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If you've listened to this show 
before, you know that I love 

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geeking out on bio mechanics and
the science of running. 

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And that's one of the reasons 
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It's a course designed not just 
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that wants to deepen their 
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evidence behind how to manage 
things like training load and 

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design training so that you can 
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to achieve. 
It's a great course that blends 

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the evidence based and science 
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tools that you can actually use.
Again, whether that's for 

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yourself in your own training or
if you are someone who is 

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coaching others. 
It's also help me understand 

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training so that I can help 
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with in physical therapy. 
This is a course that has been 

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that this education can give you
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thinking of the why and how you 
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yourself, for others. 
If you want to check it out, you

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certification. 

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Hello everybody, and welcome to 
the Doctors of Running podcast 

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where we, a group of doctors of 
physical therapy, discuss the 

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art and science of running and 
the stuff that we put on our 

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feet. 
Today I am solo hosting. 

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My name is Nathan Brown, but I'm
not alone, thankfully, because 

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you would have to put up with me
the whole time. 

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I have the privilege of having 
Doug Adams with me, and Doug has

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been on this podcast before. 
He's a physical therapist. 

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He has trained for Tin Man 
Elite, which are the elite 

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athletes for Adidas we have. 
He has tons of experience in 

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gait analysis. 
He's an expert in that area, and

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he's just a phenomenal physical 
therapist. 

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He went to the University of 
Delaware, which is also my alma 

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mater. 
So I'm reppin. 

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You're on YouTube. 
You can see I'm repping the 

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Fighting Blue Hens today. 
Ironically, the Packers on day 

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of recording played the Bengals 
who just had Joe Flacco traded 

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to them. 
And Joe Flacco is an alum of UD.

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So big day for the Fighting Blue
Hens, except thankfully, they 

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lost to the Packers. 
My youngest son was at the game 

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with his grandpa. 
And that is not why you come and

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listen to this podcast. 
So, Doug, thank you for joining 

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us today. 
Thank you as always, Nathan. 

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Great to be here. 
And you know, anytime we're 

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calling out some Blue Hen stuff,
Delaware, Small wonder, first 

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date, you know, we got a Rep. 
Got to speak loud and proud 

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about it. 
Anything, anytime we can elevate

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UD is a good thing. 
They don't get a lot of they 

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don't get a lot of attention. 
So, Doug, thank you for joining 

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us. 
Could you, just for the people 

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who may not have heard you speak
on this podcast before, could 

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you just share a little bit more
about yourself as a physical 

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therapist and a runner and kind 
of what you do now? 

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Absolutely, yeah. 
I am a giant running nerd is 

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basically what I've done. 
I was the typical. 

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I was an triathlete in high 
school and got injured there and

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got really interested and did my
senior project on fitness 

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testing and gait and all these 
different things and got kind of

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exposed to running firm 
analysis. 

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Then got lucky in PT school and 
got to train with some of the 

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top researchers in the world 
that we're looking at running 

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with. 
Irene Davis, Rich Willy. 

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Yeah, my mentor, Lynn Snyder 
Mackler, just got a lot of 

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chance to to get there. 
And I just spent my career 

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really working with runners, 
developed some education courses

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and found a lot of good 
reception to that, classifying 

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how runners are moving and what 
their form looks like. 

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And then we built some 3D 
technology to support that 

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education later, you know, 
worked with the Department of 

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Defense and started working with
professional runners. 

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And now I just get to teach 
about running and work with 

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runners and just spend all and, 
and now coaching 3rd and 4th 

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grade crush country for Saint 
Mary Magnum Bulldogs. 

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Let's go boys. 
Got my little squad there so. 

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It's got to be the same as those
elite athletes, right? 

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Exact same tactics. 
Yes, exactly. 

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They just love doing, you know, 
1000 meter repeats on the track.

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They're so locked into that. 
But that's actually a lot of fun

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too. 
I enjoy that a lot. 

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Good. 
Well, we're glad that you are 

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willing to take up time and just
come talk with us because when 

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we bring you on, what we'd love 
to do is just hear another 

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physical therapist perspective 
on usually a specific kind of 

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common injury that runners will 
see. 

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And so that's what we're going 
to do. 

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Again, today we're going to be 
talking specifically about the 

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term shin splints, and what we 
want to do is address some of 

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the biggest and most common 
questions that come up on shin 

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splints on social media. 
What we've seen with doctors 

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running what UCU, with all of 
your platforms and education to 

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run DNA, and just what is out in
the stratosphere. 

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So we're going to address some 
of these top questions. 

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We're going to get through as 
many as we can and hopefully 

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through that you can learn a 
little bit about what this 

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condition is and what that means
for you and how you can think 

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about it well and how that can 
maybe change how and what you do

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as you try to continue to run 
healthy. 

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So I think the first thing that 
we should probably do is talk 

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about what this term is. 
So if you when you hear the word

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shin splints, what comes to mind
and what are we going to be 

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really talking about today? 
Yeah, there's a technical term 

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that makes it sound a lot more 
scientific that we call it 

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medial tibial stress syndrome. 
It also makes it sound like 

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something we should raise money 
for. 

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It's like a charity type thing, 
but it's actually not that 

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scary. 
And this is pain. 

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We're going to differentiate a 
little pain on the inside of 

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your shin, the big toe side of 
the shin, versus on the outside,

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the pinky toe side of the shin, 
because there is shin splints 

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can be a tetal phrase. 
And we should clarify really 

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which side we're talking about. 
So when we say spins, blends, 

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especially today just for ease, 
we'll be talking more about that

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medial tibial stress syndrome. 
Yeah, that's fantastic. 

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And I think as we go through 
some of these questions, we will

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continually tease out what that 
meaning is, because there are 

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implications for different types
of things that cause pain in 

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that area. 
So that'll be a fun part of the 

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conversation as well. 
I also like to think of shin 

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splints as this big umbrella 
term. 

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It's kind of like saying that 
someone has knee pain And that's

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not like a specific diagnosis of
something in particular. 

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It doesn't really tell you what 
to do. 

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Shin splints is the same. 
And so when as a therapist, and 

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you would probably agree with me
here, if a runner comes into 

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like, yeah, I've got some shin 
splints going on, me, I'm like, 

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all right, we got to figure out 
what's actually going on then 

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Cuz shin splints just means you 
have pain in your shin 

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somewhere. 
And right, that's what we're 

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going to talk about more today. 
So I think one of the big 

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questions that people who are 
runners have, because we never 

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want to stop running, if you're 
experiencing shin splints with 

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that, first big question is, can
I keep running with shin 

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splints? 
Yeah, that's a huge one, right? 

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Because that is the number one 
question. 

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Probably for every injury, the 
runners are going to come to you

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and say like can I keep running 
or should I keep running? 

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Maybe is the question they 
should be asking there. 

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I think it's really important to
use some criteria for this and 

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start to ask yourself a couple 
questions. 

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When, when somebody asked me 
that question, I, I'm not just 

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going to give a blanket answer, 
but like absolutely you can or 

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you can't run when you're having
the champagne. 

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So there's a couple 
clarification questions I think 

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really help that help you 
understand what state that's in.

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In the early stage of medial 
type of stretch times. 

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I'm shin splints. 
You're going to see that this is

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something that it might not 
start when you first start 

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running and then the pain comes 
on and then the pain goes away 

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and the intensity isn't that 
high. 

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Maybe it gets to two or three 
out of 10. 

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If that's the case, you can keep
running and we just need to ask 

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yourself a couple follow up 
questions. 

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How long does it hurt after the 
run? 

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So now you're done the run. 
Did it, did you get pain later? 

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Did you have increased pain with
walking around the house? 

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And did that stick around for a 
while? 

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So Delaware has these like 
soreness rules that we've used 

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more for ACL. 
But it's really helpful in this 

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scenario too, that if you have 
pain for a day after you're 

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running, it's probably like 
good, but don't progress it. 

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If you haven't pain for 48 hours
after it, that was too much and 

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you need to back it off. 
And then if the pain comes on a 

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day or two later and it's really
intense, that was definitely too

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much and you need to back off. 
So that early stage is one that 

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you can really keep running 
with, but we're probably going 

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to hit on this later or some of 
the other questions too. 

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One of the biggest reasons that 
people get chin spins is what we

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call training load errors. 
This means that you're running 

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too fast, too far, too frequent.
And when we see that people are 

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doing this, this is when they 
get fin splints because in my 

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mind, this is almost nearly 100%
preventable. 

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These fin splints are something 
that you really could get ahead 

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of and you should be able to 
trace it back to something that 

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happened or something you did or
something that you have that is 

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contributing to it. 
And therefore, if you manage it 

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well and maybe you're backing 
off the training volume a little

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bit, but you can keep running, 
then I think that's important. 

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When you know, when we get to 
later stages, that's when you 

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really have to say, when should 
I shut down? 

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How long should I shut down for 
and what else can I be doing 

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when I'm shut down? 
I think those are really 

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important distinctions too. 
Over time is like at what point?

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And the soreness rules is a 
really nice resource. 

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And if you're like, OK, tell me 
more about these soreness rules.

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Delaware puts those out for 
people to look at. 

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So you can just type into Google
UDPT protocols. 

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And then if you go under, 
there's little tabs under the 

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first hit that you'll get on 
Google, you can find those 

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soreness rules and kind of take 
a peek at what they're talking 

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about. 
And I don't know if this will be

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helpful for people, but as you 
were talking, I, I drew some 

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really fancy graphs. 
And one of the things you talked

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about, Doug, was kind of pattern
of pain during a run. 

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And if you're having this 
pattern of pain where you start 

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with no pain, it just 
continuously worsens throughout 

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a run. 
That's very different than it 

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kind of comes on at first, but 
then dissipates by the end. 

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In my mind, those patterns 
really matter where it tells you

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tissue irritability. 
Maybe it's just like, oh, this 

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is load and then it's like, oh, 
I'm not, this is not a dangerous

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load in your body kind of a 
customizes to it and it takes 

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away the the signal. 
But as you said, if you're 

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worsening throughout the run, 
that's a very more advanced 

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versus something that kind of 
comes at the beginning but then 

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goes away. 
So those patterns are just as 

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important as the severity of the
pain itself. 

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Absolutely. 
And that's part of the soreness 

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rules that back in the day when 
I was a resident minor my day I 

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think, I don't know. 
I don't think I was the first 

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00:11:32,040 --> 00:11:35,480
one to publish them at EUD, but 
one of the early ones for the 

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JOSPT paper IN202012, we 
published them in there and it's

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00:11:40,760 --> 00:11:42,640
a good resource. 
And part of it is if the 

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soreness goes away with warm up,
then you can continue. 

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If the soreness doesn't go away 
during warm up, stop. 

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Yeah, that's a huge deal. 
So when you talk about maybe you

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can keep running at these 
earlier stages, maybe not so 

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much at the end. 
Usually when people are asking, 

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can I keep running machines, 
splints, it's because they got a

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race coming up. 
So, you know, let's say you've 

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got a marathon runner, half 
marathon runner, they're in a 

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training block, they've got 
maybe a month left, maybe two 

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months left. 
What do you think is the success

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00:12:11,840 --> 00:12:14,520
rate to getting to race? 
Stay healthy when you're having 

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00:12:14,520 --> 00:12:18,040
these symptoms. 
The success rate, it's a great 

226
00:12:18,040 --> 00:12:21,120
clarification too, because a lot
of times you're like, well, 

227
00:12:21,120 --> 00:12:24,200
which runs, you know, if I'm 
going to modify, let's say that 

228
00:12:24,200 --> 00:12:28,080
you're not in that early stage 
and you're in a medium to high 

229
00:12:28,080 --> 00:12:31,640
stage of having this, like which
run should you do? 

230
00:12:31,640 --> 00:12:36,360
Should you do your long run? 
Should you do your track workout

231
00:12:36,360 --> 00:12:38,000
and your race pace kind of 
workout? 

232
00:12:38,000 --> 00:12:41,480
Or could you just do easy miles 
and try to maintain fitness? 

233
00:12:41,960 --> 00:12:45,600
I think like, first of all, you 
don't, you don't have to do a 

234
00:12:45,600 --> 00:12:49,680
whole lot to maintain fitness. 
If you're doing half of what 

235
00:12:49,680 --> 00:12:51,360
you're doing, you're going to 
maintain fitness. 

236
00:12:51,640 --> 00:12:53,760
Now, that doesn't mean you're 
building fitness. 

237
00:12:53,960 --> 00:12:56,360
So if you're planning to get 
more and more fit, you're not 

238
00:12:56,360 --> 00:13:00,240
building, you're not losing it. 
So don't you know, hit the five 

239
00:13:00,240 --> 00:13:03,400
alarm button here. 
You're going to be OK if you do 

240
00:13:03,400 --> 00:13:06,440
a little bit. 
I think a little bit of it 

241
00:13:06,440 --> 00:13:11,040
depends again on when you feel 
the symptoms right are. 

