The Run Smarter Podcast

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In this listener Q&A episode, Brodie dives into four fascinating research-backed topics that every runner should understand โ€” from aging performance to tendon rehab science:
  • How running performance declines with age โ€” and the key training interventions to slow it down
  • Recovery potential after Achilles tendon rupture or tendinopathy, with or without surgery
  • The true accuracy of MRI vs. CT scans for stress fractures and other running-related injuries
  • Whether isometric exercises after a run can strengthen tendons and reduce โ€œstress shieldingโ€
Episode Summary

In this โ€œAsk Brodie Anythingโ€ edition, Brodie tackles questions from listeners covering performance longevity, injury recovery, and the science behind imaging and tendon adaptation.

๐Ÿƒโ€โ™‚๏ธ 1. Aging & Running Performance
Brodie unpacks the 2019 paper โ€œThe Physiology and Biomechanics of the Masterโ€™s Runnerโ€ by Rich Willy, revealing:
  • Performance decline typically begins around age 35, with VOโ‚‚ max dropping ~7% per decade.
  • Active runners experience slower declines due to training volume and intensity.
  • Step length decreases and cadence increases with age, while ankle power and tendon stiffness reduce, leading to slower speeds.
    ๐Ÿงฉ Key takeaways:
  • Maintain high-intensity interval sessions and training volume.
  • Add heavy resistance training (2โ€“3x per week) and plyometrics to preserve tendon stiffness and bone density.
  • Use cross-training (ski erg, bike, rower) to build aerobic fitness while reducing joint stress.
๐Ÿฆถ 2. Achilles Tendon Rupture: Can You Fully Recover?
Drawing from the 2016 World Congress on Sports Physical Therapy Consensus Statement, Brodie explains that:
  • Return-to-sport rates range from 55โ€“90% after 1 year of rehab.
  • Surgical cases report 29โ€“87% return, but recurrence rates remain high (27โ€“44%).
  • Recovery depends on age, injury severity, and rehab adherence.
    ๐Ÿง  Brodie emphasizes that full recovery without pain or fear of re-injury is possible โ€” but addressing psychological readiness is as vital as physical rehab.
๐Ÿฉป 3. MRI vs. CT for Stress Fractures
Brodie reviews a systematic review comparing imaging accuracy:
  • CT scans: Sensitivity 32โ€“38%, Specificity 88โ€“98% โ†’ great for confirming, poor for ruling out.
  • MRI: Sensitivity 68%, Specificity 99% โ†’ still the gold standard for stress fractures.
    ๐Ÿ‘‰ Clinical takeaway: A CT scan can confirm, but a negative CT often still needs MRI.
    Scans should be used only when clinically justified โ€” chronic tendinopathies are best diagnosed via functional assessment, not imaging.
๐Ÿ’ช 4. Isometrics After Running: Useful or Overhyped?
Referencing tendon researcher Keith Baar, Brodie discusses โ€œstress shieldingโ€ โ€” when tendons redirect load away from damaged fibers.
  • Post-run isometrics (3ร—20โ€“30s holds) can help load fatigued tendons more evenly.
  • But for true tendon remodeling, progressive heavy slow resistance remains essential.
  • Alternatives like โ€œcreep loadingโ€ and time-under-tension exercises can also reduce stress shielding โ€” no need to be fatigued to gain benefits.
๐Ÿงฉ Key Takeaways
  • Stay strong as you age โ€” resistance and high-intensity training slow decline.
  • Achilles rehab success depends on gradual loading, not just surgery.
  • MRI beats CT for stress fractures; be strategic about when to scan.
  • Isometrics help, but heavy slow load is still the cornerstone of tendon rehab.
๐Ÿ“š Resources Mentioned
  • Willy et al. (2019): The Physiology and Biomechanics of the Masterโ€™s Runner
  • 2016 Consensus Statement on Return to Sport after Injury (World Congress in Sports Physical Therapy)
  • Diagnostic Accuracy of Imaging Modalities for Lower Extremity Stress Fractures
  • Keith Baar: Stress Shielding and Tendon Adaptation episode

What is The Run Smarter Podcast?

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 letโ€™s begin your run smarter journey.