not put hot 

314
00:14:59,580 --> 00:15:01,680
water on here. 
Do not put hot water on here. 

315
00:15:01,680 --> 00:15:04,688
Just like scrape this off with 
the towel. 

316
00:15:04,688 --> 00:15:05,440
Yeah. 
Cool. 

317
00:15:05,440 --> 00:15:10,014
So I thought I'd run through a 
few of my like top top things 

318
00:15:10,014 --> 00:15:11,644
for winter and dark. 
What? 

319
00:15:11,644 --> 00:15:12,948
Cool story. 
Oh cool. 

320
00:15:12,948 --> 00:15:14,890
Yeah, yeah. 
Yeah, whatever. 

321
00:15:14,890 --> 00:15:17,810
Okay. 
Let me talk to you about real 

322
00:15:17,810 --> 00:15:20,000
winter here over Wisconsin. 
It's fine. 

323
00:15:20,399 --> 00:15:24,299
No, it's been I mean, we've been
in the seventies the last couple

324
00:15:24,299 --> 00:15:25,799
of days. 
It's been crazy. 

325
00:15:25,799 --> 00:15:26,399
Yeah. 
Yeah. 

326
00:15:26,399 --> 00:15:29,288
We haven't cooled down much here
yet. 

327
00:15:29,288 --> 00:15:31,760
Yeah, it's been hot, 
unseasonably hot. 

328
00:15:31,759 --> 00:15:35,739
We've been at we we got to go to
a corn maze and the warm 

329
00:15:35,739 --> 00:15:36,799
weather. 
I don't know. 

330
00:15:36,800 --> 00:15:40,163
It's too warm for probably what 
it should be. 

331
00:15:40,163 --> 00:15:44,266
Anyway, two pair two different 
pants that I've been using from 

332
00:15:44,266 --> 00:15:46,494
Rabbit. 
One of them are the runners or 

333
00:15:46,494 --> 00:15:48,879
sorry, yeah, runners, I think 
that's what they're called. 

334
00:15:48,879 --> 00:15:52,662
They're a pair of joggers from 
them, but they're just thin, 

335
00:15:52,662 --> 00:15:54,720
lightweight, they're cuffed at 
the bottom. 

336
00:15:54,960 --> 00:15:56,892
Are you wearing them right now? 
Yeah. 

337
00:15:56,892 --> 00:15:59,094
Me too. 
Otherwise, I would I can't show 

338
00:15:59,094 --> 00:16:01,040
y'all very much. 
But they're just lightweight. 

339
00:16:01,039 --> 00:16:04,316
They've got a zipper, so you can
get them over stuff, but they 

340
00:16:04,316 --> 00:16:06,836
they cuff really well, so 
they're usable for as like 

341
00:16:06,836 --> 00:16:09,356
running stuff but, I use them 
casually all the time. 

342
00:16:09,356 --> 00:16:11,120
So they're just a really nice 
layer. 

343
00:16:11,120 --> 00:16:13,820
The other pair of pants that 
I've been loving from them is 

344
00:16:13,820 --> 00:16:16,848
their high country pant. 
Love this thing too from like a 

345
00:16:16,848 --> 00:16:19,280
fit and comfort standpoint. 
It's got good pockets. 

346
00:16:19,279 --> 00:16:22,436
So again, it's got that 
crossover between like I can run

347
00:16:22,436 --> 00:16:26,160
in these, I can hike in these, I
can also do casual wear. 

348
00:16:26,159 --> 00:16:29,940
I can almost wear them to work, 
but I I'm just not ready to wear

349
00:16:29,940 --> 00:16:33,680
cuffed pants to work yet. 
Loving those pants as well. 

350
00:16:33,840 --> 00:16:40,812
Another I have a new version of 
that called the Low Country 

351
00:16:40,812 --> 00:16:46,040
because it's it's a ripaway. 
That was a joke. 

352
00:16:46,040 --> 00:16:49,426
All right. 
That sounded great in my head. 

353
00:16:49,426 --> 00:16:52,020
All right. 
With the colder weather, too, 

354
00:16:52,020 --> 00:16:54,240
it's also like puffer coat 
weather. 

355
00:16:54,240 --> 00:16:58,356
And last year I had a puffer 
coat from this company called 

356
00:16:58,356 --> 00:17:01,439
Paka and I wore it like all the 
time. 

357
00:17:01,440 --> 00:17:04,640
I wore it by itself for a long 
stretch of time. 

358
00:17:04,640 --> 00:17:09,601
I would say it fits really well 
for like upper 20s to 30s, even 

359
00:17:09,601 --> 00:17:13,614
like mid-40s, because it it once
it's warmer it doesn't like get 

360
00:17:13,614 --> 00:17:17,291
super hot but it can keep warm. 
But if I'm being active it can 

361
00:17:17,291 --> 00:17:19,920
go into the lower twenties and 
even the teens a little bit. 

362
00:17:19,920 --> 00:17:22,409
So it's their lightweight ultra 
lightweight puffer jacket. 

363
00:17:22,409 --> 00:17:25,519
And so I wore that like all 
winter last year. 

364
00:17:25,519 --> 00:17:28,180
I took it on our backpacking 
trip that I went on a few weeks 

365
00:17:28,180 --> 00:17:31,675
ago and I wore it like the whole
week and we were down in the 30s

366
00:17:31,675 --> 00:17:33,265
at night. 
So it super awesome. 

367
00:17:33,265 --> 00:17:37,010
But they sent me their new one. 
And so this is the Mayu 

368
00:17:37,010 --> 00:17:39,839
Ultralight long you know it's 
like a long sleeve. 

369
00:17:39,839 --> 00:17:42,856
They have a vest too, but this 
is the hooded version with my 

370
00:17:42,856 --> 00:17:44,480
bald head. 
I'm thankful for the hoodie. 

371
00:17:44,480 --> 00:17:47,863
But I just want to give a 
shout-out because durability has

372
00:17:47,863 --> 00:17:50,012
been awesome. 
Range of temperatures has been 

373
00:17:50,012 --> 00:17:52,443
awesome. 
It's good for being active and 

374
00:17:52,443 --> 00:17:56,686
it also like doesn't get stinky 
in the for what it's worth 

375
00:17:56,686 --> 00:17:58,907
category. 
I appreciate that about a jacket

376
00:17:58,907 --> 00:18:01,084
that I'm using for like active 
stuff. 

377
00:18:01,084 --> 00:18:04,726
So big shout-out to Paka. 
I don't think they're a very big

378
00:18:04,726 --> 00:18:06,514
company. 
They use alpaca, like wool. 

379
00:18:06,514 --> 00:18:09,600
That's why they're called Paka. 
And it's it's been awesome. 

380
00:18:09,600 --> 00:18:12,480
So just wanted to give that a 
shout out. 

381
00:18:12,480 --> 00:18:17,385
But I I would say if I was gonna
buy one thing to keep myself 

382
00:18:17,385 --> 00:18:20,000
safe in winter. 
It's something to be visible. 

383
00:18:20,000 --> 00:18:23,368
And Jana got this for me for 
Christmas two years ago. 

384
00:18:23,368 --> 00:18:27,040
And I've talked about it before,
but it's the Noxgear Tracer 2. 

385
00:18:27,039 --> 00:18:29,965
And so this thing, I'm going to 
see if I can light it up on 

386
00:18:29,965 --> 00:18:31,945
here. 
So it lights up and it keeps 

387
00:18:31,945 --> 00:18:34,997
gives like it it goes around 
your back and around your front 

388
00:18:34,997 --> 00:18:37,505
and you can do like all these 
different colors. 

389
00:18:37,505 --> 00:18:40,124
It's super bright. 
So you're this is this thing 

390
00:18:40,124 --> 00:18:42,160
that I'm holding is on your 
back. 

391
00:18:42,640 --> 00:18:46,619
Okay. 
And then all of the the R like 

392
00:18:46,619 --> 00:18:51,039
the wires are make it flash 
different colors and stuff. 

393
00:18:51,120 --> 00:18:55,048
So it's just an awesome flash if
you want to. 

394
00:18:55,048 --> 00:18:58,968
Anyway, I'll turn that off. 
So it's super awesome for 

395
00:18:58,968 --> 00:19:01,523
visibility. 
It also like you have these LED 

396
00:19:01,523 --> 00:19:05,531
wires, but it all is held by the
strap that goes around your 

397
00:19:05,531 --> 00:19:07,111
chest. 
So it doesn't feel like it's 

398
00:19:07,111 --> 00:19:09,655
hanging on you at all, and it's 
even more comfortable than like 

399
00:19:09,655 --> 00:19:12,239
the other vests that I've bought
before, where they're just like 

400
00:19:12,239 --> 00:19:13,919
a yellow vest with the 
reflective stuff. 

401
00:19:13,920 --> 00:19:18,084
So huge fan of this thing. 
Jana also bought me the clip-on 

402
00:19:18,084 --> 00:19:22,240
light, which is like the tracer 
lamp, I think they call it. 

403
00:19:22,240 --> 00:19:25,119
And so that's just a lamp that's
it'll sit right on your chest. 

404
00:19:25,120 --> 00:19:28,370
And so instead of needing a 
headlamp, you can just have it 

405
00:19:28,370 --> 00:19:29,990
on your chest. 
Doesn't bounce around. 

406
00:19:29,990 --> 00:19:32,359
It's super great. 
So shout out to Noxgear. 

407
00:19:32,359 --> 00:19:35,707
They do great stuff there. 
And then the two other things I 

408
00:19:35,707 --> 00:19:38,359
was gonna give a shout-out to, I
think I've talked about them 

409
00:19:38,359 --> 00:19:39,939
before because they're my 
favorite. 

410
00:19:39,939 --> 00:19:44,527
This is a pair of like a 
windshell glove that I bought in

411
00:19:44,527 --> 00:19:46,639
college. 
So now it's been wow. 

412
00:19:47,039 --> 00:19:51,813
Yeah, 12 years, 14 years, 14 
years since I bought these 

413
00:19:51,813 --> 00:19:54,413
gloves. 
Still wear them because they're 

414
00:19:54,413 --> 00:19:57,200
just windproof. 
And I put them over the top of 

415
00:19:57,200 --> 00:20:00,960
like a thin glove. 
And then that can get me all the

416
00:20:00,960 --> 00:20:04,800
way down to like single d single
digits or single digis. 

417
00:20:04,799 --> 00:20:06,885
We talk in single digis, triple 
digis? 

418
00:20:06,885 --> 00:20:08,673
Dude, people know what I'm 
referencing. 

419
00:20:08,673 --> 00:20:11,360
If you do, you know. 
If you don't, that's okay. 

420
00:20:11,360 --> 00:20:16,271
So I I don't know if they sell 
these anymore, but I I'm a huge 

421
00:20:16,271 --> 00:20:19,412
proponent for windshell stuff 
when it comes to cold weather, 

422
00:20:19,412 --> 00:20:23,104
because that blocking out all of
the wind that can like move the 

423
00:20:23,104 --> 00:20:26,088
heat that you're generating, 
that's where you can get really 

424
00:20:26,088 --> 00:20:27,933
cold. 
So windshell gloves are the 

425
00:20:27,933 --> 00:20:30,214
best. 
I also wear them biking on my 

426
00:20:30,214 --> 00:20:33,877
commute to work when I bike. 
And then the last thing, this is

427
00:20:33,877 --> 00:20:36,556
my favorite beanie. 
It's from Ciele, and it's just 

428
00:20:36,556 --> 00:20:40,220
like a waffled beanie. 
I don't I this one again is like

429
00:20:40,220 --> 00:20:43,312
three years old now. 
I've had it for a long time, but

430
00:20:43,312 --> 00:20:45,182
it's still it stood the test of 
time. 