242
00:13:11,040 --> 00:13:14,200
And some of it is like where is 
it coming from? 

243
00:13:14,480 --> 00:13:17,800
Because the whole thing with it 
is we said it's highly 

244
00:13:17,800 --> 00:13:21,560
preventable and we didn't say it
yet, but I'll say it now. 

245
00:13:21,800 --> 00:13:23,720
She influence. 
There's something that's highly 

246
00:13:23,720 --> 00:13:28,560
recurrent in people as well. 
And the reason I think that the 

247
00:13:28,560 --> 00:13:31,320
high recurrence is is because 
people aren't addressing the 

248
00:13:31,320 --> 00:13:34,520
root cause. 
They're not addressing like why 

249
00:13:34,520 --> 00:13:36,880
did they develop these shin 
splints in the 1st place? 

250
00:13:37,360 --> 00:13:40,160
And if they do, they'll 
understand it better. 

251
00:13:41,080 --> 00:13:45,400
So a little tangent to your 
question, but I think if you're 

252
00:13:45,400 --> 00:13:48,640
saying the success rate of it 
here, I think people can 

253
00:13:48,640 --> 00:13:51,880
successfully get to the race 
with just modifying their 

254
00:13:51,880 --> 00:13:56,880
training load and having a plan,
whether that's a take a short 

255
00:13:56,880 --> 00:14:01,200
break and just do nothing for a 
little bit and cross train or is

256
00:14:01,200 --> 00:14:04,440
it I'm only going to hit my key 
workouts that I'm doing. 

257
00:14:04,680 --> 00:14:08,160
They're pretty successful at 
getting through the race, but I 

258
00:14:08,160 --> 00:14:11,480
think they're not always happy 
with the results of the race if 

259
00:14:11,480 --> 00:14:13,440
they're still having the pain. 
Right. 

260
00:14:13,640 --> 00:14:16,840
Yeah, there's that little left 
on the table. 

261
00:14:16,840 --> 00:14:19,400
Probably that would have been 
attainable with some training 

262
00:14:19,400 --> 00:14:22,040
and but you can get there 
usually. 

263
00:14:22,760 --> 00:14:26,720
It's just not as not as smooth, 
not as smooth of a path, Yeah. 

264
00:14:27,320 --> 00:14:31,320
It's not always a disqualifying 
run kind of good to continue on 

265
00:14:31,320 --> 00:14:36,520
the should I run or not right. 
It is something that is not a 

266
00:14:36,520 --> 00:14:41,480
stop, do not pass go, you must 
rest type workout or type 

267
00:14:41,480 --> 00:14:44,520
injury. 
But it is something that if it's

268
00:14:44,520 --> 00:14:48,520
managed well early, it can 
really be a non factor. 

269
00:14:48,880 --> 00:14:54,240
If it's not managed well early, 
it can become a big issue that 

270
00:14:54,240 --> 00:14:55,920
you really don't want to have to
deal with. 

271
00:14:56,600 --> 00:14:59,000
Yeah. 
I think one of two of the things

272
00:14:59,000 --> 00:15:01,640
you've mentioned that I think 
are going through, one of them 

273
00:15:01,720 --> 00:15:05,480
is one of the questions that is 
hit the top kind of the top 

274
00:15:05,480 --> 00:15:07,120
questions that people ask about 
this. 

275
00:15:07,440 --> 00:15:09,800
It's that question about will 
this keep coming back? 

276
00:15:10,080 --> 00:15:12,880
And then you also reference this
concept of it's highly 

277
00:15:12,880 --> 00:15:16,800
preventable, which isn't 
directly addressed in one of 

278
00:15:16,800 --> 00:15:18,840
these questions. 
So if you're OK, I'd love to go 

279
00:15:18,840 --> 00:15:21,040
there and get your perspective 
because I think that's what 

280
00:15:21,040 --> 00:15:23,240
people really want is they don't
want to have to rehab. 

281
00:15:23,560 --> 00:15:27,040
They want to stay healthy. 
So when you think about what it 

282
00:15:27,040 --> 00:15:30,760
looks like to prevent, you know,
shin splints or medial tibial 

283
00:15:30,760 --> 00:15:33,720
stress syndrome, how do we do 
that? 

284
00:15:33,720 --> 00:15:36,360
What's what's your concept and 
perspective there? 

285
00:15:36,480 --> 00:15:38,600
Because this is like one of 
those most common ones that 

286
00:15:38,600 --> 00:15:41,200
people like, you know, once I 
start running again, my 

287
00:15:41,200 --> 00:15:42,440
shouldn't start hurting. 
I'm done. 

288
00:15:42,440 --> 00:15:44,080
You know, like it's a very 
common thing. 

289
00:15:44,080 --> 00:15:48,360
So what are your thoughts? 
Well, the first thing isn't 

290
00:15:48,360 --> 00:15:50,800
always possible, but it really 
if we're talking about 

291
00:15:50,800 --> 00:15:55,000
prevention, I would get my 
DeLorean out and go back in time

292
00:15:55,000 --> 00:15:59,320
and prevent sports 
specialization and have everyone

293
00:15:59,320 --> 00:16:01,920
do jumping and cutting sports 
until they're 16. 

294
00:16:02,360 --> 00:16:06,760
Oh my gosh, that would be. 
Probably one of the best 

295
00:16:06,760 --> 00:16:10,960
preventable things because what 
we know about doing jumping and 

296
00:16:10,960 --> 00:16:15,880
cutting sports is that it 
increases the size of the bone 

297
00:16:16,080 --> 00:16:18,920
better than just running alone 
would do. 

298
00:16:19,240 --> 00:16:25,680
So if you were the three season 
runner that never did any 

299
00:16:26,480 --> 00:16:29,440
different sports or cross 
training, I would highly 

300
00:16:29,440 --> 00:16:33,320
recommend that you go back in 
time and teach yourself that you

301
00:16:33,320 --> 00:16:36,680
need to do some jumping. 
Play basketball in the winter. 

302
00:16:36,880 --> 00:16:40,760
I'm not popular in Delaware. 
Thanks for saying this, but I'm 

303
00:16:40,760 --> 00:16:44,040
not a big fan of winter track. 
I think that they should play 

304
00:16:44,040 --> 00:16:49,560
other sports and do basketball 
is great for cross training or 

305
00:16:49,560 --> 00:16:52,320
even swimming just to give them 
a deloading time. 

306
00:16:52,720 --> 00:16:56,480
They need to do things other 
than run to help prevent it so. 

307
00:16:57,840 --> 00:17:00,000
Yeah, I want to add one thing to
that. 

308
00:17:00,000 --> 00:17:03,840
I went to a conference and there
was someone presenting on this 

309
00:17:03,840 --> 00:17:08,240
topic and really quick medial 
tibial stress syndrome, shin 

310
00:17:08,240 --> 00:17:10,280
splints. 
This is ultimately dealing with 

311
00:17:10,280 --> 00:17:15,079
the bone and what what is really
common in younger athletes are 

312
00:17:15,079 --> 00:17:18,200
bone related injuries. 
A little bit less common in 

313
00:17:18,200 --> 00:17:19,920
adults, though. 
It's definitely still very 

314
00:17:19,920 --> 00:17:22,280
prevalent, but it tends to be 
more soft tissue stuff. 

315
00:17:22,839 --> 00:17:25,720
But they found for these kids 
that for those who are non 

316
00:17:25,720 --> 00:17:29,000
sports specializers or the ones 
who are sports specializers and 

317
00:17:29,000 --> 00:17:32,680
they define that as them who do 
the, the the sport for nine 

318
00:17:32,680 --> 00:17:35,200
months or more out of the year. 
They don't have this three month

319
00:17:35,480 --> 00:17:37,360
alteration. 
That's what the studies did. 

320
00:17:37,680 --> 00:17:43,320
It's like a 60, like 67% like 
decrease in your injury risk for

321
00:17:43,320 --> 00:17:46,280
bone stress injuries if you are 
not sports specializing. 

322
00:17:46,800 --> 00:17:51,240
So I totally am on board with 
you here and evidence backs this

323
00:17:51,240 --> 00:17:53,520
up. 
So I love that number one, if 

324
00:17:53,520 --> 00:17:56,880
you're a kid or you got kids, 
like don't sports specialized 

325
00:17:57,160 --> 00:17:58,760
because you can actually perform
better too. 

326
00:17:58,880 --> 00:18:02,280
If you don't get hurt, you're 
going to be a lot better anyway.

327
00:18:03,160 --> 00:18:05,040
Yeah. 
Now for the rest of us that are 

328
00:18:05,040 --> 00:18:08,680
already running and maybe you 
haven't had these or you have 

329
00:18:08,680 --> 00:18:12,080
and you want to keep them from 
coming back again, I think 

330
00:18:12,080 --> 00:18:15,720
there's a couple simple things 
and maybe let's pick one or two 

331
00:18:15,720 --> 00:18:19,000
that people could do just to 
like get ahead of it there. 

332
00:18:19,840 --> 00:18:23,200
So I think calf strength is 
probably one of the biggest ones

333
00:18:23,200 --> 00:18:26,640
that we can do here. 
This is an injury that 

334
00:18:26,640 --> 00:18:28,960
influence. 
There's a little bit of debate 

335
00:18:28,960 --> 00:18:33,680
and a lack of pure understanding
of whether this comes from this 

336
00:18:33,680 --> 00:18:38,440
pure mechanical bone loading 
versus the pull of the muscle on

337
00:18:38,440 --> 00:18:40,920
the bone that they call the 
periosteum. 

338
00:18:41,320 --> 00:18:42,440
And there is a little bit of 
debate. 

339
00:18:42,440 --> 00:18:47,320
But either way, from what we 
know, I believe that having a 

340
00:18:47,320 --> 00:18:51,120
stronger calf is going to reduce
either method of injury. 

341
00:18:51,160 --> 00:18:52,880
And it might be a combination of
two. 

342
00:18:53,200 --> 00:18:56,280
In my brain, it makes sense 
that, but periosteum pulls on it

343
00:18:56,280 --> 00:18:59,520
and the bone is weakened and 
then it gets loaded and then it 

344
00:18:59,520 --> 00:19:01,720
doesn't like that. 
And that's where you start to 

345
00:19:01,720 --> 00:19:06,120
get the shin pain here. 
And so having a stronger calf 

346
00:19:06,120 --> 00:19:09,920
muscle or plantar flexure 
strength is going to really just

347
00:19:09,920 --> 00:19:15,560
help you to be able to reduce 
and absorb some of the forces 

348
00:19:15,560 --> 00:19:19,600
that are occurring at the tibia,
your shin bone there. 

349
00:19:20,040 --> 00:19:24,440
So I think that doing that on a 
regular basis is extremely 

350
00:19:24,440 --> 00:19:27,560
helpful because it's also 
beneficial for performance. 

351
00:19:27,840 --> 00:19:31,400
It's also beneficial for like so
many different other injuries 2 

352
00:19:31,680 --> 00:19:36,760
so doing fast renting is just a 
no brainer to keep up with. 

353
00:19:37,640 --> 00:19:41,040
For those of you on the YouTube 
channel Bald guy, not much to do

354
00:19:41,040 --> 00:19:43,640
in the shower. 
Calf raises keeps me in the warm

355
00:19:43,640 --> 00:19:51,000
water for a little longer. 
So yeah, just be mindful of 

356
00:19:51,000 --> 00:19:54,360
doing calf raises if you can. 
Do you think that those can be 

357
00:19:54,360 --> 00:19:57,680
just single like body weight and
that's sufficient for the type 

358
00:19:57,680 --> 00:19:59,160
of strengthening you're thinking
about? 

359
00:19:59,160 --> 00:20:01,960
Or do you think, oh, you got to 
add some external load to this? 

360
00:20:01,960 --> 00:20:06,920
Where were you at on that? 
In an ideal and we would add 

361
00:20:06,920 --> 00:20:10,640
external load and I think it's 
really helpful to get that, but 

362
00:20:10,920 --> 00:20:15,800
I think there are marginal gains
to be made with that or if it's 

363
00:20:15,800 --> 00:20:19,040
just doing consistent cash 
strengthening from a 

364
00:20:19,040 --> 00:20:23,400
neuromuscular standpoint of just
keeping the body activating 

365
00:20:23,400 --> 00:20:28,760
there and focusing on control. 
One of the things that I huge 

366
00:20:28,760 --> 00:20:31,440
people when they do calf raises 
and when they do a lot of foot 

367
00:20:31,440 --> 00:20:34,760
exercises, it's about the foot 
pyramid, basically the foot 

368
00:20:34,760 --> 00:20:37,680
triangle. 
So think about there's three 

369
00:20:37,680 --> 00:20:40,680
spots underneath of your foot, 
right underneath of the big toe,

370
00:20:40,680 --> 00:20:43,640
the knuckle joint underneath of 
your big toe, the knuckle joint 

371
00:20:43,840 --> 00:20:47,160
by your pinky toe, and then in 
the center of your heel. 

