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The Physio insights Podcast by Runeasi
Welcome to The Physio Insights Podcast by Runeasi, your trusted space for real conversations at the intersection of science and sport.
Every two weeks, we sit down with passionate clinicians, biomechanists, and rehab experts to share the insights, tools, and stories shaping the future of running performance, injury recovery, and movement science.
🔍 Created for physical therapists, gait geeks, and rehab specialists who care deeply about helping athletes move better, faster, and stronger.
Hit subscribe and elevate your clinical game!
Welcome to the Physio Insights podcast presented by RunEasy. I'll be your host, doctor Jimmy Picard. I'm a physical therapist, running coach, and team member here at Runeasy. On this show, we have real conversations with leading experts, digging into how we recover from injuries, train smarter, and use data to better guide care. Whether you're a clinician, coach, or an athlete, we're here to explore what really matters in rehab and performance.
Speaker 1:Let's dive in. Alright, Jay. Welcome to the podcast. How's your day going?
Speaker 2:Thanks for having me, Jamie. Good to be here.
Speaker 1:Of course. Yes. We're talking a bit off air, but I mentioned that in my mind, you're the OG running specialty PT. So everyone should know who you are. You've authored a few books.
Speaker 1:You got a product mobo board out there, but tell the tell the listeners who you are.
Speaker 2:Yeah, for sure. I mean, my name is Jay. I've been a PT for almost twenty five years now, actually twenty five. It's quite simple. Everything I've done has been born out of kind of frustration from things not working out well.
Speaker 2:Right? I mean, I became a PT because I got garbage answers when I was a, you know, middle school and and high school athlete. I got really garbage answers when I was in school about things that we were learning and how significance was to carry over an athletic populations. I got more garbage answers when I took more CME courses and everything else on the line. Right?
Speaker 2:And so, you know, I think that PT was very much like that in a box, right? It was like, oh, rehab is way over here and athletes operate here. Right? Like, and and I'm one of them and you're one of them and we all wanna make things relevant. And I just got sick and tired of like, you know, reading a research article and then seeing what's out there in the lay media and like, you know, the three exercises every runner must do and runners world is like helpful, right?
Speaker 2:Like if three exercises solved all the problems for runners, we wouldn't be here anymore, right? And I I really just got into the aspect of like anytime everything's lots of times, things have not worked out, I try and break down the problem, break down the task, and I found that, you know, we as a entire health care system, we're doing a really bad job of doing that running. And then we were doing a really bad job at making it relatable. Right? Because again, research existed way over here on the left, and then we had people way over here on the right, and, like, nobody brought the ones and bits and the zeros in research lab over to, like, humans.
Speaker 2:And, you know, when I was at University of Virginia, I was in an amazing position. Doctor Casey Carrigan came down from Harvard with a really big start up fund, and we actually established one of the better labs in the whole world with some pretty cool toys to look at running a very objective way. And, I I was just I mean, I I I always go back to the experience over and over again because, you know, when you've got data, objective data on over 7,000 runners, plus you've done musculoskeletal analysis on over 7,000 runners, and you put that together, a lot of stuff rises to the surface. Right? Like, those of you who've been in recent studies or, you know, authoring yourselves, there's lots of nuances.
Speaker 2:Right? And so when you got that much resolution in front of you, lot tends to come to the surface and I've just tried to make it a big part of my career to kinda spread those messages over the, you know, over what I've done, whether it be from, you know, working my own patients to teaching CME courses or teaching my own students. I teach at Oregon State University and the PT program here. So I'm just trying to give people context and insight. You know, I I laugh like when I teach, I always tell people like, I I hope you don't learn a whole lot.
Speaker 2:Right? I hope you just try to take all this stuff, you know, and kind of funnel it into it. It makes sense for your population you're dealing with and how to make that gel with what the demands of the sport are. And and I really hope that's kind of the message for everything. Right?
Speaker 2:I just wanna take what we already know and help you find a way to kinda funnel it down into something that makes sense for the sport, that makes sense for the athlete, and to get better results. That's all we're trying to do is get people smiling and and hit PRs and just have a good life.
Speaker 1:Yeah. 100%. So at UVA, is that where you first started, like, really getting into the gait analysis stuff? Yeah. Yeah.
Speaker 1:And that we didn't overlap, but I was a student there. I think you had must have just left. When did
Speaker 2:you I left in in eleven. Yeah.
Speaker 1:And that's we must have been like a month apart or something. I was there as a student working with Eric Magram. Yeah. But, yeah, I was fortunate enough during that time to go over to that lab and, like, see what it was like. And it was incredible.
Speaker 1:It was a huge facility. Everything state of the art. So you mentioned that while, like, doing all these analysis, things are rising to the top and you're noticing kinda what sounded like consistent patterns. Is that right?
Speaker 2:You know, it's like things have come down the line. Right? Like, for a long time back in the eighties, it was, you know, you have to get miles per week all the time. That's the number one predictor of running injuries. Now, or or, you know, don't do too much too fast too soon.
Speaker 2:There's some merit in that, right, not being overload in terms of volume. But, you know, I just go back, like, I work with lots of, you know, recreational elite athletes across the world. And for every runner I see that does, you know, the too much, too fast, too soon kinda, you know, mistake, I see somebody else who's very calculated, very intelligent
Speaker 1:Yeah.
Speaker 2:As a great coach, and they still get hurt. And they didn't do they didn't do couch to marathon. Right? Like, they're they're the epitome of a great training plan. Why they still get hurt?
Speaker 2:And people get defensive and say, oh, it's just not like, okay, hold on. Let's take a step back and let's start dropping some bombs here. Okay. So I find it interesting. This is like my my thoughts on all the stuff will change over the years too.
Speaker 2:And like, I I look at what resonates people, what does it. But I think here's one of the most interesting things out there. I think it's gets into really like nails why we tend to see some so many overuse injuries at endurance athletes, specifically in runners. If I said, let's optimize bone development. We do a series of stuff that's not running.
Speaker 2:If I said, let's optimize 10 development, we do a series of stuff that's not running. I sell it to improve muscular strength and power, we do a series of stuff which is not running. And the reality is people can argue with me as much as you want. I don't care. I it's not I'm not not getting my feelings hurt.
Speaker 2:Okay? Bone loading is it doesn't occur fast enough when you run to improve bone health. Tendon loading doesn't occur slow enough running to improve tendon density, and run the mechanics of running aren't enough to really optimize strength and power. So you've got a sequence of events where people don't have great bones, don't have good tendon density, don't have good muscle strength, and now they're loading volume on volume on volume on volume. Right?
Speaker 2:And so people say, oh, I just wanna run. I just wanna run. I want you to run too. Okay? You're not showing up with a smart plan to optimize your path as a running athlete.
Speaker 2:Right? And that's the problem. Right? Like, have to look back and say, how can we fix the person you're putting into each run? And and, you know, it's like makes me laugh, you know, if we go back fifteen years ago, we're talking about why runners should core strength.
Speaker 2:We have to beg runners to do core strength. Now they all at least do something, right? Like, where it's just plank, which is not my mind a great exercise, but something, you know, they're doing some step. Right? It's like, think the doors have finally opened up a communication.