431
00:20:45,182 --> 00:20:47,279
I wear it all the time for my 
runs. 

432
00:20:47,279 --> 00:20:49,280
It's super comfortable, 
lightweight. 

433
00:20:49,279 --> 00:20:52,416
And then for me, if I if it's 
colder, I just wear this and 

434
00:20:52,416 --> 00:20:54,880
then I just put like my stocking
cap over the top. 

435
00:20:54,880 --> 00:20:58,960
Like I don't I don't know if 
it's worth buying like some 

436
00:20:58,960 --> 00:21:06,055
fancy like warmer hat. 
Just like throw whatever hat on 

437
00:21:06,055 --> 00:21:16,570
you have over some sort of like 
That'd be pretty cool. 

438
00:21:16,570 --> 00:21:20,645
All right. 
So that is our in-for-testing 

439
00:21:20,645 --> 00:21:23,243
segment. 
We are always thankful for 

440
00:21:23,243 --> 00:21:25,839
Skratch Labs for fueling our 
in-for-testing. 

441
00:21:25,839 --> 00:21:29,247
If you want to check out any of 
their stuff for in-run 

442
00:21:29,247 --> 00:21:31,796
nutrition, hydration, or 
recovery, you can use the code 

443
00:21:31,796 --> 00:21:35,202
DOCTORSOFRUNNING at 
skratchlabs.com to get 20% off 

444
00:21:35,202 --> 00:21:39,256
your first order. 
Let's transition into our main 

445
00:21:39,256 --> 00:21:43,229
segment for the day. 
This is where again we're gonna 

446
00:21:43,229 --> 00:21:45,827
be talking about different 
issues, pain, injuries that 

447
00:21:45,827 --> 00:21:48,239
we've been dealing with 
personally, and we're going to 

448
00:21:48,239 --> 00:21:51,119
walk through maybe a little bit 
behind what that thing is and 

449
00:21:51,119 --> 00:21:54,228
the rehab. 
But then we're really going to 

450
00:21:54,228 --> 00:21:59,045
focus on what footwear selection
has looked like to this point. 

451
00:21:59,045 --> 00:22:02,917
So, David, let's start with you.
You already gave a little bit of

452
00:22:02,917 --> 00:22:06,110
an update that you're a week 
into a pretty significant ankle 

453
00:22:06,110 --> 00:22:08,514
sprain. 
What updates do you want to give

454
00:22:08,514 --> 00:22:12,438
us about this process for you, 
or what are some of the top 

455
00:22:12,438 --> 00:22:15,510
things you consider about 
recovering from an ankle sprain?

456
00:22:15,510 --> 00:22:19,040
Yeah, that's a good question. 
I think first things first. 

457
00:22:19,039 --> 00:22:22,926
So obviously we're still in the 
acute phases being seven days 

458
00:22:22,926 --> 00:22:25,064
out. 
Anytime you have any kind of 

459
00:22:25,064 --> 00:22:27,440
injury assess, make sure that 
you're safe first. 

460
00:22:27,440 --> 00:22:31,257
So really taking a look at how 
you're doing first off. 

461
00:22:31,257 --> 00:22:35,414
And so in my situation, can I 
actually put weight on it? 

462
00:22:35,414 --> 00:22:37,074
Right. 
Like that's step number one. 

463
00:22:37,074 --> 00:22:40,230
If you can't put weight through 
it, there's always a chance that

464
00:22:40,230 --> 00:22:43,043
it may be fractured. 
There is a set of rules called 

465
00:22:43,043 --> 00:22:46,057
the Ottawa Ankle Rules that you 
can go through to help guide 

466
00:22:46,057 --> 00:22:48,834
whether or not you have a need 
for imaging. 

467
00:22:48,834 --> 00:22:50,779
Nate just taught this like 
yesterday. 

468
00:22:50,779 --> 00:22:54,104
He's got it on lock. 
I'll I'll let you run through 

469
00:22:54,104 --> 00:22:55,519
the rules real quick. 
Yeah. 

470
00:22:55,519 --> 00:22:59,789
And now Matt, you I got a double
checker too with Matt here, but 

471
00:22:59,789 --> 00:23:02,685
the Ottawa ankle rules, if 
you're like just a person 

472
00:23:02,685 --> 00:23:05,741
hanging out on like hanging out 
and running and you sprain your 

473
00:23:05,741 --> 00:23:07,519
ankle, you don't need to 
memorize these. 

474
00:23:07,519 --> 00:23:09,359
Ultimately, these are really 
great tools. 

475
00:23:09,360 --> 00:23:12,890
This is a great screening tool 
that helps medical practitioners

476
00:23:12,890 --> 00:23:15,360
know does someone need X-rays or
not? 

477
00:23:15,360 --> 00:23:18,728
Do are they are we able to say, 
no, you definitely don't need 

478
00:23:18,728 --> 00:23:20,800
X-rays to see if you have a 
fracture? 

479
00:23:20,799 --> 00:23:23,098
And so I'll I'll run through 
them quick though, because there

480
00:23:23,098 --> 00:23:26,343
are some easy things that you 
might be able to do to test 

481
00:23:26,343 --> 00:23:28,100
yourself. 
So ultimately, it's trying to 

482
00:23:28,100 --> 00:23:31,604
find what are the likely areas 
where you could break a bone 

483
00:23:31,604 --> 00:23:35,296
after your kind of foot rolls 
into some side some sort of 

484
00:23:35,296 --> 00:23:37,384
ankle sprain. 
And the first thing that you 

485
00:23:37,384 --> 00:23:40,556
would do is you would palpate or
push on a couple of different 

486
00:23:40,556 --> 00:23:42,878
bones. 
The first two are on the inside 

487
00:23:42,878 --> 00:23:45,840
and outside of like those ankle 
bones that you feel. 

488
00:23:45,839 --> 00:23:49,285
You feel right on the back side 
of those for about six 

489
00:23:49,285 --> 00:23:52,888
centimeters from the tip up. 
So you that'd be on what we call

490
00:23:52,888 --> 00:23:54,239
the medial and lateral 
malleolus. 

491
00:23:54,239 --> 00:23:56,399
You'd be kind of pushing on, 
palpating those. 

492
00:23:56,400 --> 00:23:59,940
And if those are tender, then 
you can't quite rule out the 

493
00:23:59,940 --> 00:24:02,000
fact that one of those isn't 
impacted. 

494
00:24:02,000 --> 00:24:04,799
The next bone that you push on 
is called your navicular bone. 

495
00:24:04,799 --> 00:24:07,789
It's like the most bony 
prominent thing on like the 

496
00:24:07,789 --> 00:24:11,310
inside of your like arch. 
So there's a big bone there that

497
00:24:11,310 --> 00:24:13,630
you can push. 
Again, you'd be feeling for 

498
00:24:13,630 --> 00:24:15,462
tenderness. 
The last bone that you'd be 

499
00:24:15,462 --> 00:24:18,543
pushing on is the what's called 
the fifth base of the fifth 

500
00:24:18,543 --> 00:24:20,479
metatarsal. 
So that's on instead of the arch

501
00:24:20,479 --> 00:24:23,839
of your foot on the inside, it's
the bone most bony thing on the 

502
00:24:23,839 --> 00:24:27,380
middle part of the outside of 
the foot, and you would again be

503
00:24:27,380 --> 00:24:29,754
feeling for tenderness there. 
The last piece to make sure that

504
00:24:29,754 --> 00:24:31,937
you don't think you have a 
fracture is if you can bear 

505
00:24:31,937 --> 00:24:33,968
weight on it. 
So if you're trying to put 

506
00:24:33,968 --> 00:24:36,696
weight on after a fracture and 
you can't take subsequent steps,

507
00:24:36,696 --> 00:24:41,061
the Ottawa ankle rules say four,
but if if you're not able to 

508
00:24:41,061 --> 00:24:44,577
regularly put weight through 
that leg, it's worth going to 

509
00:24:44,577 --> 00:24:47,920
get it checked out and screened 
to see if you have a fracture. 

510
00:24:47,920 --> 00:24:52,060
The last thing that I would add,
I hit I have a printer next to 

511
00:24:52,060 --> 00:24:55,645
me and I like there. 
I smacked, I didn't mean to, but

512
00:24:55,645 --> 00:24:58,160
I accidentally smacked the yeah,
the print here. 

513
00:24:58,160 --> 00:25:01,136
I also smack is kind of a 
triggering word right now 'cause

514
00:25:01,136 --> 00:25:04,152
today the Packers just lost to 
the Lions and our kicker Trey 

515
00:25:04,152 --> 00:25:07,320
Smack missed two field goals and
he also missed some field goals 

516
00:25:07,320 --> 00:25:09,900
the week before and the week 
before that. 

517
00:25:09,900 --> 00:25:12,000
Poor guy. 
He's a rookie. 

518
00:25:12,000 --> 00:25:14,808
So I just the pressure on those 
people, but I can't imagine he's

519
00:25:14,808 --> 00:25:16,960
gonna have a job for that long. 
Maybe they will. 

520
00:25:16,960 --> 00:25:19,760
Maybe they give him a chance. 
They took a draft pick on him. 

521
00:25:19,759 --> 00:25:24,712
Anyway, the other thing that I 
think is worth pushing on is a 

522
00:25:24,712 --> 00:25:28,943
bone on the outside of your 
knee, like just below your knee,

523
00:25:28,943 --> 00:25:32,720
it's called your fibular head. 
So there's a yeah, there's a 

524
00:25:32,720 --> 00:25:36,320
bony prominence on the outside 
just below your knee. 

525
00:25:36,319 --> 00:25:40,071
And if that's super tender after
you sprain your ankle, that's 

526
00:25:40,071 --> 00:25:43,907
another reason to probably go in
for X-rays, because based on how

527
00:25:43,907 --> 00:25:47,784
that long bone sits, if you bend
it at the bottom and it could 

528
00:25:47,784 --> 00:25:51,703
break up at the top there. 
And they call that a Maisonneuve

529
00:25:51,703 --> 00:25:53,369
fracture. 
And so that would be something 

530
00:25:53,369 --> 00:25:56,157
that you would want to just feel
and make sure if that's that'd 

531
00:25:56,157 --> 00:25:59,824
be a weird spot to feel 
tenderness on if you rolled your

532
00:25:59,824 --> 00:26:01,840
ankle, but it's worth checking 
out. 

533
00:26:01,840 --> 00:26:05,582
I probably talked about that way
too long, but there you go, 

534
00:26:05,582 --> 00:26:07,448
David. 
I think it was great. 

