Interdisciplinary Case Miles

What if your hip pain is actually coming from your ankle? Episode 18 of Interdisciplinary Case Miles follows a 38-year-old ultra marathon runner with lateral hip pain, back discomfort, and a long history of recurring ankle sprains.What many runners dismiss as “no big deal” can lead to instability, altered mechanics, and long-term performance limitations.This conversation connects chronic ankle sprains to changes in the kinetic chain, showing how foot and ankle instability can drive hip and back pain. It also highlights the role of ligament health, balance, and neuromuscular control in keeping runners strong and resilient. Nutrition and hydration are also key factors especially for ultra and trail runners.Fueling, collagen support, and electrolyte balance all influence healing, coordination, and injury risk. Whether you’re running trails in the mountains, training for your next ultra, or dealing with nagging injuries that won’t go away, this episode offers practical, evidence-informed strategies to improve stability, prevent setbacks, and optimize performance. 00:00 – Intro to Interdisciplinary Case Miles Meet the team and today’s focus on real runner cases. 01:10 – Case Overview: Ultra Runner with Hip & Back Pain A 38-year-old athlete presents with lateral hip pain, but there’s more to the story.03:15 – The Overlooked Clue: Chronic Ankle Sprains Why “it doesn’t hurt” doesn’t mean it’s not a problem.06:20 – Hip Impingement vs. Kinetic Chain Dysfunction How foot and ankle issues can drive hip pathology.09:10 – Hypermobility vs. Tightness Explained Why some joints are loose while others compensate. 12:00 – What Happens When You Keep Spraining Your Ankle Ligament damage, collagen breakdown, and loss of stability over time.15:30 – The 2% Stability Loss Rule Why repeated ankle sprains create long-term dysfunction. 18:40 – How Ankle Instability Causes Hip & Back Pain Connection between foot mechanics, glutes, and loading patterns.22:10 – Physical Therapy Strategies for Ankle Stability Balance training, foot control, joint mobilization, and plyometrics.27:00 – Collagen, Nutrition & Ligament Healing What runners need to know about fueling and recovery.30:15 – Electrolytes, Hydration & Injury Risk How dehydration affects reaction time, coordination, and proprioception.34:40 – Trail Running Risks & Cognitive Fatigue Why fueling impacts decision-making and injury prevention.38:10 – Shoe Choice & Terrain Considerations Stack height, stability, and trail-specific risks.42:20 – When an “Ankle Sprain” Might Be More Serious Recognizing fractures and complications. 45:00 – Key Takeaways from Each Expert Simple, actionable advice to prevent and manage ankleinstability.Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Is your low back pain coming from running or is it something else entirely?In this episode of Interdisciplinary Case Miles, Dr. Sara Raiser, sports medicine physician and running medicine speicalist, Dr. Kate Mihevc Edwards, orthopedic physical therapist and running PT, and sports dietitian Kelsey Pontius walk through a runner case involving low back pain during the perimenopause transition.The case involves a 41-year-old female physician and half-marathon runner who initially seeks help for nutrition during perimenopause. During the consultation, she casually mentions intermittent low back pain, poor sleep, and high work stress, factors that can all influence recovery and musculoskeletal health.The conversation expands into a deeper discussion of how hormonal changes, sleep quality, fueling habits, biomechanics, and pelvic floor health can all play a role in back pain for runners. We explain how shifting hormones like estrogen, progesterone, and testosterone influence collagen health, tendon recovery, muscle repair, sleep quality, and energy levels. For active women, these changes can show up as slower recovery, stubborn body changes, and nagging aches that weren’t there before.In this episode, we discuss:Why low back pain in runners is often multifactorialThe impact of perimenopause and hormonal changes on recovery and connective tissueHow sleep and fueling patterns influence injury risk and healingWhy runners with back pain should evaluate core stability, breathing, and pelvic floor functionHow hip mobility and running mechanics can affect the lower backWhen back pain requires medical evaluation—and when runners can safely stay activeStrategies to keep running while managing back discomfortIf you're a runner dealing with low back pain, sleep disruption, hormonal changes, or training stress, this episode explores how all of these factors intersect and what you can do to stay healthy and keep running.If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives. This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes  and stronger runners.00:00 — Podcast IntroductionMeet the hosts and overview of Interdisciplinary Case Miles.01:05 — Case Introduction: Perimenopausal Runner. A 41-year-old half-marathoner experiencing body changes, sleep issues, and intermittent low back pain.02:30 — Nutrition & Hormonal Changes in PerimenopauseHow hormonal shifts affect recovery, metabolism, and nutrition needs.05:10 — Addressing Body Changes & Sleep FirstBody neutrality, sleep quality, and fueling regularly during busy workdays.08:00 — Medical Evaluation of Low Back PainDr. Reiser explains axial back pain, possible causes, and clinical screening.11:00 — Physical Therapy AssessmentCore activation, breathing patterns, pelvic floor health, and movement mechanics.14:00 — Running Mechanics & Back PainHip mobility, posture, and how running form can influence back stress.17:00 — Training Modifications & Staying ActiveWhen runners should modify activity instead of stopping completely.20:00 — Managing Persistent “Niggling” PainUnderstanding chronic discomfort and avoiding unnecessary interventions.22:00 — Pre-Run & Post-Run StrategiesSimple mobility and activation exercises that may reduce pain.23:30 — Key Takeaways from Each ExpertBack pain management, nutrition mindset during body changes, and pelvic floor considerations.24:45 — Episode Wrap-UpClosing thoughts and invitation to follow and share the podcast. Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Are you hobbling to the bathroom in the morning because of heel pain? Many runners with plantar fasciitis ignore that early symptom for months until it starts affecting every run. In episode 16 of the Interdisciplinary Case Miles Podcast, Dr. Sara Raiser, sports medicine physician and running specialist, Dr. Kate Mihevc Edwards, orthopedic physical therapist and running PT, and sports dietitian Kelsey Pontius break down a case involving chronic plantar fasciitis that slowly worsened over time.The case involves a 42-year-old runner who runs 3–5 miles nearly every day to manage work stress. For over a year she ignored classic plantar fasciitis symptoms, morning heel pain and stiffness after sitting because the pain would improve once she started moving. Eventually, the pain began showing up during her runs and getting worse halfway through, forcing her to finally seek help.In this episode, the team explains why plantar fasciitis often becomes a chronic plantar fasciopathy, why morning heel pain happens, and why runners often wait far too long before addressing the root causes.You’ll learn:Why morning heel pain and hobbling after sitting are classic plantar fasciitis symptomsWhy many runners develop plantar fasciitis after months or years of subtle warning signsWhy foot strength and running mechanics matter more than stretching aloneThe role of calf mobility, great toe motion, and the kinetic chain in plantar fascia loadingWhen treatments like shockwave therapy, PRP, or injections may be appropriateWhy plantar fasciitis rehab can take 6–9 months for chronic casesHow nutrition, protein intake, vitamin D, and micronutrients support connective tissue healingThe mental side of injury when running is your primary stress reliefHow long rehab realistically takesIf you're a runner struggling with heel pain, plantar fasciitis, or foot pain when you first step out of bed, this episode will help you understand what’s really happening and how to recover without giving up running.If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives.This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes  and stronger runners.00:00 — Podcast IntroductionMeet the hosts and overview of Interdisciplinary Case Miles.01:05 — Case: Chronic Plantar FasciitisA 42-year-old runner dealing with persistent heel pain.03:20 — What Plantar Fasciopathy MeansWhy this injury is usually chronic rather than inflammatory.05:40 — Evaluation & DiagnosisGait analysis, imaging, and identifying root causes.08:40 — Treatment FoundationsStrengthening the foot and addressing biomechanics.11:20 — Physical Therapy & Rehab TimelineWhy recovery may take several months.14:10 — Running Mechanics & Foot FunctionKey mobility and strength factors affecting the plantar fascia.17:00 — Nutrition for HealingProtein, collagen support, and key micronutrients.19:30 — Vegetarian Diet ConsiderationsEnsuring adequate amino acids and nutrients.21:10 — Mental Side of InjuryManaging stress and staying engaged during recovery.23:20 — Key TakeawaysFinal advice from each expert.24:40 — Episode Wrap-UpClosing thoughts and how to submit a case.Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

 Do You Need PRP or Is Rehab the Real Fix?In Episode 15 of the Interdisciplinary Case Miles podcast, we discuss a case involving a 40-year-old age group runner whose long-standing hamstring tendinopathy became acutely aggravated after a slip on ice revealing the layered challenges of acute-on-chronic tendon pain in runners.This case highlights why proximal hamstring injuries require precise diagnosis and an individualized treatment plan. Dr. Sara Raiser(MD) explains how to differentiate high hamstring tendinopathy from lumbar spine or nerve-related pain, when imaging such as MRI or diagnostic ultrasound is indicated, and how to determine whether a partial tear is present.The conversation also covers when regenerative medicine options like platelet-rich plasma (PRP) injections or percutaneous tenotomy may be appropriate, and why they are rarely first-line treatment.Dr. Kate Mihevc Edwards(PT) takes us through the rehabilitation process, including early integration after PRP, the role of blood flow restriction (BFR) training, and why eccentric strengthening remains the gold standard for tendon rehabilitation. She emphasizes addressing the entire kinetic chain hip mobility, lumbar and thoracic spine mechanics, neural tension, gait changes, and stiffness patterns that often contribute to chronic hamstring overload. You’ll also hear practical insight into return-to-run timelines, common pain spikes around the six-week mark post-PRP, and how to safely reload a healing tendon.Sports dietitian Kelsey Pontius rounds out the discussion by explaining how nutrition directly influences tendon healing and regenerative outcomes.The team discusses energy availability, protein targets, iron status, collagen-supporting micronutrients like vitamin C, zinc, and copper, and how fueling strategies can optimize recovery after procedures like PRP and during BFR training.If you’re dealing with chronic hamstring pain, considering PRP for a running injury, or navigating a return to running after a proximal hamstring tear, this episode offers evidence-informed guidance from a running medicine physician, physical therapist, and sports dietitian working collaboratively to support runner health and performance.If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives. This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes  and stronger runners.00:00 – Welcome to Interdisciplinary Case MilesHosts introduce the case-based, evidence-informed discussion format.02:00 – Case Presentation: High Hamstring