Speaker 2:I've seen some things evolve on the big spectrum, which has blown my mind away as far as like, there's a level of base competency with how we work with running athletes now, which is awesome. But it's taking a long time to get there, you know? And and it's it's trying to help you reflect on the, you know, again, putting those breaking the task down to help you understand the task of running and and and not just saying, okay, now just do squats. Right? Like, you don't have to be complex, but you do have to be specific.
Speaker 2:I mean, that's one of the things that, you know, as we we look at society, so clicked on, you know, addicted to one click Instagram posts and stuff like that. Like, you can make things cool and sexy fine, but don't lose sight of the reality of you have to make the things you're doing specific to your running athlete and not just specific to general fitness. Right? Because, you know, if you said I wanna be generally fit, we can just put a bunch of general truths out there just fine. But if you said, hey, let's really work with runners and meet the demands of runners, that's not CrossFit.
Speaker 2:Right? That's not your high school gym hunting program. There's nothing wrong with either of those two methodologies at all. That's not specific to the sport of running. So we need to look at, again, what that rate limiting step is.
Speaker 2:And I think that's one of the, you know, technology lets you dig one level deeper. Right? You can't see forces. And tech let us, you know, really dig down into the hows and whys and what's moving and how can we optimize that. And more importantly, can you make an impact on those things?
Speaker 2:Right? This isn't just me. I mean, I've you know, there's phenomenal researchers across the world who've really stepped up in the past decade or two. And, it's funny I say not year or two, but decade or two, I'm sold. But, you know, that really can can help synthesize things.
Speaker 2:And, you know, you put the stuff together from like this study says this, this one says this, this one says this, but like, what's the general consensus? And then how do you take all that general body of knowledge and make it apply to each person? Right? Like, research guides your thought process. Doesn't tell you how to treat your patient.
Speaker 2:Yeah. So, you know, that's where tech insight lets you find out a little bit more specifically where some imbalances are and when they occur and how much they are. And once you have a a good framework on that, like, it's not that hard to really intervene. Right? Again, like, we tell our students that we all learn as clinicians ourselves, do a really good assessment.
Speaker 2:Like Yeah. I think from a clinical side, a lot of us are getting better at that. But from the run analysis side, like, what are you doing? Right? Like, if you're just sitting there looking at an iPad and drawing some lines, which are probably not very accurate, you know, it's a great teaching tool, but probably not the best way to really help you get a deeper understanding of what's happening.
Speaker 1:Yeah. 100%. So you you said a lot there. And I think like, the first thing I wanna pick up on is this idea of like, the trying to make the runner fit. The guy that the person the runner who just wants to run when all these other things are equally as important and trying to help convince them of this.
Speaker 1:It's almost like a system problem where like, runners just wanna run. And like you said, I do think there's this trend nowadays where strength training is kind of cool. It's okay for runners to strength training. We're over this hump of like having to convince them you're not going to get bulky and put on 20 pounds. But maybe what you're saying is that we're we've made that step, but maybe the specificity step is where we're still kind of struggling.
Speaker 1:Would you is that right?
Speaker 2:Yeah. Totally. I think most runners are open to the idea of like, hey, there's some other stuff I should be doing. Right? It's like, you know, people, you know, for a long time you say, okay, I run.
Speaker 2:What else do do? And they'd say, well, I do yoga or strength training or pilates or gyrotonics or insert thing here, right? Like, it was just something and that's great. I'm glad you're doing something else to become more diversified as far as movement skill, but when it comes down to it, like, I think that not just me. I think our our sport, again, this is not I I don't have an I don't have a stake in this from an opinion piece.
Speaker 2:It's like our sport demands that you show up with a certain prerequisite of skill. Right? Can I move well? And our sport demands that we show up with tissues and prepare for the task at hand. And if you do that, you're gonna have a lot of success as an athlete.
Speaker 2:Right? And if you don't do that, you're gonna either be sidelined half your season, or you're that runner who's like just barely squeaking by the tight rope of death. Right? Like, I can kinda do this, but not that. You know, it's like the other runner who's constantly obsessed with, wow, I don't know if I can try this one shoe today.
Speaker 2:It's gonna throw me off or this one runner, you know, friend I don't usually run with. They invite me for a run. I run ten seconds slow per mile. I get hurt like, you're so one tracked, right? Like, Yeah.
Speaker 2:Let's expand your movement skill. Let's expand your tissue capacity, and let's see you put a better body into every run and you'll do a whole heck of a lot better. Yeah. And so this comes in again like, you know, I I always ask runners like, are you doing? What are doing specifically to improve your bone health?
Speaker 2:Because just lifting heavy weights doesn't do that. Just wearing a weighted vest doesn't do this. That's trendy. Right? What are you specifically doing to improve your tendons?
Speaker 2:So not just sets the rest, but how are you lifting? Spoiler alert, you have to lift incredibly slow to get tendons to respond. Two to three seconds on the concentric, two to three seconds in the eccentric to actually improve tendon density. You can do any exercise you want. You're not lifting slow, it's not gonna get the tendon to remodel.
Speaker 2:Okay? And then for muscle strength and power, right? Like there's times a year we look at more strength based stuff. There's times you're looking more powers, more puritization type approach. We blend it into where you are in season.
Speaker 2:But, you know, it's not this linear model of, oh, we just work on bones, then just tendons and muscles. It's like, you're constantly hitting all the bases throughout the season. And in a way that's going to build up the body without breaking down, you know, your your will to live. Right? Like, we don't want people to trust it.
Speaker 2:I want you have energy to run. And so it's how much do we need to do to get positive responses and not overload your body. Right? But we do wanna overload tissues to kind of nudge it along in the upward direction, but wanna make sure you can still show up to run well every single session. And so it's like, yeah, find the balance points and then gets into the fun part.
Speaker 2:Right? Which is like talking to each person and say, hey, like, what typical week look like for you? Right? Are you a professional runner that does nothing else as run and nap? Okay?
Speaker 2:Or do you have three kids and two jobs? And, like, what's that life stress look like? Plugging all that knowledge that's in your head, right, that you just wanna throw at every single person, like, make it adjustable for them. So the I guess where that specificity piece comes in. There's specificity in the interventions we're doing and specificity in how we apply it to someone's lifestyle.
Speaker 2:Okay. If you give a plan that works for one week, it's not gonna help them. Right? Like, these are things that need to be long term.
Speaker 1:Yeah. And we know runners are we're a little anal, we're a little OCD. And if, like, you tell us we need to strength train, it doesn't matter how busy life is. If you're like, hey, you you need to do this, They're going to find a way and they're just piling stuff on top. That or they're just not going to listen to you and they're not going to do it.
Speaker 1:So we want to be super specific. In your book, you do a great job kinda laying this out that how do we train the bone? How do we train the tendon? So you just talked a little bit about the tendon. With bones, I've heard you talk about some pre run plyometric.
Speaker 1:Is that right?
Speaker 2:Yeah. So, you know, this is interesting. Right? Like, it's for a long time, we're told that let me back up for a second real quick because I think it's important people understand this. You know, we've all been told that running lots of impact, build strong bones.
Speaker 2:Look at the research. Again, don't get mad at me. Get mad at the papers. Running is barely more helpful for bone density than swimming and cycling.
Speaker 1:Which is crazy.
