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Expand your running knowledge, identify running misconceptions and become a faster, healthier, SMARTER runner. Let Brodie Sharpe become your new running guide as he teaches you powerful injury insights from his many years as a physiotherapist while also interviewing the best running gurus in the world. This is ideal for injured runners & runners looking for injury prevention and elevated performance. So, take full advantage by starting at season 1 where Brodie teaches you THE TOP PRINCIPLES TO OVERCOME ANY RUNNING INJURY and letโs begin your run smarter journey.
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On today's episode, I'm answering all of your questions to help you run smarter. Welcome to the only podcast delivering and deciphering the latest running research to help you run smarter. My name is Brodie. I'm an online physiotherapist treating runners all over the world, but I'm also an advert runner who just like you have been through vicious injury cycles and when searching for answers, struggled to decipher between common myths and real evidence-based guidance. But this podcast is changing that. So join me as a run smarter scholar and raise your running IQ so we can break through the injury cycles and achieve running feats you never thought possible. Hello, Run Smarter Scholars. A big thank you. have saved my butt because I typically have an episode that I want to record and publish and schedule by Friday so that it is released by Monday. But come now it is Wednesday and the recording of an interview I was meant to have recorded has had to be delayed or postponed. And so I was left without an episode. And so Last Minute Thinking pushed the question out to my email list of you've run Smarter Scholars, looking for content, looking for your questions. And thankfully, I had a pool of questions come in. I had 10 emails within the first 45 minutes of your questions. So I appreciate you. have ah saved the podcast for this week and left me with some great content and some great thought provoking questions that I'm excited to go through. So once again, thank you. I I'm blessed to have such a awesome running community backing this podcast and listening each and every week. So I appreciate you. Let's move on with these questions. So let's start with, I should say as well, I put in that email first come first served. And like I said, there's a mountain of questions that have come in. And so apologies if I haven't got to your question. I do plan to schedule a part two that should be released on the 13th of April provided. all goes well. So if I haven't answered your question today, just know that it might be in the next Q &A. And if it isn't in the next Q &A, unfortunately, like I say, first come first served, I can't answer every single question. But um just with that, let's move on. First one that came in was from Melinda, who says, How do I transition to zero drop shoes? I need to go to a zero drop wide toe box to help with a neuroma. So looking to move from a Hoka to an Ultra. Okay, happy to help you out here, Melinda. I guess for people who aren't familiar, so yes, minimalist shoes typically have zero drop and they typically have a wider toe box, which just means more space for the toes. If you do have a neuroma, that's typically a nerve. One of the nerves that kind of passes in between the base of the toes, like the knuckles of the toes. And if that gets irritated, we're looking for space. We don't really want tight shoes that cram everything together, because that's how the nerve in between those knuckles kind of gets irritated. So it could be wise to go to a minimalist shoe that often has a wider toe box. um I guess the general response that I would say is how do I transition? Well, you do so gradually. You kind of need to. um how conservative you want to take it will just depend on how much risk you want to assign. None of these decisions are 100 % risk free or 100 % safe. It's just working out, based on my injuries and based on how I've transitioned for shoes or training or how I've generally responded to changes in training in the past, would I consider myself really robust and resilient to make that transition? If your answer is no, then you'd be more gradual. If the answer is yes or probably, then you might not have to be as conservative as what the research suggests. um But we also need to factor in what you're currently used to with your current shoes. So typically a hoaker, I think most hoakers are zero drop shoes, but they're very supportive. They're very stiff and very, um yeah, I guess supportive would be the best word. Um, if that's you, then going to a minimalist zero drop, really light, flimsy, less supportive shoe is a big, big, big change. And so your body will definitely register that change. And I would say the transition needs to be extremely gradual when we come to, when it comes to that. But then again, like ultra shoes, some ultra shoes may be considered like minimalist yet. and zero drop yet they've still got some sort of support to them. And so we're just looking for how big of a shift it is. If you have like a neutral shoe that's quite flexible and then you go to a minimalist shoe that still has a bit of stability but it's a little bit more flexible, then your ability, the transition from what you're used to to what you have to adapt to, that gap isn't so big. And