Sports Medicine Project

Blake Withers
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5 snips
Sep 7, 2025 • 11min

Running for a PhD: Can Changing Your Gait Instantly Reduce Knee Pain? #122

study link :https://pmc.ncbi.nlm.nih.gov/articles/PMC9884822/pdf/fspor-04-1048655.pdfKey takeaways: Gait modifications can immediately reduce patellofemoral pain in some runners.The most effective strategies were increasing step rate by 10% and adopting a forefoot strike pattern.Runners with a rearfoot strike benefitted more from forefoot strike and “running softer,” while non-RFS mainly improved with a higher step rate.Reductions in patellofemoral joint force were linked to pain decreases, but not always — suggesting other mechanisms (psychological/central factors) may also contribute.Increasing step rate is likely the safest first option; forefoot strike may work but carries higher Achilles tendon load, so requires caution.
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Aug 24, 2025 • 1h 34min

Online Running Influencers: Coaches, Con Artists & Evidence Informed? with Issac Heyne #121

Issac instagram: https://www.instagram.com/isaacheyne/Substack: https://substack.com/@isaacheyne?r=jxf68&utm_medium=ios&utm_source=profile&fbclid=PAZXh0bgNhZW0CMTEAAadhAnzfZo7PbmOOABf-9MoarClQRKfYUPEdbOD-PgKY6y7d1bBdYhSKAcUV1A_aem_2VWcJabI4cL4gvFebIjangSkip to 8mins to get started!What way to evaluate information is:Applying the CRAAP testCRAAP frameworkCurrency: Is the information up‑to‑date?Relevance: Does it directly address your question or topic?Authority: Who is the author? What are their credentials and affiliations?Accuracy: Is the content supported by verifiable evidence and citations?Purpose: What is the reason behind the content—informative, persuasive, commercial, or satiricalkeywords: running, influencers, training load, misinformation, social media, sports medicine, physiotherapy, nutrition, community, injury prevention, running culture, injury prevention, running community, evidence-based practice, footwear innovation, personal experience, inclusivity, social media, athlete support, training methodssummaryIn this conversation, Blake Withers and Isaac Hain discuss the influence of running influencers on the sport, the importance of understanding training load, and the challenges of navigating misinformation in the running community. They explore the evolution of running knowledge, the impact of social media, and the necessity of critique in professional development. The discussion also touches on the role of nutrition in injury prevention and the positive aspects of running communities. In this conversation, the speakers explore the evolution of running culture, the impact of increased participation in the sport, and the importance of inclusivity within the running community. They discuss the challenges of traditional running paths and the role of evidence in running practices, emphasizing the need for individualized approaches to running injuries. The conversation also touches on the balance between tradition and innovation in running, the emotional connection to the sport, and the significance of engaging with the running community online. Ultimately, the speakers reflect on their personal experiences and the purpose they find in helping others navigate their running journeys.Chapters00:00 Introduction to Running and Physiotherapy10:18 Isaac's Journey: Runner and Clinician13:34 The Evolution of Running Knowledge16:15 The Impact of Misinformation in Running19:25 Navigating Social Media and Running Advice22:30 The Role of Critique in Professional Growth25:33 Finding Truth in Running Information28:22 The Balance of Sharing Knowledge31:25 Conclusion: The Future of Running and Health Information37:54 Understanding Knowledge Gaps in Physiotherapy41:34 Navigating Scope of Practice and Online Influence43:45 The Role of Nutrition in Physiotherapy46:58 The Impact of Social Media on Running Culture52:34 The Evolution of Running and Its Community58:36 Challenging Traditional Paths in Running01:03:27 Balancing Old and New Practices in Training01:08:25 Understanding Individualized Treatment in Healthcare01:11:28 The Complexity of Physiotherapy and Patient Care01:14:22 The Role of Social Media in Running and Community Engagement01:17:21 Personal Experiences Shaping Professional Passion01:20:36 Navigating Online Presence and Telehealth in Physiotherapy01:22:38 The Evolution of Running Footwear and Personal Preferences
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Aug 18, 2025 • 31min