Speaker 2:Totally. Right? Like barely better. Okay. But then at the
Speaker 1:same time, it kind of makes sense when we see it. So it's like because but runners, you're getting these DEXA scans and you're like, what? You were running with this? Like,
Speaker 2:yeah. So, you know, that speaks to the question. Okay. Well, if if obviously swimming is not putting a big weight bearing strain on bones. Right?
Speaker 2:Cycling is not putting a big weight bearing stress on bones. Tendon, wait, I thought that's putting a big weight bearing stress. But if you look at, you know, bone formation is constantly a battle between osteoblasts and osteoclasts to regulate bone health. Right? And so what we have to do is we have to find out what's the mechanism to upregulate bone building.
Speaker 2:Right? There's osteoblasts in my classes to kind of maintain homeostasis, but shifting is a bone building way to improve bone density. And the rate limiting factor here comes into not amount of load, but the timing of load. Right? So if you look at the research right now on on bone health, if you're a soccer player let's let's back up for a second.
Speaker 2:If you're a runner in middle age, let's say you're a middle aged person who decided to kinda take up running, but you played d one, soccer in college, you probably have excellent bones. Okay? And why? You did tons of acceleration, deceleration in multiple planes. Right?
Speaker 2:And you have so much starting, stopping. There's a ton of really beneficial stress goes to bones to build really strong resilient bones. Right? The cool thing is we do that when you're in grade school and high school and for those, like, let's say early twenties, before 25, your bone health is like, standard deviation is well above the average person. Okay?
Speaker 2:However, if you're that person who started running at middle school and high school and college and you just ran, and you wonder why you struggle with bone health issues over your time, you never took positive steps to build bone. Right? Like, I'm again, that just hasn't happened. And again, just go back to reason why. To improve bone health, we need reaction forces of over three and a half times body weight, which when you're running there about two and a half, maybe three, some people, but usually two and a half times body weight.
Speaker 2:And they're applied for about point one five to point three seconds. Bone building to be effective, you have to apply those loads for less than point one second per per contact. Okay? So you can't run that fast as you're sprinting. Hussein Bolt's contact time is point zero eight seconds.
Speaker 2:But, again, that's world champion 100 meter. Right? So you're probably not going to do that because you're probably not as fast as he is. When we look now at how we do that, right, plyos have been talked about in great exercises to improve strength and power, and they are. Right?
Speaker 2:But they're also a phenomenal pathway to improve bone health. Right? So, I mean, let's make this ridiculously simple. Like, every runner out there, okay, should you be doing what I call curb jumps. Everyone has a curb in front of their house.
Speaker 2:You don't
Speaker 1:have to I heard you talk about this and now, like, all my run I coach half my business is coaching and they are all starting with this. At least,
Speaker 2:yeah. Like Yeah.
Speaker 1:Go ahead. Explain.
Speaker 2:Everyone has a curb. Right? And so the thing is, we're gonna use we know that people can jump easier off both feet than single leg. Right? So I try and make this as appropriate as possible because we have to get people to get off the ground stupidly fast.
Speaker 2:Okay? So what you do is go on up, go outside in front of a curb, face the curb, you're gonna put your left foot up on the curb and your right foot on the street. Okay? And what you're gonna do is you're going to drive down as hard as you possibly can. I tell my runners, pretend you're not on a curb, you're on glass, and you wanna shatter the glass.
Speaker 2:You push it as hard as you possibly can. You bounce up in the air, you switch feet. Okay? So now your right foot's gonna come down the curb, left foot comes down the street, you come down and you explode. Okay?
Speaker 2:Break the glass as you come down. And that's how we do our jumps. Now here's the thing. Looking for a total of 40 jumps, not 40 together. Okay?
Speaker 2:No one can maintain contact times of less important second for 40 in a row. Maybe you're doing four in a row, six in a row, five in a row. Take fifteen, twenty seconds rest. Doesn't take any more time. This whole thing can be done in two minutes.
Speaker 2:Okay? But we do these 40 jumps, and the key thing here is it has to be done before you run. Yeah. Okay? There is a bone stimulation effect that occurs when you do it in this sequence.
Speaker 2:About 40 jumps, less than point one seconds of contact on the ground, and done pre run. After you run, we see this this bone building modulation effect actually suppressed. Okay. So you can't if you want to them for strength and power, you can do whatever you want, as long as you're not neuromuscular fatigued. But if you're bone building, you have to do them free run.
Speaker 2:Okay? And it takes two minutes. Yeah. The old adage is, let's warm up and then we do this other stuff. Stop.
Speaker 2:If you warm up first, you already suppress this fat, so don't do that. Like, tell my athletes, if you don't walk for a second, fine, but like, put your shoes on, find a curb and go. Like, running.
Speaker 1:Yeah. That's been one of the hang ups I've gotten from runners is like, oh, I need to warm up before I do this. Yeah. And so is this is this similar to that? I think it was one of like, Warden's paper or something where he had that saying like bones get bored.
Speaker 1:Is this like
Speaker 2:What is it? I love this quote. It's like, yeah, bones find running boring. Yeah.
Speaker 1:I'll tell people it's like my two year old, like, stops listening after one minute. Totally. Yeah. And so you think like across the board, this is something like just runners should kind of adopt. Is that kind of how you feel?
Speaker 2:Yeah. I think it goes back to again your background. Right? Again, if you play multi, you know, if you play look, don't this is a whole change I can go off on, but, you know, I I tell people all time, like the worst that you can do for your body is to start being a runner earlier in life, right? Like, build a bigger capacity, okay?
Speaker 2:And that should be first and foremost, and we have to look at what esports looks like and we're failing miserably in every every aspect of this right now. But, you know, I would say that if you come from a background which you this has not been a priority for you, absolutely must must do. Right? Must must must make happen. And then, you know, the other side is is, you know, middle aged adults, right?
Speaker 2:Like we start to think, oh, we'll just keep going and you only keep going if you keep going, you know. And so, you know, as we age, a lot of us stop moving fast and we stop doing all this other stuff and like the reality is like wearing your weighted vest and a walk is not gonna improve your bone health. I know it's trending Instagram, but it's not gonna do the thing. Right? I actually saw a paper come out just two weeks ago about this, but said specifically, a weighted vest didn't respond result in improved bone mineral density.
Speaker 2:So Yeah. You need to do the things. And so, you know, if you're if you look, let's be realistic. If you play d one soccer and you're 24 years old, you know, who taking up running later on in life, like the biggest rate limiting step probably isn't your bone density, but there's only a few 100 of those people out there every year, right?
Speaker 1:So For sure.
Speaker 2:For most of us, they should definitely be bones are important, right? Like you should be taking steps to preserve them.
Speaker 1:Yeah. So alright. So we got the bone loading program, and then it seems to me like in my practice working with runners, would you agree with this? So like we're seeing tendon injuries and bone injuries. Those are kind of the two the two main injuries.
Speaker 1:Totally. Yeah.
Speaker 2:So on the tendon side, yeah, it's interesting. Right? Like it's it's different. You know, Carrie Lane is one of my great friends. She's been a collegiate coach multiple places at UVA for a little while, the Nebraska and Wyoming.
Speaker 2:She's now the head coach for Under Armour. And she has this quote I love. She's like, all running is is throwing a last guarantee from joint to joint. And and that's like nailed it. Like, that's that's all running is right now.