Pain After a Slip40-year-old runner with chronic hamstring tightness that became acute after slipping on ice.05:00 – Why This Case Is TrickyChronic symptoms masked until an acute event; athletes often keep training through early tendon pain.08:00 – Medical Evaluation PrioritiesRule out lumbar spine and nerve involvement; assess for proximal hamstring tendon injury vs referral.12:00 – Timeline Matters: Acute on Chronic InjuryLong-standing tendon changes increase the likelihood of partial tearing with sudden load.15:00 – Imaging Decisions: When and WhyMRI used to confirm tendon involvement and rule out hip pathology that can mimic hamstring pain.18:00 – Why Rehab Comes FirstConservative care focuses on progressive loading, not rest, to restore tendon capacity.21:00 – Key Biomechanics: Hip Extension Drives LoadLimited hip extension shifts demand to the hamstring, increasing strain and injury risk.24:00 – When to Consider PRP or TenotomyProcedures introduced after failed rehab; choice depends on presence and size of tendon tear.27:00 – PRP vs Tenotomy: Clinical Decision MakingPRP for larger tears; tenotomy for smaller or degenerative tendon changes30:00 – Post-Procedure ManagementInitial protection followed by gradual return to loading and early reintroduction of rehab.33:00 – Rehab Progression After InterventionIsometrics → eccentric loading → return to running with controlled progression.36:00 – The Biggest Mistake Runners MakeRelying on passive treatments instead of structured strength and loading progression.39:00 – Final TakeawaysSara: Rule out spine and confirm diagnosis earlyKelsey: Recovery requires supporting the whole systemKate: Tendons don’t heal with rest—they need progressive load42:00 – Closing and Where to Learn MoreOutro and resources for runners dealing with hamstring pain.Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

A 41-year-old female runner and experienced half-marathoner develops mid-Achilles tendon pain, morning stiffness, and a noticeable bump along the tendon. Symptoms improve after warming up but return with longer runs, leaving her caught in the common cycle of pushing through pain, resting without progress, and uncertainty about what actually helps. She wonders if her tendon, “hurts at the start but warms up, is that okay?”In this episode of Interdisciplinary Case Miles, Dr. Sara Raiser (MD) , Kelsey Pontius, and Dr. Kate Mihevc Edwards (PT) discuss the clinical presentation of Achilles tendinopathy, why it often becomes chronic, and why complete rest is rarely the solution.Key topics include:Tendon loading principles and why tendons require progressive strength workBiomechanical contributors such as foot control, dorsiflexion limits, hip extension, and proximal weaknessThe role of perimenopause, estrogen changes, and life stress in tendon vulnerabilityNutrition foundations for tendon healing, including energy availability, collagen synthesis, and carbohydrate supportPractical considerations around footwear, heel-to-toe drop changes, and carbon-plated shoesIf you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives.This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes  and stronger runners.00:00 – Welcome to Interdisciplinary Case MilesHosts introduce the evidence-informed case format.02:05 – Case Presentation: Mid-Achilles Pain in a Half-Marathon RunnerMorning stiffness, crepitus, tendon thickening, and pain that fluctuates during runs.05:10 – Why These Cases Are ChallengingThe warm-up effect, post-run soreness, and training “push-through” patterns.08:20 – Medical Evaluation PrioritiesTraining changes, hormonal factors, surgery history, and load management.12:30 – Tendons Require More Than RestWhy conservative care emphasizes strength, mechanics, and progressive loading.16:10 – Foot Posture and the Kinetic ChainRigid vs flexible feet, arches, glute engagement, and core contribution.20:05 – Achilles Mechanics: The “Wringing Out” EffectHow pronation and poor control increase tendon stress.24:40 – Running With Tendinopathy: Pain Monitoring GuidelinesWhen continued running can be appropriate and how to track symptom response.28:10 – PT Interventions: Eccentrics, BFR, and Load ProgressionStrength-based tendon rehab and improving blood flow.32:45 – Nutrition for Tendon HealingEnergy availability, collagen synthesis decline with age, and micronutrient support.37:20 – Collagen Supplement Timing and Practical UseWhy collagen works best 30–60 minutes before tendon loading.41:10 – During-Run Fueling and Injury RiskCarbohydrate needs, glycogen depletion, fatigue-related mechanics breakdown.45:30 – Chronic Tendon Changes Take TimeWhy tendinopathy develops over years and requires patience in rehab.48:10 – Proximal Drivers: Low Back, Hip Extension, and Glute FunctionHow upstream issues overload the Achilles.52:20 – Footwear Considerations and Heel-to-Toe Drop ShiftsCarbon-plated shoes, shoe rotation, cushion effects, and transition errors.57:30 – Final TakeawaysSara: Tendon recovery takes time but allows continued activityKelsey: Fueling protects long-term tissue healthKate: Rest alone fails tendons need load and strength adaptation1:01:30 – Closing and Case Submission InfoBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