535
00:26:07,448 --> 00:26:09,040
Great. 
There's also an Ottawa this 

536
00:26:09,040 --> 00:26:11,920
Ottawa, the Canadians do a good 
job with this, an Ottawa knee 

537
00:26:11,920 --> 00:26:15,267
rules as well for a knee fract 
like again, screening do you 

538
00:26:15,267 --> 00:26:16,960
need imaging for potential knee 
fracture? 

539
00:26:16,960 --> 00:26:19,690
And it's tenderness of the 
fibular head, tenderness of the 

540
00:26:19,690 --> 00:26:22,645
patella, inability to flex the 
knee ninety degrees, and then 

541
00:26:22,645 --> 00:26:25,300
inability to weight bear 
immediately after or take four 

542
00:26:25,300 --> 00:26:31,160
steps after the injury. 
So yeah, good job, Ottawa. 

543
00:26:31,160 --> 00:26:35,839
Yeah, thanks, Ottawa. 
Thanks, Ottawa. 

544
00:26:36,319 --> 00:26:39,602
But no, I think you did an 
excellent job of summarizing 

545
00:26:39,602 --> 00:26:42,284
that. 
So that's why I was like, we got

546
00:26:42,284 --> 00:26:44,960
the professors in the house, let
them just break it down. 

547
00:26:47,360 --> 00:26:51,097
And you know, in truth be told, 
you know, in terms of personal 

548
00:26:51,097 --> 00:26:54,808
day to day life, I tend to 
generalize it a little bit more 

549
00:26:54,808 --> 00:26:58,474
where it's like can I actually 
put weight down in a way that's 

550
00:26:58,474 --> 00:27:01,904
meaningful and does it hurt in 
any of those given areas when I 

551
00:27:01,904 --> 00:27:05,488
push on it in a significant way?
And so that's where I come from 

552
00:27:05,488 --> 00:27:07,830
on that. 
I don't necessarily break it 

553
00:27:07,830 --> 00:27:11,120
down super systematically when 
I'm talking my own health. 

554
00:27:11,120 --> 00:27:14,760
But in that situation, I was not
able to bear weight very well 

555
00:27:14,760 --> 00:27:17,840
within the first four steps. 
I mean, it was it was pretty 

556
00:27:17,840 --> 00:27:19,040
immediate. 
It hurt a lot. 

557
00:27:19,040 --> 00:27:21,680
And eventually I was able to get
going on it again. 

558
00:27:21,680 --> 00:27:23,868
I was able to get down to the 
base of the trail. 

559
00:27:23,868 --> 00:27:26,562
I was able to get home. 
And then later that evening, I 

560
00:27:26,562 --> 00:27:29,760
was still not able to put weight
on it very well again. 

561
00:27:29,759 --> 00:27:32,685
And so at that point I had made 
that decision where I was like, 

562
00:27:32,685 --> 00:27:34,560
oh crap, I can't go to work like
this. 

563
00:27:34,559 --> 00:27:37,876
Like this is I I can barely get 
around my living room like this.

564
00:27:37,876 --> 00:27:40,000
And so I called off work the 
next day. 

565
00:27:40,000 --> 00:27:44,230
Thankfully I work in an 
orthopedic practice, and I went 

566
00:27:44,230 --> 00:27:49,214
in, I got X-rays, I saw the doc,
X-rays came back clean, 

567
00:27:49,214 --> 00:27:51,217
thankfully. 
So basically, we just sprained 

568
00:27:51,217 --> 00:27:53,881
it really bad. 
And if you've been following 

569
00:27:53,881 --> 00:27:56,698
socials, I have been sharing 
some photos out there. 

570
00:27:56,698 --> 00:27:59,120
Don't worry. 
There's no toes in the photos. 

571
00:27:59,120 --> 00:28:02,856
But there are there's a lot of 
bruising. 

572
00:28:02,856 --> 00:28:07,519
It bruised up quite a bit. 
It got really swollen. 

573
00:28:07,519 --> 00:28:10,930
So I mean, chances are I 
probably did tear something on 

574
00:28:10,930 --> 00:28:12,480
the lateral ligamentous 
structures there. 

575
00:28:12,480 --> 00:28:15,720
But there's a chance I probably 
already had some of those torn 

576
00:28:15,720 --> 00:28:18,000
from previous falls beforehand. 
And that brings up a good point.

577
00:28:18,000 --> 00:28:21,864
And this is not medical advice, 
but a lot of times when people 

578
00:28:21,864 --> 00:28:24,830
do tear those, they don't always
need to be touched. 

579
00:28:24,830 --> 00:28:28,954
So a lot of times, doctors will 
tell you to see how it goes. 

580
00:28:28,954 --> 00:28:32,800
If you need PT, go see PT. 
See how it goes for a little 

581
00:28:32,800 --> 00:28:35,440
while and if it's truly not 
getting better, then they can 

582
00:28:35,440 --> 00:28:37,580
get advanced imaging and then go
from there. 

583
00:28:37,580 --> 00:28:40,822
But for the most part, usually 
you're able to do conservatively

584
00:28:40,822 --> 00:28:42,880
as long as the bone doesn't 
break. 

585
00:28:42,880 --> 00:28:45,048
And so that's where I'm at right
now. 

586
00:28:45,048 --> 00:28:48,570
And so we're seven days out. 
I was in a boot up until 

587
00:28:48,570 --> 00:28:51,640
Thursday of the last week. 
With the fall being Sunday. 

588
00:28:51,640 --> 00:28:53,702
Wait, Wednesday, Thursday. 
Yeah, Thursday, Friday. 

589
00:28:53,702 --> 00:28:56,984
I did not wear a boot. 
And partially it's because I 

590
00:28:56,984 --> 00:28:59,920
just simply could not get my 
foot into a shoe at all. 

591
00:28:59,920 --> 00:29:08,687
Like my I just So the Teva Trail
Setter Hurricane Mid. 

592
00:29:08,687 --> 00:29:15,852
And it was also raining, so it 
was great. 

593
00:29:15,852 --> 00:29:20,665
Gore-Tex, it works. 
But main idea was getting 

594
00:29:20,665 --> 00:29:25,515
something that you trust on your
feet, pretty structured overall 

595
00:29:25,515 --> 00:29:28,960
like shoe and then a gentle 
rocker on both sides. 

596
00:29:28,960 --> 00:29:32,080
One of the first things to go 
when the ankle gets that small 

597
00:29:32,080 --> 00:29:35,331
is your range of motion. 
And that's the next step where 

598
00:29:35,331 --> 00:29:38,400
it's like, okay, safety is 
assessed, you are good. 

599
00:29:38,400 --> 00:29:41,726
Now let's start getting that 
range of motion back and start 

600
00:29:41,726 --> 00:29:45,700
in non weight bearing positions 
first, make sure I can do it to 

601
00:29:45,700 --> 00:29:48,800
what I can tolerate pain and 
discomfort wise within reason. 

602
00:29:48,799 --> 00:29:52,639
Then I start working on doing it
in weight bearing and gradually 

603
00:29:52,639 --> 00:29:56,047
easing the weight bearing 
tolerance and then gr working on

604
00:29:56,047 --> 00:29:59,767
walking etc balance and then 
starting to work strength back 

605
00:29:59,767 --> 00:30:02,609
in as appropriate. 
Now being seven days out at this

606
00:30:02,609 --> 00:30:04,831
point it still hurts a little 
bit, you know? 

607
00:30:04,831 --> 00:30:06,799
So I really haven't hit it super
hard. 

608
00:30:06,799 --> 00:30:10,064
I've been mostly working on 
getting my range back. 

609
00:30:10,064 --> 00:30:12,960
Plantarflexion is almost back. 
Dorsiflexion isn't back yet. 

610
00:30:12,960 --> 00:30:15,699
Inversion's getting there. 
I can let me see. 

611
00:30:15,699 --> 00:30:18,435
I'm gonna just oh nope. 
Not there yet. 

612
00:30:18,435 --> 00:30:21,488
Eversion's there. 
So just working on getting the 

613
00:30:21,488 --> 00:30:24,640
range back first and then going 
from there. 

614
00:30:24,640 --> 00:30:27,480
And then at that point, it's 
balance, proprioception, 

615
00:30:27,480 --> 00:30:31,095
strength, making sure you trust 
it again, start to incorporate 

616
00:30:31,095 --> 00:30:34,198
protected weight bearing, and 
then like more dynamic 

617
00:30:34,198 --> 00:30:36,747
activities on it. 
Like, can you actually push up 

618
00:30:36,747 --> 00:30:39,715
onto your toes? 
Can you actually like use it in 

619
00:30:39,715 --> 00:30:42,639
ways that aren't like super 
dynamic, but loading it? 

620
00:30:42,640 --> 00:30:45,712
And then if you can do that well
without pain, gradually scaling 

621
00:30:45,712 --> 00:30:49,160
your way into things that are 
more dynamic and that'll be like

622
00:30:49,160 --> 00:30:52,782
gentle plyometrics, skips, hops.
And then I'll work my way back 

623
00:30:52,782 --> 00:30:55,167
into running. 
You know, that's kind of the 

624
00:30:55,167 --> 00:30:57,176
general plan. 
And that can take upwards 

625
00:30:57,176 --> 00:30:59,759
sometimes of like four to six 
weeks for people. 

626
00:30:59,759 --> 00:31:04,088
Like really the first two weeks 
is kind of the like get it under

627
00:31:04,088 --> 00:31:06,560
control phase, and then we go 
from there. 

628
00:31:06,559 --> 00:31:08,720
And sometimes it's accelerated. 
Sometimes you get it under 

629
00:31:08,720 --> 00:31:11,600
control within a few days and 
you're back on it really quick. 

630
00:31:11,600 --> 00:31:14,824
Sometimes it takes a while. 
And so you just kind of have to 

631
00:31:14,824 --> 00:31:16,560
see everyone's situation's a 
little bit different. 

632
00:31:16,559 --> 00:31:19,871
It's not my first time rolling 
the crap out of this thing. 

633
00:31:19,871 --> 00:31:22,079
So it's thankfully I've gone 
through this before. 

634
00:31:22,079 --> 00:31:25,130
I have broken it before, but 
we'll see. 

635
00:31:25,130 --> 00:31:28,559
Well just one thing at a time 
right now. 

636
00:31:28,559 --> 00:31:31,273
But right now it's getting the 
range back and protected weight 

637
00:31:31,273 --> 00:31:34,137
bearing. 
For the first time as of like 

638
00:31:34,137 --> 00:31:38,240
probably today I can walk pretty
normally again without a shoe. 

639
00:31:38,240 --> 00:31:40,560
Like some kind of assisted 
rocker help. 

640
00:31:40,559 --> 00:31:43,111
And the reason why that helps, 
and we've talked about this 

641
00:31:43,111 --> 00:31:45,668
before on the podcast, not 
related to ankle sprains, but if

642
00:31:45,668 --> 00:31:48,028
you have really stiff ankles 
and/or great toes, the rockers 

643
00:31:48,028 --> 00:31:51,186
can help pivot you over because 
you don't need as much 

644
00:31:51,186 --> 00:31:52,809
dorsiflexion. 
And so that's what the walking 

645
00:31:52,809 --> 00:31:55,598
boots do for you early on, and 
that's what a rocker shoe can 

646
00:31:55,598 --> 00:31:57,280
help you with. 
I guess one other consideration 

647
00:31:57,280 --> 00:31:59,557
with footwear I haven't talked, 
I'm going on a long time. 

