Hello, thank you for joining us. My name is Matt Phillips and do listening to One Chat Live episode 3. So this episode was recorded on the day of the Berlin Marathon and it was Elliot Kichose trying to get a new world record and spoiler alert, he did. He managed it.
He got a 2-1-39, which meant he beat Dennis Cometto's previous record by over a minute. So it was an incredible day. In this episode anyway, I was answering a question from Jack Chu at the Physiomassus Podcast, which all therapists should really be listening to and be aware of if you're not, then look them up and subscribe. And the question from Jack was, how much should we tweak the running technique and form of a pain free runner?
We know if they're injured, we can offload tissues and do write your things. What about if they just want to improve performance? So that was the topic for this episode. I hope you enjoy it.
If you do, then please do remember to like and share. We're all over the board now as a podcast. We're on iTunes. We're on Spotify, Podbean, who hosts us, Stitcher.
So do go, subscribe, like, etc. to help get the word out there. And hopefully, I will join you at a later date listening to episode number 4. Okay, why am I late?
I've been watching the Burley Marathon on Twitter, how should you do? And it's getting very exciting. I don't know if anyone's watching it, but it looks like Kip Chock is about to get my new world record. If you continue to pace, he is.
I think I've got 40K or something and he's ahead at the moment. But hey, I've decided to sacrifice my enjoy in. You're not watching the Burley Marathon either. I decided to sacrifice my enjoyment to the Burley Marathon because I said I was going to do this and I want to try and keep the time regular.
So I might go right. You're not watching the Burley Marathon either. Can people type what's happening in the Burley Marathon just so I can read it when it comes up? That would be great because that's what I'm thinking of at the moment.
But anyway, so if you joined us now, then thanks for tuning in. If not, remember you can always watch this recording later on in the comfort of your own schedule. So it's the third of three just informal chats we're going to do from the clinic here at Studio 57. Give another little look at where I am.
This is where all the action starts about, about 45 minutes from Studio 57 in Hove. When I work on Sundays, because like I say, where the people need me, I will be. That's my motto in the way I live. Anyway, so what I'm going to talk about today, well, I put some questions out there on various social media on Instagram and that to see what people would like to hear me ramble on about.
And the main one that stood out was from Mr. Jack Chu, the chiseled man from Physiomattice podcast. And he asked me to articulate my views on to what extent would I try and change the runner's gate to come as in for gate analysis. But he's not in any pain and he just wants to get that PB or he just wants to become a better runner.
So in other words, how much can I influence performance by making tweaks to running for? Pretty interesting topic. A tricky one, because there's always one of the things that I try and do and it's kind of the niche of people that I sit in is very much, have we got any evidence for it? Because as soon as you leave evidence-based practice, you open up the doors to all sorts of pseudoscience and anecdotal evidence.
And some things which may be worth trying, you've got to realize there's no proof they're going to work and you mustn't chase them. And if you have a pyramid of evidence-based first of all, and then if that's all covered, then work your way up a little bit. If you really start and there's not a good evidence-based practice to follow, then maybe you start trying the other stuff. But as hopefully we'll see through these broadcasts, a lot of people when it comes to running injury performance, will start with non-evident-based practice at the top of the pyramid, which I'm not saying you should totally ignore, but they'll go straight, for example, to actually punch because they're Achilles hurts rather than starting off with more evidence-based heavy loading, abstaining maybe from stretching if it's an insertion or Achilles problem.
Because unfortunately runners will always go for the quick fix, and also they'll go for the most attractive option. And that comes into getting as is as well because runners will look at the pictures, they'll look at the blurb, and the more scientific it looks, the more flashy lights, the more theatre, then the more likely they are to go and spend their money. In fact, Ian Griffith is watching now once accused me of theatre. Oh my god, I like that, and meekins when I frown.
Anyway, Ian Griffith wants to ask about body marking. If you're not following Ian and watching SportsPod, he'll be creating pain, lots of fantastic information on looking at the foot-end of running. Too much emphasis is placed on from the hips down. Obviously, the head cam worked the other way up from foot upwards, and Ian Griffith is in great pain.
I go to people for looking at when indeed you might miss that foot-up approach, or indeed looking at everything, but not forgetting that foot. Anyway, as Ian Griffith's once asked me, why did you do body marking that? What's the idea of felt tipping people with foregate analysis? And I obviously defended it, being loyal to my company and the Stride UK.
But in actual fact, at the time, now we don't use body marking, now we've got depth-sensing cameras, which allow us to get a digital imprint to the person without any body marking, which is fantastic. But at the time, we were conscious that body marking, potentially, as long as you didn't go down any red-haired roads, was better than just using the naked eye in some cases. It made it a little bit easier for angles and things to stand out when you stand back and look globally. But also, let's not lie, the body marking was part of, I don't like the word theater, but it was part of the same way as you wipe down the couch and put on a clean paper before you bring someone into the clinic.