What happens when a highly conditioned collegiate swimmer transitions into marathon training too quickly? In this episode of Interdisciplinary Case Miles, a 23-year-old former swimmer increases weekly mileage from 15–20 miles to 40 miles, adds hills and speed work, and begins to worry about low ferritin when performance stalls.What initially appears to be an iron concern reveals a broader picture involving low energy availability, fueling gaps, training load errors, and bone stress injury risk, ultimately resulting in a diagnosis of femoral shaft stress fracture.Dr. Sara Raiser (running medicine physician), Kelsey Pontius (sports dietitian), and Dr. Kate Mihevc Edwards (physical therapist) discuss:Why ferritin is often a marker of a larger issueThe relationship between nutrition, iron stores, and bone healthUnique injury risks when transitioning from non-weight-bearing sportsHow cardiovascular fitness can exceed musculoskeletal readinessRehabilitation principles, plyometric loading, and safe return-to-run progressionsThis episode is essential listening for runners, clinicians, coaches, and endurance athletes navigating performance concerns, injury prevention, and the demands of marathon training.00:00 – Welcome to Interdisciplinary Case MilesMeet the hosts and the evidence-informed approach behind real runner cases.02:10 – The Case IntroductionA former collegiate swimmer increases mileage from 20 to 40 miles/week while marathon training.04:45 – “Is It My Ferritin?”Why athletes fixate on iron and ferritin when performance plateaus.07:30 – Ferritin vs Iron ExplainedWhat ferritin actually represents and why it changes slowly.10:15 – Red Flags for Low Energy AvailabilitySleep, libido, GI symptoms, recovery, and early warning signs of REDs.15:40 – Nutrition, Bone Density, and Stress Injury RiskHow low ferritin, low energy intake, and bone health intersect.18:30 – Thigh Pain Isn’t “Just a Quad Strain”Why distance runner thigh pain raises concern for femoral stress fractures.22:15 – Diagnosing a Femoral Shaft Stress FractureWhy this injury matters and how it differs from higher-risk stress fractures.26:40 – The Swimmer-to-Runner ProblemCardio fitness vs bone loading, gravity, and anti-gravity sports.31:50 – The Three Pillars: Nutrition, Training Errors, BiomechanicsA framework for evaluating bone stress injuries.36:20 – Training Errors That Add Up FastMileage spikes, speed work, lack of rest, and life stress post-college.41:10 – Starting PT Before You Run AgainStrength, education, and early rehab during protected weight-bearing.45:30 – Plyometrics, Bone Loading, and Return-to-RunWhy jumping matters and how bones adapt to force.50:40 – Bone Geometry, Density, and Multi-Directional MovementWhy specialization matters—especially in adolescence.55:30 – The “Engine vs Chassis” ProblemWhen cardiovascular fitness outpaces muscles, tendons, and bones.59:20 – Why Return-to-Run Feels So HardManaging athlete frustration while protecting long-term health.1:02:30 – Final Takeaways from Each ExpertBig-picture thinking, history matters, and don’t self-coach in isolation.1:06:00 – Wrap-Up & How to Submit a CaseBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

In this episode of Interdisciplinary Case Miles, Co-hosts Dr. Kate Mihevc Edwards (PT), Dr. Sara Raiser (MD) and Kelsey Pontius (RD) discuss a case about a exertional leg pain in a 19-year-old collegiate distance runner.Dr. Sarah Raiser leads this case and explains how exertional leg pain can present in runners, outlining key diagnoses such as chronic exertional compartment syndrome (CECS) and popliteal artery entrapment syndrome (PAES). The discussion also covers how these conditions differ from stress fractures, nerve-related pain, and other causes of lower-leg symptoms, as well as how these cases are properly evaluated and diagnosed.Dr. Kate Mihevc Edwards addresses the physical therapy and gait-related factors that may contribute to exertional leg pain, including overstriding, crossover gait, heavy landings, strength deficits, and footwear considerations. She discusses when conservative management may be appropriate, when surgery may be indicated, and the importance of runner-specific, functional strength training during rehabilitation.Sports dietitian Kelsey Pontius shares the nutrition considerations relevant to these cases, including hydration, blood flow, anti-inflammatory nutrition, nitrates, and the role of adequate fueling to support recovery, gait changes, and long-term adaptation—particularly in injured collegiate and high-level runners.Key topics in this episode include:Common causes of exertional leg pain in runnersChronic exertional compartment syndrome vs. other diagnosesGait retraining and physical therapy considerationsSurgical and non-surgical treatment optionsThe role of fueling and hydration in injury recoveryThis episode is relevant for runners experiencing persistent lower-leg pain, clinicians working with endurance athletes, athletes, coaches and anyone interested in an interdisciplinary, evidence-informed approach to running injuries.Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Welcome to Interdisciplinary Case Miles, a podcast where real runner stories meet clinical expertise.In Episode 11, Dr. Kate Mihevc Edwards (PT), Dr. Sara Raiser (MD), and sports dietitian Kelsey Pontius break down a common but often misunderstood injury: shin splints (medial tibial stress syndrome) in adolescent runners.Using the case of a 15-year-old male cross-country runner with bilateral shin pain, the team explores why shin splints are so prevalent in this age group and how rapid growth, training load changes, biomechanics, footwear, surfaces, and nutrition all intersect. The discussion highlights the critical role of energy availability, especially during periods of rapid growth, and why skipping meals, inadequate fueling, and school-related barriers to eating can contribute to ongoing symptoms.The hosts also discuss how shin splints can look very different depending on the athlete’s age and training history ranging from sudden spikes in mileage to more complex, layered cases involving chronic pain, stress, and low energy availability. From a physical therapy perspective, the episode covers gait patterns during growth spurts, strength and mobility needs, and the importance of collaborating with coaches and parents to support young athletes.In this episode you’ll learn:What shin splints are and how they differ from other bone stress injuriesWhy adolescents are at higher risk during growth spurtsThe role of nutrition and energy availability in healing shin painCommon fueling challenges for high school athletesHow training load, surfaces, shoes, and