372
00:20:47,720 --> 00:20:51,960
And when you're doing calf 
raises, we want to keep pressure

373
00:20:51,960 --> 00:20:55,360
between the 1st 2 points and 
make sure that you're 

374
00:20:55,360 --> 00:20:58,240
maintaining that so that they're
good quality of mushroom with it

375
00:20:58,240 --> 00:21:00,320
too. 
I actually see a lot of people 

376
00:21:00,320 --> 00:21:03,480
with Achilles as well, different
injury, but I see a lot of 

377
00:21:03,480 --> 00:21:07,760
Achilles people doing calf 
raises incorrectly and 

378
00:21:07,760 --> 00:21:10,840
potentially contributing to some
of these symptoms because 

379
00:21:10,840 --> 00:21:14,640
they're actually loading the 
tissues, not the way we're 

380
00:21:14,640 --> 00:21:18,240
really looking for or using 
different muscles to accomplish 

381
00:21:18,240 --> 00:21:19,800
the activity. 
Yeah. 

382
00:21:19,960 --> 00:21:24,960
So calf strength seems like a 
some low hanging fruit to ward 

383
00:21:24,960 --> 00:21:27,440
this off. 
Is there another one that you 

384
00:21:27,440 --> 00:21:30,240
think is the other kind of low 
hanging fruit for people? 

385
00:21:31,280 --> 00:21:34,800
I would say this one is a little
more abstract, but it's really 

386
00:21:34,800 --> 00:21:38,280
helpful would be to do barefoot 
hip strengthening. 

387
00:21:39,000 --> 00:21:43,640
So doing exercises for proximal 
stability, so focusing on your 

388
00:21:43,640 --> 00:21:47,040
hip and core, but doing in a 
weight bearing positions in a 

389
00:21:47,040 --> 00:21:51,120
barefoot position. 
Because we do know that one of 

390
00:21:51,120 --> 00:21:56,080
the things that contribute to 
the development of insulins is 

391
00:21:56,080 --> 00:21:59,480
that we spend a lot of time 
where we go through a lot of 

392
00:21:59,480 --> 00:22:04,240
motion into pronation. 
And that E version pronation 

393
00:22:04,240 --> 00:22:08,520
that we see often times has 
contributions from the hip. 

394
00:22:08,800 --> 00:22:12,120
And I find that it's best to 
train in barefoot because we're 

395
00:22:12,120 --> 00:22:15,720
trying to create the connection 
between our foot and our hip so 

396
00:22:15,720 --> 00:22:19,000
that we're understanding both 
and we're training, training the

397
00:22:19,000 --> 00:22:22,600
foot muscles and the calf 
muscles to be able to control 

398
00:22:22,600 --> 00:22:25,360
the foot while we're also doing 
hip exercises. 

399
00:22:25,640 --> 00:22:29,360
So we do like a stork exercise. 
We stand against the wall 

400
00:22:29,360 --> 00:22:33,480
pushing a knee out into that. 
We call it hip abduction 

401
00:22:33,480 --> 00:22:36,200
isometrics. 
Those are really great 

402
00:22:36,200 --> 00:22:38,720
exercises. 
And doing that stuff barefoot 

403
00:22:39,120 --> 00:22:42,000
gives you a good connection and 
awareness of how to control the 

404
00:22:42,000 --> 00:22:45,160
foot a little bit better, but 
also how to have control of the 

405
00:22:45,160 --> 00:22:48,720
hip so that you're not going 
into as much of that pronation 

406
00:22:48,720 --> 00:22:50,720
as you're running. 
That's great. 

407
00:22:51,120 --> 00:22:55,480
I am preaching to myself in 
this, but there was a study that

408
00:22:55,480 --> 00:22:57,600
came out last year. 
So what you're saying like just 

409
00:22:57,600 --> 00:23:00,600
lines up with this so well. 
The study basically had three 

410
00:23:00,600 --> 00:23:03,320
different exercise regiments 
that it gave a bunch of runners 

411
00:23:03,480 --> 00:23:06,080
to try to prevent injuries 
period. 

412
00:23:06,160 --> 00:23:09,040
They didn't weren't specific 
specific to some sort of injury.

413
00:23:09,600 --> 00:23:12,000
And ultimately I'm not even 
going to go into the details, 

414
00:23:12,000 --> 00:23:15,120
but one of the groups of the 
three different regiments did 

415
00:23:15,120 --> 00:23:18,040
better than the other ones. 
But it was only the people who 

416
00:23:18,040 --> 00:23:23,560
were consistent in that group, 
meaning they missed over a very 

417
00:23:23,560 --> 00:23:26,160
long period of time. 
They only missed two over like 

418
00:23:26,600 --> 00:23:28,880
it was something like 2436 weeks
or something. 

419
00:23:28,880 --> 00:23:31,080
So over six months they only 
missed 2 sessions. 

420
00:23:31,400 --> 00:23:35,720
And so in my mind, even thinking
about calf raises and then these

421
00:23:35,720 --> 00:23:38,640
other hip exercises, being 
consistent is going to be better

422
00:23:38,640 --> 00:23:41,880
than being perfect because if 
you have to wait for perfection,

423
00:23:41,880 --> 00:23:44,200
like you're probably going to 
miss out on the benefits that 

424
00:23:44,200 --> 00:23:47,120
you can get. 
I don't know if this is the same

425
00:23:47,160 --> 00:23:51,640
study but I saw one recently 
that saying to get the benefits 

426
00:23:51,760 --> 00:23:55,640
of strength training for runners
you pretty need pretty much need

427
00:23:55,640 --> 00:23:58,880
to do it for about 7 months and 
that's how well you need to be 

428
00:23:58,880 --> 00:24:01,200
consistent with it. 
It might be a different study. 

429
00:24:01,200 --> 00:24:04,640
Maybe different, yeah. 
Like you have to do it seven 

430
00:24:04,640 --> 00:24:06,880
months before you start getting 
some of the benefits for your 

431
00:24:06,880 --> 00:24:10,520
bone, before you really start 
seeing some cross-sectional 

432
00:24:10,520 --> 00:24:13,480
differences in the muscles. 
It's important to be really 

433
00:24:13,480 --> 00:24:16,800
consistent. 
So the exercise selection, if 

434
00:24:16,800 --> 00:24:20,480
you're hitting the major muscle 
groups, that's important, but 

435
00:24:20,720 --> 00:24:24,080
which exercises you're doing 
isn't as important as just that 

436
00:24:24,080 --> 00:24:25,720
you're doing them on a 
consistent basis. 

437
00:24:26,240 --> 00:24:28,120
Totally. 
And I'm going to throw one thing

438
00:24:28,120 --> 00:24:32,400
out there with as we talk about 
consistency, I can hear people 

439
00:24:32,400 --> 00:24:36,160
that I've worked with in the 
past saying, OK, but what if I 

440
00:24:36,160 --> 00:24:38,480
take some time off of strength 
training because I'm in a heavy 

441
00:24:38,480 --> 00:24:42,520
block of my training? 
In my mind, great periodization 

442
00:24:42,520 --> 00:24:44,280
is a thing. 
We're going to have these waxes 

443
00:24:44,280 --> 00:24:47,600
and waning of what's important. 
So if you're like, crap, at my 

444
00:24:47,600 --> 00:24:51,040
last marathon training, I took 
four weeks off of my heavier 

445
00:24:51,040 --> 00:24:53,520
strengthening because I was 
doing so much running. 

446
00:24:53,840 --> 00:24:57,120
Awesome, that's great. 
You're not going to like lose 

447
00:24:57,120 --> 00:24:59,120
everything that you gained from 
that. 

448
00:25:00,600 --> 00:25:06,240
You know, IA 100% agreed, like 
periodization is huge here, you 

449
00:25:06,240 --> 00:25:07,840
know, and we really should look 
at that. 

450
00:25:07,840 --> 00:25:14,760
There is, there is some 
interesting things to where I'm 

451
00:25:14,760 --> 00:25:18,040
seeing a lot of strength 
training and people that are 

452
00:25:18,080 --> 00:25:22,280
very vocal in strength training 
for runners saying that there is

453
00:25:22,280 --> 00:25:26,720
benefit from doing isometric 
exercises in that period because

454
00:25:26,720 --> 00:25:30,080
your body is used to load but it
doesn't want to have the same 

455
00:25:30,200 --> 00:25:33,280
tissue damage, but it keeps the 
activation. 

456
00:25:33,760 --> 00:25:38,680
So sometimes doing limited 
repetitions of isometric 

457
00:25:38,680 --> 00:25:43,000
activities will get your body to
still feel fresh and good 

458
00:25:43,320 --> 00:25:47,040
without putting the stress on it
and keep some of the 

459
00:25:47,720 --> 00:25:51,080
neuromuscular benefits, which is
basically meaning your brain is 

460
00:25:51,200 --> 00:25:53,720
able to contract the muscles 
better, which is what we're 

461
00:25:53,720 --> 00:25:56,160
looking for with running anyway.
Perfect. 

462
00:25:56,880 --> 00:25:59,160
Well, let's move on to another 
one of the most common 

463
00:25:59,160 --> 00:26:03,840
questions, and this is 1, where 
people are probably experiencing

464
00:26:03,840 --> 00:26:06,600
this pain and they're starting 
to be like, what's actually 

465
00:26:06,600 --> 00:26:08,720
going on here? 
Because as we said, this is a 

466
00:26:08,720 --> 00:26:11,560
bone related thing. 
So another extremely common 

467
00:26:11,560 --> 00:26:14,600
question is, is this shin 
splints or medial tibial stress 

468
00:26:14,600 --> 00:26:17,120
syndrome or is this a stress 
fracture? 

469
00:26:17,560 --> 00:26:19,720
So how do you answer that 
question? 

470
00:26:20,760 --> 00:26:24,720
So that's a great 1 here. 
And I think we could have said 

471
00:26:24,720 --> 00:26:26,040
this maybe towards the beginning
too. 

472
00:26:26,040 --> 00:26:29,920
But one of the first ways to 
assess to see if you even have 

473
00:26:29,920 --> 00:26:34,080
maybe up to tibial stretch 
syndrome is to start to palpate 

474
00:26:34,520 --> 00:26:40,200
and start to see if there is an 
area of about 3 inches or so 

475
00:26:40,640 --> 00:26:45,800
along the between the lower 3rd 
and middle third of your shin. 

476
00:26:46,080 --> 00:26:49,280
If you have tenderness along 
that Ridge of the bone right 

477
00:26:49,280 --> 00:26:53,440
there that a lot of the times is
that medial tibial stress 

478
00:26:53,440 --> 00:26:56,400
syndrome where it's about a more
diffuse area. 

479
00:26:56,760 --> 00:27:00,880
When we start to see it progress
towards stress fracture, we 

480
00:27:00,880 --> 00:27:05,000
start to see it gets pretty 
focal and there's a very high 

481
00:27:05,000 --> 00:27:08,840
amount of pain in one specific 
area here. 

482
00:27:09,200 --> 00:27:12,240
That's where we start to get a 
little bit more concerned that 

483
00:27:12,240 --> 00:27:15,320
it's not diffused. 
Now it's become fairly focal. 

484
00:27:15,840 --> 00:27:18,120
Couple other things to look out 
for too. 

485
00:27:18,360 --> 00:27:21,040
One of the big things I always 
ask is, are you having pain at 

486
00:27:21,040 --> 00:27:23,760
night? 
Are you having pain when you're 

487
00:27:23,760 --> 00:27:27,280
unloaded, when you're sleeping 
at night, when the bone is 

488
00:27:27,280 --> 00:27:31,120
starting to do some of its 
regenerative process here? 

489
00:27:31,400 --> 00:27:34,560
If you're getting a lot of pain 
there, that's a warning sign. 

490
00:27:35,240 --> 00:27:39,960
And then I actually there is a 
test that I use from a study, 

491
00:27:40,720 --> 00:27:44,760
It's a fairly recent one. 
It's the single leg hop test. 

492
00:27:45,240 --> 00:27:49,000
And if you, are you familiar 
with that one, if you do like 10

493
00:27:49,000 --> 00:27:55,560
hops on single leg, if you can't
do that, it's fairly sensitive 

494
00:27:56,080 --> 00:27:59,200
to say whether you have a bone 
stress injury. 

495
00:27:59,200 --> 00:28:02,200
So it can't. 
What that means is you're not 

496
00:28:02,200 --> 00:28:07,600
saying that you have a fracture 
if you can't hop 10 times in a 

497
00:28:07,600 --> 00:28:12,240
row because of pain, But what 
you are saying is it's very 

498
00:28:12,240 --> 00:28:17,920
unlikely that you do have a 
stress factor if you can hop 10 

499
00:28:17,920 --> 00:28:22,040
times on a single leg without 
having to stop through the pain.

500
00:28:22,400 --> 00:28:26,160
So that's an important one. 
If you're at home and looking to

501
00:28:26,160 --> 00:28:27,960
say, hey, should I go for that 
run? 