Speaker 2:But to do that, you're put all that last energy through very rigid levers, right, which are your bones, okay? And through kind of pulleys, right, which are kind of like the muscle intended units, right? And so when you run, muscles don't really have a lot of short and lengthening. They actually stay pretty much isometric, but the work, because work is forced to a distance, that mechanical change in length comes from tendon length. Right?
Speaker 2:And you're storing releasing that elastic energy in the tendons, and that has to be applied through a very stable system. Right? Meaning, you know, like, for example, Achilles tendinopathy. Right? Like, we have to have a very stable solid foundation in the foot because the Achilles tendon is gonna store and release a whole bunch of work, but that's going through a stable forefoot, mid foot, rear foot, right, to be applied in a way so they get our runner to move forward with control and good propulsion and not somebody who's a wobbly mess.
Speaker 2:Right? So it's not just the foot. Right? Like there's a great paper from it's a while ago. It's probably ten, 12 years old, but it looked at gait changes in people with or without Achilles tendinopathy.
Speaker 2:And it wasn't just like, oh, a rear foot calcaneal eversion change. It was things all the way up to spine control. Right? So it's like, we have a yeah. Yeah.
Speaker 1:I was
Speaker 2:telling my folks, like, if you take a slingshot and you pull back on a slingshot to store elasticity, if that front arm is nice and stable, and you release it, you'll hit your target. But if your front arm's limp, you're not gonna hit your target. Right? So you've gotta have good control from us to neuromuscular stability side to harness the elasticity. And so when you get into tenopathy, I'm giving this long winded answer here to say this.
Speaker 2:When we get tenopathy, yes, you have to strengthen the tendon. Okay. You do. And we just talked about ways to do that. It's pretty simple.
Speaker 2:Apply slow loads, two to three seconds on the concentric, two to three seconds on the eccentric. So you have to get the tissue, but you also have to fix the problem. Okay? Movement imbalances creep in, and they cause imbalances the way we move, the way we run, and now we're loading a system, which is wildly unstable. You know, my a quote I've been saying to all my runners is like, load the solution, don't load the problem.
Speaker 2:Right? Like
Speaker 1:Yeah. I love this this diagram in your book of the, like, the block where it's like the worker, like, you get injured or you have this physical block, you go find a workaround, you fix it, then you still do this workaround and it's like, how do we fix it and get that that path back?
Speaker 2:Yeah. Yeah. Improve your strategy. Right? And so, you know, again, there's there's rhetoric, right?
Speaker 2:But it's like a low tissue, low tissue, low yes. Great. Low tissue. Okay? Mhmm.
Speaker 2:But don't forget that you have to look at movement skill. Right? There's I just taught a core I just I teach a running mechanics block to all our students every year. I just taught this the other day, and this is a great little thing to those of you who are resistant to looking at form changes of movement skill and say, oh, this is garbage. Do me a favor, stand up and do a squat for me, and do a quad dominant squat.
Speaker 2:Meaning your knees are gonna go more forward as you squat down. Okay. Great. And do do three or four of those. Then do me a favor, do a hip dominant squat.
Speaker 2:So squat more vertical shin, hips back, and do three or four of those. You'll feel, one, I feel my quads working more, one, I feel my posterior chain working. Right? Both those are squats. Mhmm.
Speaker 2:So for those of you who think that the way you do something is important, stop. Because you just showed yourself technique changes where forces go. Forces go somewhere. Right? So if you're someone who says running form doesn't matter, stop it.
Speaker 2:Like, you're not your bias is not helping your athletes. Okay? Running form does matter.
Speaker 1:Yeah. Cause what's gonna happen though is you're gonna get those and this I've had a few of these these patients that are like the most challenging ones and they're telling they're coming to you and they're like, it just feels off on this side. It doesn't feel right. And you're sitting there and you're like loading it up, you're hammering it with strength, maybe you're doing your drills and they're just like six months later, it still feels off. There's something off.
Speaker 1:And it just I like every time I hear that, I visualize that little like thing. It's like, yes, how do we smooth that up? And I think that's where, like, off air, I think you said you can't measure what you don't or you can't see what you what was your saying? What'd say?
Speaker 2:You can't measure you can't you can't look at you can't see forces.
Speaker 1:You can't see forces. That's what it was. Yes. And so that's where I think like the gate tech, some of the wearable technology, things like run easy where you can get a lens into that. I think every time I've heard that story of like, oh, it feels off.
Speaker 1:I visually assess them. You do the slow motion thing. You're like, dude, it looks pretty solid. But then you put some tech on them and all of a sudden your eyes are opened a little bit. Can you talk a little bit about that?
Speaker 2:100%. Yeah. I mean, you can see kinematics. Right? You you can see range of kinematics or range of motion and joints.
Speaker 2:You can see that with your eye, whether using your eye or an iPad or a dartfish or whatever thing you like. The kinetics are basically looking at forces. Right? And so you can't visualize someone's knee extensor moment. How rapidly they control flex and bend the knee.
Speaker 2:You can't visualize someone's mediolateral oscillation of center of mass as they run. You can't visualize how fast they put force down the ground, rate of force development. Right? Like, you need different tools. Okay.
Speaker 2:And so look at what are those tools? Well, traditionally, they've been force plates. Okay. Force plates, you don't buy them at Target. Okay.
Speaker 2:You buy them at higher end shops. They cost between 8 to $25,000, and typically, you just get a force plate, and you have to then have an engineer program the interface to actually read that data and make sense of it. And you have to have some way to make that into something actual number, meaning clinicians have to understand those numbers, and you have to have some real time feedback module to figure out how to do something with it. You just spent a lot of money. Okay?
Speaker 2:So wearable tech has stepped in and and it's amazing. Right? Like you can get things from one or two sensors and on the body, different tests and and you can get a higher end insight into what you're looking at. I'll share it with you. We're doing a study right now.
Speaker 2:Every year we have a different research project we do with our faculty. We pick a topic and look at. I'm actually doing a snowboarding study, but I think it's interesting. We're actually using running to look at jump performance. Right?
Speaker 2:So they have a jumping module now. We're actually looking at the reactor strength index, which is basically a single leg hop. So you're looking at how well they utilize basically, looking at flight time versus contact time, which is looking at how well you harness elastic energy each each and every hop. Right? So Spring
Speaker 1:efficiency. Is that what
Speaker 2:Spring efficiency. Yeah. Yeah. Yeah. So basically, we're trying to find out, you know, look, like, snowboarding is interesting because everybody has a sort of preferred stance.
Speaker 2:Right? And then we have a switch stance. We run the opposite side. Right? So different leg first.
Speaker 2:And so we're doing a study in elite slash professional snowboarders only because you have to get a jump switch well-to-do our study. So that's why we did that. But, you know, it's it's interesting to me that you ask somebody, you're right handed or left handed. People are pretty good at that. Right?
Speaker 1:Yep.
Speaker 2:You ask somebody, you're right footed, left footed, and they're kinda look around for a while, and they don't really know or they typically think it's the same side as their hand dominance, right? Yes. And we found that found a bunch of things so far. People do a really bad job of objectifying, which is their dominant leg. And dominance meaning on being able to apply more force down to the ground.
