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My Podcast Review #1: Physio, S&C, Running



This is the first in hopefully a little series of blog posts I will put together reviewing the podcasts I have been listening to. Last week I put a 'call for help' on my Instagram (@kywynnephysio) asking for some podcast recommendations in the S&C, physio and running spaces. Having been away for awhile on a career break (see 2022 updates here), I have been looking to jump back in and refresh my clinical knowledge. I previously listened to podcasts a few years ago when my work commute was longer, however I have been blessed with a shorter commute and thus the podcast listening time has reduced.


The following podcasts all gave me a little something (and some a lot). I am always keen to hear what podcasts you enjoy, so please comment below or let me know what you are rating at the moment! Remember, these are only a few notes I jotted down while listening, and I would recommend you check them out yourself if you want to know more!






PODCAST 1: Melbourne Athletic Development: Lateral Think

Episode: Nutrition and injury healing



Considerations:

  • Tendon health and gelatin - collagen and vit c are important, want 1hr before exercise. Collagen also has a role for protein synthesis in muscle. Consider re muscle strain.

  • Protein and CHO: key for muscle mass. Consider re hypertrophy but also post injury.

  • Bone health: important dietary components for healthy bone & treating bone injuries (e.g. BSI): vit d, calcium, protein, magnesium needed to allow calcium to enter cell, vit K 2 important for calcium metabolism found animal products like eggs, organ meats and more.

  • Older adults - high protein needed to combat the anabolic resistance that is present in this population group.

  • Micronutients - are we getting enough in our current diet. Enough calories but the balance? Not all calories are equal.

  • CHO particularly important for intense exercise - high fat diets (e.g. paleo style/keto) don't meet this requirement.

  • Whole foods > supplements, natural > artificial.. e.g. iron from meat vs tablets

  • Limited diets e.g. vegetarian/vegan, no dairy etc.. impacts micronutients. Can influence rehab. It can be hard to navigate moral/ethical here. Unsure right/wrong. Note. you can't get collagen from plant based diets.

  • Intense exercise impacts multiple systems - consider how nutrition can impact here e.g. immune system.

  • Chronic diseases/pain - diet also can have impact. Consider systemic inflammation impact due to diet as well. Think holistically here.


Should we involve dietitians? Note not physio scope. Need base knowledge here and when to refer. Act as screening.


Good Qs for athletes:

- what does a normal day of food look like for you

- anything you don't eat?


My thoughts: great intro into this area. Good to get thinking. Bring attention the importance of diet. This topic could easily be broken down into many hour long podcasts. I have previously written an evidence-based blog on this topic for those wanting to read more.







PODCAST 2: Physio Edge

EPISODE: 119 - suspect a stress fracture



4 key areas when suspecting & diagnosing stress #

  • History: good history very important, need good training history, look for changes in training (e.g. volume or intensity), sleep - important for bone health - look for lack of sleep,

  • Signs and symptoms: weightbearing pain is key! - walking/impact, pain behaviour- no warm up, continues to increase with incr activity, night pain, swelling, bony tenderness - focal tenderness,

  • At risk patients: female patients esp younger women, previous Hx BSI, low BMI, poor nutrition, menstrual irregularities, PMHx, post pregnancy

  • Trust your gut: if worried get assessed early


Investigation: need MRI - other alternatives don't give enough info/limitations


My thoughts: brief but to the point. A great reminder of some key things to consider when working with runners.




PODCAST 3: Athletes Authority on air

EPISODE: 85 - From the floor - Freshening athletes up mid-season, Patellar tendinopathy.



Work culture - we spend so much time at work, culture important. As business grows, needs to have more planned social events rather than just organically happening.


Freshening Up Athletes Mid-Season: Mid season can start to drop motivation, switch off, burn out.

  • Contrast to the normal routine can be important

  • Add in 'silly things' to make the mundane more fun

  • Have a few days off can be good


Have plans/scenarios as a team for if things aren't going well - e.g. few losses in a row.


If a lot of sore bodies/fatigued - reduce volume but keep intensity up - don't just drop weights and do full sessions, short session but keep intensity up is better.


Monitoring athletes important to check if needing to change routine


Building resilience

  • Isolated "extras"

  • Specific to area e.g. joint/muscle/injury specific

  • Focus on risk areas for the sport

  • Put end of session


Example: Patellar Tendinopathy:

- trial variety of isometrics specific to sport, start 2-5 x 20-30s and every 2nd day

- settle symptoms first

- then progress capacity - don't just hold load steady. Need to advance


My thoughts: some unique thoughts from someone who has had experience inside elite sport on how to break up the mid season monotony. And the importance of culture for staff and athletes.






PODCAST 4: The Physical Performance Show

EPISODE 316: Prof Eric Hegedus - Return to Run Programming



Most common running injuries *seen by Eric Hegedus

- BSI

- PFPS

- plantar fasciopathy

- achilles tendinopathy


This paper addresses: gap in literature for returning to running from running injury. Cardiorespiratory fitness reduces during rehab period, affect seasons. Need to return athletes with fitness maintained.


6 phases of return to running: framework


Progression of phases:

  • Successful completion of workouts in phases

  • Have goals - work back from 'key goal' e.g. race

  • Do some cardiorespiratory testing

  • Pain levels

  • Prritability of injury

  • Psychological readiness

  • Team based decision making

  • Intensity is very important to consider re injury risk - esp BSI

  • Model/paper is a linear progression

  • Think about the goal and return to competition early in program - match their xtraining to the 'end goal' e.g. short and hard x training bouts for middle distance runners


Quantifying load:

  • High tech options with wearables

  • TRIMP - training impulse - simple and easy - RPE x time


Phase 1: return to participation - cross training

- water running not a good option unless highly irritable

- multiple options helpful

- ability to work hard with xtraining - not be lazy, important for psychological standpoint

- vary intensities with different modalities

- can push and improve fitness if right intensity with x training


Phase 2 - <5-25% running

- increase training volume within a workout of running

- not overground running as yet

- use anti-gravity treadmill - not full WB

- if starting with no antigravity treadmill have them run for just e.g. 60s

- walk run programs - hard for competitive runners to buy in - useful for rec runners


Phase 3 - 50% running


Phase 4 - >50% running

- return to overground running in this phase

- have performance test before get to this stage - e.g. 20 x consecutive times hops down the track

- pain and irritability

- monitor that not doing too much


Phase 5 - 60-100% running

- Questionnaire: SANE 0-100% scale readiness to RTS/COMP


Phase 6 - 100% running


My thoughts: Not all the phases were covered in depth on the podcast. I would recommend to read the paper if you interested in this area. Cross training and intensities of this xtraining is important. The phases and graded return are a good guide to plan return to run programs.



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