648
00:31:59,557 --> 00:32:02,591
I don't usually talk as much. 
I'm like getting winded. 

649
00:32:02,591 --> 00:32:05,279
Is also looking, there's 
swelling, right? 

650
00:32:05,279 --> 00:32:08,510
So looking for a shoe that has 
appropriate amounts of volume in

651
00:32:08,510 --> 00:32:10,662
it. 
And so that brings me to the 

652
00:32:10,662 --> 00:32:13,125
next point. 
And so the two that I used 

653
00:32:13,125 --> 00:32:16,423
during that time, I wanted to 
have a little bit of extra 

654
00:32:16,423 --> 00:32:19,157
support around the ankle. 
So I had two different shoes 

655
00:32:19,157 --> 00:32:22,159
that I was using with the Teva 
Trail Setter Hurricane Mid. 

656
00:32:22,160 --> 00:32:24,899
And then I honestly don't 
remember the name of this one. 

657
00:32:24,899 --> 00:32:26,639
This is the waterproof Deckers 
Chukka Mid. 

658
00:32:26,799 --> 00:32:30,054
It's not the Chukka though. 
This one is it's not the cozy 

659
00:32:30,054 --> 00:32:33,408
'cause it was the cozy Chukka. 
I know which one you're talking 

660
00:32:33,408 --> 00:32:33,982
about. 
Okay. 

661
00:32:33,982 --> 00:32:37,426
This one was like its own thing.
It's like but yeah, waterproof 

662
00:32:37,426 --> 00:32:39,250
and RIP. 
This shoe doesn't exist anymore.

663
00:32:39,250 --> 00:32:40,995
No. 
But those those were the two 

664
00:32:40,995 --> 00:32:43,829
shoes that I started with. 
And then from there, I I mean 

665
00:32:43,829 --> 00:32:46,324
I'm gonna bring it up again 
apparently, but the Mount to 

666
00:32:46,324 --> 00:32:49,020
Coast C1 was the next one. 
Super voluminous shoe, stiff 

667
00:32:49,020 --> 00:32:53,369
rockered ride, and I could get 
my foot in it, and so that's 

668
00:32:53,369 --> 00:32:57,509
what I wore on Friday. 
And yeah, that's that's what I'm

669
00:32:57,509 --> 00:32:59,032
doing. 
So basically, looking for 

670
00:32:59,032 --> 00:33:01,532
something that's rockered and 
structured that feels good on 

671
00:33:01,532 --> 00:33:04,869
your foot, but also volume, so 
that you can get your foot in 

672
00:33:04,869 --> 00:33:08,080
it, and as the ankle and or foot
swells throughout the day, it 

673
00:33:08,080 --> 00:33:11,668
actually has space to do it and 
it doesn't start hurting as the 

674
00:33:11,668 --> 00:33:15,040
day goes on and on and on. 
And so that that's been the 

675
00:33:15,040 --> 00:33:17,680
angle that I've been taking and 
we're in the acute phases. 

676
00:33:17,680 --> 00:33:20,100
So I think it's actually a 
pretty good episode to have 

677
00:33:20,100 --> 00:33:23,015
because we're gonna go from like
all stages of the injury here 

678
00:33:23,015 --> 00:33:26,125
where there's acute management, 
then you start going into like 

679
00:33:26,125 --> 00:33:29,600
kind of acute on chronic type of
presentations, and then chronic.

680
00:33:29,600 --> 00:33:33,120
So yeah, I mean that that's kind
of what I got. 

681
00:33:33,120 --> 00:33:36,529
What were you saying, Klein? 
I was gonna add, you know, back 

682
00:33:36,529 --> 00:33:40,141
in the day it we didn't used to 
have as many maximal shoes, so 

683
00:33:40,141 --> 00:33:42,480
that really finding a good 
rocker shoe was an option. 

684
00:33:42,480 --> 00:33:46,418
So a boot was a really classic 
suggestion for getting that 

685
00:33:46,418 --> 00:33:48,560
rockered back with protected 
weight bearing. 

686
00:33:48,559 --> 00:33:50,925
Now that we have so many maximal
shoes, that that can be an 

687
00:33:50,925 --> 00:33:53,543
option, but you hit that on the 
head where you have to really 

688
00:33:53,543 --> 00:33:55,755
make sure there's enough volume 
because of the swelling 

689
00:33:55,755 --> 00:33:57,314
component. 
Because if the shoe's too tight,

690
00:33:57,314 --> 00:33:59,101
it's going to be painful. 
It's putting pressure on the 

691
00:33:59,101 --> 00:34:00,419
area. 
There's not enough room for 

692
00:34:00,419 --> 00:34:02,240
things for the blood flow to be 
occurring. 

693
00:34:02,240 --> 00:34:05,500
So make sure that you have a 
shoe that has enough room and 

694
00:34:05,500 --> 00:34:07,750
especially volume. 
So not just width, but height as

695
00:34:07,750 --> 00:34:09,800
well. 
The ladder lacing is also a 

696
00:34:09,800 --> 00:34:12,659
really helpful tool if you just 
need a little bit more room and 

697
00:34:12,659 --> 00:34:15,840
that's where you can undo the 
laces and instead of crossing 

698
00:34:15,840 --> 00:34:19,174
them like this, you just go 
straight across and you kind of 

699
00:34:19,174 --> 00:34:21,204
go back and forth. 
Look this up on the internet, 

700
00:34:21,204 --> 00:34:24,187
there's lots of photos of this, 
but it can be very simple way to

701
00:34:24,187 --> 00:34:26,974
offload pressure on the top of 
the foot as well as get a little

702
00:34:26,974 --> 00:34:29,797
bit more room in your shoe. 
But yeah, getting room and that 

703
00:34:29,797 --> 00:34:33,071
rocker to try to maintain normal
as normal of a gait and 

704
00:34:33,071 --> 00:34:35,484
dorsiflexion as you can. 
Yeah, good luck with the 

705
00:34:35,484 --> 00:34:37,599
inversion's always the hardest 
thing to get back. 

706
00:34:38,800 --> 00:34:41,063
Yeah, inversion and 
plantarflexion, I feel like it 

707
00:34:41,063 --> 00:34:43,039
just gets torqued, you know, 
stretched on. 

708
00:34:43,679 --> 00:34:47,333
And then dorsiflexion just gets 
locks locked out usually. 

709
00:34:47,333 --> 00:34:49,359
Yeah, it's surprisingly really 
good. 

710
00:34:49,360 --> 00:34:51,835
Like it's probably normal. 
Inversion though, I can't I 

711
00:34:51,835 --> 00:34:53,759
can't do it full. 
There's no way. 

712
00:34:57,440 --> 00:35:01,130
This may not work, but if you 
ever done the mobilization with 

713
00:35:01,130 --> 00:35:04,162
movement for inversion can be 
very helpful, but not everybody 

714
00:35:04,162 --> 00:35:06,801
responds to that. 
Or even like a posterior like 

715
00:35:06,801 --> 00:35:08,559
fibular mob or something like 
that. 

716
00:35:08,559 --> 00:35:10,480
So just work dorsiflexion and 
things. 

717
00:35:10,720 --> 00:35:13,316
And if you have a PT that's 
really experienced with this 

718
00:35:13,316 --> 00:35:15,440
stuff, that's great too if 
you're going through this. 

719
00:35:15,440 --> 00:35:18,377
Because there's different things
they can do even just in the 

720
00:35:18,377 --> 00:35:21,396
short term, whether it be taping
techniques and or just other 

721
00:35:21,396 --> 00:35:24,864
recovery means that can help 
take some pressure off it in the

722
00:35:24,864 --> 00:35:27,239
short term. 
And just kind of help you take 

723
00:35:27,239 --> 00:35:30,063
that next step 'cause sometimes 
it's hard to get over that 

724
00:35:30,063 --> 00:35:31,279
painful step for a lot of 
people. 

725
00:35:31,280 --> 00:35:34,031
So if you could just get that 
pain to just come down a little 

726
00:35:34,031 --> 00:35:36,859
bit, then they can start doing a
little bit more on it and 

727
00:35:36,859 --> 00:35:39,127
accelerate that process. 
So always good to have someone 

728
00:35:39,127 --> 00:35:43,107
in your pocket if you can. 
Thankfully I know a guy. 

729
00:35:43,107 --> 00:35:45,790
Yeah. 
I I wanted to highlight a few 

730
00:35:45,790 --> 00:35:49,223
things you talked about that I 
think are are important adages 

731
00:35:49,223 --> 00:35:53,403
or just things to keep in mind. 
One of them is if you sprain 

732
00:35:53,403 --> 00:35:56,637
your ankle and you know there's 
not a fracture, putting weight 

733
00:35:56,637 --> 00:36:00,484
on it helps accelerate healing. 
So you want to promote as much 

734
00:36:00,484 --> 00:36:03,498
weight bearing as you can that 
isn't so provoking of pain that 

735
00:36:03,498 --> 00:36:07,840
it worsens your pain day to day,
but you So David took strategies

736
00:36:07,840 --> 00:36:11,679
to be able to weight bear as 
much as he could. 

737
00:36:11,679 --> 00:36:13,360
Thankfully he didn't have to do 
crutches. 

738
00:36:13,360 --> 00:36:16,331
He could go boot, but then he 
could weight bear and he put the

739
00:36:16,331 --> 00:36:19,244
boot on so that he could put 
more weight on it because they 

740
00:36:19,244 --> 00:36:22,500
it's been shown that the more 
weight you put on it, it helps 

741
00:36:22,500 --> 00:36:25,477
with a lot of the recovery from 
a number of different factors 

742
00:36:25,477 --> 00:36:28,730
that we don't need to go into. 
So I th I wanted to encourage 

743
00:36:28,730 --> 00:36:31,128
that if you know that there's 
not a fracture, putting weight 

744
00:36:31,128 --> 00:36:34,455
on it is going to be something 
that promotes your healing and 

745
00:36:34,455 --> 00:36:37,564
is really, really beneficial. 
The second thing that David 

746
00:36:37,564 --> 00:36:41,703
pointed out was that most people
will recover from ankle sprains 

747
00:36:41,703 --> 00:36:44,305
conservatively and kind of on 
their own. 

748
00:36:44,305 --> 00:36:49,119
And I've also wanted to point 
out that number of most is 60%. 

749
00:36:49,119 --> 00:36:54,580
So 60% of people are going to 
heal pretty much fully without 

750
00:36:54,580 --> 00:36:57,525
complications with conservative 
management of their situation. 

751
00:36:57,525 --> 00:37:01,650
Forty percent of people go on to
develop what's called chronic 

752
00:37:01,650 --> 00:37:04,183
ankle instability. 
That's a pretty high number. 

