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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 let’s begin your run smarter journey.
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On today's episode, we are diving into the latest running research. 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. Smarter Scholars, as we do at the end of every month, we have a research review where we go through what has been released in the latest month, what I find particularly interesting, what I think you will find interesting and relevant to helping your performance, reducing your risk of injury, better understanding running injuries. And this month I had a lot to choose from. had a lot of carryover from the end of December to... or through January as I had to record last month's episode earlier in the month. So publications kept coming out. um There were a few ones that I really wanted to include, but for the sake of time couldn't. But if you are a member of the database, then go check this one out. The title is Psychological Profile of Trail Runners Associated with Running-Related Injuries, a Prospective Study. um Go have look at that one. I think that one's really fascinating. Also, there's one called bodily awareness predicts functional improvement and injury risk in elite long distance runners. If you are interested in bicarb soda uh dosing for performance, there's one on that which has, that goes against what a lot of people claim. There's some rehab specific stuff around Achilles, patella femoral pain. Chronic plantar fasciitis, another one on prolotherapy for Achilles tendinopathy. There is a long, long list, which you will find in the Google folder in the month of January. So go check that out if you're interested. The papers that I've chosen, the first two I wanna discuss sort of coincide with one another. I sort of have the same particular topic. So I thought it'd be nice to sandwich these together. The first one is titled association between bone mineral density and ground reaction force in male and female runners. So bone mineral density is just a calculation for how dense your bones are. And a low bone mineral density has been associated with bone related disease, bone stress fractures and those sorts of things. And it is a big goal of ours as athletes, but also as humans just to try to maintain as much bone mineral density as we possibly can. We sort of hit like a bone density peak kind of around our late 20s, 30s, and it's hard, really, really hard to maintain and really, really hard, even harder to gain the later and later in age we become. And so, yeah, we wanna try to preserve it as much as possible. And there are some associations while this paper goes out to with the question of does certain running mechanics does ground reaction force. coincide with different bone mineral density. So let's start off with the introduction. In this paper, they talk about running proposes imposes a ground reaction force on the body, some of which is absorbed by bone and can contribute to micro damage. Micro damage stimulates skeletal remodeling with sufficient recovery. That's only once sufficient recovery is there. ah Similar to like how you might do a bicep curl, perform a few like micro tears of the bicep. then the bicep heals, gets stronger and can lift heavier. Same goes with ground reaction force or like anything that puts strain or micro damage to the bone. We want this bone turnover. That turnover is a lot slower than muscle. We're talking weeks and sometimes months to turnover and become stronger, but requires that recovery window requires sufficient recovery in order to have that turnover. This results in greater bone mineral density and insufficient bone regeneration occurs if the rate of remodeling is outpaced by the repetitive micro damage, so like overuse, which may contribute to low bone strength. Low bone mineral density has been associated with greater stress fracture risks in runners, which are more prevalent in females than males. Females generally have lower total body mass, lower lean mass. and greater fat mass compared to males, which may influence the force attenuation strategies and bone mineral density. Moreover, males run faster than females, which contributes to greater ground reaction force. However, males also have greater bone mineral density and larger bone cross-sectional area than females. Bone geometry, architecture, and externally applied forces contribute to bone stress, and thus bone response may differ between males and female runners. This is getting to an interesting point where if we have males who, well, to their claims run faster, they might hit the ground harder. They might have thicker bones, bigger bones as like the stature is generally larger in males. The applied force might trigger more bone stress, which might trigger more bone adaptation and therefore greater bone mineral density in theory. And then they say finally, There are sex based differences in hormone production which may influence skeletal remodelling. For instance, greater testosterone in males contribute to their greater bone mass compared to females. As such, runners of different sexes may have unique relationships between external loading and bone mineral density. Therefore, the purpose of this study was to compare ground reaction force and bone mineral density between males and female distance runners and to explore the potential association between ground reaction forces and bone mineral density for each sex. The method for this study, it was a cross sectional design, which included 40 participants. And to be included within this study, the participants were required to be between the ages of 20 and 35 years old. They needed to run more than 15 kilometres for more than 15 kilometres per week for more than three sessions per week and doing so for more than 18 months. So, an experienced runner that's pretty