Foot Orthoses Explained: What Every Health Professional Should Know #120

Foot orthoses are crucial for effective patient care, moving beyond just basic materials. Their role in treating conditions like Achilles tendinopathy and tibialis posterior pain is highlighted, emphasizing the importance of foot biomechanics. Listeners gain insights into proper assessment and clinical reasoning, helping health professionals make informed decisions. The discussion encourages collaboration among podiatrists, physiotherapists, and other allied health experts, fostering a clearer understanding of orthotic prescriptions.
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Aug 3, 2025 • 50min

Super Shoes or Super Risk? Are Super Shoes really the best race shoe? Jack Crago #119

 Blake Withers and Jack Craigo discuss the nuances of running shoes, particularly focusing on super shoes and their suitability for different runners. They explore the importance of shoe fit, the role of retail in guiding shoe selection, and the potential injury risks associated with performance footwear. The discussion also highlights the significance of comfort and the impact of shoe technology on running performance, concluding with recommendations for runners on choosing the right shoes for their needs.Jack Crago youtube and instagram: @jog.on.cragosuper shoes, running shoes, injury prevention, shoe fit, marathon training, footwear technology, running performance, retail experience, shoe selection, running communitySuper shoes, also known as advanced footwear technology (AFT), are designed to enhance running performance by incorporating features like aggressive rocker geometry, high stack heights (often ≥35–50 mm), lightweight and compliant foams, carbon or composite plates, and minimal weight. These features aim to improve running economy and propulsion. However, their widespread use has prompted questions about whether they are the best option for all runners—especially when it comes to injury risk and biomechanical stability.Running participation continues to grow, with events like marathons selling out rapidly (Barrons et al., 2023). Many runners get their footwear advice from online sources or retail staff. Research suggests that both runners and retailers prioritise comfort, with super shoes often perceived as more comfortable than generic alternatives (Malisoux et al., 2020). While footwear is known to influence both performance and injury risk (Nigg et al., 2023), the assumption that super shoes are universally superior oversimplifies a complex trade-off.One of the major proposed performance benefits of high stack height is an increase in effective leg length, which may lengthen stride and improve running economy (Burns & Tam, 2020). However, these gains may come at the cost of reduced frontal plane ankle stability, particularly at higher speeds (Hoogkamer, 2020; Barrons et al., 2023). This potential drawback becomes even more important in longer races when fatigue sets in and motor control becomes more challenged.Recent studies have begun to test these assumptions more rigorously. Garofolini et al. (2024) and Möhler et al. (2022) hypothesised that high-stack shoes increase instability in the control of the centre of mass (CoM), and that these effects are exacerbated at higher speeds due to the added demands on motor coordination. Their findings suggest that super shoes may impose additional coordination demands that not all runners can accommodate.In one of the most comprehensive studies to date, Kettner et al. (2025) tested runners using shoes with low (27 mm), medium (35 mm), and high (50 mm) stack heights. The high stack shoes caused measurable changes in running style: increased vertical oscillation of the centre of mass (COMosc), lower step frequency, and higher duty factor (i.e., more time spent on the ground). These shoes also altered ankle mechanics, especially increasing time in eversion and eversion angles. Critically, they found lower local dynamic stability at the hip—measured using Maximum Lyapunov Exponent (MLE)—with the high stack shoes, suggesting impaired control of the centre of mass. These changes were largely independent of running speed, appearing consistently at both 10 and 15 km/h.From a clinical perspective, this evidence indicates that super shoes are not one-size-fits-all. Runners with a history of injury, reduced neuromuscular coordination, or poor fatigue resistance may be better served by lower stack, more stable footwear. Coordination and stability may be just as critical as cushioning and propulsion—especially in long races or for less experienced runners.
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Jul 27, 2025 • 58min

Achilles and lower limb tendonopathy - Dr Myles Murphy #118

Dr Myles Murphy is a clinical physiotherapist and early-career clinician researcher from the Nutrition and Health Innovation Research Institute at Edith Cowan University. Myles’ works clinically at SportsMed Subiaco and has worked with or consulted for a variety of elite sporting teams. While working clinically, Myles’ completed his PhD part-time at The University of Notre Dame Australia investigating the different mechanisms related to pain and dysfunction in people with lower-limb tendinopathy. Myles’ research involves investigating the drivers of pain and impairment in people with lower-limb musculoskeletal injury and disa
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Jul 13, 2025 • 1h 29min