502
00:28:28,240 --> 00:28:31,000
Should I do this? 
Or am I getting closer to stress

503
00:28:31,000 --> 00:28:34,080
fracture? 
Those are some things that I use

504
00:28:34,160 --> 00:28:38,480
clinically to be able to help my
patients understand if it's 

505
00:28:38,480 --> 00:28:42,400
something that we should be 
getting some more input on or if

506
00:28:42,400 --> 00:28:44,200
it's something that we can keep 
pushing through. 

507
00:28:45,040 --> 00:28:48,880
Yeah, that's a good distinction.
I the that focal tenderness is 

508
00:28:48,880 --> 00:28:52,360
super helpful. 
And again, so if you're if 

509
00:28:52,360 --> 00:28:56,000
you're pushing on that shin on 
the inside Ridge and it's a very

510
00:28:56,000 --> 00:28:59,760
small like less than you know, 
basically one fingers with if 

511
00:28:59,760 --> 00:29:02,720
that's the only tender area, 
that's a little bit on the more 

512
00:29:02,720 --> 00:29:05,160
concerning side. 
If you haven't seen somebody 

513
00:29:05,160 --> 00:29:09,200
might be worth like calling up 
your favorite PT and working 

514
00:29:09,200 --> 00:29:11,600
with them on it. 
But if it's this really diffuse 

515
00:29:11,600 --> 00:29:15,320
thing, probably less likely that
you're looking at an actual 

516
00:29:15,320 --> 00:29:19,040
stress fracture with the hop 
test. 

517
00:29:19,040 --> 00:29:21,720
I just want to ask a clarifying 
question with how you use it and

518
00:29:21,720 --> 00:29:25,040
how people can think about this.
If they're doing it at home, if 

519
00:29:25,040 --> 00:29:28,600
there's like some soreness but 
they can do the hops through it,

520
00:29:28,800 --> 00:29:32,120
that's still considered a 
negative test and it's less 

521
00:29:32,120 --> 00:29:34,600
likely that it's a stress 
fracture. 

522
00:29:34,600 --> 00:29:37,920
It's just that you try to do 10 
and the pain's so bad that you 

523
00:29:37,920 --> 00:29:40,440
have to stop. 
Am I interpreting that 

524
00:29:40,440 --> 00:29:42,640
correctly? 
That's how I use it, yes, 

525
00:29:42,760 --> 00:29:44,640
correctly. 
I forget the study. 

526
00:29:44,640 --> 00:29:47,400
It's been a little bit since 
I've read the study around it 

527
00:29:47,400 --> 00:29:50,120
there. 
But what I say is like, hey, 

528
00:29:50,320 --> 00:29:54,680
like I will stop somebody. 
Oh, if they're doing it in front

529
00:29:54,680 --> 00:29:57,840
of me and I start to notice 
maybe they were getting 2 inches

530
00:29:57,840 --> 00:29:59,960
off the ground and now it's like
they're barely getting off the 

531
00:29:59,960 --> 00:30:01,600
ground and they're kind of 
cheating it. 

532
00:30:01,920 --> 00:30:06,720
If they're doing consistent 10 
hops in a row without resting, 

533
00:30:06,960 --> 00:30:10,920
kind of like a Pogo hop, if you 
can do ten of those in a row, 

534
00:30:11,320 --> 00:30:15,080
then you're pretty good. 
Now if you can't walk for an 

535
00:30:15,080 --> 00:30:18,800
hour after that, you got your 
answer basically that you need 

536
00:30:18,800 --> 00:30:20,560
to go figure it out. 
Yeah. 

537
00:30:20,560 --> 00:30:24,320
I think it's important that you 
have these kind of clinical 

538
00:30:24,320 --> 00:30:27,120
based tests that you can just 
real quickly say, you know, 

539
00:30:27,160 --> 00:30:30,760
should I go run or shouldn't I 
do your hop test That'll help 

540
00:30:30,760 --> 00:30:32,400
you figure it out. 
Great. 

541
00:30:33,240 --> 00:30:35,760
All right. 
Our next most common question is

542
00:30:35,760 --> 00:30:38,560
one that's pretty logical in 
this progression of people 

543
00:30:38,560 --> 00:30:41,600
experiencing pain. 
Usually they're like, my shin's 

544
00:30:41,600 --> 00:30:42,560
hurting. 
What is it? 

545
00:30:42,560 --> 00:30:45,240
Is this a stress fracture? 
And then they're like, why did 

546
00:30:45,240 --> 00:30:47,880
this happen in the 1st place? 
Because if I can figure out what

547
00:30:47,880 --> 00:30:50,960
happened, maybe I can fix it. 
So if I can get to the root of 

548
00:30:50,960 --> 00:30:54,480
what caused it, I can fix it. 
So I think the next most common 

549
00:30:54,480 --> 00:30:58,760
question is what is the thing 
that's causing shin splints and 

550
00:30:58,760 --> 00:31:01,680
that has all of these Does blank
cause shin splints? 

551
00:31:01,680 --> 00:31:03,640
Like did my shoes cause my shin 
splints? 

552
00:31:03,640 --> 00:31:05,280
Did my form 'cause my shin 
splints? 

553
00:31:05,280 --> 00:31:06,960
Did my training 'cause my shin 
splints? 

554
00:31:06,960 --> 00:31:09,280
Those are all the questions that
fit under this umbrella. 

555
00:31:09,720 --> 00:31:13,720
How do you think about what 
causes this condition for 

556
00:31:13,720 --> 00:31:17,360
people? 
Yeah, it's that probably is the 

557
00:31:17,360 --> 00:31:18,960
first. 
The first question is going to 

558
00:31:18,960 --> 00:31:21,800
be kind of run, but probably the
first question should be this 

559
00:31:21,800 --> 00:31:24,640
one of like what caused this in 
the 1st place there. 

560
00:31:24,640 --> 00:31:26,840
That's going to be their last 
question after you've educated 

561
00:31:26,840 --> 00:31:29,560
them a little bit. 
But it's a really important one.

562
00:31:29,560 --> 00:31:35,080
And I think if we listed kind of
in a hierarchy, training is 

563
00:31:35,080 --> 00:31:37,520
probably one of the most 
important ones here. 

564
00:31:37,840 --> 00:31:40,720
I think this is one that you 
have to address and really look 

565
00:31:40,720 --> 00:31:46,440
at right away and review the 
training program to see where 

566
00:31:46,440 --> 00:31:50,960
did I spike my intensity, where 
did I spike my long runs? 

567
00:31:50,960 --> 00:31:53,000
I mean, there's lots of good. 
We could go into a whole 

568
00:31:53,000 --> 00:31:59,200
conversation about acute to 
chronic workload ratios and 10% 

569
00:31:59,200 --> 00:32:01,920
rules and all those kind of 
things and what's good, what's 

570
00:32:01,920 --> 00:32:05,680
not good. 
And I think it's important. 

571
00:32:05,680 --> 00:32:12,960
I, I will just say that if you 
can identify and track a like in

572
00:32:12,960 --> 00:32:17,200
your training load, that's 
really important to address and 

573
00:32:17,200 --> 00:32:21,280
try to avoid that from happening
again because that is 100% 

574
00:32:21,280 --> 00:32:24,120
preventable. 
I'll never forget when I first 

575
00:32:24,120 --> 00:32:28,160
started working with a lot of 
professional runners, I was 

576
00:32:28,160 --> 00:32:32,280
treating this one professional 
runner and he almost, he was 

577
00:32:32,760 --> 00:32:34,440
really hesitant to tell me 
something. 

578
00:32:34,440 --> 00:32:36,400
I was like, like, what's going 
on? 

579
00:32:36,400 --> 00:32:38,680
What like, why didn't you want 
to tell this? 

580
00:32:38,680 --> 00:32:41,800
He's like, I'm embarrassed. 
I have shin splints. 

581
00:32:42,240 --> 00:32:47,080
He's like, I haven't had in pain
since I was a JV runner in high 

582
00:32:47,080 --> 00:32:49,480
school, but I feel embarrassed 
to have. 

583
00:32:49,480 --> 00:32:52,400
It was like, don't worry, it 
happened to a lot of people 

584
00:32:52,400 --> 00:32:56,080
actually there. 
And it is very much related to 

585
00:32:56,080 --> 00:32:58,640
training. 
And we were able to trace back a

586
00:32:58,640 --> 00:33:03,160
spike in that person's training 
and we're able to address it. 

587
00:33:03,160 --> 00:33:05,960
And it can go away pretty 
quickly once you know how to 

588
00:33:05,960 --> 00:33:10,840
address it, ma'am. 
So that's got to be #1 priority 

589
00:33:10,840 --> 00:33:14,000
is, is looking at training. 
Then I think this is the big 

590
00:33:14,000 --> 00:33:17,560
part, and one of my favorite is 
an underlooked thing is actually

591
00:33:17,560 --> 00:33:20,160
the running form. 
I think this has to be looked 

592
00:33:20,160 --> 00:33:22,040
at. 
It has to be something that we 

593
00:33:22,040 --> 00:33:26,480
look at and with a fine tooth 
comb and and try to get to that 

594
00:33:26,480 --> 00:33:29,120
root cause of what is 
contributing to this. 

595
00:33:29,720 --> 00:33:32,480
This is one of the injuries that
does have pretty good evidence 

596
00:33:32,480 --> 00:33:36,240
to show that there are 
biomechanical changes. 

597
00:33:36,240 --> 00:33:38,720
So people's running form is 
different. 

598
00:33:39,560 --> 00:33:42,800
I think there could be a little 
bit better evidence about like, 

599
00:33:43,240 --> 00:33:46,520
is this a result of the pain 
that they're different or is 

600
00:33:46,520 --> 00:33:51,080
this the cause of the pain? 
But there's enough evidence in 

601
00:33:51,080 --> 00:33:54,360
my mind to start to see that 
this is something that we're 

602
00:33:54,360 --> 00:33:58,760
seeing before people get this 
injury that they're going into 

603
00:33:58,760 --> 00:34:02,440
some of that excessive pronation
and they're in that collapsing 

604
00:34:02,440 --> 00:34:04,760
category. 
So we've got these five 

605
00:34:04,760 --> 00:34:08,199
categories of runners that we 
talk about a lot that run DNA 

606
00:34:08,840 --> 00:34:12,600
and in that collapser is a big 
one or basically the knees are 

607
00:34:12,600 --> 00:34:16,440
coming in, the feet are you're 
coming in, toes are rotating 

608
00:34:16,440 --> 00:34:18,840
out. 
That changes the stress on the 

609
00:34:18,840 --> 00:34:23,040
body because our bones are 
really good at loading straight 

610
00:34:23,040 --> 00:34:26,000
up and down, but they don't like
any twisting. 

611
00:34:26,440 --> 00:34:29,120
And one of the things we teach 
and of course is that when you 

612
00:34:29,120 --> 00:34:35,199
get that twisting motion, your 
bones only can absorb 59% of 

613
00:34:35,199 --> 00:34:40,480
their normal capacity, which is 
not enough to run downhill 

614
00:34:40,719 --> 00:34:44,239
without causing micro trauma to 
your bone. 

615
00:34:44,800 --> 00:34:49,000
So if you think about that like 
this is a Bony type injury that 

616
00:34:49,000 --> 00:34:52,840
we're talking about here, we 
need to address those mechanics 

617
00:34:52,840 --> 00:34:57,560
and we need to identify if we 
are a collapser, if there are 

618
00:34:57,560 --> 00:35:01,240
those things going on. 
We can also see the high forces 

619
00:35:01,240 --> 00:35:04,760
related to over Strider, one of 
the other five categories that 

620
00:35:04,760 --> 00:35:07,920
we talked about. 
If the forces are high and we're

621
00:35:07,920 --> 00:35:10,480
really not observable absorbing 
of forces in the appropriate 

622
00:35:10,480 --> 00:35:13,480
structure, then something else 
is going to take more of the 

623
00:35:13,480 --> 00:35:16,600
forces and it should and that's 
where we can get some of these 

624
00:35:16,600 --> 00:35:19,880
influence as well. 
So I think addressing those two 

625
00:35:19,880 --> 00:35:25,440
big categories is really 
important from a gate or running

626
00:35:25,440 --> 00:35:29,000
form standpoint with runners. 
I've, I've got a question for 

627
00:35:29,000 --> 00:35:33,560
you and I, I know that there are
mixed opinions on the answer to 

628
00:35:33,560 --> 00:35:35,080
the question that I'm about to 
ask you. 

629
00:35:35,200 --> 00:35:37,160
And so I'm just curious about 
yours. 