so we don't need to worry too much about it. And we can be a little bit more aggressive, I guess, in our transition. I do have a paper, if anyone here is a part of the Run Smarter database and has access to my Google Drive, if you want to search for this paper, it is titled, Transitioning to Minimal Footwear, a systematic review of methods and future clinical recommendations, that is the title. ah It's a very extensive and helpful paper that walks through uh Yeah, general recommendations for transitioning into footwear, minimalist footwear with some uh useful graphics that covers like a four week kind of stage. Like I say, you can access that. You can try, I'm not sure if it's open access. If it is, you can try just Googling the title of that paper. uh And so what they recommend is for the first week or two, uh starting out just wearing minimalist footwear or barefoot, outside of your running. So that would be just walking around the house, just walking or cross training, or even strength training. If you want to do that outside of the running itself, that is sort of building up your foot strength, building up your intrinsic strength and function. And so the transition to minimalist footwear when running isn't so vast. And so that's what you should do. This paper also recommends for the first couple of weeks actually knocking back your overall training volume by 10 to 20%. So if you're currently running, you know, 30 Ks or 20 miles per week, just knock 10 % off that. And then we reintroduce, oh well, then we introduce the minimalist footwear into your running, just to make sure that this is like the safest way possible. um If we knock off some of that load, then we don't have such a high, we're sort of creating a bit of a damper in a way, or like a safety buffer. It's like, let's drop it all altogether. And when we introduce our minimalist footwear, we are still only running five to 10 minutes or five to 10 % of your training in that minimalist footwear, and then gradually building that up over time. This paper recommends, you know, building up about 10 % every week and like I say, extremely gradual but their clinical recommendations are warranted. I've seen papers where uh runners ignore the transition phase and a lot of them suffer from foot stress fractures because of the abrupt load that they're just not used to or plantar fasciitis or Achilles tendonopathy. The load that is required when running in minimalist footwear is quite high. And so we just wanna make sure that you naturally uh build up the strength that's required. And so, yeah, step one, let's just run in your normal shoes. Hopefully the neuroma sort of is at bay for now. I suppose that's something in your case, Melinda, that we have to factor in. How, if it's continuing to affect the neuroma, maybe we need to just do minimalist footwear. and totally scrap your current hokas because it irritates the neuroma. Maybe we're starting from just a run walk for five minutes in the minimalist footwear without doing any running in the hoka because that irritates, who knows? But what I would recommend is yes, spend one or two weeks in bare feet or minimalist footwear doing the other stuff, cross training, strength training, um yeah, just walking around the house and then do some run walks five to 10 minutes like in the first week. ah So when I say five to 10 minutes, it's five to 10 minutes per run throughout whatever run you decide to do. So if you're running three days a week, that is running three days, all three days in the minimalist footwear, but per run, it's about five minutes. um And then we build on, you know, maybe 10 minutes per week. And very important that week by week, we're just monitoring your symptoms. Do you wake up with calf tightness or plantar fascia? tightness or Achilles stiffness or are you starting to get foot pain, you know, hopefully it helps the neuroma, but in terms of any other symptoms, we really want to be careful of that. And yeah, if you feel like you're struggling with that transition, we can just do more and more minimalist footwear outside of the running while we gradually build that up. Or we can do some dedicated foot strengthening exercises as well. My favorite is some wobble board exercises, just one foot in the middle of a wobble board, trying to keep all sides off the floor and sort of activating the foot, activating the toes, the pads of the toes while on that wobble board. So you should get a nice burn, fatigue sensation in the foot throughout say 30 to 45 seconds. And we do three sets of those. Typically we do it once a day. uh That would be a really good way of, I guess, proactively strengthening the foot intrinsic muscles while we're waiting for it to catch up. um So that's a good one as well. If the wobble board gets too easy, we can progress. I like to do weighted passes. So like you still keep the foot in the center of the wobble board, yet you are patiently or slowly transitioning a heavy kettlebell or a dumbbell or something from the right hand into the left hand, back to the right hand, back to the left hand. And that would, you know, challenge your center of gravity, make it extremely difficult and therefore the foot has to work harder. If you don't like this Smalindo and you don't really like the careful gradual process, you might be able to find a shoe that's non-minimalist, that still has a wide toe box. There may be some shoes out there