Women’s Bodies, Women’s Data: What the Research Actually Says #117

In this conversation, Blake Withers and Kelly Kortick host Esther Keown and Dr Claire Badenhorst to discuss the importance of understanding female physiology in sport, particularly running. They explore the challenges young female athletes face regarding body image and performance, the significance of individualised training programs, and the role of communication in supporting female athletes. The discussion also highlights the launch of Femmi's membership, which aims to empower women through education, community support, and personalised training that considers the unique physiological needs of women. The Femmi app is available for download on iOS and android: iOS: https://apps.apple.com/au/app/femmi-running-plans-for-women/id1672881899Android: https://play.google.com/store/apps/details?id=com.femmico.femmi&hl=en&pli=1Femmi: https://tinyurl.com/c7r732bsEsther: https://www.instagram.com/estherkeown/?hl=enClaire: https://www.instagram.com/claire_bades/?hl=enTakeawaysUnderstanding female physiology is crucial for optimizing training and performance.Communication about body image and performance is essential for young female athletes.Individualized training programs are necessary to accommodate the unique needs of female runners.FEMI provides resources and support for women to understand their bodies better.The menstrual cycle significantly impacts training and performance for women.Empowerment through education can enhance confidence in female athletes.Community support plays a vital role in encouraging women to participate in running.Research on female physiology is still evolving and needs to be more inclusive.FEMI's membership offers personalized training and expert guidance for women runners.Tracking menstrual cycles can help women understand their bodies and improve performance.Chapters00:00 Introduction to FEMMI and Its Mission01:29 Understanding Female Physiology in Training02:17 Optimizing Communication and Support for Female Athletes02:44 The Impact of Societal Norms on Female Athletes04:21 New Chapter04:36 The Role of Coaches and Clinicians in Body Positivity07:24 Understanding Female Physiology and Injury Prevention10:04 Research Insights on Female Athlete Well-being13:08 The Importance of Open Conversations in Sports Medicine15:45 Celebrating Progress in Female Sports Education24:24 Understanding Menstrual Cycle Research Limitations30:16 Individual Variability in Menstrual Cycle Symptoms33:13 FEMI: Tailoring Training to Female Physiology37:24 The Complexity of Hormonal Impact on Performance42:52 Recognizing Luteal Phase Defects and Their Implications51:31 Empowering Women Through Cycle Tracking56:12 Understanding Your Body and Hormones57:12 The Importance of Iron for Female Athletes01:06:43 Debunking Foot Strike Hemolysis01:11:30 The Dangers of Generic Training Programs01:14:35 Maximizing Performance for Female Athletes01:17:54 Introducing the Femi MembershipKeywordsFEMMI, female physiology, running, training programs, women's health, empowerment, communication, performance, menstrual cycle, community support
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Apr 21, 2025 • 47min

How To Diagnose Metatarsal Stress Fractures #116

TakeawaysMetatarsal stress fractures are common injuries in athletes.Understanding the remodeling process of bones is crucial for recovery.Subjective questioning can reveal important clues about the injury.Palpation techniques are essential for accurate diagnosis.Systemic factors like energy availability can influence bone health.Imaging, particularly MRI, is vital for diagnosing bone stress injuries.Treatment should focus on offloading the affected area.Recovery time varies significantly between individuals and injuries.Communication with patients about their condition is key to effective treatment.Injury prevention strategies should include monitoring training loads. ** You should always see a medical professional for diagnoses and assessment. This is not medical advice and is for educational purposes only.SummaryIn this episode of the Sports Medicine Project, hosts Blake and Kelly delve into the complexities of diagnosing metatarsal stress fractures and bone stress injuries. They discuss the importance of understanding the clinical assessment process, including subjective questioning, palpation techniques, and the role of imaging in diagnosis. The conversation emphasizes the significance of systemic factors and adequate recovery in preventing these injuries, as well as the need for effective treatment strategies. The hosts share insights from their clinical experiences, making the discussion both informative and engaging for listeners interested in sports medicine and injury management.Chapters00:00 Introduction and Overview of Metatarsal Injuries03:01 Understanding Bone Stress Injuries05:46 Diagnosis and Clinical Assessment09:04 The Role of Training Load and Recovery12:06 Systemic Factors Influencing Bone Health14:49 Imaging and Diagnostics for Metatarsal Injuries18:01 Palpation Techniques and Patient History20:53 Conclusion and Key Takeaways25:35 Palpation Techniques for Metatarsal Assessment32:06 Clinical Decision-Making in Bone Stress Injuries37:54 Differentiating Between Tendon and Bone Injuries48:02 Imaging and Diagnosis of Bone Stress InjuriesKeywordsmetatarsal stress fracture, bone stress injury, diagnosis, clinical assessment, imaging, treatment, sports medicine, recovery, palpation techniques, systemic factors
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Mar 16, 2025 • 1h 24min