630
00:35:38,240 --> 00:35:40,640
You've, you talked about those 
common patterns that we're 

631
00:35:40,640 --> 00:35:43,840
seeing with the bone loading and
then you said what's not super 

632
00:35:43,840 --> 00:35:47,400
clear in the evidence is whether
it's causing it or if it's a 

633
00:35:47,400 --> 00:35:49,520
result of. 
So if you're looking at 

634
00:35:49,520 --> 00:35:51,600
somebody, we already talked 
about some of the common 

635
00:35:51,600 --> 00:35:54,560
prevention things and we talked 
about calf strengthening and hip

636
00:35:54,560 --> 00:35:58,840
stuff in terms of the doing hip 
kind of coordination control 

637
00:35:58,840 --> 00:36:02,920
exercise with bare feet. 
Is changing running form 

638
00:36:02,920 --> 00:36:05,480
something that you do for 
prevention of shin splints as 

639
00:36:05,480 --> 00:36:06,840
well? 
Where do you fall on that 

640
00:36:06,840 --> 00:36:10,240
spectrum of like every 
collapser? 

641
00:36:10,240 --> 00:36:13,320
Do you change you try to change 
their gait or are some 

642
00:36:13,320 --> 00:36:16,040
collapsers fine to be collapsers
because their bodies adapted to 

643
00:36:16,040 --> 00:36:17,040
it? 
Where do you live? 

644
00:36:18,680 --> 00:36:21,000
I'm going to take a strong 
stance on this because I've 

645
00:36:21,000 --> 00:36:23,960
been, I've been getting this 
question for a long time and I 

646
00:36:23,960 --> 00:36:28,120
think we're doing a disservice 
to people by not changing the 

647
00:36:28,120 --> 00:36:30,960
mechanics if we see these 
mechanics happening. 

648
00:36:31,640 --> 00:36:33,760
And that's a strong stance on 
it. 

649
00:36:33,920 --> 00:36:37,480
And I know that there are people
that will outright disagree with

650
00:36:37,480 --> 00:36:41,640
me on it, but I am going to say 
those people just aren't injured

651
00:36:41,640 --> 00:36:47,280
yet. 
There is a high amount of load 

652
00:36:47,280 --> 00:36:53,320
that are in stress that our body
occurs when we are running and 

653
00:36:53,400 --> 00:36:55,840
they're the person that has bad 
mechanics. 

654
00:36:55,840 --> 00:37:00,200
Even if they're not injured, 
they might be 1 bad night sleep 

655
00:37:00,200 --> 00:37:04,160
away from not being able to 
absorb the forces anymore. 

656
00:37:04,480 --> 00:37:08,760
They might switch from training 
for five KS to going to 1/2 

657
00:37:08,760 --> 00:37:13,600
marathon and that form that 
wasn't an issue now is going to 

658
00:37:13,600 --> 00:37:17,440
become an issue. 
And I've been very successful in

659
00:37:17,440 --> 00:37:22,200
my career of helping people to 
improve their running gate 

660
00:37:22,520 --> 00:37:25,560
because I think here's here's 
the caveat to this and why I'm 

661
00:37:25,560 --> 00:37:28,760
so strong on this. 
You don't have to make somebody 

662
00:37:28,760 --> 00:37:32,320
perfect. 
We're just going for a 10% 

663
00:37:32,320 --> 00:37:34,400
improvement in the running 
mechanics. 

664
00:37:35,120 --> 00:37:39,640
It's so I'm strong on the front 
of it, but I'm a little bit more

665
00:37:39,640 --> 00:37:42,800
moderate in the middle. 
It's like, we absolutely need to

666
00:37:42,880 --> 00:37:45,360
address that, but they 
absolutely don't have to be 

667
00:37:45,360 --> 00:37:48,240
perfect. 
We need to think about can we 

668
00:37:48,240 --> 00:37:50,520
reduce it? 
Because what the science shows 

669
00:37:50,520 --> 00:37:54,920
is that tissues like bone, if 
you reduce the stress by 10%, 

670
00:37:54,920 --> 00:38:00,360
they can run twice as far before
the body breaks down. 10% is so 

671
00:38:00,360 --> 00:38:04,000
easy to do. 
It is something that is when you

672
00:38:04,000 --> 00:38:08,560
find the right thing, it makes 
all the difference in the world.

673
00:38:09,200 --> 00:38:12,760
It's so that's where you need to
do a good job of, of doing the 

674
00:38:12,760 --> 00:38:16,360
running form analysis and you 
need to understand what could be

675
00:38:16,360 --> 00:38:18,040
contributing to it and what's 
not. 

676
00:38:18,360 --> 00:38:22,960
And when you find that right 
thing, making 10% no problem at 

677
00:38:22,960 --> 00:38:26,560
all. 
So I 100% think that running 

678
00:38:26,560 --> 00:38:29,920
form needs to be addressed for 
every single runner. 

679
00:38:30,520 --> 00:38:33,400
And the worst that's going to 
happen, I think is you probably 

680
00:38:33,400 --> 00:38:37,480
can run a little faster because 
you're running more efficiently 

681
00:38:37,920 --> 00:38:40,960
if you do the gateway training, 
right, Right. 

682
00:38:40,960 --> 00:38:43,440
You know, because you can't just
say, OK, change your form and go

683
00:38:43,440 --> 00:38:46,520
do it. 
Like a well trained qualified 

684
00:38:46,520 --> 00:38:48,920
professional is going to know 
how to get you to change your 

685
00:38:48,920 --> 00:38:53,520
form appropriately gradually so 
that you know exactly what to 

686
00:38:53,520 --> 00:38:55,440
do. 
And you do need guidance on 

687
00:38:55,440 --> 00:38:57,360
this. 
We're one of the few sports that

688
00:38:57,360 --> 00:39:00,240
things like, oh, we don't need 
coaches, We don't need pros. 

689
00:39:00,480 --> 00:39:04,320
Like, yeah, I mean, how many 
people make a living as a golf 

690
00:39:04,320 --> 00:39:08,160
pro or a tennis pro, right? 
Where's our running pros? 

691
00:39:08,280 --> 00:39:10,320
Right. 
Our running pros need to be out 

692
00:39:10,320 --> 00:39:15,880
there too because it's it's more
important than I would say even 

693
00:39:15,880 --> 00:39:18,760
than swinging a Golf Club 
correctly or a tennis racket. 

694
00:39:19,480 --> 00:39:21,960
Yeah, that's great. 
And I think something that you 

695
00:39:21,960 --> 00:39:24,600
said that's interesting is 
having it guided by a 

696
00:39:24,600 --> 00:39:25,960
professional. 
It's going to probably take a 

697
00:39:25,960 --> 00:39:29,000
while. 
I kind of have two swirling 

698
00:39:29,000 --> 00:39:31,680
thoughts in my head, so we'll 
see if I get them out coherently

699
00:39:31,680 --> 00:39:35,480
or not. 
One of them is when you think 

700
00:39:35,480 --> 00:39:39,400
about when to do this, like is 
this something that you'd I work

701
00:39:39,400 --> 00:39:42,520
with a lot of college runners is
changing running form something 

702
00:39:42,520 --> 00:39:45,360
you do during the cross country 
season or is it in the 

703
00:39:45,360 --> 00:39:48,360
offseason? 
Is is changing your running 

704
00:39:48,360 --> 00:39:49,520
form? 
Again, we're talking on a 

705
00:39:49,520 --> 00:39:51,640
preventative lens. 
These are non injured yes. 

706
00:39:52,360 --> 00:39:54,760
Is this something that you do 
with a runner during their 

707
00:39:54,760 --> 00:39:56,880
marathon training block or 
during an offseason? 

708
00:39:56,880 --> 00:39:59,440
So my first question is kind of 
like what do you think is the 

709
00:39:59,440 --> 00:40:04,080
appropriate time to do this The?
Best time would be in going back

710
00:40:04,080 --> 00:40:06,680
to periodization in that base 
phase, right? 

711
00:40:06,680 --> 00:40:10,840
You're in a pretty base or 
you're in the base phase and 

712
00:40:10,840 --> 00:40:14,280
you're doing lots of easy stuff,
not a lot of intensity. 

713
00:40:14,280 --> 00:40:16,360
It's a great time to just work 
on the forum. 

714
00:40:16,680 --> 00:40:19,400
I think everyone should get a 
running forum analysis at a 

715
00:40:19,400 --> 00:40:22,680
minimum 4 * a year. 
I think you should be checking 

716
00:40:22,680 --> 00:40:27,840
on it quarterly and just see 
things change when we get stiff,

717
00:40:27,840 --> 00:40:31,960
when we get weak, when we get 
overtrained or undertrained, our

718
00:40:31,960 --> 00:40:34,680
running form can change and we 
should be checking up on it 

719
00:40:34,680 --> 00:40:38,480
there. 
So, yeah, I that was a tangent. 

720
00:40:38,480 --> 00:40:41,120
I don't know if I got that. 
That's great question there. 

721
00:40:41,440 --> 00:40:43,960
Kind of timing. 
Yeah, timing. 

722
00:40:44,880 --> 00:40:48,640
The other part of the timing 
issue is like I had a runner 

723
00:40:48,640 --> 00:40:53,560
come in, had seen four or five 
other providers having different

724
00:40:53,560 --> 00:40:58,480
injury, but IT band issues and 
we were going through and 

725
00:40:58,480 --> 00:41:01,920
there's three or four weeks left
in the press country season and 

726
00:41:01,920 --> 00:41:05,560
this is, you know, not 
preventative, but I'm absolutely

727
00:41:05,560 --> 00:41:08,240
changing the running mechanics 
on that person. 

728
00:41:08,600 --> 00:41:14,360
And we saw an instant reduction 
of pain by over 50% with three 

729
00:41:14,360 --> 00:41:16,960
minutes of drills and two 
minutes of gait retraining. 

730
00:41:18,360 --> 00:41:23,000
It's huge. 
And I think if runners are 

731
00:41:23,000 --> 00:41:25,840
honest with themselves in the 
middle of the season like this, 

732
00:41:25,840 --> 00:41:28,240
and we talked about the 
preventative, most of the time 

733
00:41:28,240 --> 00:41:31,160
they're going to be having some 
sort of ache or pain. 

734
00:41:31,720 --> 00:41:35,280
And if you can relate it back to
what you're seeing in the 

735
00:41:35,280 --> 00:41:39,000
running form analysis, then I 
would address that as well too. 

736
00:41:39,280 --> 00:41:43,000
Even if it's just how quickly am
I going to get them to change 

737
00:41:43,000 --> 00:41:46,200
their form? 
Depends on how much it's 

738
00:41:46,200 --> 00:41:48,440
impacting their current running 
abilities. 

739
00:41:49,840 --> 00:41:52,640
I work, so I work two days a 
week. 

740
00:41:52,640 --> 00:41:55,920
We have runners come in from the
cross country team and students 

741
00:41:55,920 --> 00:42:00,240
are leading them through 
evaluations for 3D run analysis 

742
00:42:00,240 --> 00:42:02,760
that we use, strength, mobility,
functional movement, and we kind

743
00:42:02,760 --> 00:42:06,000
of assess their 2D motion during
like step downs and squats and 

744
00:42:06,000 --> 00:42:09,600
things like that too. 
And we always do an early 

745
00:42:09,600 --> 00:42:11,200
subjective asking them 
questions. 

746
00:42:11,200 --> 00:42:13,200
And the questions always ask, 
hey, have you had any recent 

747
00:42:13,200 --> 00:42:15,720
running injuries? 
And they always say no. 

748
00:42:16,000 --> 00:42:19,880
And most of the students haven't
either aren't, like, intense 

749
00:42:19,880 --> 00:42:21,880
runners or haven't worked with 
runners before. 

750
00:42:22,200 --> 00:42:23,880
And so I check in with him 
after. 

751
00:42:23,880 --> 00:42:26,120
Hey, would you learn about them?
Yeah, Everything's good. 

752
00:42:26,120 --> 00:42:28,600
There's no pain. 
And we're going to keep going 

753
00:42:28,600 --> 00:42:30,640
with the evaluation. 
Then I go, OK, great. 

754
00:42:30,640 --> 00:42:32,520
I'm just going to come chat with
him for a minute. 

755
00:42:32,520 --> 00:42:35,080
And then I'm like, oh, have you 
had any niggles in the last 

756
00:42:35,080 --> 00:42:36,160
week? 
Like, anything bugging you? 

757
00:42:36,160 --> 00:42:38,840
And like, oh, yeah, my hamstring
and my foot and my knee and 

758
00:42:38,840 --> 00:42:42,480
like, all of these things are 
hurting, but runners just take 

759
00:42:42,480 --> 00:42:44,720
that as normal, right? 
Like, oh, I have these things 

760
00:42:44,720 --> 00:42:48,040
that hurt. 
And so the reality, like you're 

761
00:42:48,040 --> 00:42:50,960
saying, is if things are 
hurting, now is the time to 

762
00:42:50,960 --> 00:42:53,720
maybe modify something to 
decrease some of those symptoms.

763
00:42:55,000 --> 00:42:55,960
Right. 
It doesn't have to. 

764
00:42:56,080 --> 00:42:59,520
Don't wait for it to be an 
injury that they need to stop 

765
00:42:59,520 --> 00:43:02,360
running for it. 
You made a really good point 

766
00:43:02,360 --> 00:43:06,840
that pain is an acceptable part 
of the sport for most people, 

767
00:43:07,240 --> 00:43:09,440
right? 
And it doesn't have. 