designed for that. Sometimes some trail shoes typically have the wider toe box, but you probably can find some trail shoes that do have the support. the very much it mimics a hokushu and therefore the transition doesn't need to be so gradual. And so hopefully that helps. Sarah asks, what are your top exercises for ITB syndrome? Also known as ITB friction syndrome, i.e. pain on the outside or lateral side of the knee that's very, common with runners. What's happening with this? I'll answer your question in a second Sarah, but give people... or run people up to speed with what is ITB friction syndrome. Your ITB runs along the outside of your thigh and attaches to somewhere in like the side slash front of the knee. There's a common attachment there and it can cross friction over some structures on the outside of the knee as you run. If you run at slightly different angles, can essentially what we can think of it as a rubbing. And if that happens, 10 times, no biggie, 100 times, a few hundred times, no biggie, but thousands and thousands and thousands of times, it can get irritated. And therefore, once it is irritated, then the number of repetitions it takes to irritate, dramatically drops. And therefore, you just keep getting this irritation at the side of your knee, the outside of the knee. And there are a few tests that we can do, but it's pretty classic ITV friction syndrome. Some causes. can be very typical. I mean the classic one is downhill running for whatever reason like when you run downhill your knee is bent and lands at a different angle accompanied by a higher load because you're competing against gravity when you run downhill so it's a bit more of a thud so the combination of the different knee angle with the increased ground reaction force can irritate the ITB so it's typically seen with someone who's trapped you know maybe abruptly adjusting to trail running or all of a sudden they need to do more hill work and yeah, just an abrupt shift to downhill running. And therefore, and if they develop pain on the outside of their knee, that's pretty classic. But we also see it with a crossover step width. There is research to show if you have a narrow step width. So if you run on a road and you can see that dotted line that runs straight down the road, if you're sort of running in tandem. So your right foot contacts right in the middle of that line and the left foot contacts right in the middle of that line and there's no sort of width to it, then that could be a narrow step width. But some people have a crossover step width where their right foot contacts the left-hand side of that line that's running straight down the middle and vice versa. The left foot is making contact on the right side of the line. People who have that typically like sort of catch themselves, sometimes they trip over their swinging leg like hits their stance leg, or sometimes if they're running trail, they have like these mud marks on the inside of their calves because of that gap is just way too narrow. And there is research to show if you do have a narrow or crossover step width, that just further increases the strain on the ITB, leaves them all prone to this syndrome. And so I say that because we need to know the origins. to better answer this question because what I do first and foremost, strengthening exercises sort of is secondary for me when it comes to treating this. Primary is activity modification because it's a repetitive thing. And if we identify that you have an abrupt shift downhill running or we do identify that you have a crossover step with running on a camber or like a slope, sideways is also one of those things. So like if you're running, if you're running on a riverbank or the beach or, you know, one of the roads or sidewalks or things that are just slightly cambered, let's just say it's cambering from right to left, you're going to sort of have a natural crossover with your right foot. And that will, you know, build up over time. that change is too abrupt, then you can be left with this. um Talking to a lot of my North American clients ah where there is a lot of snow, a lot of people have tried running on the roads because the footpaths are just covered in snow, but you know, I guess they have plows or do you call them snow plows? They like clear out the snow. And so they run on the road instead of the footpath, but the road has a bit of a camber. It sort of raises in the middle of the road and sort of slants out to each side. And if that's an abrupt shift in your training, then you might be left with some of these issues. And so if we find the cause, we find the issue, we find that abrupt change and just make an adjustment and edit that, modify that change, that might be all that's needed. We don't need to spend six weeks building up your strength. And so that's why first and foremost, we try to identify these things. If we identify there is a narrow step width, or maybe a low cadence or something, we can just... make a slight adjustment to that. And if that significantly improves symptoms, then yes, we'd just do that. We wouldn't necessarily do the strength work. The other thing is like a walk, run, rebuild, because this is a repetition injury. Some people might find that the first 20 minutes is symptom free, then you get to 30 minutes and oh, there it is. It's like a one out of 10 hanging around. And then from 30 minutes to say 35 minutes, quickly shoots up