Tendon Rehab, Stress Fractures, Running & Pain w/ Greg Lehman #115

Gregs social: https://www.instagram.com/greglehman/Pro version Heidi AI Scribe (time saver) Link: ⁠https://scribe.heidihealth.com/?via=SMP⁠Support the show: ⁠https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLinkGregs Website: https://www.greglehman.ca/Chapters00:00 Evaluating Shockwave Therapy in Tendinopathy00:44 The Role of Exercise in Rehabilitation03:43 Understanding Patient Ecosystems and Health06:23 Case Studies: Practical Applications in Treatment08:49 The Complexity of Pain Management11:43 Research Critique: Shockwave Therapy and Evidence14:10 Psychological Factors in Pain Perception17:02 Clinical Decision-Making in Patient Care26:00 Trusting Experts and Knowledge Translation27:21 Challenging Established Beliefs28:30 Comparing Treatment Philosophies31:03 The Role of Patient Understanding33:35 Exercise vs. Alternative Treatments34:26 Load Management in Rehabilitation35:54 Creative Approaches to Running Rehabilitation37:06 Resistance Training for Runners40:12 Skepticism Towards New Research42:50 Understanding Bone Stress Injuries54:53 Understanding Pain and Structural Changes58:59 Navigating Risks in Running Injuries01:04:20 The Role of Social Media in Health Information01:09:39 Strength Training and Recovery Insights01:12:24 Research Aspirations and Future DirectionsKeywords:shockwave therapy, tendon rehabilitation, exercise, pain management, sports medicine, patient education, metabolic health, case studies, research appraisal, individualized treatment, training protocols, bone health, stress fractures, plyometric training, rehabilitation, pain management, social media, health information, research ethics, performance.Summary:This conversation delves into the complexities of sports medicine, focusing on shockwave therapy, exercise rehabilitation, and the importance of understanding patient ecosystems. The speakers discuss recent research findings, the role of exercise in pain management, and the need for individualized treatment approaches. They also explore the psychological factors influencing pain and the critical appraisal of existing research in the field. In this conversation, Blake Withers and Greg delve into various aspects of training protocols, bone health, and the complexities of rehabilitation. They discuss the importance of flexibility in training, the role of frequency in plyometric exercises, and the nuances of managing pain in relation to structural changes. The dialogue also touches on the ethical considerations of pain in research, the impact of social media on health information, and future directions in rehabilitation research.takeawaysShockwave therapy may not provide additional benefits compared to exercise.Exercise should be critically evaluated just like other treatments.Improving a patient's overall health ecosystem is challenging but essential.Patient motivation is crucial for successful rehabilitation.Understanding the mechanisms of pain can enhance treatment outcomes.Research in sports medicine often lacks strong evidence for certain treatments.Individualized treatment plans are necessary for effective rehabilitation.Psychological factors play a significant role in pain perception.Exercise can positively influence peripheral nociception.Critical appraisal of research is vital for informed clinical practice. People can improve despite not following traditional protocols.Flexibility in training is crucial for optimal results.Frequency of training may be more important than intensity.Understanding bone health is essential for preventing stress fractures.Pain is not always a reliable indicator of injury severity.Social media can be a double-edged sword for health information.Research ethics play a significant role in studying pain management.The relationship between structure and pain is complex and often misunderstood.
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7 snips
Feb 16, 2025 • 1h 6min