Speaker 2:Okay. Like objectively dominant leg. And so we're looking at, you know, how people again utilize power, right, from spring aspect to generate power and then how does that play a role in their riding position and then what's the rate limiting aspect of performance? Is it more in your muscle capacity, right? That traditional model of we just have to get stronger, right?
Speaker 2:Or is it more the on snow technique, right? And so we're finding some interesting things as far as how things sort of correlate and you couldn't do that with your eye. You can't have a stopwatch, but you can do it with an IMU. IMU is inertial measurement unit. Right?
Speaker 2:And so it allows you to capture data that you couldn't otherwise see. Okay. So those of you may go, dude, stop talking about snowboarding. I work with runners. Fine.
Speaker 2:Let's make this really simple, really specific. Let's say that you have a runner come in and you're just using your eye or your smartphone to draw lines on screen, and you're trying to illustrate the point that one side is not, you know, is quick off the ground or has some imbalance wobbly, something you can see it's very much different right side versus left side. Right? And you wanna find out how much this might be a running form problem and how much this might be, I just forget running. This person just can't they can't spring off the ground as fast enough.
Speaker 2:Forget running, there's even a hop. Right? And so where do I start? Where do I intervene? Where's my point of entry, right?
Speaker 2:Well, if you can put a device on them, it takes about three seconds. You put a belt on and buckle it, okay? Have them jump for ten seconds in the right leg, ten seconds in the left leg, okay? And then now you've got your RSI data and now you actually have run data and it's right in front of you. Like, you don't have to read a paper.
Speaker 2:The results of your experiment, your n of one experiment, the only thing that matters is the subject in front of you. Have it in front of you, you can find out where the rate limiting aspects of where this person needs to be. Right? You may find that person's amazingly symmetric, but we have a problem in form. Right?
Speaker 2:Things are asymmetrical in form, but not in the in the muscular capacity. Go straight to your gate cues. Okay? You don't have to go back and load to like, stop. Just you already have your answer in front of you versus somebody where, you know what?
Speaker 2:We see a huge difference. Right? Let's say that left leg was 74% deficient in in putting up power compared to your right. Those of you go, that's a lot. Yeah.
Speaker 2:We found that much of an asymmetry in somebody who just won a gold medal at x games. So, you know, that old standard of like, well, you have to get people to 85% symmetry, the 90% symmetry, then you can go back to sport like, people are compensating all over the place. Right? And so can you find those imbalances and you can't see them? Right?
Speaker 2:And like there that's insane. Tech lets you do this in a scale that even two years ago we couldn't do, you know. So it's a pretty cool time to be alive.
Speaker 1:Yeah. And so the way I hear you describe me is like, it's a way to, like, amplify your clinical reasoning. Totally. Yeah. It's not like a substitute for it.
Speaker 1:It's like a piece of the puzzle for you.
Speaker 2:Yeah. But it's a big piece of the puzzle. Those of you who said, you know, I wonder you're talking you're talking a patient in front of you, right? You're in a Okay? And you're like, I wonder how this person modifies or gait changes or gait when.
Speaker 2:Wonder how this happens. Put the sensor on them
Speaker 1:And do it.
Speaker 2:This This is how simple it is. You you you basically have your patient come and see you at 02:30. Okay. Great. Get here at 01:15.
Speaker 2:Okay? Put the fan, go run outside in whatever loop you want to for an hour, come back.
Speaker 1:Yep.
Speaker 2:Look at the data. You've got your answer in front of you. Okay? You wanna look at jump performance? Do that.
Speaker 2:Like, you can do all these things now.
Speaker 1:Yeah. Those are both two things that I love doing is like, have a patient show up early for their appointment, put the thing the belt on, go do their run. Now I got data. I can see what happens with fatigue. If they're using their Garmin watch, we can pair it with that data and say, oh, you hit a hill at twenty minutes in and this is what happened downhill at twenty two.
Speaker 1:This is what happened. So now you're, yeah, you're not guessing anymore. And then the, the newer ability to kind of assess the jumping and especially that reactive strength or the reactive single leg hopping, double leg hopping. I had a case recently with an eleven months post op ACL patient who is two months into trying to get back to sport and she was just struggling, pulling herself out of practice. Put the belt on her, had her run.
Speaker 1:She scored an 88 and everything was perfect. Greens all over the place. I was not expecting it. Then I did the explosive strength test or the explosive hop test, a squat jump and a counter movement jump. She crushed that too.
Speaker 1:I was like, oh shit, she can run-in a straight line no problem. She can develop power no problem. I had isokinetic testing data from her previous PT. Perfect. I did single leg hopping.
Speaker 1:Boom. Everything fell apart. And it was so easy for me then to say like, look, you've hammered strength training. That like and I think a lot of like, PTs nowadays are all about strength training and hammering that. And I think it's like so easy to get caught up in that and to just the blinders on and say, just lift more weights.
Speaker 1:And I'm guilty. I've been guilty of that for sure. But like that one assessment has been able to like open my eyes a little bit and show me like, yeah, there's this other, there's an objective way to measure this to show me and to show the patient that this is what we need to focus on. It was frustrating for her because she was like, man, why haven't we why haven't I been doing this before? And I was like, well, we are here we are.
Speaker 1:You've crushed your rehab up to this point. Now it's this what last little box, and let's get rolling with that.
Speaker 2:Yeah. I mean, yeah. It's again, like, it's insight. Right? Let me just say one thing real clear.
Speaker 2:I I'm not just speaking just about a shelf or run either anything else. I'm unpaid, but, I will say that I have lots of tech tools because it gives me better insight. I can do a better job when I have more pieces of puzzle in front of me. Right? So we do a day after we do all of our education stuff.
Speaker 2:We do a day of just technology for runners with our RPT students, right? And RunEasy had just sent me a system to kinda just check out and and play with, and I laughed. I put this thing on one of our students, had him run for about five minutes. He came back and I said, what was your left side injury and how long ago was it? And he's like, what?
Speaker 2:And I was like, yeah, I see something very clear. And he's like, what do you mean? And sure enough, he had ACL tear basically ten months previously, and his strength numbers looked really good. And he's like, what I've been doing?
Speaker 1:I've been doing lots
Speaker 2:of lifting in the rehab. Right? But his power numbers were horrible. Okay. This is looked at.
Speaker 2:It's on the running. He's just supposed to impact duration. They were, over 60% asymmetric. Right? And so again, we're so focused on like strength and strength and strength and strength is very important.
Speaker 2:It has a place for a foundation, but most people aren't looking at that power piece. Right? And so a lot goes into that. Right? It's it's neuromuscular coordination skills, stability, all these different things.
Speaker 2:Right? But like when you can harness that and find out what the wink link in the chain is, you know what to go after and you know what to fix and you know what actually will get you translation into running. That's the thing like, this isn't other stuff, right? Like, the whole goal of all these things is to make you a better running athlete. And so that's what trying to do to make things specific.
Speaker 2:If I'm gonna take your time, right, and say, hey, I wanna do these things, you know, a handful of times a week, like, let's make it realistic. Let's make it actionable. And the cool thing about tech is, I can go back, I don't have to read a research paper. You can come back in in a few weeks or months and I can retest this and things should move this way, right, or where you want them to. And you can assess that and call your own bluff and bias.