to like a four out of 10. That's because the repetition, repetition, repetition eventually gets to a point where it just becomes really, really irritated and rants up really quickly. Whereas if you catch it before that big ramp up in symptoms and you dedicate yourself to like a run walk to complete your run and it stays really settled at a zero to one throughout that entire run, that's a big success because we're not further contributing to more irritation. And therefore you've got some recovery time or healing time that carries over into the next day, more healing time. And then when it comes to your next run, maybe you can be a bit more successful and actually run a little bit further rather than irritating it just a little bit every run and the capacity actually reduce. So those are the things I really like to do for ITB friction syndrome. However, I do want to answer your question, Sarah. Top exercises for ITB syndrome. If we're looking at the cutting in angle or the knees coming together, yes, we might do some glute medius exercises to help retrain any dysfunction or cutting in of the foot. So glute medius would be up there. Step downs would be one of them. So starting on a box, possibly holding onto weights if you're strong enough and your form is good enough. And then just stepping down might even be just like a four inch box. where we're trying to control the alignment of your hips and knees and then coming back up. That might be progress to like single leg taps or like single leg squats with you start raised up on a box. So let's just say you're on a step and you slowly lower yourself down to which you just tap your foot onto the ground. Then you come back up, not placing any weights down, just giving it a tap and then come back up, focusing on hip knee alignment. That could be a nice exercise, three sets of 10, very basic. People might be familiar with crab walks. So band around the knees and then we're into a quarter squat and we're doing sideways shuffling, focusing on keeping the knees out nice and wide. Can be quite nice for glute medius strength. Hip hikes are another exercise which is hard to coach. It's hard to get the quality correct. But when done correctly, you really feel a nice deep burn in your glute medius, but you're essentially standing legs are staying straight. You're say on your stance leg being the left side and you're hiking your right hip up towards the ceiling, engaging the glute medius as you do that. um If that fire fires really well, you can add some weights. You can hold onto a kettlebell on your right side so that the stance leg is the one that's really working hard. um Captain Morgan's is another one where you sort of have a ball, maybe a Swiss ball, those big yoga balls up against a wall and you're standing on one leg. Let's say you're standing on your left leg and your right knee is up sort of at hip height. So 90 degrees hip flexion and you're pressing the Swiss ball outwards into the wall. um Again, just Google image if you're not familiar with this exercise that will really fire up the glu medius, um could be a nice isometric, you can hold those for 15 seconds, three sets on each side. Yeah, that'll be really good. And if you do that and progress nicely alongside all the other modifications I suggested, hopefully that helps resolve the issue. Next question comes in from Kate who says, hi Brody, love your work. If Strava, Garment and Apple all give different heart rates for the various training zones, Is it worth getting a proper VO2 max test done to sort out and ensure that zone two really is zone two? Okay, thanks for your question, Kate. I feel like this is slightly outside of my wheelhouse, but I'll do my best to try to answer it because yeah, I guess there would be different accuracies, different data points, different, I guess equations and interpretation of the equations for different software. And so yeah, you'd get different numbers. Also some use different. zones like some use like a five, a three, three tier training zone. Some use five training zones, some use seven training zones. And so if you're really wanting those numbers and wanting that data, sure, the VO2 max test is gold standard recommended. Especially like I say for runners who are more like data driven. uh And also for those who like really elite, you'd really want to know those numbers and really hone in. uh Otherwise, like you can just fall back on combining the heart rate with RPE because your zone two can be, ah I guess, subject to or like interpreted as just really easy training. And it should feel like technically there should be not a very, very gradual build up almost imperceptible like build up of your lactic acid. If there's ah build up of lactic acid, you're probably in zone three or zone four. uh If there's a really sudden, uh drastic one, I guess, you know, people know when they're in zone five. um But it feels like you can just maintain for hours. Like I've been four runs where it might be an hour to two hours and I just feel fresh the entire time. I'm sure it might get a little bit more fatigued towards the end, but in terms of like lactic acid buildup and effort, it stays easy. Like I feel like I could do it all over again when I finish. And I know I'm safely in zone two. Um, and you know, other descriptors could be like, just, uh, can have a easy conversation with someone. You can chat to someone on the phone and see