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My Podcast Review #2: Physio, S&C, Running





This is the second blog where I post up some of my thoughts from the podcasts I listen to. For some, this may be interesting, while for others it will not be your thing. If you do think the podcasts sound interesting and want to know more, I have linked the episodes on the blog. You can also find the first podcast reviews blog here.


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: Pacey Performance Podcast

Episode: Training the lower limb to improve performance and reduce injury risk with Colin Griffin




There has been an increase in calf injuries due to increased HIIT/high intensity running training and demands. Possible lack of calf capacity building as well.

Calf assessments:

  • Force place: 90deg bend - isometric assessment. For soleus *important for field sports/running

  • Isokinetic test at 30deg per sec in supine with isokinetoc dynamometer - want sprint athletes to be 200% BW peak torque, distance runners 150-60% BW

  • Standing straight leg isometric with force plate

  • Calf raise endurance test - metronome 1sec up, 1 sec down - if lose tech, speed etc. Want min 25 or stop at 30reps.


Monitoring: lots of options, you can use the seated calf isometric with force plate as a monitoring tool.


Strengthening:

  • Smith machine or leg press, seated calf raise machine to isolate and go heavy - heavy, isometric, supramaximal eccentrics

  • Calf raises - can do 4 x 8-12 (2 x RER) as a start

  • Ratio soleus to gastroc/general calf complex: 1.8-2.2 x BW

Foot strength:

  • Assessing: test with HDD - slight DF ankle angle and DF 1st MTP. - measure FHL. Then do same thing with more PF angle for intrinsic foot muscles (as FHL is shortened) - *check article for this

  • FHB, ABDH, ADDH, FHL - key muscles

Training foot muscles:

  • Banded big toe curls - into some PF to take out tib ant

  • Want to feel burn/cramp in foot

  • Calf raises shoes off gives good foot work, especially at the top of range


Developing reactive strength: 2nd half of the article

  • Important for all sports that involve running and reactivity

  • Expose muscle tendon unit to high loading demands

  • Early vs late RFD


Assessment of reactive strength:

  • Hop for distance - high ankle/hip for propulsive phase of horizontal hop

  • Single leg double hop/rebound - use force plate


Programming:

  • Coordination patterns

  • Play with ground contact times

  • Basic hops/pogos - ankle driven (no knee) DL progress to SL

  • Progressions: drop jumps, hurdle jumps, bleacher/stair jumps


Progression back to training: as soon as the athlete can run then build some in.. even if basic plyos. Build plyo and capacity before building volume. Calf takes longer to build volume and running vs other muscles. This is due to large tendon contributions in calf injury.

  • Need to keep calf rehab up for 6 months

  • Need to expose to good level of reactive strength

  • Need to expose to good volume.of running prior to return to sport

  • Start short efforts 50-60m at 80% Max speed while building capacity. Then build distance later.


My thoughts: great podcast for those working with runners and team sport athletes. Content heavy but excellent info on calf/foot rehab. Would recommend all to read the sportsmith article (see above).






PODCAST 2: Sports MAP Podcast

EPISODE 6: Calf injuries with Shane Kelly




Case study on "elite 800m runner" with intramuscular tendon (IM) soleus injury


Timelines:

  • IM tendon injury (2c) 4 weeks return too early

  • Don't need to give timeliness Day1

  • Give time frame not specific


General:

Imaging in isolation shouldn't be used for prognosis


Subjective

  • Determine MOI

  • If they had to stop a session "immediately suspicious of muscle injury"


Assessment:

  • Quick clearing tests (spine/ankle etc)

  • Assess muscle injury: 3 cardinal signs of muscle injury: pain on palpation, awareness/pain on stretch; awareness/pain on contraction - if positive then will scan in elite level


Acute phase: 0-14 days

If tendon injury/involvement (c part of classification) then need to give respect to tendon. First 2-3 weeks is basic tendon healing. Acknowledge week 2 and 3 of rehab tendon still healing. Tendon involvement initial phase is longer.


Aims:

  • Pain reduction

  • Swelling control

  • Neuromuscular rehab

  • Static strength

  • Proprioception and balance

  • Gait re-education

  • Xtraining - bike etc to keep fitness

  • Gym non injured areas


Day 0-3:

Theraband work on bed: PF , inversion, eversion

Heel wedge first few days?

Gait re edu


Day 3-5:

BW resistance work/loading

Dlcr to SLCR

Some seated CR


Other: sandpit walking, toe walking, foot intrinsic work


Foot intrinsic exercises:

- isolated toe movement

- dome/arch control

- sitting to standing exercises

- add foot control into calf raise exercises


Targets:

- 30 SLCR metronome with side of ledge good quality

- heel raise height - measure heel to floor - if can't get full PF with BW then this is a concern. Measure how high on 1 rep. Compare L vs R.