768
00:43:09,440 --> 00:43:12,760
To be, doesn't have to be. 
Like we can't address that. 

769
00:43:12,760 --> 00:43:14,880
Like running doesn't have to 
hurt. 

770
00:43:15,160 --> 00:43:19,360
Yeah, Yeah, it's so good. 
The the other thing that I was 

771
00:43:19,360 --> 00:43:22,200
thinking about as you're talking
about this, because I think from

772
00:43:22,200 --> 00:43:24,840
your end of the spectrum on we 
should retrain everybody. 

773
00:43:24,840 --> 00:43:28,360
I kind of sit a little bit more 
in the middle and I think part 

774
00:43:28,360 --> 00:43:33,160
of my hesitancy is the 
implications of gait related 

775
00:43:33,160 --> 00:43:35,600
changes. 
So if you like change gait, 

776
00:43:35,720 --> 00:43:38,240
that's going to shift load 
places and if you don't know 

777
00:43:38,240 --> 00:43:40,680
what those changes are, you can 
just cause new problems. 

778
00:43:40,680 --> 00:43:47,840
That's one potential downfall. 
And so I in my mind, it's man, 

779
00:43:47,840 --> 00:43:50,800
if you're all on your own and 
you go try to change your gait, 

780
00:43:50,800 --> 00:43:52,840
you could be setting yourself up
for something worse. 

781
00:43:52,840 --> 00:43:56,040
Or even if you're seeing APT, 
but they don't know running gait

782
00:43:56,040 --> 00:43:58,960
mechanics, they could also screw
you up too. 

783
00:43:58,960 --> 00:44:02,640
Like just things that in a in 
some worlds would be a good 

784
00:44:02,640 --> 00:44:05,720
thing, whether that's cadence 
increase or whatever it is. 

785
00:44:05,960 --> 00:44:08,520
Like they seem like a good idea,
but they could cause problems. 

786
00:44:08,520 --> 00:44:11,960
So I get a little more yellow 
lighty with it, like less ready 

787
00:44:11,960 --> 00:44:15,960
to go change everybody's. 
But maybe that's when I expand 

788
00:44:15,960 --> 00:44:19,240
it to like everyone else's scope
of practice versus like my own 

789
00:44:19,400 --> 00:44:22,560
decision making. 
I think if that makes sense. 

790
00:44:22,600 --> 00:44:26,360
And then the other thing I say 
to students a lot when we're in 

791
00:44:26,360 --> 00:44:29,080
the running clinic is you're 
going to observe a lot of 

792
00:44:29,080 --> 00:44:32,280
things, but it doesn't I, I say 
this, I'm like, but it doesn't 

793
00:44:32,280 --> 00:44:34,960
matter unless it does. 
Like if somebody's got a bunion 

794
00:44:34,960 --> 00:44:38,840
deformity or somebody has kind 
of a pronated foot posture with 

795
00:44:38,840 --> 00:44:42,920
no arch or they have a really 
high arch, don't automatically 

796
00:44:42,920 --> 00:44:45,600
assume that needs to be 
addressed unless it matters. 

797
00:44:45,600 --> 00:44:48,200
So I always, I have that like 
lens too, or it's like, Oh, 

798
00:44:48,200 --> 00:44:52,040
maybe you see some collapsing, 
but does that matter for them in

799
00:44:52,040 --> 00:44:54,720
this scenario? 
You know, if they I I think of 

800
00:44:54,720 --> 00:44:58,520
like this is anecdote, but I 
look at like Conor Mance run and

801
00:44:58,520 --> 00:45:00,680
the dudes running with his 
knees, like touching each other,

802
00:45:00,680 --> 00:45:02,760
right. 
Yeah, yeah, and and. 

803
00:45:02,760 --> 00:45:04,480
Just set the American record 
today. 

804
00:45:04,960 --> 00:45:08,320
Yeah, exactly. 
So I'm like, oh, then there's 

805
00:45:08,320 --> 00:45:11,160
these guys like this that it's 
like doesn't matter that he 

806
00:45:11,160 --> 00:45:16,080
maybe has femoral antiversion 
and then also maybe has like 

807
00:45:16,080 --> 00:45:17,840
high Q angle and all these 
things. 

808
00:45:18,360 --> 00:45:20,160
What's your thoughts on some of 
this? 

809
00:45:21,000 --> 00:45:23,840
I, I and I love this 
conversation too. 

810
00:45:23,840 --> 00:45:25,760
Yeah. 
Because it's like, yeah, see, my

811
00:45:25,800 --> 00:45:27,400
friends just I'm going to change
everyone. 

812
00:45:27,520 --> 00:45:31,240
But I also have a holistic view 
of them before I get anybody on 

813
00:45:31,240 --> 00:45:33,280
the treadmill. 
I know what their range of 

814
00:45:33,280 --> 00:45:36,040
motion is, their strength is. 
I know what their training 

815
00:45:36,040 --> 00:45:37,840
history is. 
I know what they sleep. 

816
00:45:37,840 --> 00:45:39,920
I know how. 
Like there are so many other 

817
00:45:39,920 --> 00:45:43,200
things to address too. 
And we do need to have the 

818
00:45:43,200 --> 00:45:47,240
foundations of health in place 
before we start focusing on 

819
00:45:47,240 --> 00:45:49,880
sports and performance and bio 
mechanics and some of those 

820
00:45:49,880 --> 00:45:52,480
things too. 
Like listen, I could do gait 

821
00:45:52,480 --> 00:45:54,760
retraining with everyone, but if
they're sleeping 4 hours a 

822
00:45:54,760 --> 00:45:56,280
night, it's like it's not going 
to help. 

823
00:45:57,200 --> 00:46:02,840
So we do need to look at kind of
a periodized approach to that as

824
00:46:02,840 --> 00:46:04,920
well here. 
Like hey, at the bottom of the 

825
00:46:04,920 --> 00:46:07,640
pyramid is health, you know? 
Then we're going to focus on 

826
00:46:07,640 --> 00:46:11,680
basic range of motion and 
mobility and strength and then 

827
00:46:11,680 --> 00:46:14,280
we can start to get movement 
patterns involved and do some of

828
00:46:14,280 --> 00:46:19,880
those other things too. 
I guess I'm just strong on it 

829
00:46:20,480 --> 00:46:24,080
because I think it's something 
that people don't look at. 

830
00:46:24,320 --> 00:46:29,040
And you are right that there is 
often times unintended 

831
00:46:29,400 --> 00:46:31,760
consequences of changing people 
gait. 

832
00:46:32,120 --> 00:46:35,520
And you know, you and I both 
have the advantage of seeing 

833
00:46:35,520 --> 00:46:39,560
those objectively with 3D, when 
we change somebody's state, we 

834
00:46:39,600 --> 00:46:42,520
can be like, oh, when we did 
this, this change. 

835
00:46:42,760 --> 00:46:45,840
So just think about leaning a 
little forward when you do that 

836
00:46:45,840 --> 00:46:47,200
too. 
And that should address that. 

837
00:46:47,600 --> 00:46:49,640
So doing this on your own is 
hard. 

838
00:46:49,640 --> 00:46:52,160
And that's, I'll go back to the 
point like we need those running

839
00:46:52,160 --> 00:46:56,120
pros that are really able to 
teach us how to run 

840
00:46:56,120 --> 00:46:59,720
appropriately. 
That is a really important part 

841
00:46:59,720 --> 00:47:04,000
of that. 
But if you're just making small 

842
00:47:04,000 --> 00:47:06,760
minor changes and listening to 
it and and adapting them 

843
00:47:06,760 --> 00:47:12,040
gradually where I had, I had a 
literally a Olympic medalist 

844
00:47:12,040 --> 00:47:15,920
come in to me and I was changing
the gate and I had him on a run 

845
00:47:15,920 --> 00:47:19,360
walk program. 
This is a person that is the 

846
00:47:19,360 --> 00:47:21,320
fastest in the world at their 
sport. 

847
00:47:21,760 --> 00:47:25,240
And I said, you're going to run 
for two minutes and walk for a 

848
00:47:25,240 --> 00:47:27,240
minute. 
And he looked at me and I was 

849
00:47:27,240 --> 00:47:33,400
like, trust me, it's going to 
work and it'll work. 

850
00:47:33,480 --> 00:47:38,520
So if you have to take it there,
there's so much to running form.

851
00:47:38,520 --> 00:47:42,840
And I, I don't know, I, I, I, I 
go back and forth between 

852
00:47:42,840 --> 00:47:44,600
letting people know. 
Like it's actually really 

853
00:47:44,880 --> 00:47:48,240
complex, but it's also really 
simple to like find something, 

854
00:47:48,240 --> 00:47:51,120
get to the repose and like, it 
doesn't have to take a whole lot

855
00:47:51,120 --> 00:47:52,840
of effort. 
You just need to make sure 

856
00:47:52,840 --> 00:47:55,320
you're doing the right thing. 
Yeah, that's great. 

857
00:47:55,840 --> 00:48:00,280
Super fun, I think. 
I think that being able to 

858
00:48:00,280 --> 00:48:04,280
actually address running form, 
despite my more moderate stance,

859
00:48:04,720 --> 00:48:08,880
is a huge boon to people, 
particularly when you have them 

860
00:48:09,120 --> 00:48:11,920
starting to make those changes 
and preparing all of the other 

861
00:48:11,920 --> 00:48:14,560
holistic parts. 
And we preach that here at 

862
00:48:14,560 --> 00:48:18,120
Doctors of Running that like 
sleep, nutrition, hydration, 

863
00:48:18,280 --> 00:48:22,520
stress levels, baseline stuff 
like every other thing is like 

864
00:48:22,520 --> 00:48:25,400
the cherry on top in some ways. 
There's other more foundational 

865
00:48:25,400 --> 00:48:31,040
things, but you got to have that
as a foundation and otherwise 

866
00:48:31,040 --> 00:48:34,080
these other little fun things 
like Norma Norma tech boots or 

867
00:48:34,080 --> 00:48:36,400
whatever aren't going to make 
the meaningful change. 

868
00:48:36,400 --> 00:48:38,760
They're not going to make up for
six hours lost of sleep. 

869
00:48:38,760 --> 00:48:41,160
So you got to got to get the 
foundation down. 

870
00:48:42,400 --> 00:48:44,720
Absolutely. 
Let's move to another question 

871
00:48:44,720 --> 00:48:47,400
that we spent a lot of time. 
I don't know how we got to where

872
00:48:47,400 --> 00:48:49,880
we got, but that was fun. 
Oh, no, I have to bring up one 

873
00:48:49,880 --> 00:48:51,400
more thing. 
It's funny. 

874
00:48:51,400 --> 00:48:54,440
I had a colleague who is 
actually a physics professor, 

875
00:48:54,640 --> 00:48:57,240
not at all in the physical 
therapy run, but he's a runner, 

876
00:48:57,240 --> 00:49:01,040
and he sent me this article that
was published in BJSM, so the 

877
00:49:01,040 --> 00:49:02,480
British Journal of Sports 
Medicine. 

878
00:49:02,760 --> 00:49:07,800
And it was a study of over 5200 
people and it was for runners. 

879
00:49:07,800 --> 00:49:11,080
And they were evaluating, I 
think it was Garmin data or some

880
00:49:11,280 --> 00:49:14,560
kind of data source to look at, 
like you were talking about 

881
00:49:14,560 --> 00:49:17,920
training errors as being one. 
And this 10% rule that's out 

882
00:49:17,920 --> 00:49:19,560
there. 
What they did with this one is 

883
00:49:19,560 --> 00:49:23,760
they they found, again, I have 
to look further into the study, 

884
00:49:23,760 --> 00:49:27,120
but they basically found that 
it's not only total workload 

885
00:49:27,120 --> 00:49:30,120
changes over time, but it's kind
of your longest effort and how 

886
00:49:30,120 --> 00:49:33,600
quickly you change that longest 
effort, the findings. 

887
00:49:33,600 --> 00:49:35,760
Of the study. 
Yeah, they basically found that 

888
00:49:35,760 --> 00:49:39,360
not 10% a week, but if you 
increase that longest run by 

889
00:49:39,360 --> 00:49:44,600
more than 10% that increased 
this cohorts injury risk as 

890
00:49:44,600 --> 00:49:47,200
compared to a more gradual 
return. 

891
00:49:47,560 --> 00:49:51,080
Do you mind spending just a few 
minutes on your perspective on 

892
00:49:51,440 --> 00:49:54,440
like, how to manage training 
load in a smart way? 