if you're able to hold that conversation. You're still breathing and you still like a kind of interrupted per sentence, but you can still maintain that conversation. And like I said, if I finished my run feeling like I can do it all over again, I know I'm not in zone three. I know I'm safe in zone two. Um, But I guess the VO2 max stuff and lactic acid testing should be done if you're sort of wanting to know where that definitive line is, because you might want to train in sort of the upper limits of zone two. I feel like most people can train pretty safely in zone two when they're like in the mid to lower zones of zone two. It might just be a walk, might just be a power walk or an uphill walk. That might be zone two. In fact, Peter Atiyah says that for most people zone two training is the like an uphill walk, that's what it should feel like. But yeah, if you're wanting to know where that real cutoff is, because you want it to train in sort of the upper limits of zone two, then that's what you do. You get a VO2 max test. And you do so when they have also with that test, they have these routine kind of pin prick blood markers where they just pin prick and analyze your blood through various stages of the VO2 max test, because that's where they record what the lactic acid is doing in your blood so they can see where that definitive uh transition point is um from zone two to three to four to five. So yeah, you could do that. I'm actually thinking of doing a VO2 max test soon. There's a university very, very close to where I live. It's where I studied and they do VO2 max testing. And just for my own, I guess, uh curiosities um and you know, seems to would align nicely with the high rocks training that I'm doing. Just getting a VO2 max value, because right now my Garmin says that my VO2 max is quite superior. It's 58 at the moment, which I don't know how high it goes. It seems like I'm kind of maxing out. It seems it probably goes up to 60. So if I'm 58 out of 60, I wouldn't consider myself extremely fit. I don't do a lot of mileage at the moment, but I know like if max is out at 60, I'm nowhere near 58. I'm telling you now. um But it would be nice to actually know a number, like I say, more just for curiosity purposes, but then also to probably reassess every few years, just to see if I'm maintaining that VO2 max value. um And would give me a bit of motivation to preserve that VO2 max. And also, yeah, I'd be curious to know what intensities I train at that sort of shifts into different training zones. I know it's recommended for like athletes or if you're having a big shift in fitness to get a VO2 max test done every, I think they say every like four to six months, but not a lot of people are gonna do that. But that's only just because as you get fitter and your VO2 max maybe hopefully increases, then your training zones will also shift along with that as well. um But yeah, I'd be curious. think if I end up doing a VO2 max test, I might do a podcast episode on it, just talking through my experiences and what it's like and that sort of stuff. It's not cheap though. I think it's like around 150 to $200 to do it. Maybe more, not sure. But anyway, yeah, I'll keep you posted on that. Hopefully that helps you Kate, but like I said, it's not entirely within my wheelhouse, but let's move on. We have Becky who says, hi Brody, what is the best way to go about incorporating sprints? for the first time into future training. Okay, there are ways we can go about introducing sprints, especially if you haven't done it for the first time. And I guess this is based on just preferences, but my typical go-to is to do strides. And if people aren't familiar with strides, you sort of do these at the end of your run. So you might do an easy 20, 30, 40 minute run. whatever your fitness level is like, and then you do strides afterwards. So you assign a distance that's approximately like 25 to 30 seconds in duration. So I typically like flat, straight, consistent terrain. So we're looking at like an athletics track or a bike path, or even just like a football oval or something that's, you know, we just don't want potholes and those sorts of things. But what we do with strides is that it's not just like a hundred meter sprint. It is a, you start quite slow and there's a 15 second acceleration phase where you just slowly build up, build up, build up over 15 seconds. Then you reach your top desired speed and you hold that for about eight to 10 seconds. And then that gives you about five seconds to uh decelerate, slow down, stop. Then we have a one to two minute rest to recover. And then we turn around and we repeat that same thing. So that's the structure of your strides. And typically what I say for most, what that phase, what those phases look like is we start quite conservative. We start gradually and we build in because like you say, we haven't done any speed work for a while. So let's start on the safer side and then maybe do it once or twice a week and progress through that. Phase one, I typically say for most is do four repeats. So up, back, up, back with a one to two minute rest in between. And the top desired speed that I want you to reach is around about 75 % of your maximum sprint. Now that's going to be very hard for you to know in the moment. And I know the percentage will be slightly off here and there. That's okay. What I typically describe to clients is 75 % of your max