It's part of the package, which makes runners feel comfortable, which opens up their ears, which then allows you to look at the individual rather than just focusing on their ankle, which is hurting. So, we don't use body marking anymore, but definitely it's marketing, isn't it? Not in a bad way, it's just marketing in the sense of, there you go, you forgot about that. Well, I didn't forget about it and I'll find you.
Anyway, so yeah, it's not theater, so it's just, what am I talking about? Oh, because you have to be aware that runners will migrate towards the fluscious, most fantasy equipment. And as I said in the first broadcast we did, how fantasy and technical and the data your equipment produces with a gator now is. It means nothing, means absolutely nothing if you're making bad interpretations if you're not following the evidence.
I'm even more aware that now using motion metrics because it's a fantastic bit of kit and it's a bit of kit which I've trained people in Kenya recently. I'm very confident in it and I'll happen to do great workshops anywhere using the kit. But I'm just as quick, if not first thing I'll say is this bit of kit is useless unless Martin, how are you doing? Talking about Kenya, he's one of the lovely gentlemen of physios on it in Kenya during my time there.
So Kenyan physio, so check him out, check him out just to be a better person. That's what I like to say about Martin. Hi Martin, how are you? Anyway, yeah, you're flescious, your kit is useless unless you know how to interpret it.
So there was my 10 minute introduction of what we're talking about today. So yeah, so Jack Chu's question was, when do you change someone's form if it's not actually in pain or anything? That was my main question. So yeah, great question.
When people come to see us and they're not in pain and they just want to run faster or run longer for a quick period of time. There's obviously all sorts of temptations to give them something revolutionary, give them something new. You've got this fantastic kit and the last thing you want to do is actually say, you know what mate, it's all looking pretty good, you're running forms fine. But sometimes that's going to be the case.
One because maybe you haven't got any evidence to suggest otherwise, pass my regards to the Chu. I will do my friend Martin, I will do. Sometimes because you haven't got evidence to suggest otherwise. And sometimes more importantly is because there's something more evidence based which is holding back their performance.
So again, if you haven't checked out the first broadcast I didn't get analysis and maybe go back and have a little look. But again, using that pyramid idea, I can't see it by the comments now, doing the pyramid idea, we know that definitely with injury 60, 70% of injuries are because of inappropriate training. And then we know to a certain extent better than any other application that strength training can hold people back. The whole philosophy and idea behind the elastic we call exchange and all that.
If you haven't got the strength of those springs, then that's going to hold you back. So strength is very important. And also we know that there's a lot of myths out there which runners of all levels go chasing in seeking improvements to performance, particularly in getting rid of injury or reducing injury risk. Which we can either say probably not very likely or you know what, it's just you're running up a I can't think of expression.
You're just chasing. You're going down a rabbit hole. It's just there's no evidence for it. I know it's expressed in massive red letters, all other websites.
But you haven't got to run at 180 steps a minute mate. I'm sorry, it just doesn't make sense. And maybe your performance is being held back by that. So do we tweak a runners form when they come in and they're not suffering from pain?
Number one rule, go through the more evidence based stuff first of all. Don't skip it. Go through the case history. The fact that the runner has come through the door to see you probably means there's something up.
Unless they want to vouch or a friend just say I'll go and check them out. Even when the friends says go check them out, there's probably something in their back of their mind which is even if they're not injured that they feel they're being held back. I've had people come from the States who have come all the way here and I've checked in the emails like in an educated profession away like saying why are they coming all the way from Las Vegas to Hove. What is it that you're hoping to get here that you're not getting in the States with all the information you've got there?
And again, because a certain amount of the attractions are they must know all the stuff over the pond. It works both ways. We think America's so far advanced with their technology but they think we are as well. So again, I have to make sure before someone travels that far, I mean that's quite extreme example.
But even coming from the North, if I'm not even even higher, then I want to make sure that the reason is why they're coming down. So anyway, they come through the door. The fact they're coming to see you and they're willing to spend money is that something's up. And maybe it's the belief that their running form is not working.
It's not right. Maybe it's that belief which I, Francis, a massage. So you'll find that's fantastic career in if that's your name Francis, a massage. Anyway, maybe the belief that their running form is not right is what's actually holding them back.
So that's an important thing to consider in the case history and the consultation. So let's imagine that a runner, you've covered their case history, you've covered their beliefs. They're not purposely trying to do something which might not be true or might not be helping them. What about if all that's covered and then you get another treadmill?
What is it that you might see which you might decide, you know what, let's try tweaking this. Let's have a play around with these bits of the puzzle and see how it goes. Well, we've covered it before on high-risk, right? We've covered it before on the other, on various podcasts and stuff.