spikes affect shin stressWhy interdisciplinary care leads to better outcomes for young runnersAs always, this episode reinforces a core message of Interdisciplinary Case Miles: shin splints aren’t just a “training issue” or a “nutrition issue” they’re often both. Supporting young runners requires understanding the whole picture and meeting athletes where they are.Subscribe for evidence-informed conversations on running healthLike, rate, and share this episode with parents, coaches, and runnersHave a case you’d like us to discuss? Email us at [email protected] a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Welcome to Interdisciplinary Case Miles, a podcast where real runner stories meet clinical expertise. In this episode, Dr. Kate Mihevc Edwards (PT), Dr. Sara Raiser (MD), and sports dietitian Kelsey Pontius present a common but often misdiagnosed case of glute tendinopathy in a female runner during the menopause transition.This case goes over running biomechanics, hormonal changes, nutrition, sleep, and recovery. The team explores how perimenopause and menopause-related hormonal shifts particularly changes in estrogen can affect tendon health, joint lubrication, gut function, nutrient absorption, sleep quality, and overall healing capacity.This episode discusses misconceptions around weight, health, fueling, and aging, emphasizing that bodies are meant to change and that under-fueling, overtraining, and “black-and-white” health advice can slow recovery and increase injury risk. The hosts discuss why glute tendinopathy is often misdiagnosed as bursitis, how to properly evaluation lateral hip pain, and why a stepwise, individualized approach to care is essential.Some of the main topics include:-The role of hormones in tendon health and injury risk-Why weight is not a reliable indicator of health-The importance of adequate fueling, including carbohydrates, during midlife transitions-How sleep, stress, and digestion impact healing-Why interdisciplinary care leads to better outcomes for runnersThis episode reinforces a core theme of the podcast: there are no one-size-fits-all answers in medicine or performance. By understanding the whole person and working with the body rather than against it runners can recover more effectively, reduce injury risk, and continue doing what they love.                                                                                                                      00:00 Welcome to Interdisciplinary Case Miles01:25 Meet the Hosts & Their Clinical Roles04:00 What We’ve Been Working On Lately06:15 Kelsey’s New Ebook: Miles & Meals09:30 Outreach, Education & Bridging the Gap in Running Medicine13:10 Returning to Running After Health Challenges16:20 Introducing the Case: Lateral Hip Pain in a Midlife Runner19:45 Nutrition, Hormones & Gut Health in Perimenopause24:30 Bodies Are Meant to Change28:40 Weight Is Not Health & The Risk of Under-Fueling33:20 Why Glute Tendinopathy Is Often Misdiagnosed as Bursitis38:10 Estrogen, Collagen & Tendon Healing43:50 Biomechanics, Hip Load & Physical Therapy Considerations49:30 Pelvic Floor, Core Health & Hip Pain53:40 Sleep, Stress & Recovery During Midlife Transitions57:45 Doing Less to Heal More01:01:30 Key Takeaways from Each Expert01:04:10 Final Thoughts & How to Connect with the TeamBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Welcome to Interdisciplinary Case Miles, a podcast where real runner stories meet clinical expertise.In Episode 10, Dr. Kate Mihevc Edwards (PT), Dr. Sara Raiser (MD), and sports dietitian Kelsey Pontius address a very common question: Can you keep running with knee osteoarthritis?Using the case of a 60-year-old male runner with knee OA, the team walks through how clinicians evaluate pain, imaging, goals, and functional limitations to help runners make informed decisions about continuing to train. The discussion covers activity modification, gait retraining, strength and mobility work, physical therapy, injections, regenerative medicine options, and when knee replacement may become part of the conversation.The episode also highlights the role of nutrition, hydration, inflammation management, and consistency in supporting joint health and long-term running longevity especially for master’s athletes. As always, rather than offering black-and-white answers, the hosts emphasize individualized care, realistic expectations, and meeting runners where they are. This episode reinforces a core message of Interdisciplinary Case Miles: staying active with OA is often possible, but it requires an individualized, interdisciplinary approach.In this episode, you’ll learn:How knee osteoarthritis is evaluated in runnersWhen running may still be appropriate and how to modify itThe role of physical therapy, gait retraining, and strength workInjection and regenerative medicine options for knee OANutrition strategies to support joint health and recoveryHow to think about longevity, pain management, and performance00:00 – 02:30 | What this podcast is aboutAn interdisciplinary approach to keeping runners healthy and active.02:30 – 05:00 | The case: 60-year-old runner with knee OAAnterior/medial knee pain and the big question—can I keep running?05:00 – 09:30 | How clinicians decide if running is appropriateImaging, goals, symptom history, and functional exams matter more than age alone.09:30 – 13:30 | Using pain to guide training decisionsWhy pain doesn’t have to be zero—but must stay controlled to avoid gait changes.13:30 – 18:30 | Physical therapy priorities for knee OABalance, quad/glute/core strength, and restoring mobility across the kinetic chain.18:30 – 23:00 | Injection options explainedSteroids vs. hyaluronic acid (“oil change”) and realistic expectations for pain relief.23:00 – 27:30 | Regenerative medicine: who benefits mostPRP, mild-to-moderate OA, bone pain considerations, and insurance realities.27:30 – 32:30 | Gait retraining and shoe changesCadence, footwear, and subtle form