Is Shockwave A Sham? w/ Dr Peter Malliaras #114

We discuss the latest review PMID: 39704142 with Prof Peter Malliaras✅ Identifying early responders – Can we predict who will benefit?✅ Effect – Does it work?✅ Diminishing returns – When does adding SWT to exercise stop being beneficial?✅ Types of shockwave therapy – Why radial shockwave was chosen in this study✅ Sham treatments – Do they still have a therapeutic effect?✅ Mechanisms of action – Neuromodulation, therapeutic alliance, and tendon adaptation✅ The ‘Big Machine Effect’ – Is patient belief in SWT part of its effectiveness?✅ Comparisons to exercise – Would fewer appointments with exercise yield similar outcomes?We also discuss clinical implications—will these findings change how shockwave therapy is used in practice?🔗 References & Studies Discussed: • Alsulaimani et al. (2024) - Achilles tendinopathy & shockwave RCT • Benli et al. - SWT vs. exercise alone • Heide et al. - Shockwave therapy for plantar heel painFind out about Peter and upcoming course:https://www.tendinopathyrehab.com/homeSocials: https://www.instagram.com/tendinopathyrehab/https://www.linkedin.com/posts/petermalliaras_my-new-tendinopathy-rehabilitation-framework-activity-7296743926009368576-GNRW/?utm_source=share&utm_medium=member_ios&rcm=ACoAAAexDmkBlV5e4jGTX2E4X9J6s8ZitO8yX0M&fbclid=PAZXh0bgNhZW0CMTEAAabnnAaDDYH_S3We7eJaZZbOHWHxrtGYC_5AiRO-rDUtmh29GdmHqrWh9fI_aem_FLbCehDnORljxK3cgMA8fQ
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Feb 2, 2025 • 39min

#113 - Never do these 10 Things as a Runner with Achilles Tendinopathy

Patreon: ⁠https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink 1. Keep Intensity the Same This is the biggest and easiest mistake. If your Achilles is sore, what will aggravate it most is higher rates of loading—formally, this happens more when you run faster. Yes, it might warm up during the run, but you’ll pay for it 24 hours later. You need to stress it just a little, see how it responds, and build from there. 2. Rest, Then Go Straight Back to Full Load You shouldn’t completely rest and then jump straight back to the same training load. If you usually do speed work on Tuesdays, and you’ve had a week or two off, that first run back shouldn’t be the same session. Don’t do that. Start gradually—try something like 6 x 1-minute efforts and progress from there. 3. Wear Flat Shoes Heel pitch helps Achilles tendon pain. A higher heel reduces both tensile and compressive forces by limiting dorsiflexion. Achilles pain isn’t just about the run—it’s about everything you do throughout the week. If you’re on your feet all day, even if it’s not sore at the time, that will contribute to your pain during training. 4. Not Question the Diagnosis Sometimes, it’s not Achilles tendinopathy. Yes, if you’ve had it before, you can get it again—but not always. Other things mimic Achilles pain. Be sure. 5. Keep Training Load the Same If you’re dealing with Achilles pain, take something away. Reduce intensity or volume—adjust something. If you’re not sure how, see someone who can help you make it graded. 6. Think the Adjuncts Are the Answer They can help, but they’re not the solution. Shockwave, massage, needling—useful, sure. But if you’re not loading appropriately, nothing else will fix it. 7. Not Load It Properly You have to load it. Strength, plyometrics, progressing appropriately—it all matters. 8. Smash the Anti-Inflammatories and Think That’s Enough Anti-inflammatories aren’t bad, but if that’s all you’re doing, you’re missing the point. This isn’t an inflammatory condition—it’s a load issue. 9. Think Injections Are the Quick Fix Too many people jump to injections too early. They can have a role in specific cases, but they’re not a cure. 10. Ignore the Psychology Behind Injury This is huge. Achilles pain isn’t just about the tendon—it’s about the mental load of not running, the frustration, the identity shift. Understanding this can change everything. Achilles tendinopathy, injury management, running injuries, health professionals, rehabilitation, load management, resistance training, anti-inflammatories, psychological impact, running performance

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