sprint should feel like you can go two more gears up. And think that description sort of helps a lot of people. um So we're not going full out. It's backing off two gears and it's still fast. Tell you that 75 % of your maximum sprint is still fast, but it's a bit more controlled. And yeah, like I said, we've got two more accelerations if we so desired, but that's um how I like to describe it. So four of those, see how you feel during, see how you feel afterwards. If your body's responding well the next day, we know that we've tolerated that bout. then we can go from four repeats to six repeats, try that, then go to eight repeats, try that. If eight repeats is good, let's drop down to five repeats and increase the speed. So drop to five, increase to say 80 to 85 % of your maximum sprint. So this will be that next gear up. Then we increase the number of rounds. So we go from five to six to seven. Maybe we can go from seven down to six. and increase your intensity yet again. So now let's go more to 90 to 95 % of your sprint. So this will be as high as we're going. ah And like we say, we're just holding this for eight to 10 seconds. And once you gradually improve and we hone in on the rounds being six to eight and your intensity being 90 to 95 % of your maximum sprint, that's all you need to. do for strides, we wouldn't do any more, we wouldn't do any more repeats. Six dates generally recommended. And yeah, that's how I would introduce sprints. Anything beyond that, sure, we can start playing around. Once people get to can well handle at least a couple of the 90 % sprints, then we I tend to say we've got enough buffer, or enough evidence to suggest doing faster kind of one minute, two minutes, three minute efforts, if you so wanted to. um But that's sort of, yeah, it come at a tailored kind of lens, sort of personalized training to you. But to answer your question, Becky, that's the general advice I like to give and follow and talk through with my clients about how to incorporate sprints. Another layer of complexity, you can maybe add this same setup, but with a hill. I don't like doing that initially because it's very hard to measure the incline and all that sort of stuff, but some people like to do heel sprints. You can just do it in the same systematic way. Okay, next question comes in from Heather, who says, hi Brody, I love your input on something that I've been dealing with on and off for about seven years. One reoccurring issue I keep running into is my soleus muscle becoming the limiting factor, especially on uphill efforts and sometimes even on flatter terrain. They tend to feel like they're on fire early in the run and forces me to stop and stretch even when my cardiovascular system and overall energy feel good. Seems like when you say they tend to feel like they're on fire, it seems like it's on both sides. I'm going to move forward assuming that. You continue Heather, I incorporate stretching, foam rolling, strength work and recovery into my routine, but. this issue continues to show up and limit my performance. So my questions are, what are the most common causes of persistent solius overload in runners? And number two, what are specific strength and loading strategies you would recommend to build capacity in the solius so it's not my limiting factor? um I have an answer for you that's taking a slight different tangent. But let me answer these questions directly, assuming like this is a soleus overloaded issue, because I really don't want to attempt to diagnose anyone with these questions based on the limited information I received. So I'm not going to diagnose anything. So I will answer your questions, but then I'm going to open your mind up to something else in a second. Okay. So the root causes of persistent soleus overload would be like within that load versus capacity model, the load being how much we're subjecting our muscle to and capacity being how much load can this structure tolerate. Recovery will come into that capacity model as well. And so if we look at this equation, we look at, okay, what are the why is this soleus muscle, I should say as well, your soleus muscle is a part of your calf, it's one of your two main calf muscles, in particular the deep um calf muscle that works harder. It's the hardest one that works when you run. So your soleus works eight to 10 times your body weight every step that you take. Your gastrocnemius, which is the one that's clearly visible on the outside of like you can clearly see for runners on the outside. That typically tends to work about three to five times your body weight. So we're looking significantly more load going through that soleus. uh Okay, so yeah, we're looking at load and seeing if there's any sort of training philosophies or mindsets or habits that are really pushing that soleus over the limit. So we look at your overall training load, your mileage, your training intensity distribution, seeing like what are your overall speeds that you run at because the faster you run, the more it's the more load that's going to go through the calves. So is the bulk of your running at an appropriate intensity? to offer that right balance between load and recovery. What is your footwear like? Like I said earlier, minimalist footwear will generate high calf loads. And so if a lot of your running is in barefoot shoes or something similar, then maybe that's something we do evaluate. And terrain, hills, if