tweaks to reduce knee stress while running.32:30 – 36:30 | Training modifications for longevityCross-training, deloads, and strategic adjustments instead of stopping running.36:30 – 41:00 | Running after knee replacementCurrent recommendations, real-world experiences, and individualized decisions.41:00 – 46:00 | Nutrition strategies to support joint healthAnti-inflammatory foods, hydration challenges in master’s athletes, and consistency.46:00 – 49:30 | Lifestyle factors that affect recoveryEating patterns, fueling consistency, and supporting healing capacity.49:30 – 52:00 | Key takeaways & closing thoughtsPain management, teamwork, and why nutrition is always part of the equation.Become a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Welcome back to Interdisciplinary Case: Miles, where real runner stories meet clinical expertise. In Episode 8, Dr. Sara Raiser (MD), sports dietitian Kelsey Pontius, and physical therapist Dr. Kate Mihevc Edwards (PT) team up to break down a complex case: a mid-30s female roadrunner and backpacker navigating persistent butt pain, posterior leg symptoms, and unexpected GI challenges. This episode uncovers why seemingly simple running injuries often have not-so-simple causes and why a whole-body, interdisciplinary lens matters.In this case study, we explore:Buttock and posterior thigh pain, what “sciatica” really means, why it’s often misdiagnosed, and how nerves, joints, tendons, and biomechanics interactThe nervous system connection how an injury high up (like the hip or butt) can contribute to issues farther down the chain, including the AchillesThe hidden role of nutrition & gut health, IBS, GI testing, microbiome insights, nutrient absorption, and how underfueling impacts nerve healing and recoveryBreathing, stress & recovery why parasympathetic activation, rest, and mindful eating support both performance and injury resolutionClinical decision-making differential diagnoses, red flags, when imaging is needed, and how PT, nutrition, and sports medicine intersectReal-life biomechanics like hiking with a backpack, running form, posture, core engagement, nerve mobility, and how everyday habits amplify or relieve symptomsThis episode takes a comprehensive look at the messy, interconnected reality of running injuries where gut function influences glute activation, posture affects nerve mobility, and stress and recovery can make or break healing. Whether you’re a runner, clinician, or coach, you’ll walk away with: A clearer understanding of butt and posterior leg pain Practical insights on GI issues, fueling, and stress management A roadmap for thinking holistically about athlete health.00:00 – Podcast Intro & HostsOverview of Interdisciplinary Case Miles and introduction of the three clinicians. 01:35 – Case Overview: Mid-30s Female Road RunnerRunner background, hiking/backpacking at altitude, work-from-home lifestyle, inconsistent meals. 03:40 – Initial Presentation: Butt & Posterior Thigh PainWhy the PT flagged nutrition as a possible barrier to healing.05:30 – GI Symptoms & IBS-C / IBS-D ExplainedConnection between alternating constipation/diarrhea, discomfort after meals, and training disruption. 07:40 – Why Gut Health Matters for Injury RecoveryMicronutrient absorption, inflammation, and nerve healing considerations.09:40 – Nutrition Interventions: Eating Enough & ConsistentlyHydration, missed meals, work-from-home challenges, and fueling basics.12:00 – Gut Testing & Microbiome FindingsTrail runner risks, lab testing, microbiome imbalance, and implications for healing. 14:20 – Polyphenols, Probiotics & Fiber StrategyGreen tea, targeted probiotics, fibers, and supporting beneficial bacteria.16:20 – Chewing, Digestion & Parasympathetic StateWhy slowing down eating and breathing matters for gut regulation.18:10 – Exercise Load vs Recovery (The “90-Minute Rest Day”)Why constant training prevents healing and nervous system recovery.19:50 – Medical Perspective: Diagnosing Butt PainHip vs spine vs nerve vs tendon; complexity of posterior chain pain in runners.22:20 – Red Flags & Imaging DecisionsWhen imaging, injections, and stepwise diagnostics are appropriate.24:45 – What “Sciatica” Really MeansWhy true sciatica is uncommon and often misdiagnosed.26:30 – Sciatic Nerve Anatomy & Referred PainLumbar roots, piriformis myths, nerve pathways, and distal injury risk.29:45 – Nerve Loading: Hiking, Backpacks & Downhill StressHow posture, stride length, and load affect nerve irritation.32:10 – Nerve Mobility & Gliding ConceptsWhy nerves get “stuck” and how that mimics muscle tightness.34:10 – PT Assessment PrioritiesSingle-leg control, posterior chain loading, core and hip coordination.36:30 – Piriformis Syndrome: What’s Really Going OnSecondary pain generators, trigger points, and referral patterns.39:00 – Gut Health, Core Control & Pelvic FloorHow GI distress, surgeries, trauma, and bloating affect muscle engagement.42:00 – Medications, Microbiome & Bone HealthPPIs, acne meds, absorption issues, and injury risk.44:30 – Manual Therapy & Anterior Chain ConsiderationsAbdominal work, hip flexors, visceral restrictions, and pain patterns.46:40 – Recovery Is the Missing LinkSleep, relative rest, nutrition, and why breakdown exceeds adaptation.48:40 – Key Takeaways: Nutrition PerspectiveSeeing experts, gut health beyond trends, mental health, and mindfulness.50:20 – Key Takeaways: PT & BiomechanicsRunning gait, hiking mechanics, backpacks, unloading the nerve.52:40 – Final Thoughts & ClosingBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