Speaker 2:Right? We've all got them, you know. I think you see this thing. Is it really there or not? Right?
Speaker 2:And so, you know, I tell people all the time, like, if you're somebody saying, I kind of see this little wiggle thing you do on this right side, like, that's not helpful. Okay. Hey, you have an imbalance of blank percent at this phase of gate and here and like, that's helpful. Right? So, you know, being able to be more objective about the way you approach anything, right, gives you more answers to help your patients.
Speaker 2:That's what we're trying to do is to just to get people to sort of take action and oversight of the of the data and make it something that's real world.
Speaker 1:So I guess I've I've been a PT for half the time you've been a PT. But I've seen like a swing from like manual therapy, anti manual therapy, maybe a little bit in the middle now, obsession with form. And then now I feel like I've seen people like like you're saying, like, not even looking at form or not doing assessments of or devaluing it in a way. Can you speak on that?
Speaker 2:Yeah. I've hit both. You have two extraordinarily good points. We have both of them. One is the manual therapy piece, and the other one is the the form piece.
Speaker 2:Let's say both of those. These are really important to talk about. So manual therapy piece. People ask me all the time, hey, I wanna become as running guru too, be there at this stuff. What running course do I take and they're kind of newer into the profession?
Speaker 2:I'm like, get really damn good at being an orthopedic manual therapist. Okay? And and here's why. I'm not gonna sit here and debate the points of dry needling versus manipulation versus like, all you're doing is remember David Letterman? Like, had this his skit called stupid human tricks.
Speaker 2:Right? That's why I call this stuff. It's like ways to decrease neuromodular tone. Okay? Insert technique or thing here.
Speaker 2:Right? Those are needed things sometimes. Right? You've got people come in, you've got, you know, high tone and locked up and compensations, and all you're doing is help our nervous system shut down so you can access range they've got. And that's a part of things I used to get people into more advantageous environment to train skill and train capacity.
Speaker 2:So it's not like manual therapy exercise. Like, you're an idiot if you're asking that question. Like, how do I use manual therapy to get my patients into a better environment to get better outcomes out of their skill and tissue loading program? That's an intelligent conversation to have. Okay.
Speaker 2:So I think that we need to look at that continuum.
Speaker 1:Yeah. So it's do you feel like it needs like, when I first graduated in, I think at UVA actually, when I was there in Vamti, I don't know if is Vamti still around?
Speaker 2:Yeah.
Speaker 1:Yeah. Like how specific, I know we're going off on a tangent here, I'm just curious of your thoughts because I haven't heard you talk about this. How specific do you think we need to be with our manual therapy? Do you think it's like, yeah, very specific or is this more of like, could it be used in a very general way to get patient buy in, to build rapport, to calm the nervous system down just by like having a good conversation while you're doing something with the patient?
Speaker 2:Yeah, I would say, you know, I can't speak to how every single person out there approaches their patients. I can just offer this. I mean, I use a lot of manual therapy. I'm not like maybe letting somebody c one c two every session. Okay.
Speaker 2:But but how specific? I mean, I think you need to be incredibly good at foot and angle because the vast majority of clinicians have no idea where the calcaneus is, let alone second cuneiform. Okay. You need to be pretty good with spine, right, because spine impacts how pelvic function and hip function is gonna gonna react. And even with thoracic spine, I think you need to be really darn good too because again, lot of counter rotation issues we see throws a lot of asymmetry in terms of mediolateral force instability.
Speaker 2:So basically the whole runner shifting side to side. And so, you know, a big stick of looking at the free moment, which is this line of rotational force that comes up from the ground, and you have to able to twist and adapt around that to get your foot to twist down on the ground, your hips twist in and out, your spine twist in and out, right? And so if you've got motion blocks on that system, you have to address those. Like nobody no exercise is going to do that, Now, the exercise might work in synchrony, right, to restore control and coordination. But if you've got somebody who's, you know, guarded or high tone or whatever, there's not allowing one side to move, you know, and you say, we're gonna load this.
Speaker 2:Like, their nervous system's like, dude, no. Like Yeah. And so that nail therapy piece is something you're using to sort of unwind some of those tendencies and behaviors. I mean, I I I am a very heavily I would say the best tool I've got stole my hands. Right?
Speaker 2:Like, 100%.
Speaker 1:And that we can kinda like bring back that image of I'm gonna have to like share it here, but the image of the block, right? It's like that for you, it sounds like that is a way to remove that block or that limitation. And then you're using exercise of running or form or whatever to restore the path.
Speaker 2:You said that even better than I did. Thank you. Alright.
Speaker 1:So then let's like circle back to form and how form fits in there. Like form.
Speaker 2:Okay. So this is the thing I'd say, you know, right? Like a new buzzy thing comes out. It's flashing glittery and then like it fails and the public goes, all that stuff is dumb. Right?
Speaker 2:Like we were told that wearable tech is gonna save running and Garmin came out and gave you contact time and what else did they give you? Yeah. Work oscillations like not helpful. Okay. And so Ronald said, wearable tech is stupid.
Speaker 2:That's unfortunate. Right? But that's what happened. Okay. And then clinicians, you know, we were looking we were told wearable tech's coming out.
Speaker 2:I I've shared with you, I had a wearable tech company over fifteen years ago. Right? And we had great software and great algorithms, but the hardware was garbage. We abandoned it and left and moved on. Right?
Speaker 2:So it's like, we were promised this ultimate thing coming that was gonna help us do our job, and it didn't. It didn't work out very well. So we said, okay. This is stupid. So you look at GateQ.
Speaker 2:Right? We were all told that GateQ is gonna save the world. And you have to remember, I have a great slide with I I have runner running. Right? And I say, open up your stride.
Speaker 2:That's all I told her. And that cue is intended to teach her to push more out the backside. Right? Do a better job of propulsion. If you look at her video a and b, the only thing she did when I gave her that cue was hyperextend her lumbar spine, increase her pelvic tilt.
Speaker 2:Okay? Because the way for her to, quote, open up her stride to get more propulsion in the backside was to compensate her spine and pelvis position. Now it's not what I wanted, but it's all she knew how to do. Okay? And so what I found is clinicians have these ideas for gate cues, but you're you're sending mixed messages.
Speaker 2:Right? Like, you're basically having them do these two or three or four or five exercises or whatever, and you're giving them these cues that like are off like somewhere else. Right? Like, your cues should mimic your exercises. Your exercises should mimic what you want.
Speaker 2:I tell my therapist all the time, stop asking me what's the best exercise for runners. I don't know. I don't care. And your runners don't care if they're good in exercise. Okay?
Speaker 2:They care if they can maintain their possible integrity. They care if they can push a leg back behind without compensating and breaking out their form for mile after mile, right? They care about their form. So, you know, your cues should mimic where your runner is at point of entry, right? And they're constantly evolving.
Speaker 2:So the message and the things they're feeling and the skill they're learning from moving it through exercise is the same message you're getting in your cues and vice versa. So you're giving people a message that can make sense because running form is not, you know, those are down your central pattern generators. They're entrenched. Right? And so you have to look at, does a person have the ability to move so that they don't get your manual therapy tools out your hands, go back and unblock those blocks.