753
00:37:04,183 --> 00:37:07,432
So that's like four in ten. 
And what chronic ankle 

754
00:37:07,432 --> 00:37:10,490
instability is is that means 
that six to twelve months after 

755
00:37:10,490 --> 00:37:12,874
an ankle sprain, they still are 
experiencing moments of 

756
00:37:12,874 --> 00:37:15,424
instability where their ankle 
will continually like roll in on

757
00:37:15,424 --> 00:37:19,500
them or they'll have continued 
pain in that ankle due to excess

758
00:37:19,500 --> 00:37:21,597
motion. 
And a big part of that is 

759
00:37:21,597 --> 00:37:24,358
because when once you sprain 
your ankle at the point where 

760
00:37:24,358 --> 00:37:27,789
you stretch out the ligaments 
that are on the outside, they 

761
00:37:27,789 --> 00:37:30,559
never fully go back to their 
original state. 

762
00:37:30,559 --> 00:37:32,000
They're going to be stretched a 
little bit. 

763
00:37:32,000 --> 00:37:34,729
And not only that, but the 
mechanoreceptors, the things 

764
00:37:34,729 --> 00:37:38,436
that tell you where your ankle 
is in space, those are less 

765
00:37:38,436 --> 00:37:42,143
ready to tell you boom, boom, 
boom, your ankle's moving five 

766
00:37:42,143 --> 00:37:44,064
degrees. 
It might take 10 degrees for 

767
00:37:44,064 --> 00:37:46,968
your your brain to perceive a 
change in position, which makes 

768
00:37:46,968 --> 00:37:49,599
you more susceptible for it 
giving out on you again. 

769
00:37:49,599 --> 00:37:52,151
So what David mentioned that I 
wanted to highlight is he's 

770
00:37:52,151 --> 00:37:54,204
like, okay, I'm getting my 
swelling down, I'm getting 

771
00:37:54,204 --> 00:37:57,039
weight bearing going, I'm 
getting my range of motion back.

772
00:37:57,039 --> 00:38:01,389
And then I move into, and one of
the things he listed was like 

773
00:38:01,389 --> 00:38:03,820
proprioceptive balance stuff. 
And training your dynamic 

774
00:38:03,820 --> 00:38:07,945
stabilizers is going to be a 
really important part as you 

775
00:38:07,945 --> 00:38:09,856
recover. 
So if you're managing it by 

776
00:38:09,856 --> 00:38:12,159
yourself, don't just wait for it
to feel better. 

777
00:38:12,159 --> 00:38:16,259
I'd encourage you to add in like
all of this mobility work and 

778
00:38:16,259 --> 00:38:19,391
doing some balance stuff. 
And it can be as simple as just 

779
00:38:19,391 --> 00:38:21,855
like working on balancing on a 
single leg, adding some unstable

780
00:38:21,855 --> 00:38:26,034
surface underneath your foot. 
Just start to train your body to

781
00:38:26,034 --> 00:38:28,799
protect the position, excuse me,
in space. 

782
00:38:28,800 --> 00:38:32,660
So that was the only other 
couple things that popped into 

783
00:38:32,660 --> 00:38:34,902
my head. 
Anything else you we want to 

784
00:38:34,902 --> 00:38:36,444
talk about about the ankle 
sprain? 

785
00:38:36,444 --> 00:38:38,239
I would say a very important 
thing. 

786
00:38:38,240 --> 00:38:41,110
You mentioned the high, those 
fairly high percentage of those 

787
00:38:41,110 --> 00:38:43,119
who develop CAI, or chronic 
ankle instability. 

788
00:38:43,119 --> 00:38:46,905
There is good evidence that you 
can reduce that with again the 

789
00:38:46,905 --> 00:38:49,374
early weight bearing, early 
proprioceptive work, and then 

790
00:38:49,374 --> 00:38:52,651
obviously David and David knows 
this when appropriate and get a 

791
00:38:52,651 --> 00:38:55,465
weight for tissue healing. 
Power training of those lateral 

792
00:38:55,465 --> 00:38:58,390
ankle muscles is extremely 
important because we know with 

793
00:38:58,390 --> 00:39:01,521
ankle sprains there's actually a
delay in those things being able

794
00:39:01,521 --> 00:39:04,188
to like fire. 
So being able to restore, like 

795
00:39:04,188 --> 00:39:06,987
hey, side-to-side hopping and 
like plyometric side to side, 

796
00:39:06,987 --> 00:39:12,051
which a lot of runners don't do.
They do everything in the 

797
00:39:12,051 --> 00:39:14,799
forward plane. 
Side to side work. 

798
00:39:16,320 --> 00:39:19,256
For those of you for the 
listeners, just go watch what 

799
00:39:19,256 --> 00:39:22,060
was happening on YouTube. 
Just I don't know how to 

800
00:39:22,060 --> 00:39:24,670
describe what was happening. 
But yeah, side to side 

801
00:39:24,670 --> 00:39:27,510
plyometric. 
So not just jumping, but jumping

802
00:39:27,510 --> 00:39:31,335
into inversion and bouncing out,
really loading those those 

803
00:39:31,335 --> 00:39:36,585
everters is very important from 
a high power perspective, 

804
00:39:36,585 --> 00:39:39,200
especially for long term. 
Perfect. 

805
00:39:40,159 --> 00:39:42,996
Well Matt, do you want to talk 
about you next? 

806
00:39:42,996 --> 00:39:45,170
Sure. 
So for those who have heard me 

807
00:39:45,170 --> 00:39:47,593
complain about this enough, I've
had Achilles tendinopathy for 

808
00:39:47,593 --> 00:39:50,059
the last a little over a year. 
Although it's healing. 

809
00:39:50,059 --> 00:39:51,947
I've had it a lot longer than 
that. 

810
00:39:51,947 --> 00:39:53,599
Yeah, he'll lift in every shoe 
now. 

811
00:39:53,599 --> 00:39:56,400
I mean, I've got like five or 
six of these as backup. 

812
00:39:56,400 --> 00:40:00,564
So for those, again, I did a a 
short thing recently talking 

813
00:40:00,564 --> 00:40:03,679
about heel lifts and this is 
ProFoot from Amazon. 

814
00:40:03,679 --> 00:40:06,747
They're just like 10 bucks. 
I've got a bunch of them that I 

815
00:40:06,747 --> 00:40:08,159
kind of go between different 
shoes. 

816
00:40:08,159 --> 00:40:10,811
One of the lessons that I 
learned is that I first of all, 

817
00:40:10,811 --> 00:40:12,900
when this first happened, I 
probably should have taken some 

818
00:40:12,900 --> 00:40:14,880
time off, but I didn't because 
I'm an idiot. 

819
00:40:14,880 --> 00:40:18,214
So if things are really bad, you
know, modifying your running or 

820
00:40:18,214 --> 00:40:19,599
like cross-training is really 
important. 

821
00:40:19,599 --> 00:40:22,227
I didn't do that because I'm 
moron and so this has probably 

822
00:40:22,227 --> 00:40:24,960
lasted longer than it should 
have, should have, but there's 

823
00:40:24,960 --> 00:40:29,200
two, there's more than this. 
But two of the most common types

824
00:40:29,200 --> 00:40:31,760
of Achilles tendinopathy 
experienced by the population is

825
00:40:31,760 --> 00:40:34,167
mid-portion, where the middle 
part of the tendon is where 

826
00:40:34,167 --> 00:40:36,480
people tend to get symptoms and 
then insertional where the 

827
00:40:36,480 --> 00:40:37,824
actual tendon goes onto the 
bone. 

828
00:40:37,824 --> 00:40:40,736
I have a Haglund's deformity, so
already at risk for the kind of 

829
00:40:40,736 --> 00:40:42,623
stuff. 
And the challenge with tendon, 

830
00:40:42,623 --> 00:40:45,279
so it's very opposite to what 
David's experiencing. 

831
00:40:45,280 --> 00:40:48,067
So tendons function very 
differently than ligaments, than

832
00:40:48,067 --> 00:40:48,763
muscles. 
Okay. 

833
00:40:48,763 --> 00:40:51,199
So like my calf strength's 
fairly good. 

834
00:40:51,200 --> 00:40:52,239
That wasn't necessarily the 
problem. 

835
00:40:52,240 --> 00:40:56,032
It was the overuse and risk that
I had from limited dorsiflexion 

836
00:40:56,032 --> 00:41:00,823
and variety of other things that
may have put me at risk for what

837
00:41:00,823 --> 00:41:04,511
I developed and overtraining and
some pretty intense life stress 

838
00:41:04,511 --> 00:41:07,884
that happened during that point.
So definitely some psychosocial 

839
00:41:07,884 --> 00:41:11,759
things that played into that. 
But tendons can take a while. 

840
00:41:11,760 --> 00:41:14,208
And I would really encourage you
to listen to our episode with 

841
00:41:14,208 --> 00:41:16,320
Karin Silbernagel, who did a 
great job talking us through 

842
00:41:16,320 --> 00:41:18,240
this stuff. 
And I'm finally on the other 

843
00:41:18,240 --> 00:41:20,159
side after some kind of back and
forth. 

844
00:41:20,159 --> 00:41:23,599
And one of the biggest lessons 
is that with insertional 

845
00:41:23,599 --> 00:41:26,672
Achilles tendinopathy, you 
cannot mess with range of motion

846
00:41:26,672 --> 00:41:29,696
and excessive dorsiflexion. 
You can't mess with low heel 

847
00:41:29,696 --> 00:41:32,719
drop shoes. 
It just you have to be slow. 

848
00:41:32,720 --> 00:41:36,128
You can do loading and tendons 
and bones respond very well to 

849
00:41:36,128 --> 00:41:38,960
load, but you have to wait to 
get dorsiflexion back. 

850
00:41:38,960 --> 00:41:40,880
You should not be stretching 
early on. 

851
00:41:40,880 --> 00:41:44,000
You should not be doing range of
motion training early on because

852
00:41:44,000 --> 00:41:47,081
it's usually very irritable. 
And so I had to wait on that for

853
00:41:47,081 --> 00:41:49,356
about a year. 
And at about the like 11, 12 

854
00:41:49,356 --> 00:41:52,319
month mark, I went, okay, this 
has been going on for a year. 

855
00:41:52,320 --> 00:41:56,155
I'm gonna try to work on getting
my ankle motion back and slowly 

856
00:41:56,155 --> 00:41:57,920
carefully started adding stuff 
back in. 

857
00:41:57,920 --> 00:42:02,031
Had a flare up, kind of knew 
what was gonna happen, so limped

858
00:42:02,031 --> 00:42:06,134
my way through that, and finally
got some of the motion back and 

859
00:42:06,134 --> 00:42:08,960
now have actually some decent 
dorsiflexion on that side. 

860
00:42:08,960 --> 00:42:12,852
And so now that I I have a kind 
of a calf raise program that I 

861
00:42:12,852 --> 00:42:15,855
do, now I've added stuff in 
where I work doing like single 

862
00:42:15,855 --> 00:42:18,836
leg squats and trying to get 
that tibia forward and really 

863
00:42:18,836 --> 00:42:21,960
loading the other direction into
dorsiflexion, going, can I get 

864
00:42:21,960 --> 00:42:25,360
my quad and ankle plantar 
flexors to deal with handling 

865
00:42:25,360 --> 00:42:28,349
going into that range? 
And that's what's made probably 

866
00:42:28,349 --> 00:42:30,949
the biggest difference is 
getting my dorsiflexion back, 

867
00:42:30,949 --> 00:42:35,023
loading through that range and 
making Karin made this comment 

868
00:42:35,023 --> 00:42:40,485
that stuck with me that if you 
really, really want to deal with

869
00:42:40,485 --> 00:42:44,394
this stuff, it takes a year of 
loading after this thing stops 

870
00:42:44,394 --> 00:42:46,524
hurting. 
And we used to say 9 to 12 

871
00:42:46,524 --> 00:42:48,779
months just to get here. 
And that's it takes a while. 