consistent. They then did some questionnaires about just their characteristics, their height, body mass, sex, age, gender, training history, lifestyle factors, and female specific considerations. They then all underwent a DEXA scan, which accurately depicts your bone mineral density in different regions of the body. And they looked at the spine, the pelvis, their dominant limb bone mineral density. and then they underwent a running assessment. they, on a treadmill, they had a whole bunch of reflectors placed on their body and they were asked to run on a treadmill at their self-selected speed. And they performed this, they were asked to perform as an easy run, uh an easy five kilometer run, which they could run comfortably while maintaining a conversation. So that's whatever self-selected pace fits that description. and participants also completed a standardized pace of 3.33 meters per second. They had a five-minute warm-up and then they had the self-selected speed and the standardized pace and completed that for five minutes each and then they collected data. They said what was the ground reaction forces, what was their scans, what are the associations and so what did they find? So for male runners, they said that male runners had a higher ground reaction force. So they're essentially hitting the ground harder. They had a higher loading rate, which is pretty much the same thing, and vertical impulse. And they were moderately to strongly associated with higher bone mineral density at the spine, femur, pelvis and shank, which would be your tibia. These associations were present at both the self-selected pace and the standardized pace. So of the male runners only, of those male runners who had higher bone density than the other male runners, they seem to be hitting the ground harder with harder ground reaction forces, sort of contributing to the theory that we need the ground reaction force to stimulate more bone growth. And therefore with more bone growth comes more greater higher bone mineral density and the opposite. So out of the male runners in that group. that had softer kind of landings. There was an association with lower bone mineral density. For the female runners, however, there was no meaningful association between ground reaction force metrics and bone mineral density at any site. Meaning any site being like the pelvis, hips, shank, that sort of thing. They also reported that absolute bone mineral density and ground reaction values were consistently lower than males. So, uh goes to support what they were saying earlier that just generically speaking, females have lower bone mineral density. And it seems as they do run, they also hit the ground. They don't hit the ground as hard, but maybe just because they're not, uh well, one might question that they're lighter because they're lesser in stature, therefore hitting the ground less. But an important nuance they said, they tried to normalize the ground reaction force. So they had the ground reaction force relative to body weight. And this showed weaker or inconsistent relationships compared to the absolute forces that they found. And so in the discussion, bone adapts to mechanical loading as we discussed earlier, but the response appears sex specific. In males, repetitive vertical loading from running may be sufficient to stimulate the bone adaptation. But in females, it seems like the same loading stimulus may not be enough. And this might be likely due to hormonal fluctuations. energy availability and differences in muscle mass and force production. So this challenges the assumption that just running alone is adequate for bone stimulus for everyone. I think there's, I've discussed this a couple of times on the podcast, but a lot of people think that because they run, they impact the ground, they, you know, have this impact based sport that they do all the time that they should have pretty good bone mineral density, but often it's a case like recreational runners don't necessarily have high bone mineral density compared to the general population. um And so yeah, we do need to be careful of that. In conclusion, the running related impact forces are linked with higher bone mineral density, but only in males, not in females. Female runners likely require additional or alternative mechanical stimuli to meaningfully influence bone health. Based on what I've seen in other papers, how you can... significantly influenced bone health would be like a change in direction type of sports. So you're looking at like basketball or like team sports that require a lot of change in direction. The muscles will pull on the bone in different directions, which bones love that. But also just heavy strength training has also been shown to help bone mineral density. Belinda Beck is a researcher here who's done a lot of studies on helping the elderly increase their bone mineral density and she just gets them safely but doing very heavy squats, very heavy deadlifts and to that effect, um just to really bulk up the muscle which pulls on the bone, which stimulates the bone, which improves the bone mineral density. And so she has certain protocols for that. So if you're wondering how you can best adapt or best come up with some additional or alternative mechanical stimuli. Those are the first things that I think about. So some practical takeaways for you listening, running mileage alone probably won't suffice in terms of a bone building strategy and strength training, some jumping, jump training, sprinting, multi-directional loading. These all play big roles in bone health. And it's important to note that bone health isn't just about mechanical loading. We also need to recover. We need that load response, but also the downtime so the body can have a time to turn over that. the bone and get stronger. But also, guess nutrition will play a role in that as well. Next up, we have another paper on bone stress and bone related