Speaker 2:Right? Retrain the strategy and use cues to reinforce things that will creep into their running, because running happens fast. And so I think that's where a lot of people have gotten frustrated running cues and say they don't work, because you're giving cues, well intended, that your patient doesn't know how to to act on. Right? And so you have to again, we wanna tell our patients one or two messages.
Speaker 2:Those messages might be, you do a better job about maintaining sagittal plane control of your spine and pelvis, doing a better job at getting rotation through your thoracic spine. Great. Then give them tasks to mimic that pattern, help them feel a difference between where they were and where they're going, and give them cues when they're running that meet that same message. Then you see success. Right?
Speaker 2:And so, you know, if if I could quick quick thing here. When I look at, are we making a difference? Right? Like, I hope I'm making a difference with my own athletes. I hope you're making a difference with your athletes, but like, I would make a difference in the in the world stage.
Speaker 2:I think that this past Olympic cycle was amazing for me because when I watched prior to this Olympic Games, watched the last 200, 400, 600, 800 meters of whatever race is going on. And what you saw come across the finish line was a really fast person who was a biomechanical nightmare. Okay? Their form just fell apart. If you look at them from, let's say, you know, the first quarter of the race to the last quarter of the race, they're two different people.
Speaker 2:Okay? That didn't happen this year. Yeah. If you I saw I was at Olympic trials almost every day. I saw three American runners break form three times the entire Olympic trials.
Speaker 2:That's it. Why? Because people are finally doing this stuff. AeroPress are looking at it with a trained eye. Athletes are paying attention to it.
Speaker 2:Like, we're finally getting through. People are coming across our last 200, 400 meter, whatever. They're closing with the same person that went out fresh. So I go back to like, I always say, are you training your athlete for the entire demands of their event? If your athletes form is breaking down, everybody gets tired, right?
Speaker 2:Prepare for it. Like, figure out what that needs to be, whether it's improving capacity or improving scale or just awareness, right? Some florists may just, hey, give me two things to think about. That might be enough. It goes back to queues, but like, you gotta deliver that consistent message.
Speaker 2:And if you do that, people look really good. Right? And I think we lose sight of that. Like, that's the goal is that running needs to look great.
Speaker 1:Nice. Yeah. Who do you think, like, yeah, in the Olympic trials or the Olympics, who do you think did that the best? Just curious.
Speaker 2:Oh, man. I'm not gonna single body out. There are a lot of people who do pretty good. I'm not so I'm not gonna tell you who fell apart. They weren't my asses.
Speaker 1:Nice.
Speaker 2:Tell you what though, like I have I'm not gonna call her out because I I don't work with her by the way, but I was there and off her first prelim, I said, she's going to Paris. And our friends like, yeah, whatever, and she went to Paris. Right? So like
Speaker 1:Just because you could tell like she's holding her form together throughout her event and how she looked or
Speaker 2:What's that expression like the lion crouching about just pounds of prey? She looked so impeccably just consistent from, you know, after the first eight strides out the block, she looked amazing. I could tell she was like ready to hold back and she had a little surge in semis. But yeah, come find was like finals like that's what was expecting to see. Like, you know, you can just tell she's worked on these things, right?
Speaker 2:And and I think it goes back to again, like, you prepare for the whole demand of the thing you're trying to do.
Speaker 1:Yeah. Where did this path like, I'm hearing you talk with a lot of passion about just like running in general. Where did that come from?
Speaker 2:Don't know, man. I'm half Sicilian, so I probably just get worked up on everything. Okay. Nice.
Speaker 1:Because now you know, love it. It's I can hear it in you and you're you're like, I guess maybe it goes back to what you said at the opening of this and then it's just like built out of frustration or whatever and you're
Speaker 2:I don't know, man. I just go back to, you know, at the end of day, like, I don't care about nobody cares about me. Right? They care about how athletes perform. I mean, it's like, you know, if I can help athletes to get where they wanna go, like, then I'm happy.
Speaker 2:Right? Like, I don't care about how I feel about something. It's all goes back to I think the passion goes back to if people are gonna work hard, right, like, I better have good things to tell them for sure, but they're gonna work really hard and I want great things for people who are gonna work hard. And I love to see people have success.
Speaker 1:So you you kinda see your role as like a guide, like you're like the Yoda, you're kinda
Speaker 2:like helping cog in a wheel, man. But, hopefully I mean, you know, I'm not saving the world, but, I mean, no. It's just you're a cog in a wheel, but you gotta be there. And, you know, as I tell everybody, like, here's the reality. Running coaches don't get the biomechanical education side we get.
Speaker 2:Right? Like, strength conditioning coaches get the strength conditioning process, but they don't understand the sports as well as some of us do. Right? And so it's like, you look at like where we fall. We always talk about takes a village and we have to work together, but like, you someone else may have better answers than you, but oftentimes as a PT, you're kind of like case manager, right?
Speaker 1:Like You are. Yeah. Yeah.
Speaker 2:If there's somebody who's better at the strength finishing side, fine. Use them. Great. Right? Like, but don't just think all we have to is load the tissues and that's it.
Speaker 2:Right? Like Yeah. The skill thing still matters. Right? The the form assessment matters.
Speaker 2:And coaches are more open to this now. Right? But some of them are still like, oh, just run. Like, fine. Have those discussions.
Speaker 2:Right? If you have a success story from somebody you work with their team, say, hey, can I just kinda tell you sort of what we did? Like, I'm not looking at market, but I just wanna help you figure out what helped Sally do a better job. Right? Like, because I wanna give you the best runners I can for your team.
Speaker 2:That's it. Right? And like, based upon we found, you know, I saw this imbalance with Sally. I also see the same things with like the majority of runners I see. Would it be possible for us work together if you told me, hey, I've got ten minutes three times a week before practice to work on these three things.
Speaker 2:I give you three little drills to work on your athletes like that opens the door. Right? And and you're sat there and say, hey, I just wanna altruistically help. Right? That's it.
Speaker 2:But I think that, like, get that discussion started, your local community because, you know, coaches don't come to you unless things go south. Right? And and I think that if you can stay on the forefront of that, it's like, hey, Luke, let's help your athletes do well from day one. Like, let's give them the tools you need to succeed. Coaches are great with volume intensity and all that kind of stuff, but this isn't their real house.
Speaker 2:Right?
Speaker 1:And Yeah. And don't yeah. Maybe don't assume that they're getting it from somewhere because they're probably not. You know, I think, like, I ran at a d one school and our strength training days was, like, go do, like, five pound bench presses. And, like, literally, was like, don't use your legs.
Speaker 1:Don't do plyometrics. You need to save those for your run. And it's like, I mean, that was however that was fifteen, twenty years ago, but I'd like seeing the same thing. Yeah.
Speaker 2:Yeah. If it makes you any better, I've been consulted by a lot of collegiate programs across the world.
Speaker 1:Amazing. That's good. That's good.
Speaker 2:No. But it's just like again, people get in a rut. Right? And the people there, the ones making the policies, and sometimes you have to look at, like, what are we missing? And so it's just hey.
Speaker 2:I might hear the same phrase, but I'm just saying, like, there's a path for all of us to act locally, regionally, nationally, etcetera. And I think that, you know, like, opening doors to that collaborative teamwork and and just showing we're all doing, you know, people are like, what do you do about this? You keep everything secret? Like, no, I'm gonna show you exactly what
Speaker 1:Yeah. Amazing.