893
00:49:55,800 --> 00:50:01,040
Yeah, I think it really is 
important and it's something 

894
00:50:01,040 --> 00:50:04,280
that if we really had a great 
understanding, whoever can 

895
00:50:04,280 --> 00:50:08,560
figure this out is going to be a
billionaire because it is very 

896
00:50:08,560 --> 00:50:11,480
multifactorial. 
So to give a little color 

897
00:50:11,480 --> 00:50:15,360
background to the audience here,
you know, we're talking about 

898
00:50:15,360 --> 00:50:18,600
the stress that your body goes 
under and there's different ways

899
00:50:18,600 --> 00:50:21,680
to talk about that. 
There are internal stressors and

900
00:50:21,680 --> 00:50:27,440
there are external stressors and
we look a lot at the external 

901
00:50:27,440 --> 00:50:30,520
stressors and we say, oh, what's
my volume? 

902
00:50:30,520 --> 00:50:33,080
How long, how far did I run? 
How intense did I run? 

903
00:50:33,360 --> 00:50:36,280
Look at some of the things, but 
we're it's harder to quantify 

904
00:50:36,280 --> 00:50:39,960
some of the internal things. 
Not everyone has access to the 

905
00:50:39,960 --> 00:50:43,920
technology or there's even like 
more intricate cellular level 

906
00:50:43,920 --> 00:50:45,960
things that are going on while 
we're working out. 

907
00:50:45,960 --> 00:50:48,880
That's it's kind of hard to look
at some of those things. 

908
00:50:49,480 --> 00:50:55,280
So if you could quantify stress,
you would really be able to see 

909
00:50:55,280 --> 00:50:59,800
a lot of like that's what really
training load comes down to is 

910
00:50:59,800 --> 00:51:02,920
like how much stress that I put 
my body under and did I give 

911
00:51:02,920 --> 00:51:06,160
myself enough time to recover 
before my next session. 

912
00:51:06,520 --> 00:51:09,560
That's really in a nutshell is 
what we're looking for. 

913
00:51:09,560 --> 00:51:14,240
It did I hit, there's a super 
compensation law right where if 

914
00:51:14,240 --> 00:51:17,880
you do an exercise, your fitness
goes down a little bit, then it 

915
00:51:17,880 --> 00:51:20,400
actually goes back up. 
And if you time your next 

916
00:51:20,400 --> 00:51:23,880
workout perfectly, you go to the
peak where you went above your 

917
00:51:23,880 --> 00:51:27,680
baseline and now you're taking a
stepwise progression where your 

918
00:51:27,680 --> 00:51:29,080
fitness gets better, better, 
better. 

919
00:51:30,200 --> 00:51:37,720
So however, my stance on this is
actually fairly simple and has a

920
00:51:37,720 --> 00:51:39,720
decent amount of evidence to 
support this. 

921
00:51:39,720 --> 00:51:43,280
I know there's a little bit of 
conflicting recent studies that 

922
00:51:43,280 --> 00:51:46,600
have come out, but one of the 
best predictors of how hard a 

923
00:51:46,600 --> 00:51:50,760
workout was is your brain and 
your perception of it there. 

924
00:51:51,120 --> 00:51:56,480
The rate of perceived effort on 
a one to 10 scale is really good

925
00:51:56,480 --> 00:52:00,600
at taking into account. 
Hey, I ate Chinese food for 

926
00:52:00,600 --> 00:52:04,240
dinner last night and stayed up 
late to watch the Auburn 

927
00:52:04,240 --> 00:52:05,800
football game. 
True story. 

928
00:52:06,480 --> 00:52:12,800
So I, I, I didn't feel great 
today here, so Dave didn't. 

929
00:52:12,800 --> 00:52:15,680
Pull it out either. 
I know, I know. 

930
00:52:15,680 --> 00:52:20,800
That was a rougher theft, yes, 
but it would. 

931
00:52:21,160 --> 00:52:25,680
I knew that going into my run 
and I was able to say, hey, this

932
00:52:25,680 --> 00:52:27,920
run was a little harder today 
than it would have normally 

933
00:52:27,920 --> 00:52:31,680
been. 
So I think first of all we 

934
00:52:31,680 --> 00:52:35,960
should quantify it and I think 
people should be good self 

935
00:52:35,960 --> 00:52:39,120
assessors of how hard something 
really is. 

936
00:52:39,680 --> 00:52:43,720
Then that's the first step. 
The second step is looking at 

937
00:52:43,720 --> 00:52:47,960
that over a long enough period 
of time to understand how you 

938
00:52:47,960 --> 00:52:52,240
are truly adapted to the 
exercise that you want to do. 

939
00:52:52,840 --> 00:52:58,120
And what the Garmin study was 
saying I think is relevant where

940
00:52:58,400 --> 00:53:02,920
if you are increasing your 
longest run by more than 10% 

941
00:53:03,120 --> 00:53:06,040
compared to what you've done in 
the last month that that could 

942
00:53:06,040 --> 00:53:12,640
put you at risk of injury. 
I think that study I, I wonder I

943
00:53:12,920 --> 00:53:16,800
I didn't see in the methodology 
or I didn't understand it maybe 

944
00:53:16,800 --> 00:53:20,120
if I read it, but how are they 
defining injury or how were 

945
00:53:20,120 --> 00:53:23,640
people reporting it? 
I'm like a little concerned 

946
00:53:23,640 --> 00:53:25,600
about the quality of that. 
Totally. 

947
00:53:25,600 --> 00:53:27,520
Yep. 
Which is a sticky thing, and I 

948
00:53:27,520 --> 00:53:30,080
don't know it well enough to 
answer that either. 

949
00:53:30,080 --> 00:53:32,640
But that's a sticky topic as 
well. 

950
00:53:32,680 --> 00:53:34,440
Defining it and then tracking 
it. 

951
00:53:35,680 --> 00:53:39,080
And tracking it like with 5000 
participants, how how good were 

952
00:53:39,080 --> 00:53:40,760
they had actually telling you 
when they got injured. 

953
00:53:40,760 --> 00:53:44,560
But one of the things that I use
frequently with my athletes is 

954
00:53:44,560 --> 00:53:47,720
acute to chronic workload 
ratios, where you look at your 

955
00:53:47,720 --> 00:53:51,760
average training load for the 
last four weeks. 

956
00:53:51,960 --> 00:53:54,080
So you look at your weekly 
training loads the last four 

957
00:53:54,080 --> 00:53:58,040
weeks and then you compare it to
the last seven days and see if 

958
00:53:58,040 --> 00:54:01,040
there's spikes and you're able 
to climb up. 

959
00:54:01,120 --> 00:54:05,720
And that is really been very 
beneficial where I don't think 

960
00:54:05,720 --> 00:54:13,080
it's again something that is a 
cancellation like I hit 136%, I 

961
00:54:13,080 --> 00:54:16,800
need to not run today. 
I think it's more of a pay 

962
00:54:16,800 --> 00:54:21,560
attention, listen to your body a
little bit more, focus on 

963
00:54:21,760 --> 00:54:25,400
recovery a little bit more, do a
little extra here, get a little 

964
00:54:25,400 --> 00:54:28,160
extra sleep. 
It's not necessary to say you 

965
00:54:28,160 --> 00:54:31,080
shouldn't run or back off that 
training program. 

966
00:54:31,480 --> 00:54:35,440
It's just a warning sign that 
you're a little susceptible to 

967
00:54:35,440 --> 00:54:36,880
injury. 
Yeah, totally. 

968
00:54:38,000 --> 00:54:39,520
Yeah, absolutely. 
That's great. 

969
00:54:40,160 --> 00:54:43,080
All right, because we're at the 
Doctors Running podcast, we have

970
00:54:43,080 --> 00:54:45,520
to at least have one shoe 
related question here. 

971
00:54:45,520 --> 00:54:47,840
I think that the people would go
crazy if we didn't. 

972
00:54:47,840 --> 00:54:50,800
I'm kidding. 
But I think this is actually a 

973
00:54:50,800 --> 00:54:53,880
really interesting topic and 
that's one of the most common 

974
00:54:53,880 --> 00:54:58,000
questions is a combination of 
did my shoes 'cause this and 

975
00:54:58,880 --> 00:55:02,880
will better shoes fix this? 
What's your perspective on the 

976
00:55:02,880 --> 00:55:05,000
interaction of footwear in this 
condition? 

977
00:55:06,200 --> 00:55:08,520
So I think that is a great 
question. 

978
00:55:08,520 --> 00:55:14,080
And honestly, we went long on 
the prevention, but shoes and 

979
00:55:14,760 --> 00:55:17,280
that is something that I think 
could be part of that 

980
00:55:17,280 --> 00:55:22,880
prevention. 
I think in the in the terms of 

981
00:55:23,080 --> 00:55:26,480
making sure that you're tracking
how many mileage you're putting 

982
00:55:26,480 --> 00:55:30,280
on your shoes and understanding 
what your limit is, it's 

983
00:55:30,280 --> 00:55:32,880
different. 
It's based on your body, it's 

984
00:55:32,880 --> 00:55:37,240
based on your running form. 
I might get 400 miles in a pair 

985
00:55:37,240 --> 00:55:40,400
of shoes and Nathan, you might 
get 500 in the same pair of 

986
00:55:40,400 --> 00:55:44,120
shoes based off this differences
in our body, but no one track 

987
00:55:44,120 --> 00:55:45,920
that. 
I think that's something easy to

988
00:55:45,920 --> 00:55:48,600
do and can really help out. 
That's actually something 

989
00:55:48,880 --> 00:55:51,200
personally, I know what my shoes
are wearing out. 

990
00:55:51,200 --> 00:55:55,760
I get just like I'll have my 
left shin lights up just a 

991
00:55:55,760 --> 00:55:58,520
little bit and I'm like up how 
many miles I have. 

992
00:55:58,680 --> 00:56:01,520
Oh yeah, I'm around 500 time to 
switch them out. 

993
00:56:01,960 --> 00:56:06,440
And so that is important part. 
Now the better shoes is a good 

994
00:56:06,440 --> 00:56:11,120
question too. 
And a lot of people tend to go 

995
00:56:11,120 --> 00:56:15,720
for maximalist type shoes when 
they start to get this. 

996
00:56:16,000 --> 00:56:20,400
And it actually is counter 
beneficial for this particular 

997
00:56:20,400 --> 00:56:24,080
injury because what they found 
is that maximalist shoes, so 

998
00:56:24,080 --> 00:56:26,880
those shoes that have a high 
stack height and a lot of 

999
00:56:26,880 --> 00:56:32,520
cushion people spend this tend 
to spend more time in that 

1000
00:56:32,520 --> 00:56:36,440
pronation or E version which is 
going to load some of these 

1001
00:56:36,440 --> 00:56:39,680
tissues up. 
So people feel great when they 

1002
00:56:39,680 --> 00:56:44,760
initially put these shoes on, 
but over the period of a run and

1003
00:56:44,760 --> 00:56:47,560
over the period of four to six 
weeks after they get the fuse, 

1004
00:56:47,880 --> 00:56:52,480
it can actually load them up 
more and cause more issues with 

1005
00:56:52,480 --> 00:56:54,880
this. 
So you have to be careful with 

1006
00:56:54,880 --> 00:56:58,160
going with the oh, that feels 
great when I put it on. 

1007
00:56:58,760 --> 00:57:01,280
What's it doing to your running 
form and how could that be 

1008
00:57:01,280 --> 00:57:03,880
contributing? 
I think this is one of the 

1009
00:57:03,880 --> 00:57:07,400
biggest misconceptions about 
medial tibial stress syndrome 

1010
00:57:07,400 --> 00:57:11,920
and shoes is that a more 
cushioned, highly stacked shoe 

1011
00:57:11,920 --> 00:57:16,000
is going to be better. 
And I think it stems from A1 

1012
00:57:16,000 --> 00:57:18,800
lane thought of how shin splints
comes about. 

1013
00:57:19,080 --> 00:57:22,560
And you mentioned this earlier 
that there was a thought that 

1014
00:57:22,560 --> 00:57:26,240
the only reason was because 
impact, impact, impact, impact. 

1015
00:57:26,760 --> 00:57:30,880
And so, OK, if it's all from 
impact, I'll get a more cushion 

1016
00:57:30,880 --> 00:57:34,520
shoe that would compress and get
rid of some of that impact and 

1017
00:57:34,520 --> 00:57:37,120
help my shin. 
When in reality, it's not just 

1018
00:57:37,120 --> 00:57:40,160
impact, it's the tugging of 
those muscles. 

1019
00:57:40,400 --> 00:57:43,840
And as you just mentioned, those
really compliant shoes for 

1020
00:57:43,840 --> 00:57:48,520
someone who is a collapser is 
putting you into that more, you 

1021
00:57:48,520 --> 00:57:51,320
know, and pronation's not bad, 
we would agree on that. 

1022
00:57:51,480 --> 00:57:54,320
But moving into a pronated 
position and hanging out there 

1023
00:57:54,320 --> 00:57:58,640
for a long time is a lot of pull
from that muscle on on the bone.

1024
00:57:58,920 --> 00:58:01,680
And so you're getting, and I 
think that's the missed part for

1025
00:58:01,840 --> 00:58:04,960
for a lot of people, I think for
a legitimate reason, because it 

1026
00:58:04,960 --> 00:58:06,920
just makes sense that it comes 
from impact. 