But there's kind of four or five hot areas where we know we can tweak areas which, although there's no one perfect running style, we know that there's similarities between the best forms out there. So we're talking now about your cadence. We're talking about now about how close the foot is landing to the body. I.e.
are the over-striding. We could link it into the amount of movements in the pelvis, either laterally or particularly laterally. Maybe there's less evidence than two in posterior, but we could look at that. Remember, this is for a runner who isn't in pain whatsoever.
We could look at crossover. Tricky again, because for every bit of evidence, switch links, crossover gate to maybe an early tibial band syndrome or tibial stress syndrome. There's another bit of research which shows there's not a link. With performance, the evidence is almost never going to be there because it's very difficult to get quality research for performance because they're sending other factors.
You can't rule out nutritional change or recovery change. You can try and make some factors act the same, but you can never pinpoint it and narrow it down to it. It must be this that's causing the benefit. So it does turn into a little bit of a guessing game.
And I think that's probably one of the healthiest things to get across to your runner is help them realize that it's not black and white. If you're suggesting that their cadence is particularly low for the speed that they're running at, notice I said for the speed they're running at, maybe that low cadence is creating a high vertical oscillation or something which you think may be wasting energy and reducing their efficiency. If the kind of signs you've got adds up, then let them know we should try this. Not if they've got like an important race coming out the next few weeks because we know it's going to take at least four to six weeks for habits to change and that's what you're playing with.
But if they're in a period of their training where it is after races or in a kind of a progressive season or cycle where they are tweaking stuff and they've got that luxury to be able to change things, then yeah, give them some ideas to play around with and try. I'm not a massive fan of that expression if it ain't broken and don't try and fix it. I think it's a little bit kind of polar and the fact that the person's come through the door means they're looking for some help. Don't jump straight to trying to, the word fix is wrong, but don't jump straight to trying to modify the biomechanics.
Make sure you look at the stuff at the bottom of the perimeter first of all. But I think tweaking a runner's form when you've got particular things that they're doing which have been linked to more or less successful running forms. I think that's perfectly healthy at the right time of year and it's something where you might really help them by either reducing their cadence or trying to increase their cadence, maybe doing some gateway training to increase their width, the step or something, maybe trying to get into a run taller or reduce the amount of flexion. There's plenty of variables we can play around with, but it is a bit of a game.
You just let your runner know that we're going to try this. We're going to try and keep all other factors the same because otherwise, you know, how do we know that this made the difference? And we'll get back together and see how it's going. I think that's a healthy thing to do.
Where are we? What time is it? Is the Burley Marathon finished yet? Is anyone watching it?
Can it be finished? No, it must be in the near the end. Is anyone watching the Burley Marathon? I don't know what's going on because I need my phone.
Okay, well it's 10-17. Hi Brad, how are you going Brad? Nice to see you. Well people are actually joining today.
This is incredible. Well I'm rounding out to an end because I'm really keen to see what's going on by the Burley Marathon. But anyway, so to round things up, Gates and Alice's, how much do you, it's a Jack Chews question, how much do you tweak someone's running form if they're not on any pain? And they're literally just coming because they want to perform this in answer to some form.
In a nutshell, before you do any of that, make sure that the more evidence-based parts of the pyramid are covered as in their training, consistency, as in their strength training, as in their nutrition, their recovery, as in false beliefs which could be holding them back or making them chase their false beliefs. You've got to cover all of that. And that's what we said in the first broadcast of the game. And Alice's is not just about the treadmill.
Okay, definitely not. It's about the three triangles of taking a case history and having the conversation that comes from that. It's about the physical assessment so you know if there's strength, potential strength deficits or maybe mobility deficits. Although personally again my biases, I believe that too much emphasis has put on mobility deficits.
It's about challenging any misconceptions or any situation they've got. And then once you've got that major part pieces of the puzzle, then put them on the treadmill and only start changing things once that's covered. And that's it. So sorry if you just joined me, Brad.
It depends. I have clinic today. I've got somebody in like 20 minutes. So it all depends on the train coming in.
But I'll try and do these if they're popular. It's great to see if people actually still watching. But I'll try and do these like around 9.59.39.45, which depends on a lot of factors. So it depends a lot on that.
So I'm going to sign off now. I hope you let you watch what I've talked about. As always, feel free to leave comments. I want this to be educated for everybody including myself.
Particularly when we've got people like Brad Niel who, if you're not following them, you have to follow. He's again a go-to guy for the biomechanics of running, especially knee orientated. You've got like I said Ian Griffiths who's a go-to guy for the boudai tree side of things in running, which is either ignored too much of the time or as full of myths and conceptions as he introduces all of us to some points in our career. So yeah, please leave notes if there's anything you don't agree with or stuff which you think it might be interesting for us to talk about.
I don't know whether Runners are going to watch this or Therapists. We'll see how it goes by in number three or three. Anyway, I've got to get ready and see how Kitchock is doing. Thanks for tuning in.
See you next Sunday around 9.30. You're listening to OneChat Live podcast, putting the evidence back into running injury and performance.