- SLCR bent knee heel off ground hold for 1min

- gym: 8RM straight leg calf press on good side and have LSI on affected side? - not done as commonly


Strength phase:

6-8 reps

Heavier

Improve strength


Gentle dynamic work - see below for Ax. From 2 weeks onwards.

- vertical GRF before horizontal - hopping / baby plyos DL to SL

- skipping

- the progress to forward and side hops


Before dynamic loading want:

- 8RM LSI

- CMJ

- Isometric test

- Ax elastic function


Return to running:

Work backwards from what normally do - how quickly and safely can build load


Before running:

- base strength and capacity

- hopping

- repeated hops

- side/forward hops


1st running session:

- avoid jogging for initial running

- add in ankle dribble for first "run session" 30-50 m as a trial - could do 10 x 50m here

Running: 10 x 50m (500m running)

Dribble into strides


Running periodization:

- do running on the "normal training days"

- day on/off - 48hrs apart

- heavy loading same day as running after running

- when add volume running can put in alternate days to speed e.g. speed day then jog day

- start dribbling, speed run throughs- then into jogging after ticked this off

- fatigue is an issue with back to back days

- week 2-4 take care with fatigue


Acceleration: key for runners - one of risky parts for calf reinjury - need to build rehab to match this. Resistance in acceleration positions eg using wall/sled/banded etc

- start 1 step acceleration then to 2 step then 3 step etc.


Speed progressions:

- Week 1. 10 x 50m for 10sec (20sec 100m time) 3 x sessions

- week 2. 8.5-9sec for 50m

- week 3: 7.5-8sec

- week 4: 6-7sec for 50m

Want to improve 1-1.5 sec per week


Monitoring: want LSI/quality/symptom free

- ROM

- mm palpation

- calf raise/hop


Return to "full training"

- full team meeting

- Max speed session

- acceleration 0-30m speed

- upright running max-V flying 30m time


Extras:

- heel wedge early stage rehab


My thoughts: This podcast provided an excellent insight into "elite level" calf rehab. For those with an interest in calf and lower limb rehab, this podcast had some useful points.


PODCAST 3: Physical Preparation Podcast

EPISODE: Doug Kechijan on streamlining the return to play process



Note: The podcast starts around 11mins and content from 14mins in


Rehab vs training shouldn't be that different - especially after early injury management (e.g. pain and tissue healing)


Need to rehab to meet the physical demands of sport


Return to play vs return to performance - goal should be to return back to 'performance'. Have they done to work to meet the demands to return to the sport. Need to be physically prepared.


Ethics around return to sport - risk of playing involved..need to consider.


Different roles in return to performance:

  • Need to be within scope of practice

  • Need to have health professionals who are competent - can be physio if have the knowledge but often some physios don't have this expertise. S&C coaches often have more experience in these areas.

  • Do a needs analysis of the athlete.. "am I the best person to do this". Who else can you involve? Be honest about this.

  • In team setting have preassigned roles

  • Shared responsibility often good

  • Helps to have head of performance overseeing 'who does what'

  • Having trust in others roles


Having systems in place for rehab and re stakeholders roles


Consider if 'overtesting' and what does the data tell you.


No point in your rehab where you should be 'scared to do something'. Should be prepared for next rehab stage.


My thoughts: good discussion regarding roles and also ego in return to performance. Didn't dive into any specifics and was overall more "general".







PODCAST 4: The Strength Running Podcast

EPISODE 263: How to optimise strength training for running with Jason Fitzgerald


Note: The podcast starts properly around 10mins (ads, intros)


Discussion of importance of strength training for runners - it is critical part of being a runner


Don't need to start with loaded/heavy weighted workouts when a "beginner lifter". Bodyweight appropriate


Order important: running before strength training. Prioritise sport specific training (e.g. running) before strength work.


Target training to running specific muscles. Avoid the accessories e.g. biceps curls


Beginning: have simple, bodyweight ok, focus on key running muscles


Factors to influence injury prevention:

- have a well planned training program

- don't progress load too rapidly - distancd/intensity/time all factors

- strength training - build resilience

- dynamic warm up useful - particularly in those with sedentary work


Strength training based upon differences in running goals e.g. 5km.vs marathon

- shorter rates may focus more strength/power vs more endurance vs longer running more endurance.

- however, running is base endurance so focus should be strength primarily despite distance

- don't ignore power


Don't need large amounts of equipment to start to load.


Consider: something better than nothing


Post running strength plan PLUS 2 x week gym is good balance


Strength training closer to a race: taper down volume before race but keep weight high, want periodized program


Taper: can keep up strength during taper but don't need to hit PBs during this period. Keep weight heavy less volume.


My thoughts: decent podcast for runners wanting to get a good overview of strength training for running. Most of it in laymans terms but not a lot of reference to the literature even though the information was evidence based. Not that cutting edge for health professionals with experience in these areas.



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