Speaker 2:Somebody reached out like, what would you use for progression? I'm like, yeah, this is like the stuff in my book is exactly what I use. I'm not hiding anything. Yeah. And that's why I've always operated.
Speaker 2:It's like, give people all tools to succeed. If they need you, they'll come find you. But like, it's real simple. You know, just try and help people. I don't know.
Speaker 2:Just yeah. The passion comes from helping people do whatever they wanna
Speaker 1:Yeah. So I guess a question I'm just curious about. So whatever it was fifteen years ago, you're at UVA with this massive clinic and seeing how things have evolved, you you did the wearable tech thing back in the day and then seeing things evolve to something as simple as the RunEasy Sensor. What are your thoughts on that progress? Do you see that the data that we're getting from a single sensor or some of the other tech out there is just as useful as the big gate labs that you've worked in?
Speaker 2:Yeah. I mean, I think it's it's certainly not. So there's two things in here. So you're saying is a single is a sacral mounted IMU gonna give you all the things you get from from, you know, a work
Speaker 1:like Let's say, like, clinically, like, is it giving us the things that you're or is there something missing from it maybe? Is it how do feel about it?
Speaker 2:Yeah. I'll say this. So is is is accurate and high end as as a gait lab? No. But here's the thing, runners don't just run-in the gait lab.
Speaker 2:They run outside on different surfaces and uphills and downhills and cambers and all these things that aren't in a lab. Okay? Any lab. Right? So one, it makes things real world, which is which is the most important thing.
Speaker 2:Okay? And two, it's quick. Right? When somebody comes in a lab, it takes a half hour to put markers on, calibrate the system, I need an engineer to go ahead and pull and process at the end, it takes forty five minutes. It's not sustainable.
Speaker 2:Right? There there are there are there are two other labs that I know in the in The US right now are operating kind of the level I was before and they're great. They're awesome. Right? Not blowing anything.
Speaker 2:If you want the, you know, to dwindle down the most specific thing possible, then then yeah, there's a time and a place for that. But that's overkill for what most people need. Right? And I think that, you know, letting changing things to where I'm actually the gold standard is wearable tech, but a a widely available options wearable tech, like this is awesome. Like, I mean, I've always said, like, and it's funny, like I I remember back very vividly, you know, we had this great lab.
Speaker 2:It was like we were getting tons of headlines and just, you know, this guy came one time and goes, how long do all this is on your iPhone? I remember I laughed. I was like, do you have any clue how awesome this place is? You think it's on your phone? And like, wait, he's bright.
Speaker 2:Right. Yeah. You need to take things outside. Right? Like, get an environment, meet their athletes where they're at, and that's wearable tech allows us to do.
Speaker 2:Right? And I think it's awesome. Like I I from a passion standpoint, I couldn't be any more excited that clinicians now have objective tools to measure things they can't see, because that's part of what we have to understand for running. And I think that that's it's awesome that we're, you know, what is how to be alive? Right?
Speaker 2:We've got tools to let us do this stuff and, know, you I say better information into your brain means you can do better outcomes. Right? And so running it in it didn't tell you how to treat your patients. No tech tool is. Right?
Speaker 2:People are saying, what's the thing for overstriding? There's no metric for overstride. Right? Like, if you understand the data and you understand the person's body Yeah. You can figure out why they're doing that, and more importantly, you can improve things.
Speaker 2:And so I just said something that's probably very loaded for a lot of people out there. So but when you start playing with tech tools, you start going, oh, this is really what this data point means, and this is how it works with this one. And wow, I can measure their jumps, but this isn't just telling me RSI data, it's also telling me how unstable there is a jump. So, now I can lock in instability. Like, there's all these rate limiting steps that build each other, and I think you'll be pretty blown away by the resolution you can get from one sacrum model IMU.
Speaker 2:So Gotcha. You know, system system regardless. Again, I I challenge people all the time. Give me a reason why you're not using wearable tech with your athletes. Not just running with all your athletes.
Speaker 2:Like, you should be doing something to assess with wearable tech and something to give people feedback on performance. Right? So instead of you saying, do 30 reps this, do 30 reps well. And here's feedback on how you're maintaining public stability as you're moving and doing these things. Figure out ways to use your phone.
Speaker 2:Right? Like, just little things like that to give people feedback during exercise, find ways to integrate that into what you found out from your assessment, learn to use better things to ratchet up your assessment and ratchet up your feedback.
Speaker 1:I love it. Yeah. So I was going to ask you to like kind of wrap things up by giving the clinicians like one piece of advice and I think you just did a really good job there.
Speaker 2:Yeah. Just yeah. And it just, you know, again, like, I think that we've gotten into a mindset where we're so, you know, looking for research on new things, right, looking for outcomes data and again, I just read it as I said before, like, research guide your thought process, but doesn't say it's wrong with your patient, right? And so if you some of you've read a study like, wow, I wish I would have had my patient in that study kind of like, you can do that now. Right?
Speaker 2:Like that's what tech lets you do. It lets you call your bluff, take your biases, throw them aside, and say what's really happening and where is that real limiting step? And it doesn't take a long time. It's very specific, It's pretty accurate, and it'll transform the way you work with athletes. And that's what we're looking to do is get better outcomes.
Speaker 1:Yep. People helping people and we're trying to I wonder that you see a lot of people who don't fit like they get to 90%, they don't get to 100%. And maybe this like the as tech gets better and better and we're using it more, maybe we're able to like see that, you only got to 90% and now we're not letting people go until they're a 100%.
Speaker 2:Yep. Yeah.
Speaker 1:Awesome. Alright, Jay. Well, I think that was that was really good. Thank you for your time. Where can people hear or learn more about you?
Speaker 1:You got two books out there. Like, where where would you point people?
Speaker 2:Yeah. You know, you can pretty much if you just go to the Mobo board Instagram page, I probably put the most stuff out there these days. I have a blog called anathletesbody.com. I don't put a whole lot there, but there's some information on, yeah, the Mobo Instagram, which is mobo.board, Instagram, and also on the Mobo board website, I have some articles on there which are pretty interesting too. And if you're somebody who is on the nerdier side, you want more things, there was a bunch of articles I wrote long time ago, but it's still pretty darn important on anathletesbody.com.
Speaker 2:Awesome. Some things there.
Speaker 1:Yeah. And definitely check out the books. I think I have the original anatomy for runners. Actually, you know what? I do not have that book and do you know why?
Speaker 1:I was a it was I was a student and my clinical instructor was like, can I borrow that book? And I never got it back.
Speaker 2:Both read them, tell me to pull their CC status if you don't get it back.
Speaker 1:Yeah. Right. So, yeah, check out definitely edition of the Running Rewired book. Thanks. Appreciate it.
Speaker 1:Really good book. Like Jay said in the talk, like the progressions of his exercises are in there. How to load bone, how to load tendon, all spelled out in there. Yeah. Awesome.
Speaker 1:Alright, Jay. Appreciate your time. Thank you so much. Thank you. That's it for today on the Physio Insights Podcast presented by RunEasy.
Speaker 1:Would you like to share an interesting case, insight, or have a thought about the podcast? Comment below and don't forget to follow us for more episodes.