stuff. The title is biomechanical associations with bone stress injuries in running a scoping review. A big thanks to Rich Willie, who I couldn't get full access to this paper when I discovered it. So email him, he's been on the podcast before and uh managed to hold on to his email. and he was grateful enough to send me the full paper. Also, I also noticed Adam 1040, who's uh another researcher who I follow pretty closely. He was another author of this study. And they did something slightly different. This is a scoping review, kind of like a systematic review where they go out looking for um different papers that have already been published rather than that previous paper who conducted the study themselves or looked at conducting or recruiting the participants themselves. So um they start off with a very similar introduction, but we've already talked about bone mineral density. You don't need to hear that again, but they did say, given that bone stress injuries result from applied bone loads, biomechanical factors are thought to increase the risk of bone stress injuries. These include kinetic differences, such as ground reaction force, tempurospatial differences, such as vertical center of mass or cadence. and kinematic variables. And this is like how someone looks when they run. So we look at hip adduction, rear foot or ankle eversion or the rolling in of an ankle. Within populations of runners, many retrospective studies have focused on ground reaction force parameters, specifically peak ground reaction forces and different loading rates. Although some retrospective investigations have found associations between high loading rates and bone. stress injury risk, primarily at the tibia or the shin bone. Studies evaluating bone stress injuries in different regions have not observed a similar association. Additional prospective investigations in collegiate runners have not observed an association between loading rate and lower extremity bone stress injuries. Instead, spatiotemporal parameters such as vertical center of mass exertion and cadence were strongly linked. to bone stress injuries. Discrepancies across these studies highlight the challenge of understanding the relationship between biomechanical variables and sustaining a bone stress injury. Differences in study methodologies, small sample sizes, populations of interest, whether it's in the military or recreational runners or competitive runners. These all narrow restrictions for the inclusion criteria and also age and gender. These may further create variability in these findings. The purpose of this scoping review is to evaluate the current evidence of biomechanical factors associated with bone stress injuries in individuals who participate in running. Identifying areas of agreement by anatomical location of injury, gender, and primary physical activity can help inform clinical management of bone stress injuries. So what did they do? In the methods, they looked for different papers that had certain population characteristics, their eligibility criteria, they needed to be running athletes and populations who engage in running for training, such as military personnel, also included in this study. No age limitations were used in the inclusion criteria as well. They ran through the databases. They initially came up with 442 papers, but after going through the inclusion criteria and sifting through, they ended up with 21 papers is what they used to come up with these final results of the study. And so what did they find? They say prospective risk factors for bone stress injuries, greater vertical center of mass exertion. So if you were to look at where your center of mass is when you run, some people run with their center of mass moving up and down at quite a large amplitude, whereas others move up and down at a smaller amplitude. And they say that there was an association with large vertical center of mass exertion, larger movement, so that every half a centimeter increase in this movement led to a 14 to 17 % increase in bone stress injury risk. So it's quite a large association. They also found an association with a lower step rate or a lower cadence. So for each one increase in cadence per minute, it led to a lower risk reduction of three to 5%. So if someone was running at a cadence of 170 and someone else was running a 171, that 171 runner had a three to 5 % lower risk of sustaining a bone stress injury. And that risk would be yet again, lower and lower and lower, the more steps per minute they found here in that association. So it's quite high. And I'd say like, my gut reaction is like these are sort of in tandem. So if your cadence is higher, you've also turned your legs over quicker and you don't have enough time for your center of mass to travel too high. so this biomechanically speaking, there is a relationship between the two. Higher cadence usually would translate to a lower center of mass exertion. and vice versa. And it seems to be these two variables that have been shown as risk factors for bone stress injuries. When it comes to site specific findings, they found that the tibia was associated with grade to hip adduction and rear foot eversion. So you could see this as like when you contact the ground, the foot is uh closer to or they sort of establish a crossover step width. So if your right foot contacts the ground, it's probably either underneath your body or over towards the left side of your center of mass, which would then lead to more ankle eversion or rolling in of the ankle, you could say that that pattern has been linked to bone stress injuries in the tibia. When we talk about the metatarsals, so the small bones in the ankle, that's been linked to again, rear foot eversion, so that rolling in and navicular stress fractures, again, another foot in the bone, is another bone in the foot, which is typically a high risk bone stress injury because it has poor blood