In this episode of Interdisciplinary Case Miles, Dr. Sara Raiser, sports dietitian Kelsey Pontius, and physical therapist Dr. Kate Mihevc Edwards team up to break down a challenging and relatable case of IT Band Syndrome in a 25-year-old female runner. What begins as knee pain following increased training and emotional stress unfolds into a deep dive on biomechanics, movement evaluation, nutrition, recovery, and the mind–body connection.Kate walks listeners through the full clinical picture from movement screens and gait analysis to the complex interplay between hip strength, foot mechanics, and neuromuscular control. Dr. Sara highlights the medical lens, including pain modulation, the role of the hip joint, and when interventions like shockwave therapy or injections can help support progress. Kelsey adds a nutrition-centered perspective, sharing how hydration, collagen-supportive foods, inflammation management, and lifestyle factors can influence tissue health and recovery.Together, the team explores why IT Band Syndrome develops, how emotional load and training spikes contribute, what to expect from a proper rehab timeline, and how seemingly small insights from running shoes to callus patterns can reveal key movement issues. Listeners will gain a clearer understanding of evidence-informed gait retraining, strength programming, and the importance of patience and consistency in healing.Whether you're a runner, clinician, or coach, this case is packed with practical takeaways, thoughtful discussion, and a healthy dose of running-nerdery.                                                                                  00:00 Welcome & introductions01:00 Case overview: 25-year-old runner with IT Band Syndrome04:30 Biomechanical findings: hip drop, knee valgus & overpronation08:30 Dr. Raiser’s medical insights: stress, pain patterns & recovery timelines12:30 Nutrition perspective: hydration, collagen & inflammation support16:00 PT approach: manual therapy, strength work & when to start gait retraining20:40 Footwear clues & common shoe/orthotic mistakes22:30 Key takeaways: patience, stress awareness & long-term strength development23:50 Closing thoughts & call to actionBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

In this episode of Interdisciplinary Case Miles, hosts Dr. Sara Raiser (MD), Kelsey Pontius, and Dr. Kate Mihevc Edwards (PT) break down a complex real-world case of a male marathoner caught in a cycle of injury, underfueling, and recovery.When multiple stress fractures, low testosterone, and low ferritin collide with emotional stress and high training volume, the team dives deep into how Relative Energy Deficiency in Sport (RED-S) affects performance, hormones, and bone health.Kelsey unpacks the concept of within-day energy deficits and the athlete’s struggles with reactive hypoglycemia. Dr. Raiser highlights why femoral neck stress fractures are among the most serious running injuries often requiring urgent imaging and complete rest. Dr. Edwards shares the detailed process of returning safely to running, from load management and biomechanics to rebuilding strength and confidence.This episode showcases the power of an interdisciplinary approach where nutrition, medicine, and physical therapy work together to help runners heal fully and sustainably.Episode Highlights00:00  Welcome & introductions01:10 Kelsey presents the case: male runner with recurring stress injuries07:45 Understanding reactive hypoglycemia and RED-S10:20 Dr. Reiser explains femoral neck stress fractures & key lab work16:50  Dr. Edwards on rehab, biomechanics, and safe return-to-run23:30  The importance of interdisciplinary collaboration28:40 Top takeaways for clinicians & athletesBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

A 32-year-old female runner and triathlete presents with deep anterior hip and groin pain that worsens with sitting, cycling, and running. Dr. Kate Mihevc Edwards (PT), Dr. Sara Raiser (Running Medicine Physician), and sports dietitian Kelsey Pontius dig into a complex but common clinical picture: when hip impingement (FAI), labral irritation, or soft tissue overload may be compounded by pelvic floor dysfunction, hormonal shifts, or fueling gaps.The team breaks down differential diagnosis—how to distinguish hip joint pathology from lumbar referral, hip flexor pain, or femoral stress—and explores gait mechanics, breathing patterns, pelvic floor “piston” function, and nutrition’s role in muscle health and recovery. Practical strategies include what to look for in gait analysis, single-leg squat, and functional movement, plus how to modify training.This conversation is built for athletes, coaches, and clinicians alike—anyone navigating stubborn hip pain that doesn’t resolve with rest or generic rehab.Timestamps0:00 – Welcome & why anterior hip pain is often misdiagnosed4:30 – Case intro: 32-year-old runner/triathlete with hip & groin pain8:15 – Red flags: femoral neck stress fracture vs. hip flexor vs. FAI13:00 – Pelvic floor clues & the diaphragm–pelvic floor piston18:45 – Gait mechanics, arm swing, and hidden rotation issues23:30 – Nutrition, hormones & pelvic floor muscle health28:50 – Lever system: managing load while rehabbing hips33:10 – Final takeaways: physician, dietitian, and PT perspectivesThank you to our sponsor, Lever Movement. Use code Casemiles for 20% offBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Dr. Sara Raiser (Running Medicine Physician), Kelsey Pontius (Sports Dietitian), and Dr. Kate Mihevc Edwards (Physical Therapist) bring their interdisciplinary lens to a tricky injury that often occurs in male young athletes: abdominal wall and groin pain. In this episode, the team unpacks the case of a 17-year-old male high school track athlete presenting with lower abdominal and groin pain that radiates into the adductors and limits his stride. The pain is nagging, sometimes sharp, but mostly tight and aching. Is it a sports hernia? Or something else entirely? Dr. Raiser explains the red flags that must be ruled out,  from inguinal and femoral hernias to femoral stress injuries and hip pathology and why standard imaging often fails to provide answers. Dr. Mihevc Edwards dives into biomechanics, thoracic mobility, breathing mechanics, and gait analysis, showing how interconnected tissues and referral patterns often blur the clinical picture. Pontius highlights