you run uphill, that is significantly more load through the soleus. So you might be banding up and down hills all day every day. And that might be an issue for persistent soleus overload. And so there are certain elements that we would look into. But then that's the training load side of things in this load versus capacity model. What about the capacity part of that? We can just generally look at how strong your calves are. We can do general strength tests, jumping tests, hopping tests, just to see, is there any imbalance? Is there any changes in endurance or strength or power? Typically what we like to see when doing like a hopping test is nice, rigid hops, getting a nice height, especially compared to the other side. Looking at endurance, if we can hop for, you know, 15 seconds, do we maintain a good quality? Is that spring maintained compared to the opposite side? So yeah, strength tests would give us an overall picture of what that capacity is like. How good's your sleep? How good's your nutrition, hydration? Those sorts of things would... be an element to see, okay, are we really balancing out this load versus capacity model? And if we are identifying any issues in that equation, then we look to balance that equation back into our favour. So that would be either on the load side, modifying those that load, or on the capacity side, looking at building up that capacity. So when we build capacity, we're looking at my favourite is standing bent knee calf raises, typically double leg. because we can just go heavy. I've talked about this in the past, but my general routine is barbell. You kind of hold the barbell at your thigh, mid-thigh, kind of like you're about to do a deadlift, starting at the top. But we slightly bend down there, about 10 to 15 degrees. We maintain that knee bend, and then we come up onto our toes and back down. So they are bent knee calf raises. And I typically do three sets of 10 to 12. and it's in the neighborhood of like 120 kilos. So getting close to kind of double my body weight. So quite heavy stuff, but that's the strength side of things. um And you would start at a dosage, a weight that's challenging for you and then just build up from there. The other thing we can do at building capacity is just making sure your training load is dialed in and progress. So you're successfully doing 20 kilometres per week and through the right training structure, we can build you up to 30, 40, 50 kilometres per week. That is building your capacity of your calf. If we can successfully reintroduce more hills, steeper hills, steeper kind of sprints, like that's building up your capacity. If we can do so successfully over the weeks and weeks and weeks and There's also the power side of things. So like looking at plyometrics, pogo hops, pogo jumps. So we'd probably start with double leg jumping, doing say 15 to 20 of them for one set, and then getting some good recovery, maybe one to two minutes. So if you're fresh, you can do that again, you're looking to jump, but jump as high as you can with a really, really stiff leg. So you're, you're recoil is really really stiff. We like that nice efficient stiff spring to encourage that. um That would be a nice way of introducing power and building upon power. So that's the building capacity side of the equation. The load side, we might need to manage that load with different load strategies. So that might be, if you do find that you wear minimalist shoes, it might be spending a couple of days running in more supportive shoes or maybe a higher heel drop. um instead of zero drop shoes, it's more of like a eight millimeter drop from your heel to your forefoot. And that takes a lot of pressure off the soleus when you run. It might be substituting one run per week with a cross training method of choice, like a bike or a salt bike or ski or something that's taking some pressure off the calves. There are some strategies that we might throw at someone. who does have a muscle strain that's constantly being overloaded and yeah, allowing the body to adapt and catch up. However, Heather, I did say I'd take a slightly different tangent and open your mind up to a different possibility that could be going on, not saying it is, but um I know you are a uh running coach as well, so you're probably familiar with this sort of stuff. um A thing called compartment syndrome. So, Compartment syndrome, like if you consider like in your calf, you have certain muscles, blood vessels, veins, arteries, nerves, they're all like encased in different sleeves of fascia. And we call these different compartments. And sometimes when you run or exercise, there's a buildup of pressure within that tight sleeve of tissue, because the fascia itself doesn't expand really well. And sometimes if the muscles and blood vessels and everything warms up too quickly, it builds up that pressure within it and it really just can't escape and becomes really uncomfortable when you exercise. It's sort of this like exercise induced buildup of pressure, which is this compartment syndrome. And why I'm bringing this up is because in this limited information that you've provided, there's a few things that sort of prick my ears. First of all, you're saying it's a soleus. You're not saying it's a calf. And I know because you're a running coach, you're probably familiar with the difference between the two, but you're probably saying soleus because it feels more