supply. Higher rear foot eversion exertion and velocity were associated with those. So I think that might be uh how quickly you move into eversion rather than the overall uh distance, the overall range of movement of eversion. So uh not all bone stress injuries have the same biomechanically uh pattern. And so location does matter. The vertical motion and the cadence are the clear standouts as the most consistent, modifiable risk factor for bone stress injuries. Some studies were retrospective, meaning that like some of the risk factors that they identified may reflect like a post injury adaptation. Are they moving differently because they have had an injury in the past and not the actual cause? And gait retraining would be helpful. It will help target your cadence. They're among a few biomechanical changes that do support what they've found here. In conclusion, excessive vertical motion and low cadence are the strongest biomechanical signals associated with bone stress risk. And site-specific mechanics are interesting, but the evidence is weaker and less actionable. So practical takeaways for you runners. So reducing unnecessary bounce, meaning increasing your cadence, may be meaningful to reduce bone stress. A small increase in cadence of five to 10 steps per minute can be a protective way, especially if you have had a history of bone stress injuries. So how we typically train someone to do that is get a identify what your natural cadence is. Most garments and Strava and that sort of thing pick up on what your cadence is. They just record that. Then you get a metronome, dial it up by five to 10 beats per minute. Usually I recommend five to start with. and then run on a treadmill at a consistent pace. I say on a treadmill because people try increasing their cadence over ground and they just run faster. The idea isn't to run faster. The idea is to try to run at the same speed but take shorter, faster steps. So a treadmill helps keep that speed consistent. So there's some tips there. They say gate changes should be subtle and load aware. Don't make, try to avoid any abrupt changes in load. And biomechanics is only one piece, making sure we're also factoring in training load, nutrition, sleep, and bone health. These all are moving pieces and interacting pieces to help the overall health of the bone. This next one's a bit of a fun one. The title is Running Shoe Recommendations Based on Gait Analysis, Improved Perceptions of Comfort, Performance, and Injury Risk. uh Single-Blinded Randomized Control Trial. One of the authors of this paper is JF Esculier, who is a great friend of the podcast, probably been on, I think three episodes in the past. And so great to see his name in the author's list. Um, like I say, it's a bit of a fun one. Let me take you through the study design and you'll see what I mean by it. Uh, so introduction, many runners use shoes to increase comfort and reduce incidents of running related injuries. The belief is that shoes can reduce injury in part stems from marketing claims. and individualized shoe prescription improves running mechanics. Researchers have challenged the efficacy of shoe prescription practices for over a decade and more recently have concluded that the role of running shoe technology in injury reduction is likely overrated. In spite of the evolution of shoe prescription theories and paradigms over the years, i.e. pronation control, impact force modification, habitual joint paths and the comfort filter, Runners currently seek shoe selection advice from many sources, including running stores, family, friends, healthcare professionals, and experts within the running community. Runners purchasing shoes at specialty stores may undergo a gait analysis, which sometimes increases the trust some of these runners have in the expertise of the salespeople, which in turn plays an important role in the runner's shoe selection. However, at other times, runners perceived the so-called expertise of the salesperson more negatively as sales tactics or gimmicks. It is also common practice to assess foot shape to prescribe the shoe based on the findings, in spite of the lack of evidence to support the view that this practice prevents running related injuries. To our knowledge, no study has directly examined if recommending a shoe based on gait analysis alters the running footwear perceptions irrespective of whether the shoe is matched to the person or not. Therefore, we aimed to determine the influence of expert recommendation based on gait analysis on perceptions of subjective comfort, performance, and injury reduction in runners while monitoring spatiotemporal and kinematic parameters. We hypothesized that runners would score and rank the gait matched shoes more favorably than the basic shoes. So we'll talk through the study design that will or make a bit more sense as I go through this paper. So when it came to the methods, they said that the based on the study design, a sample size of 19 participants was required to meet a certain power based on the findings. So they recruited up to 21 participants and then uh ceased the recruitment phase once that sample size was reached. The eligibility criteria, they studied women. aged 18 and older and two, they had to be running a minimum of once per week for at least one month. Women were targeted because historically they were relatively underrepresented in sport and exercise science, so they just made a conscious decision to do that. The design, this was a single blind crossover randomized control trial and These involved evaluations. These evaluations were performed during a single 90 minute session at a university in New Zealand. And they included three stages in this 90 minute session. There was an intake stage where they just filled out some forms. There was a shoe fitting stage where they looked at a gait analysis. And then there was a running trial phase where they got the running