the nutrition and mental health side: how underfueling, over-cross-training, and performance pressure can amplify both pain and recovery challenges in young athletes.Together, the team breaks down how an interdisciplinary approach combining medical care, physical therapy, nutrition, and communication with coaches can not only solve cases like this but also protect the identity and confidence of athletes who define themselves through sport. This episode is for athletes, parents, coaches, and clinicians who want to better understand abdominal wall and groin pain in runners and why “sports hernia” may be just one part of the bigger picture.Timestamps0:00 – Welcome & sponsor intro3:30 – Case intro: 17-year-old high school runner with abdominal wall/groin pain8:15 – Differential diagnosis: hernia, sports hernia, hip pathology, stress fracture14:00 – Why imaging often comes back “normal” & how to set expectations19:30 – Physical therapy perspective: thoracic spine, breathing, trunk control25:40 – Nutrition, fueling, and the risk of under-eating in injured adolescent athletes32:10 – Mental health & the identity struggle of the sidelined teen runner38:30 – The role of coaches and parents in the recovery plan45:15 – Lever system & safe return-to-run training tools50:00 – Final interdisciplinary takeawaysThank you to our sponsor, Lever Movement. Use code Casemiles for 20% offBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Dr. Kate Mihevc Edwards (physical therapist), Dr. Sara Raiser (Running Medicine Physician), and sports dietitian Kelsey Pontius break down the case of a professional marathoner returning to training postpartum after a C-section. From pelvic health and biomechanics to nutrition, hormones, and the mental side of recovery, the team highlights what it really takes to get back to running. Whether you’re an athlete, coach, or medical provider, you’ll walk away with practical strategies and interdisciplinary insights to support performance and long-term health.0:00 – Welcome & sponsor introduction4:15 – Case intro: professional marathoner postpartum9:00 – Physical therapy approach (Dr. Mihevc Edwards)16:30 – Physician considerations: delivery, injury history, pelvic floor (Dr. Raiser)25:20 – Nutrition & fueling postpartum (Kelsey Pontius)34:15 – Coaching influence, mindset & interdisciplinary teamwork41:40 – RED-S, underfueling & blood sugar regulation50:10 – Long-term recovery, rest, and community support58:00 – Key takeaways from each disciplineThank you to our sponsor, Lever Movement. Use code Casemiles for 20% offBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

In this episode of Interdisciplinary Case Miles, Dr. Kate Mihevc Edwards (physical therapist), Dr. Sara Raiser (running medicine physician), and Kelsey Pontius (sports dietitian) dive into the case of a 26-year-old former collegiate runner who now spends his time running trails, biking, and staying active outdoors. Since leaving the structured world of collegiate athletics, his lifestyle, training, and recovery patterns have shifted—bringing new challenges to his body, including persistent anterior knee pain. The team explores how running changes once the collegiate safety net of coaches, meal plans, and regimented schedules disappears. They unpack the biomechanics of patellar tendinopathy, patellar femoral knee pain, the impact of lifestyle stressors, the role of nutrition and hydration without institutional support, and the mental frustration of injury after multiple failed treatments. This conversation highlights what clinicians, athletes, and coaches need to consider when runners transition into “real life” training, and how an interdisciplinary approach can restore both performance and confidence. Whether you’re a weekend warrior, a coach helping athletes through transitions, or a clinician working with frustrated runners, this case will give you practical insights into recovery, resilience, and the realities of post-college running.Timestamps:0:00 – Intro & sponsor shoutout4:30 – Case intro: former collegiate runner with anterior knee pain9:15 – Physician’s perspective: imaging, biomechanics & tendinopathy15:00 – Nutrition, hydration & lifestyle after college athletics22:40 – Stress, recovery, and the mental load of long-term pain29:30 – The role of gait, bike fit, and strength training38:00 – Why multiple providers often miss the bigger picture45:15 – Interdisciplinary takeawaysThank you to our sponsor, Lever Movement. Use code Casemiles for 20% offBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].

Welcome to the first episode of Interdisciplinary Case Miles, where real runner stories meet expert clinical insight. In this episode, Dr. Kate Mihevc Edwards (physical therapist), Dr. Sara Raiser (Running Medicine Physician), and Kelsey Pontius (sports dietitian) tackle a complex case: a 32-year-old professional marathoner struggling with a non-healing proximal hamstring tendinopathy. The team breaks down biomechanics, differential diagnoses, rehab strategies, hormonal and nutritional considerations, and the mental load of chronic injury. Whether you're a runner, coach, clinician, or performance professional, this episode offers real-world strategies and a fresh, interdisciplinary perspective on one of the most frustrating injuries in endurance sports.0:00 – Intro to Interdisciplinary Case Miles3:00 – Why we started this podcast6:30 – Case intro: Proximal hamstring tendinopathy9:45 – Physical therapy evaluation insights (Dr. Mihevc Edwards)17:20 – Nutrition red flags and lab markers (Kelsey Pontius)23:00 – Stress, hormones & female athlete considerations (Dr. Raiser)30:00 – Common misdiagnoses and missed treatment steps36:30 – Sprinting, eccentrics & progressive loading42:00 – Mental fatigue, missed diagnoses & patient advocacy47:15 – Final takeaways from each expertThank you to our sponsor, Lever Movement. Use code Casemiles for 20% offBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].