872
00:42:48,779 --> 00:42:51,119
So it's really easy. 
It's easy to get frustrated. 

873
00:42:51,119 --> 00:42:53,709
Most of these things can be 
treated conservatively if it's 

874
00:42:53,709 --> 00:42:56,137
not improving, if you're not 
getting better, if you're not 

875
00:42:56,137 --> 00:42:58,280
taking this right way. 
There are some people that do 

876
00:42:58,280 --> 00:43:00,920
very well with surgery, although
what we found is that the size 

877
00:43:00,920 --> 00:43:04,515
of like the Haglund's deformity 
or like the bony growth on the 

878
00:43:04,515 --> 00:43:07,067
back doesn't actually determine 
how significant your pathology 

879
00:43:07,067 --> 00:43:10,775
is, which is really interesting.
So the other the shoe thing that

880
00:43:10,775 --> 00:43:13,877
I've learned outside of taking 
this carefully is I just have 

881
00:43:13,877 --> 00:43:16,647
started putting heel lifts in 
everything that's lower than 

882
00:43:16,647 --> 00:43:19,960
eight millimeter offset and just
going, I'm just gonna leave this

883
00:43:19,960 --> 00:43:22,427
thing alone. 
I still slowly expose myself to 

884
00:43:22,427 --> 00:43:25,991
little lower drop stuff, but 
honestly, the last two weeks is 

885
00:43:25,991 --> 00:43:29,419
the first time I've been able to
walk barefoot and actually get 

886
00:43:29,419 --> 00:43:31,360
real normal gait and 
dorsiflexion without pain. 

887
00:43:31,360 --> 00:43:35,201
So it takes time and it's it's 
it's a waiting game, it's a big 

888
00:43:35,201 --> 00:43:38,487
patient game, which I haven't 
been patient, so I kind of 

889
00:43:38,487 --> 00:43:41,216
deserve what's happened of this 
taking so long. 

890
00:43:41,216 --> 00:43:42,239
So yeah. 
Nate. 

891
00:43:42,559 --> 00:43:48,033
Yeah, I what I I've been feeling
like we've been missing out on 

892
00:43:48,033 --> 00:43:53,299
something because you have been 
doing a really good job at 

893
00:43:53,299 --> 00:43:58,231
pronouncing shoe names, people's
names, like you've said Andrea 

894
00:43:58,231 --> 00:44:03,640
correctly like for a long time. 
Gaviota, Kayano, you've got it 

895
00:44:03,640 --> 00:44:05,760
nailed. 
What did I do? 

896
00:44:05,760 --> 00:44:07,880
It's Karin Silbernagel. 
Oh, sorry. 

897
00:44:07,880 --> 00:44:09,152
Not Karen. 
Yeah. 

898
00:44:09,152 --> 00:44:13,085
Sorry, sorry. 
My bad. 

899
00:44:13,085 --> 00:44:17,300
Sorry, Card Noah. 
Good friend, brothers. 

900
00:44:17,300 --> 00:44:22,916
Another two step brothers. 
It's the other guys. 

901
00:44:22,916 --> 00:44:26,100
So anyway. 
Matt's like, no, we're talking 

902
00:44:26,100 --> 00:44:27,119
about it. 
Okay. 

903
00:44:27,119 --> 00:44:30,909
So one of the important lessons 
was just not not messing with 

904
00:44:30,909 --> 00:44:32,799
low drop shoes. 
Leaving that alone. 

905
00:44:32,800 --> 00:44:35,384
Anything lower than eight, I've 
learned that I just put a heel 

906
00:44:35,384 --> 00:44:37,116
lift. 
Like the Valkyrie Elite 2 has 

907
00:44:37,116 --> 00:44:40,521
done very well with a heel lift.
Several shoes from Altra used a 

908
00:44:40,521 --> 00:44:43,432
heel lift and it's been fine. 
Luckily there's a decent number 

909
00:44:43,432 --> 00:44:46,226
of shoes that have come out 
recently that have 10 millimeter

910
00:44:46,226 --> 00:44:47,759
drops that have done right, done
very well. 

911
00:44:47,760 --> 00:44:51,715
The Saucony Triumph, the new 
one, super bouncy foam, very 

912
00:44:51,715 --> 00:44:55,722
nice 10 millimeter drop shoe for
those that want that fit one of 

913
00:44:55,722 --> 00:44:57,378
my kind of top trainers of the 
year. 

914
00:44:57,378 --> 00:44:59,440
It's been very, very nice and 
I've still enjoyed this. 

915
00:44:59,440 --> 00:45:01,757
The other really great option is
Veloci. 

916
00:45:01,757 --> 00:45:04,400
Did I say that right? 
Yeah, yeah, Veloci. 

917
00:45:04,400 --> 00:45:07,070
Yeah, the Featherweight has been
fantastic because it's 

918
00:45:07,070 --> 00:45:10,400
definitely higher than 10. 
It feels like 12 to 14. 

919
00:45:10,400 --> 00:45:13,143
But there are now some options 
out there for those of you that 

920
00:45:13,143 --> 00:45:15,880
want of like a trainer or maybe 
a lightweight shoe that has a 

921
00:45:15,880 --> 00:45:17,770
higher stuff. 
And you just have to be patient.

922
00:45:17,770 --> 00:45:20,052
It takes time. 
And I know that now that I'm 

923
00:45:20,052 --> 00:45:22,648
getting into pain free range and
things are starting to feel 

924
00:45:22,648 --> 00:45:24,319
normal, that's not the time to 
jump in. 

925
00:45:24,320 --> 00:45:27,635
That's the still the time to go,
hey, let's if I'm gonna do let 

926
00:45:27,635 --> 00:45:31,248
me s make sure I've got symptom 
free stuff for a couple weeks 

927
00:45:31,248 --> 00:45:34,589
and then slowly carefully 
progress and just test the 

928
00:45:34,589 --> 00:45:36,706
waters. 
But I'm still gonna have heel 

929
00:45:36,706 --> 00:45:39,900
lifts around probably longer 
than I've my the longer than my 

930
00:45:39,900 --> 00:45:42,132
symptoms stick around, just 
because I'd rather be cautious 

931
00:45:42,132 --> 00:45:44,719
and work my way down. 
So then we do know that. 

932
00:45:44,720 --> 00:45:47,408
So mid-portion Achilles 
tendinopathy, you can get away 

933
00:45:47,408 --> 00:45:49,873
with this. 
Not to Jeff has talked about 

934
00:45:49,873 --> 00:45:53,759
this all the time, but I got to 
see Jeff recently, Jeff Dengate 

935
00:45:53,760 --> 00:45:57,120
from Runner's World at an ultra 
event and he was talking about 

936
00:45:57,120 --> 00:45:59,242
he's got some mid-portion 
Achilles Tendinopathy, and he 

937
00:45:59,242 --> 00:46:01,010
can get away with running in 
zero-drop shoes. 

938
00:46:01,010 --> 00:46:03,440
It's not always the best idea, 
but he can do that. 

939
00:46:03,440 --> 00:46:05,549
Insertional tendinopathy, 
because there's often a little 

940
00:46:05,549 --> 00:46:07,957
bone involvement. 
You don't mess with it, don't 

941
00:46:07,957 --> 00:46:09,750
take chances. 
And that was one of the hard 

942
00:46:09,750 --> 00:46:11,504
lessons. 
Just get the heel lifts, modify 

943
00:46:11,504 --> 00:46:14,672
the shoes, do what you got to 
do, modify your activity too, 

944
00:46:14,672 --> 00:46:17,956
and don't be a moron like me and
keep overly training through 

945
00:46:17,956 --> 00:46:19,776
stuff. 
Do what you got to do and take 

946
00:46:19,776 --> 00:46:22,911
your time to ease stuff back in.
But at the end of the day, 

947
00:46:22,911 --> 00:46:25,727
adequate load and helping that 
stuff remodel is going to be 

948
00:46:25,727 --> 00:46:27,420
really important. 
What's really interesting that I

949
00:46:27,420 --> 00:46:30,010
have observed, and I've seen 
this in a couple patients that 

950
00:46:30,010 --> 00:46:33,324
have also been doing this along 
with me, that I've been 

951
00:46:33,324 --> 00:46:36,480
treating, is that what really 
changed, once I started getting 

952
00:46:36,480 --> 00:46:40,320
my dorsiflexion back and doing 
some of the single leg squat and

953
00:46:40,320 --> 00:46:42,239
really loading into 
dorsiflexion, my Haglund's 

954
00:46:42,320 --> 00:46:46,979
deformity is decreasing in size.
And I don't know why I haven't 

955
00:46:46,979 --> 00:46:48,644
noticed that with patients 
before, because I've walked a 

956
00:46:48,644 --> 00:46:50,239
lot of people through this 
before. 

957
00:46:50,240 --> 00:46:53,664
But once you start loading into 
that dorsiflexion and like 

958
00:46:53,664 --> 00:46:57,040
getting that range back, the 
Haglund's has like I've measured

959
00:46:57,040 --> 00:46:59,839
it and it's decreasing in size, 
which is really interesting. 

960
00:46:59,840 --> 00:47:02,505
Obviously when I piss it off, it
swells up, which, you know, just

961
00:47:02,505 --> 00:47:04,060
how it goes. 
But that was an interesting 

962
00:47:04,060 --> 00:47:06,128
thing that I haven't seen in the
literature, but have noticed 

963
00:47:06,128 --> 00:47:08,239
with a lot of people, including 
myself. 

964
00:47:08,240 --> 00:47:12,616
So I will say, kind of funny, 
unrelated, when you were talking

965
00:47:12,616 --> 00:47:15,856
about the single-leg squats 
earlier, I could feel my lateral

966
00:47:15,856 --> 00:47:17,440
malleolus start to hurt. 
I'm sorry. 

967
00:47:21,599 --> 00:47:24,959
Yeah, I could I could like 
picture myself doing it and I 

968
00:47:24,959 --> 00:47:27,199
was like, nope, that ain't 
happening right now. 

969
00:47:27,200 --> 00:47:29,520
That's it. 
I've gone back and forth over 

970
00:47:29,520 --> 00:47:32,123
the years about like ankle 
dorsiflexion, which is like 

971
00:47:32,123 --> 00:47:35,299
where like your ankle kind of 
comes up towards your nose, like

972
00:47:35,299 --> 00:47:36,559
you're you're flexing your 
ankle. 

973
00:47:36,559 --> 00:47:39,291
There's been a variety of things
I've heard people say like, oh, 

974
00:47:39,291 --> 00:47:41,839
it's okay to have that stiff 
runners are naturally stiff. 

975
00:47:41,840 --> 00:47:44,540
And I've gone back and forth, 
but I think recently, as I've 

976
00:47:44,540 --> 00:47:47,631
just look at a lot more research
and gait, things like that, then

977
00:47:47,631 --> 00:47:49,360
my own experience maybe is 
influencing this. 