on a treadmill and asking for their feedback. So during the running trials, the participants ran in their own shoes and also ran into experimental shoes. So they had their own shoes. did some running biomechanics. They were asked to measure their comfort and how they felt and all those things. Then they said, okay, you can try this basic shoe and do the same thing again, ask these questions. And now we have a third shoe, which is what they call gate matched shoe. This is. specific shoe based on how you're moving based on what we found in the intake and the shoe fitting gait analysis phase, this is the perfect shoe for you. Participants were led to believe that this gait match shoe was prescribed for them based on their shoe fitting and gait analysis process and matched their foot shape and their running style to the shoe. The following standardized prescriptions were used uh verbally and provided to the runners immediately before running in them. So they've got the script here. Here's your basic shoe. This shoe model is quite basic. It is a generic shoe that doesn't necessarily match your foot shape or running style. Basically, it can be used for distance running, but this is not specifically suited for you. The script that they used for the gait matched shoe, they said based on all the tests we did and with the six pairs of shoes we have in the lab, this pair is the best option for you to maximise your comfort. Since this shoe matches your foot shape and running style, it will be extra comfortable when you run. We know from the research that when a shoe is super comfortable and matches your body and running style, it leads to better performance and lower risk of injury. That's the script they used. So let's go back and go through this intake phase of their 90 minute session. So this was just like completing basic information. They looked at someone's height and mass. that had them rank their personal running motivations. They ranked what their running footwear properties were like their comfort, their injury reduction, their performance for the certain shoes that they currently have. The runners also reported their sources of running footwear advice where they've got their running advice in the past. And runners also reported their typical running shoe purchase locations. So that's just the intake phase. gait analysis shoe fitting phase. They used running in their own shoe and they did a gait analysis with the sort of pressure pads that some shoe stores might use. But they also had a functional assessment. They had the therapist that was there get them to do a single leg squat barefoot on each leg and would pretend to document their findings. I say pretend, but the paper continues to say to assist in convincing patients that their gait matched shoes were specifically matched to them. They had the assessor simulate or simulated looking closely at the data and the results and recording fake notes using a pen and paper. I don't know where exactly it reveals in this paper. was hoping it come a lot sooner, but um maybe I missed it somewhere, but the basic shoe and the gait matched shoe are identical. They're the same shoe. They just have a different color. um And so that's deceiving the people who are in this study, but like I say, how they're being presented. This is a basic shoe. This is a gait match shoe with all these magical things that perfectly fit to your shoe, to your foot. And then we're seeing what the outcomes of the things were. So when it came to the gait analysis and the foot sort of pressure pads and all those sorts of things, like the data doesn't really matter. We're just trying to convince the participants that The data is being collected and they're finding a shoe to match them. And so yeah, I'm sure it will be revealed soon in this paper, but I was hoping it'd be earlier than this. Okay, let's continue. So when it came to the running trials, the following straight after the shoe fitting and gait analysis, runners put on their own shoe and were instructed, well fitted with a whole bunch of sensors and then. They did these running trials. They were completed on a motorized treadmill. In total, the participant completed four five minute running bouts. They had a five minute familiarization phase on the treadmill. And during this time, they were asked to run at a self-selected pace, a self-selected pace that they could comfortably sustain for 20 minutes. And then after that, throughout the process of the running trials, the treadmill speed, was blinded to the participants, they're just running to feel. Runners used their own shoes during the first and third trials. There was four blocks of five minutes. So the first and third trials were their own shoe to kind of establish a bit of a baseline, also just re-familiarize themselves of what their own running shoe was. But the second and fourth running trials were randomized with either the basic shoe or the gate matched shoe. with the script that I mentioned before, but like I said, they're the same identical shoe anyway, just different colors. And so the runners rested for five minutes between the trials and during sitting down, they completed the surveys about how comfortable they found the shoes and all those sorts of things. So it was fresh in their mind. They could step off the treadmill, quickly rate it, and then get back on the treadmill. And the surveys taken after each running trial. examined the subjective footwear perceptions related to the overall comfort, the performance and injury reduction, as well as how much the shoe matched their individual running style, the running difficulty and running pleasure, they called it. And so what did the results find? The shoes that were labeled as gait matched like their ideal shoe, they were rated more comfortable, higher performing and less injury risk. So despite these being identical shoes to the basic version, there was no