deep. And that's one of the most common compartments that does get affected with this compartment syndrome. It's sort of like the deeper calf complex, sleeve compartment, whatever you want to call it. uh The other thing is you said this has occurred over several years. And so despite... load modification, stretching, strengthening are still not resolving. Maybe there's something else that we need to open our minds to. The other thing that you included was that it is uphill efforts, typically uphill efforts. You did say sometimes on the flats, but typically uphill efforts, which um could lead to more of that pressure being built up within that compartment syndrome. And you say it forces you to stop. Like if it is like a muscle overload, typically people can... it gets uncomfortable. Typically people can run through it, but with compartment syndrome, yeah, it builds up where the pressure becomes so much that they just can't run anymore. And you also said that it feels on fire. That's not, I wouldn't say that's typical of a muscle strain or muscle overload. It still could be, but if you say on fire, I would open my mind up to something else. And so, yeah, and it's also on both sides. Like it's... um again, could be an overloaded soleus, but it could just be this buildup of pressure. And so how about we try, what I want to just suggest. I mean, like, you'd like more guidance on this, like I am an online therapist, can help guide you through this if you needed to. But if we suspect that this is the case, if you're listening to this, you're like, maybe I'll consider this as an option. um If we suspect compartment syndrome, When it gets really, really bad, like the buildup of pressure becomes quite bad. And this is only in severe cases. Some people recognize or appreciate or report like pins and needles, numbness into their toes, into their feet. If that's the case, then I highly, more highly suspect this diagnosis. That's just because the pressure builds up so much that the nerves and arteries that are encased within the compartment become so constricted that they start to alter the delivery, the delivery of either blood or the nerve signals and those sorts of things. we just look at in terms of treatment, a better warmup routine. So look for like, what is your typical warmup routine? that, can we spend a bit more time getting the body used to that pressure instead of just a very drastic rest, exercise, exercise, exercise and like that transition is too abrupt. look for signs of like body temperature are like days where you are warm and good to go are symptoms less compared to like maybe it might be winter and you feel quite cold and then you just go straight into a run. Maybe that's when things are more symptomatic and if it is maybe it's that buildup of pressure is just too drastic. So then if that is the case we'd look at like say a better warmup routine. You might do cross trainer on the indoors into a cross trainer. I've had compartment syndrome in the past. And what I would typically do is like an indoor bike for like 10 minutes before going out and doing my run. I felt like a million bucks after doing that. um A walk run would be great like on a treadmill indoors. um You know, just do a walk run, feel good, feel warmed up, feel like a light sweat, heart pumping, cars feel good, then go for a run, see what that's um Or just like, you know, start really light, really slow and just make sure that that build into your typical running pace is just a bit more gradual. Warmer clothes might be helpful. All of these things can be helpful. And if you find this really, really helps, then I would even more highly suspect that it is this compartment syndrome. And if you so happen to notice that the while running, that pressure is building up, just try to cut it, cut the run short or pause the run and do a walk. and just let the body catch up in terms of its pressure, let that pressure even out before resuming again. We definitely don't wanna get to the point where that buildup becomes that sensation like it's on fire and it forces you to stop because it can be quite hard to come back from that within that session. So what you do is like if it's a zero out of 10 to start with and you notice it's climbing up to a one, maybe a two, you sort of catch that really early, walk. or just stand, shake it out, just like give the body some chance to catch up on that pressure differential. And yeah, within that session, as soon as you take, take your time, it will, that pressure will eventually even out so that the demands of that continuous run equal the amount of pressure that's built up or eased or matched what's required for the intensity of the session. um And so Yeah, and then gradually over time, if that's more and more successful, and you develop more and more of an efficient routine, then symptoms become less and less and your body just becomes more and more used to adjusting to that pressure differential, and will lead to more success. So like I say, these are the things that I work with, with my clients a lot of the times, and find that quite helpful. yeah, Heather, if you if you notice this, and you're sort of thinking that's the case, and you make some adjustments and it's a game changer. Email me back, I'd be curious to hear how you get on. So that's it for today. Thank you once again to you Run Smarter Scholars. 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