978
00:47:49,360 --> 00:47:52,686
I would rather have really good 
dorsiflexion and have very good 

979
00:47:52,686 --> 00:47:54,800
power than be very stiff and 
limited. 

980
00:47:54,800 --> 00:47:58,603
Just because I've seen so many 
people that like it you need 

981
00:47:58,603 --> 00:48:02,079
that tibia needs to be able to 
translate over that foot. 

982
00:48:02,079 --> 00:48:04,279
When it's really stiff, there's 
all kinds of compensations that 

983
00:48:04,279 --> 00:48:06,400
you have. 
So making sure you have good 

984
00:48:06,400 --> 00:48:09,234
motions are really important. 
The other thing I will say from 

985
00:48:09,234 --> 00:48:11,432
a tendinopathy standpoint, one 
of the things that ironically 

986
00:48:11,432 --> 00:48:14,270
has given me the most pain 
relief and something that I'm 

987
00:48:14,270 --> 00:48:17,156
gonna keep taking outside of, 
I've got like two exercises now 

988
00:48:17,156 --> 00:48:20,468
that I'm never gonna stop doing 
ever, which is the super heavy 

989
00:48:20,468 --> 00:48:23,611
calf raises and then this very 
heavy single leg squats and 

990
00:48:23,611 --> 00:48:25,725
dorsiflexion. 
Last thing is choosing two or 

991
00:48:25,725 --> 00:48:27,839
three plyometrics once or twice 
a week. 

992
00:48:27,840 --> 00:48:31,217
Ironically, and this has been a 
very consistent theme the last 

993
00:48:31,217 --> 00:48:34,600
like probably four months, four 
or five months is and I waited 

994
00:48:34,600 --> 00:48:37,576
to add these because you gotta 
be careful with these, but plyos

995
00:48:37,576 --> 00:48:41,183
and the ability to contract 
really fast makes a noticeable 

996
00:48:41,183 --> 00:48:44,039
decrease in my symptoms the next
day. 

997
00:48:44,039 --> 00:48:48,371
And so go to plyos. 
Very so I just started with like

998
00:48:48,371 --> 00:48:51,640
box jumps doing hops. 
And then as soon as it was 

999
00:48:51,640 --> 00:48:54,440
comfortable, I'll do like depth 
jumps or like like really 

1000
00:48:54,440 --> 00:48:56,608
focusing on that pop off the 
ground. 

1001
00:48:56,608 --> 00:49:00,584
And so a true plyometric, not 
just a hop, but really doing 

1002
00:49:00,584 --> 00:49:03,536
like like jump jump back. 
I can't remember what these are 

1003
00:49:03,536 --> 00:49:05,912
called, but like you're facing 
away, you jump down and snap 

1004
00:49:05,912 --> 00:49:08,917
back up from varying heights has
made just such a huge difference

1005
00:49:08,917 --> 00:49:11,624
in symptoms. 
And I think it's just rate of 

1006
00:49:11,624 --> 00:49:15,048
force development and getting 
that tendon to kick on and to 

1007
00:49:15,048 --> 00:49:18,559
respond to like the stretch 
shortening cycle the way it is. 

1008
00:49:18,559 --> 00:49:21,627
And so it's been a a really good
emphasis in some of the 

1009
00:49:21,627 --> 00:49:23,367
literature supporting this that 
oftentimes people with 

1010
00:49:23,367 --> 00:49:26,639
tendinopathies, they'll get to 
the loading and then like cool. 

1011
00:49:26,639 --> 00:49:29,675
But if you want to restore the 
function of that tendon, it's 

1012
00:49:29,675 --> 00:49:31,820
really important that you add 
that plyometric component as 

1013
00:49:31,820 --> 00:49:33,527
part of your return to function,
return to sport. 

1014
00:49:33,527 --> 00:49:35,039
Like don't get rid of the heavy 
loading. 

1015
00:49:35,039 --> 00:49:37,001
That's still good. 
And people get into these camps 

1016
00:49:37,001 --> 00:49:38,960
like should I load heavy? 
Should I do plyometrics? 

1017
00:49:39,039 --> 00:49:41,183
Do both, like as part of a 
progression. 

1018
00:49:41,183 --> 00:49:44,398
You can't get away with things. 
Like, yes, the high heel drop 

1019
00:49:44,398 --> 00:49:46,586
shoes are great. 
You know, rocker high heel drops

1020
00:49:46,586 --> 00:49:48,429
are great. 
They're gonna unload that so you

1021
00:49:48,429 --> 00:49:50,477
can keep going. 
Because if you're symptoms are 

1022
00:49:50,477 --> 00:49:53,458
within tolerance, you can keep 
running through this stuff if or

1023
00:49:53,458 --> 00:49:56,960
able to keep this under control.
But you also can't ignore this 

1024
00:49:56,960 --> 00:49:59,920
and you need to restore function
and restore tissue quality. 

1025
00:49:59,920 --> 00:50:03,238
So you don't get to choose, you 
have to do what you gotta do. 

1026
00:50:03,238 --> 00:50:05,840
So I'm locking in for the next 
rest of my life. 

1027
00:50:05,840 --> 00:50:08,284
I'm not gonna be like, you know,
Karin who said the next year. 

1028
00:50:08,284 --> 00:50:11,447
No, it's the rest of my life. 
I'm gonna be loading this stuff.

1029
00:50:11,447 --> 00:50:13,598
So going for it. 
Going for it. 

1030
00:50:13,598 --> 00:50:14,826
That's great. 
Don't forget. 

1031
00:50:14,826 --> 00:50:16,750
All right. 
Well, I guess I'll go. 

1032
00:50:16,750 --> 00:50:20,238
I'll I'll round this out here. 
I've got as you all who if 

1033
00:50:20,238 --> 00:50:22,969
you've been listening, you've 
heard me talk about the issue 

1034
00:50:22,969 --> 00:50:26,752
that I had with my left foot. 
I tore some ligaments at the 

1035
00:50:26,752 --> 00:50:30,178
base of my or like what's called
the metatarsal phalangeal joint,

1036
00:50:30,178 --> 00:50:32,820
so the big toe joint, kind of 
the ball of the foot. 

1037
00:50:32,820 --> 00:50:35,039
I tore some ligaments on the 
bottom of the foot there. 

1038
00:50:35,039 --> 00:50:38,828
It swelled up huge like a 
balloon for a lot longer than it

1039
00:50:38,828 --> 00:50:40,487
should. 
I should have booted myself or 

1040
00:50:40,487 --> 00:50:43,223
like stabilized, but I I just 
was like, I'm okay, I'm okay, 

1041
00:50:43,223 --> 00:50:45,723
I'm okay. 
And then it was like six months 

1042
00:50:45,723 --> 00:50:47,766
of no running. 
So that wasn't fun. 

1043
00:50:47,766 --> 00:50:50,270
Learned my lesson. 
But the good news is I've been 

1044
00:50:50,270 --> 00:50:53,295
in a really good spot where it's
not something that I am feeling 

1045
00:50:53,295 --> 00:50:57,477
very often right now and 
therefore my footwear selection 

1046
00:50:57,477 --> 00:51:01,599
is becoming more variable. 
I want to go back and just talk 

1047
00:51:01,599 --> 00:51:04,349
about footwear as it relates to 
big toe joint and particularly 

1048
00:51:04,349 --> 00:51:07,063
what I was dealing with. 
But often when we speak about 

1049
00:51:07,063 --> 00:51:10,234
people who have issues at the 
big toe joint, some of the most 

1050
00:51:10,234 --> 00:51:13,906
common things are hallux abducto
valgus, which is like a bunion 

1051
00:51:13,906 --> 00:51:17,794
deformity, or some people are 
maybe going to be dealing with 

1052
00:51:17,794 --> 00:51:21,688
hallux rigidus, meaning that big
toe can't extend or come up 

1053
00:51:21,688 --> 00:51:25,439
towards the sky, or hallux 
limitus where it doesn't go up 

1054
00:51:25,439 --> 00:51:27,971
very far. 
And then, you know, for me I had

1055
00:51:27,971 --> 00:51:30,803
that plantar plate tear, so the 
ligaments on the base of the 

1056
00:51:30,803 --> 00:51:32,319
foot. 
And then there's like these 

1057
00:51:32,319 --> 00:51:35,135
little bones right underneath 
the ball of the foot too that 

1058
00:51:35,135 --> 00:51:37,171
are called sesamoid bones. 
They're like floating bones, 

1059
00:51:37,171 --> 00:51:39,440
just like your kneecap, but they
live down there. 

1060
00:51:39,440 --> 00:51:42,740
Those can also get irritated and
people can have swelling and 

1061
00:51:42,740 --> 00:51:45,440
irritation there too. 
So those are the common issues. 

1062
00:51:45,440 --> 00:51:49,055
And when we have issues at the 
big toe joint, I would say 

1063
00:51:49,055 --> 00:51:51,279
there's a couple features of 
shoes that help. 

1064
00:51:51,280 --> 00:51:54,375
One of them is having a more 
rigid forefoot. 

1065
00:51:54,375 --> 00:51:57,119
So you don't want it to bend 
longitudinally. 

1066
00:51:57,119 --> 00:52:00,095
That's going to allow you to 
avoid moving that big toe into 

1067
00:52:00,095 --> 00:52:02,773
extension, which is gonna put 
stress on all of those 

1068
00:52:02,773 --> 00:52:04,195
structures. 
You don't wanna necessarily 

1069
00:52:04,195 --> 00:52:06,875
protect it forever, depending on
what you're dealing with, but 

1070
00:52:06,875 --> 00:52:10,984
for the short term, having a 
more rigid forefoot that has a 

1071
00:52:10,984 --> 00:52:13,553
rockered profile, it's gonna 
decrease the loading 

1072
00:52:13,553 --> 00:52:15,679
significantly and might allow 
you to do more. 

1073
00:52:15,680 --> 00:52:18,496
So for me, when I was first 
returning to running, actually 

1074
00:52:18,496 --> 00:52:21,534
the best shoe for me was the 
Cloudboom, no, yeah, Cloudboom 

1075
00:52:21,534 --> 00:52:24,833
Echo 3. 
So it was like a super rigid 

1076
00:52:24,833 --> 00:52:27,640
shoe. 
I used it for my like my easy 

1077
00:52:27,640 --> 00:52:30,991
return to run shoe because it 
had that really rigid rockered 

1078
00:52:30,991 --> 00:52:33,369
profile and it was a slightly 
earlier rocker. 

1079
00:52:33,369 --> 00:52:36,314
So I could just like get onto it
really easy. 

1080
00:52:36,314 --> 00:52:38,960
My big toe wasn't I think the 
third one. 

1081
00:52:39,200 --> 00:52:43,918
Was it mine was like green? 
Oh, was that one it was a three.

1082
00:52:43,918 --> 00:52:46,272
I remember it was three. 
Yeah, four. 

1083
00:52:46,272 --> 00:52:48,079
I kept it. 
It's right there. 

1084
00:52:48,079 --> 00:52:51,446
And it just like their fastest 
super shoe at the time and just 

1085
00:52:51,446 --> 00:52:54,542
it was and I was all of our easy
days in it. 