meaningful difference in how they were moving. So when they had the reflectors look how they were actually running the spatio-temporal variables, they were identical. Footstrike was identical. The tibial acceleration was identical. So even though they had the, uh they were told that they were, these were different shoes and they had the perception of it feels more comfortable, feels like I'm running faster or at eight in performance, they still moved exactly the same. So where does this leave us? Where are the discussion points? So perceptions are strongly influenced by expectation and descriptions, not necessarily the biomechanics. The gait analysis and expert recommendations can act as a placebo like effect. Comfort is real, but the comfort perception of comfort can be manipulated without changing mechanics and no evidence. there is no evidence that gate matched shoes reduce injury risk in the biomechanical sense. And so some key takeaways for you runners, comfort does matter, but don't assume that it equals injury protection. Be cautious of claims that the shoe is matched to your gate based on a brief assessment. And if the shoe feels good and allows consistent training, that's still valuable, but it doesn't really like fixed mechanics. Long-term injury reduction is more about training load management rather than shoe categorization. I typically do about three research papers, but we're moving along nicely here and I think I've got time to squeeze in one more. So I thought just briefly talk on another paper. me, it's about foam rolling. So the title of the paper is a bit of a wordy one, but it is the effects of foam rolling and the knowledge to action gap. Our practitioners beliefs supported by the evidence and international survey study. So let me just quickly go through this study because I thought it was interesting and maybe you'll find it interesting too. It's in the introduction, they say that foam rolling is widely used across sport, rehab and fitness, often with strong claims about performing or increasing performance, reducing risk of injury and having this fascial release. In health and sports science, it takes around 17 years of the research to actually be put into practice, but Previous surveys showed that there's large gaps between evidence and practitioner beliefs. And so this paper asked a simple question. It's what do what practitioners believe about foam rolling actually match what the science says? this research was the study itself was kind of like a two-parter. Part one was the evidence synthesis. So they had a look kind of running their own systematic. analysis, systematic review on what does the current research show in foam rolling. And then the second part was kind of looking at an international survey where they sent these surveys out to 452 practitioners consisting of sports scientists, trainers, therapists, students, and across the large, uh across the world, multiple language regions. And practitioners rated whether foam rolling was a positive, negative, or of no benefit across several different domains. That being does it increase range of movement, decrease pain, improve performance, recovery, stiffness, blood flow, injury risk, et cetera. And they had to rank or score all of these domains. And the responses were compared against the best available evidence. So what did they show? What the evidence actually supports. So what they found was the strongest, there was strongest evidence for foam rolling. improving acute increases in range of movement. So people move better through a greater range immediately after doing the foam roller. There was short term pain reduction. There was acute increases in local blood flow. And there was a small short term reduction in muscle stiffness. There is little to no evidence for performance enhancement, whether that's acute or over long term injury prevention. or long-term structural changes to the muscle or fascia itself. So the evidence around fascial adhesions is limited, low quality and poorly defined. What the practitioners believed, only two out of those 15 domains reached the expected 80 % correct threshold accuracy, reflecting what the evidence actually shows. So many practitioners overestimated the benefits. especially around increasing performance, long-term effects and structural release of the fascia, showing that there is a knowledge gap. It exists across all professions, including sports scientists and therapists. Beliefs varied by profession and country, but the misalignment was quite widespread across the globe. So in conclusion, foam rolling does work, but only for specific short-term outcomes. Many commonly held beliefs about foam rolling are not supported by robust evidence. The biggest issue is not the foam rolling itself, but it's how it's explained, described and justified. And there's an urgent need for better science communication, more realistic claims and clearer education for practitioners and for athletes. So just a quick little update on that paper. Hopefully uh you appreciate the fourth one being thrown in there, cause that was kind of just like a last minute decision and hope you enjoyed. I hope you look forward to the next month where I start. Well, next week is going to be when I start building out the next long list of research that's going to be emerging and I'll make sure that I continue finding ones that interest you and we'll catch you in the next episode. If you are looking for more resources to run smarter or you'd like to jump on a free 20 minute injury chat with me, then click on the resources link in the show notes. There you'll find a link to schedule a call. plus free resources like my very popular Injury Prevention 5 Day Course. You'll also find the Run Smarter book and ways you can access my ever-growing treasure trove of running research papers. Thanks once again for joining me and well done on prioritising your running wisdom.