1027
00:58:07,160 --> 00:58:10,520
But I think that's the biggest 
misconception is that a softer, 

1028
00:58:10,720 --> 00:58:14,160
higher stack shoe is going to be
the best option for me because I

1029
00:58:14,160 --> 00:58:16,320
have shin splints. 
And it's more complicated than 

1030
00:58:16,320 --> 00:58:19,120
that. 
As you said, it can perpetuate 

1031
00:58:19,120 --> 00:58:21,320
some of the things that add 
stress to the bone. 

1032
00:58:22,040 --> 00:58:25,040
You're absolutely right. 
It's counterintuitive for most 

1033
00:58:25,040 --> 00:58:29,840
people to think I don't want to 
get this big cushy shoe when I'm

1034
00:58:29,840 --> 00:58:32,640
having pain in my shit and 
they're like, no, I want the 

1035
00:58:32,640 --> 00:58:34,080
cushy. 
Like give me the biggest shoe 

1036
00:58:34,080 --> 00:58:37,800
that you got. 
But that's absolutely not always

1037
00:58:37,800 --> 00:58:39,640
the best thing for it. 
And you had a good point with 

1038
00:58:39,640 --> 00:58:42,880
that too. 
Sometimes if you're already a 

1039
00:58:42,880 --> 00:58:46,000
collapser, that's going to 
magnify it here. 

1040
00:58:46,240 --> 00:58:48,840
There are some people that might
be able to wear those types of 

1041
00:58:48,840 --> 00:58:52,040
shoes if they have good form and
technique and they're not having

1042
00:58:52,040 --> 00:58:54,280
some of that. 
Like that might not be an issue 

1043
00:58:54,280 --> 00:58:58,440
for it there. 
But it it is something that you 

1044
00:58:58,440 --> 00:59:02,920
want to contribute to say, hey, 
what is the shoe selection doing

1045
00:59:02,920 --> 00:59:05,120
and, and could it be 
contributing to it there? 

1046
00:59:05,120 --> 00:59:08,360
So, yeah, yeah, I think that's 
important. 

1047
00:59:08,960 --> 00:59:14,080
And Maxima shoes too, because I 
found Maxima shoes will also not

1048
00:59:14,080 --> 00:59:17,960
Maxima, sorry, the Super shoes, 
the carbon fiber plate, they're 

1049
00:59:17,960 --> 00:59:19,560
going to put you in a little bit
more. 

1050
00:59:19,560 --> 00:59:24,000
Now the only other thing, the 
counterbalance of that is that 

1051
00:59:24,000 --> 00:59:27,600
it sometimes reduces the demand 
on the plantar flexors. 

1052
00:59:27,960 --> 00:59:32,000
So it's not, you know, there's a
little bit of trade off and it 

1053
00:59:32,000 --> 00:59:35,800
might depend on the individual 
if, if they're having like if 

1054
00:59:35,800 --> 00:59:39,280
they have calf weakness and 
that's why you think that it's 

1055
00:59:39,280 --> 00:59:42,000
contributing to some of this. 
But their form is pretty good, 

1056
00:59:42,000 --> 00:59:44,440
like a super shoe might not be 
bad for them. 

1057
00:59:44,440 --> 00:59:46,920
I wouldn't necessarily tell 
somebody to go run all their 

1058
00:59:46,920 --> 00:59:49,840
miles in those to try to prevent
it. 

1059
00:59:50,120 --> 00:59:56,080
But I might say it's not going 
to hurt you more because it 

1060
00:59:56,080 --> 01:00:00,120
actually might take a little 
stress off of your calf muscles 

1061
01:00:00,120 --> 01:00:02,560
because it's going to reduce the
stress on that. 

1062
01:00:03,360 --> 01:00:05,520
Yeah, I think you, I think 
you've hit it on the head with 

1063
01:00:05,520 --> 01:00:09,520
just kind of the matching a shoe
to the specific presentation. 

1064
01:00:09,720 --> 01:00:13,040
How 1 shoe, might we say? 
Shoes are tools all the time. 

1065
01:00:13,040 --> 01:00:16,160
And so how does a, how does a 
rocker work to your advantage 

1066
01:00:16,160 --> 01:00:17,800
right now? 
How does it work against you 

1067
01:00:17,800 --> 01:00:19,560
right now? 
How does stack work in your 

1068
01:00:19,560 --> 01:00:21,560
favor? 
How does lower stack work in 

1069
01:00:21,560 --> 01:00:23,760
your favor? 
And it's going to, it can be a 

1070
01:00:23,760 --> 01:00:27,480
mixture of things. 
And I think you hit it right on 

1071
01:00:27,480 --> 01:00:30,120
the head. 
As we yeah, we didn't mention 

1072
01:00:30,120 --> 01:00:32,680
one thing. 
Sorry, one last with this 

1073
01:00:33,520 --> 01:00:35,160
orthotics. 
Yeah, yeah, yeah. 

1074
01:00:35,520 --> 01:00:37,680
We didn't talk about that. 
And we're talking about shoes, 

1075
01:00:37,680 --> 01:00:43,560
but I tend to shy away from 
orthotics in most situations. 

1076
01:00:44,000 --> 01:00:49,360
However, short term orthotic use
can be really beneficial for 

1077
01:00:49,360 --> 01:00:51,040
people with shin splints. 
Yeah. 

1078
01:00:51,160 --> 01:00:55,000
And the key to that phrase is 
short term. 

1079
01:00:55,360 --> 01:00:58,720
This is not, I didn't make it 
during the preventative part 

1080
01:00:59,080 --> 01:01:02,640
because I don't want people 
wearing orthotics to prevent 

1081
01:01:02,640 --> 01:01:05,720
shin splints. 
You should strengthen your calf,

1082
01:01:05,720 --> 01:01:08,920
strengthen your hips, do those 
types of things in the 

1083
01:01:08,920 --> 01:01:11,920
preventative side. 
But in the presence of shin 

1084
01:01:11,920 --> 01:01:16,080
splints, that person that you 
were saying, oh I'm a couple 

1085
01:01:16,080 --> 01:01:20,760
weeks out from my race, that 
might be so muddy that you could

1086
01:01:20,760 --> 01:01:26,000
use an over the counter orthotic
just to offload some of that 

1087
01:01:26,000 --> 01:01:28,160
tissue and give it a chance to 
heal. 

1088
01:01:28,680 --> 01:01:30,920
I typically take my patients 
first. 

1089
01:01:30,920 --> 01:01:33,560
If the tape helps then I'll put 
them in orthotic. 

1090
01:01:33,960 --> 01:01:38,400
But it can be a really useful 
tool to stimulate healing. 

1091
01:01:39,160 --> 01:01:41,520
That's perfect. 
Those those treatment trials are

1092
01:01:41,520 --> 01:01:44,480
amazing. 
And for when you say orthotics, 

1093
01:01:44,480 --> 01:01:46,600
are you just saying kind of 
something over the counter that 

1094
01:01:46,600 --> 01:01:49,960
replicated you're not doing 
these custom orthotic things? 

1095
01:01:49,960 --> 01:01:52,840
It's much quicker than that 
because it's short term. 

1096
01:01:53,040 --> 01:01:54,960
Get something that just changes 
their symptoms. 

1097
01:01:55,840 --> 01:01:58,880
The foot is so intricate. 
Like I know that there's people 

1098
01:01:58,880 --> 01:02:01,000
that will disagree with me on 
this and there's a lot of 

1099
01:02:01,000 --> 01:02:03,920
orthotic based people out there.
But like I think the foot is 

1100
01:02:03,920 --> 01:02:09,920
very, very sophisticated. 
And for us to try to replicate 

1101
01:02:09,920 --> 01:02:13,840
some of that sophistication and 
get like you're teaching 

1102
01:02:14,000 --> 01:02:16,160
musculoskeletal courses right 
now, right? 

1103
01:02:16,520 --> 01:02:19,560
Do you remember learning about 
all the different like planes of

1104
01:02:19,560 --> 01:02:22,040
most? 
I remember Irene teaching me 

1105
01:02:22,040 --> 01:02:23,760
this. 
So like all the different planes

1106
01:02:23,760 --> 01:02:26,720
of motion of all this. 
And to say that I can just like 

1107
01:02:26,960 --> 01:02:30,240
put a little piece of plastic on
the inside of your heel to try 

1108
01:02:30,240 --> 01:02:33,960
to replicate this and that I've 
got that angle exactly right. 

1109
01:02:34,600 --> 01:02:38,120
I don't know about that. 
Like maybe I'm just not good 

1110
01:02:38,120 --> 01:02:40,280
enough. 
Maybe there's people that can, 

1111
01:02:40,600 --> 01:02:45,760
I'm not good enough. 
But I think a tape trial and a, 

1112
01:02:46,560 --> 01:02:50,720
you know, 30-40 bucks on a over 
the counter insert is going to 

1113
01:02:50,720 --> 01:02:53,240
do the job because you're only 
going to use it for two to three

1114
01:02:53,240 --> 01:02:55,240
weeks and then I'm going to 
transition you out. 

1115
01:02:55,800 --> 01:02:59,680
Yeah, perfect. 
So before we wrap things up, is 

1116
01:02:59,680 --> 01:03:02,480
there anything else that you 
want to share either about shin 

1117
01:03:02,480 --> 01:03:05,680
splints and medial tibial stress
syndrome or kind about what's 

1118
01:03:05,680 --> 01:03:10,280
going on with run DNA? 
Yeah, You know, I appreciate 

1119
01:03:10,280 --> 01:03:12,240
that. 
We had a lot of talk about 

1120
01:03:12,240 --> 01:03:16,640
running form here. 
That is always good to hear. 

1121
01:03:16,640 --> 01:03:19,320
I think that's why this is a fun
injury to talk about because 

1122
01:03:19,320 --> 01:03:22,160
that is something that's near 
and dear to us at Run DNA. 

1123
01:03:23,400 --> 01:03:27,040
You know, we do have some 
exciting things coming up with 

1124
01:03:27,040 --> 01:03:30,600
us to try to help runners a bit 
more here and, and trying to get

1125
01:03:30,600 --> 01:03:34,160
to the runner audience as well. 
And you can always go to 

1126
01:03:34,160 --> 01:03:37,600
randyanda.com and find one of 
our providers, like one of these

1127
01:03:37,600 --> 01:03:39,160
running pros that we talked 
about. 

1128
01:03:39,600 --> 01:03:42,200
You know, we list the people 
that have taken our courses that

1129
01:03:42,200 --> 01:03:45,080
have our 3D equipment. 
Go find those. 

1130
01:03:46,080 --> 01:03:50,520
We're having a little contest 
coming up and I have contest 

1131
01:03:50,560 --> 01:03:54,040
more like a giveaway. 
We're giving away some things 

1132
01:03:54,400 --> 01:03:56,800
just really wanting to give back
to the running community and, 

1133
01:03:57,080 --> 01:03:59,360
and learn more about runners and
what they're looking for. 

1134
01:03:59,720 --> 01:04:04,240
And there might be a little 
Easter egg in that giveaway here

1135
01:04:04,240 --> 01:04:07,320
if you are curious about what 
you're running for and looks 

1136
01:04:07,320 --> 01:04:09,440
like. 
So if you're hearing this 

1137
01:04:09,440 --> 01:04:15,320
between October 20th and 
November 20th of 2025, you might

1138
01:04:15,320 --> 01:04:18,880
want to check out the Run DNA 
Instagram for chance to win 

1139
01:04:18,880 --> 01:04:21,480
surprises. 
And there might be something a 

1140
01:04:21,800 --> 01:04:23,920
little bonus in there that you 
can check out too. 

1141
01:04:24,520 --> 01:04:28,480
Perfect is that at run DNA to 
find you all on social. 

1142
01:04:28,480 --> 01:04:33,800
We're run DNA system, run DNA 
system, Yes, run DNA. 

1143
01:04:33,800 --> 01:04:36,920
I think under score system, it 
could be there. 

1144
01:04:37,200 --> 01:04:38,600
It's give me a second one of 
those. 

1145
01:04:39,120 --> 01:04:43,320
Yeah, one of those things that 
you think about all the time and

1146
01:04:43,320 --> 01:04:48,320
then you don't actually ever 
know exactly what that is there.

1147
01:04:48,320 --> 01:04:56,160
So yes it is run DNA system all 
one word no under score. 

1148
01:04:56,480 --> 01:04:58,960
Fantastic. 
Fantastic. 

1149
01:04:59,240 --> 01:05:01,720
Well, Doug, thank you for taking
the time. 

1150
01:05:01,840 --> 01:05:03,480
We always record on Sunday 
nights. 

1151
01:05:03,480 --> 01:05:07,200
Thank you for taking this time 
to meet with us, chat about this

1152
01:05:07,200 --> 01:05:09,640
condition, share your knowledge 
and wisdom with us all. 

1153
01:05:09,640 --> 01:05:10,560
We really appreciate it.