1086
00:52:54,542 --> 00:52:56,577
Yeah. 
It was just chilling in it. 

1087
00:52:56,577 --> 00:52:59,679
But that it was that rockered or
or more rigid rocker. 

1088
00:52:59,680 --> 00:53:02,738
But the second feature that I 
found really important for what 

1089
00:53:02,738 --> 00:53:05,939
I was dealing with because I 
couldn't, if I put stretch on 

1090
00:53:05,939 --> 00:53:09,111
it, it would aggravate it and it
would flare back up and swell 

1091
00:53:09,111 --> 00:53:11,616
back up. 
So I needed not only a rigid 

1092
00:53:11,616 --> 00:53:13,920
rocker, but I needed a pretty 
firm foam. 

1093
00:53:13,920 --> 00:53:16,617
When you have a really soft 
foam, it can allow the ball of 

1094
00:53:16,617 --> 00:53:19,191
your foot when you load it to 
actually sink down into the 

1095
00:53:19,191 --> 00:53:21,080
foam, which might put your toe 
in extension. 

1096
00:53:21,080 --> 00:53:23,440
So for you people on YouTube, I 
drew a picture. 

1097
00:53:23,440 --> 00:53:26,560
So this top one is a midsole 
with like a firmer foam where 

1098
00:53:26,560 --> 00:53:29,701
even when it pretend I'm putting
all my weight through the ball 

1099
00:53:29,701 --> 00:53:33,952
of my foot, if the big toe 
doesn't sink down, you can see 

1100
00:53:33,952 --> 00:53:36,239
how the like the toe stays 
neutral. 

1101
00:53:36,240 --> 00:53:39,869
Whereas in this bottom picture, 
I've got this situation where 

1102
00:53:39,869 --> 00:53:44,278
the foam is very soft. 
So then the the ball of the foot

1103
00:53:44,278 --> 00:53:47,840
sinks down and now it puts your 
big toe into a little extension.

1104
00:53:47,840 --> 00:53:50,827
So that little bit of a change 
for me was problematic. 

1105
00:53:50,827 --> 00:53:54,079
If I had a very soft foam, I I 
could feel it. 

1106
00:53:54,079 --> 00:53:57,832
Like it was worse than like a 
rigid or a more stiff foam that 

1107
00:53:57,832 --> 00:54:01,080
was a little bit more flexible. 
It was just that continual 

1108
00:54:01,080 --> 00:54:02,719
sinking down that was 
problematic. 

1109
00:54:02,720 --> 00:54:06,345
So if you're trying to avoid 
going into extension, a slightly

1110
00:54:06,345 --> 00:54:08,319
firmer foam might be your 
friend. 

1111
00:54:08,320 --> 00:54:11,991
And then thirdly, like a wider 
toe box just to allow space that

1112
00:54:11,991 --> 00:54:13,119
things aren't getting 
compressed. 

1113
00:54:13,119 --> 00:54:16,006
For me, I had a combination 
where I tore those ligaments, 

1114
00:54:16,006 --> 00:54:17,840
but they're closely related to 
the sesamoids. 

1115
00:54:17,840 --> 00:54:21,360
So my sesamoids still to this 
day can get irritated. 

1116
00:54:21,360 --> 00:54:24,069
So having some space that those 
aren't compressed is really 

1117
00:54:24,069 --> 00:54:26,229
helpful too. 
So I'd say those are the 

1118
00:54:26,229 --> 00:54:28,706
features for me. 
It's that rigid rocker that were

1119
00:54:28,706 --> 00:54:30,645
really helpful. 
The second being a slightly 

1120
00:54:30,645 --> 00:54:32,682
firmer foam. 
The third making sure that I 

1121
00:54:32,682 --> 00:54:34,159
have enough room in the 
forefoot. 

1122
00:54:34,159 --> 00:54:37,831
I'm thankful now like I'm able 
to dabble in some stuff that's 

1123
00:54:37,831 --> 00:54:40,560
not rigid or plated anymore. 
Like I'm thinking about the 

1124
00:54:40,560 --> 00:54:43,720
Fila, what is it, Speed Tempo. 
Like I can run in that shoe and 

1125
00:54:43,720 --> 00:54:46,077
I haven't been getting any 
issues whereas a year ago I 

1126
00:54:46,077 --> 00:54:50,975
would have I'm able to run in 
like the my gosh Altra what's 

1127
00:54:50,975 --> 00:54:54,800
the four millimeter drop neutral
trainer that I love? 

1128
00:54:54,800 --> 00:54:57,495
Forward oh the Forward Via 
Experience Flow. 

1129
00:54:57,495 --> 00:54:59,805
No, not the Via. 
Experience Flow. 

1130
00:54:59,805 --> 00:55:00,960
Experience Flow. 
Yeah. 

1131
00:55:00,960 --> 00:55:03,635
So like I'm starting to be able 
to use some of those flexible 

1132
00:55:03,635 --> 00:55:05,615
shoes. 
Even actually, I'm wearing them 

1133
00:55:05,615 --> 00:55:09,519
right now, but like the Xero, 
this is like a slipper. 

1134
00:55:09,920 --> 00:55:13,599
It's the Xero Pagosa Fur 
Slipper. 

1135
00:55:13,599 --> 00:55:17,544
I couldn't wear them at all last
like fall and winter because 

1136
00:55:17,544 --> 00:55:19,840
they're Xero shoes, so they're 
very flexible. 

1137
00:55:19,840 --> 00:55:24,049
So I was always in my my 
favorite winter shoe, which is 

1138
00:55:24,049 --> 00:55:27,867
like the what's the mid shoe 
from Deckers that's not made 

1139
00:55:27,867 --> 00:55:29,737
either anymore? 
The sniper mid? 

1140
00:55:29,737 --> 00:55:31,603
Yes. 
Oh, oh my gosh. 

1141
00:55:31,603 --> 00:55:34,960
You have a they're not within 
arm's reach though. 

1142
00:55:36,000 --> 00:55:38,184
They're under my bed, which is 
right here. 

1143
00:55:38,184 --> 00:55:40,912
I can bring those back. 
Who the heck are those? 

1144
00:55:40,912 --> 00:55:43,867
I like those aesthetics. 
These are slippers, man. 

1145
00:55:43,867 --> 00:55:46,429
These are amazing. 
I love these. 

1146
00:55:46,429 --> 00:55:49,416
I've had these for like two 
years. 

1147
00:55:49,416 --> 00:55:51,120
Oh okay. 
From Xero? 

1148
00:55:51,119 --> 00:55:53,569
Yeah, they're all yeah. 
Yeah. 

1149
00:55:53,569 --> 00:55:54,549
What? 
Yeah. 

1150
00:55:54,549 --> 00:55:56,059
Oh. 
They're awesome, but I couldn't 

1151
00:55:56,059 --> 00:55:58,099
use them last year because they 
were just too flexible. 

1152
00:55:58,099 --> 00:55:59,119
I didn't know. 
All right. 

1153
00:55:59,119 --> 00:56:01,759
BJ's gonna get really upset that
I I just yelled into the 

1154
00:56:01,759 --> 00:56:03,299
microphone. 
He's gonna have to edit that 

1155
00:56:03,299 --> 00:56:08,153
out. 
But yeah, I I think, you know, I

1156
00:56:08,153 --> 00:56:13,210
I'm trying to rehearse to myself
that like as I as I keep 

1157
00:56:13,210 --> 00:56:16,415
strengthening, as I recover, my 
body isn't broken forever. 

1158
00:56:16,415 --> 00:56:18,879
My body has the potential for 
healing. 

1159
00:56:18,880 --> 00:56:21,950
Something that I've needed to 
work on from a tendon 

1160
00:56:21,950 --> 00:56:24,720
perspective is like my flexor 
hallucis longus, which runs 

1161
00:56:24,720 --> 00:56:26,960
right along where I had my 
injury. 

1162
00:56:26,960 --> 00:56:30,855
Like I have to keep loading that
tendon and those structures to 

1163
00:56:30,855 --> 00:56:32,799
add like stability to that 
region. 

1164
00:56:32,800 --> 00:56:36,544
And so I still work on that, but
I'm I'm allowing myself to 

1165
00:56:36,544 --> 00:56:39,599
dabble in some other footwear 
now instead of only rigid stuff.

1166
00:56:39,599 --> 00:56:43,983
But I still to this day, like if
I'm going on a long run, I'm 

1167
00:56:43,983 --> 00:56:47,554
that's why I love the Cloud 
Monster Hyper 3, because it's 

1168
00:56:47,554 --> 00:56:51,840
firmer, wide toe box, and it's 
got a bit of a rocker. 

1169
00:56:51,840 --> 00:56:54,672
So I just feel really confident 
that I'm gonna get a consistent 

1170
00:56:54,672 --> 00:56:57,965
experience and that it's not 
going to mess with me at all. 

1171
00:56:57,965 --> 00:57:01,903
So and and don't even bring that
shoe out, David, because I'm 

1172
00:57:01,903 --> 00:57:03,933
having FOMO. 
But yes, the what is it? 

1173
00:57:03,933 --> 00:57:05,760
Which one is that? 
The C1 or that? 

1174
00:57:05,760 --> 00:57:11,616
C1 is that the C1, yeah, Matt's 
because Yeah, the C1 I I think 

1175
00:57:11,616 --> 00:57:14,960
about like nineteen or so left. 
That's fair. 

1176
00:57:14,960 --> 00:57:19,748
Yeah. 
What is like P1, M1, H1, P1, R1.

1177
00:57:19,748 --> 00:57:24,000
They're not on twos yet for 
anything, huh? 

1178
00:57:24,000 --> 00:57:26,476
I don't think they have a two on
anything yet. 

1179
00:57:26,476 --> 00:57:28,699
See what happens. 
They got enough letters to play 

1180
00:57:28,699 --> 00:57:29,440
with. 
That's fair. 

1181
00:57:29,440 --> 00:57:32,159
All right. 
Sweet. 

1182
00:57:32,159 --> 00:57:35,449
Well, everybody, thank you for 
joining us for this conversation

1183
00:57:35,449 --> 00:57:38,079
where we kind of walked through 
different scenarios. 

1184
00:57:38,079 --> 00:57:41,309
We found hope you found it 
helpful to think about how 

1185
00:57:41,309 --> 00:57:44,339
different types of injuries or 
different stages of recovery may

1186
00:57:44,339 --> 00:57:47,599
influence how you think about 
footwear because it will change.

1187
00:57:47,599 --> 00:57:51,344
And it will change depending on 
how acute or chronic it is or 

1188
00:57:51,344 --> 00:57:54,740
how much you've rehabbed, your 
body will adapt and it will 

1189
00:57:54,740 --> 00:57:56,465
change. 
And therefore, your footwear 

1190
00:57:56,465 --> 00:57:58,880
considerations may become more 
or less important. 

1191
00:57:59,200 --> 00:58:01,679
We thank you for joining us for 
Doctors of Running podcast. 

1192
00:58:01,680 --> 00:58:06,300
If you have more things you want
to talk about, send us an email 

1193
00:58:06,300 --> 00:58:06,960
at doctorsofrunning@gmail.com.