8 Ways to Help Runners Regain Confidence and Trust in Their Body 

8 Ways to Help Runners Regain Confidence and Trust in Their Body 

As a physical therapist, nothing’s worse than seeing a runner who has lost confidence and trust in their body. Luckily, I know how to get runners back on track. Using my 20+ years of experience, I’ve outlined the 8 most important strategies to keep in mind when working with runners who seek your guidance and help in the face of a setback. 

1 – Leveraging “Non-specific Effects” & Refining the Runner’s Journey 

It’s important to appreciate that a lot goes into a physical therapy session beyond the specific intervention(s). Believe it or not, the context of an experience (AKA “non-specific effects”) is responsible for more than 4x the variance in treatment outcomes in medicine and rehab. 

When you think about the last time you went out to dinner…

  • How easy was it to make a reservation, and did you receive a confirmation? 
  • When you arrived, were you greeted by a friendly host or hostess and promptly seated at your table, or did you have to wait? 
  • Was the table clean and comfortable? 
  • Was the server upbeat and warm in their demeanor and patient with you while anticipating your needs?
  • Was the food brought out in the appropriate order on time and warm like it just came out of the oven? 
  • Was the waiter delayed in bringing you the check, and did they accept all payment options? 
  • Did they thank you for dining with them and mention they look forward to seeing you again soon?

As you can see, a lot goes into a good dining experience beyond the actual food. The same goes for every physical therapy session I have with a runner. By taking the time to understand the factors at play, you can leverage certain effects to improve buy-in, eliminate potential friction, enhance outcomes, and give runners ownership of their situation.

2 – “Inductive Foraging” & Asking Open-Ended Questions

“You can run all the wisdom of science and technical knowledge past an athlete, but behind that sits their heart, values, motivation, and doubt.”

-Stephen Rollnick

When first connecting with clients, create the time and space for them to share their story while posing calculated open-ended questions to help them reflect on their situation. 

Did you know that the average time before a physician interrupts a patient is typically 11-23 seconds? Additionally, consults are often rushed, and clinicians can often come across as abrupt, distracted, or sterile. 

I can’t help but think back to an experience I had with an orthopedist about a knee injury. After patiently waiting 45 minutes past my scheduled appointment, I finally saw the doc, who seemed to be in a hurry. He spent less than 30 seconds asking me about my knee before quickly examining it and telling me nothing was wrong and that I should “put some holy water on it.” Can’t make this s#*% up.  

As much as I want to get to the clinical examination and testing of a consult, I learned early in my career never to rush that initial conversation because it helps build rapport and open communication. Listening to patient stories, connecting, and approaching care through shared decision-making improves my clinical reasoning. This is why my PT consults are 75-90 min long and sometimes longer, pending the situation and needs of the runner.

Below are some powerful questions I routinely incorporate into my physical therapy sessions that I thought would be helpful to mention. The more I can get people to talk openly and honestly about their situation while remaining present, engaged, and genuinely curious, the better. 

  • Would you mind telling me about yourself and what brings you in today?
  • Why do you think you’re in this situation, and why seek help now?
  • What steps are necessary to move forward from this point?
  • What obstacles might hinder your progress in overcoming this situation?
  • Who is part of your support system as you address this issue?
  • What is your vision for the coming weeks and months? How do you see things unfolding?
  • If I turned out to be the most helpful PT for you, how would your life change due to our work together?
  • What would you like to walk out of today’s session with?
  • Is there anything else you’d like me to know about you to put me in the best possible position to help you?

Asking these questions invariably garners trust and connection while paving the way to a meaningful and successful outcome. 

3 – What’s Point A? 

As the great teacher and legendary strength coach, Dan John likes to ask, “What’s Point A?” 

As much as we want to rush to “point Z,” which means healthy and consistent training for most runners and perhaps running with reckless abandonment for others, clinicians often fail to clearly identify “point A” during the initial consultation. 

Running has predictable performance demands – it also involves relatively high loads performed repetitively over long durations. This is why completing a comprehensive evaluation is imperative for identifying point A.

Want a copy of my Physical Performance Tests & Clearance Considerations sheet I use as part of my comprehensive evaluation? Enter your e-mail below.

Otherwise, you risk giving a runner the greenlight only to have them report hobbling home during their first attempt. It also helps determine whether a runner is a candidate for PT or needs to be referred to a more appropriate provider. 

Another benefit is that the assessments can help you develop a bond of mutual respect and trust. Plus, when the approach is collaborative, patients feel acknowledged and optimistic about their abilities. Remember, this objective portion of an assessment is to show runners what they can do more than what they can’t. Just as much as I’m making a mental note of specific impairments or deficits, I’m verbalizing and highlighting a lot of the things that bode well for them.

Finally, it’s also important to watch runners run. Although you’re probably thinking, “DUH,” you’d be surprised how often medical professionals fail to do some form of running gait assessment. 

By the time we wrap up this part of the consultation, I have a clear sense of where a runner is on the injury-to-performance spectrum as well as the best next steps to position them for a safe and timely return to training and competition. My primary responsibility from here is to communicate the findings clearly and concisely so they have a refined understanding of their situation and the best next steps. 

4 – Load the Tissue with the Issue & The Prisoner’s Dilemma 

I consult a lot of runners who are spinning their wheels or can’t seem to get on the other side of a finicky running-related injury. A common denominator in nearly all these cases is failure to load the tissue with the issue.

This is why when crafting a home exercise program for runners, I developed “The L’s of Loading.” It’s ideal for runners with limited time and resources who would benefit from having a simple and actionable home program. Think of it as the 20% of Pareto’s principle

Below I’ve broken down the L’s of Loading.

  • Load the tissue with the issue – often in the form of isolated single-joint exercises
  • Life movement – push, pull, hinge, squat, carry
  • Linkage exercise – a drill that challenges the kinetic chain.

For example, suppose a runner is recovering from Achilles tendinopathy, and their symptoms have stabilized. In that case, a simple program that might be appropriate based on The L’s of Loading is as follows:

Ironically, after I challenge runners to directly load the tissue or region that’s been bothering them, they often remark, “Is it weird that things feel better after doing the exercise?” Nothing like having a runner discover their pain is malleable as it elicits buy-in and confidence in the program.  

Except for certain situations or precautions (i.e., stress fracture), generally aim to “Load the Tissue with the Issue” because taking an avoidance strategy typically doesn’t work. 

To read more about The L’s of Loading, you can download the PDF by entering your email below.

5 – Reframing – Highlighting Strengths & Mitigating Threats 

“The mentality distracting habit of always looking for faults is so powerful that this shift to focusing on strengths take some getting used to.”

-Jonathan Fader

Most physical therapists and medical professionals are trained in an impairment-based model that emphasizes a runner’s weaknesses or deficits. This approach can often stoke anxiety and have the runner walk out of the session with their tail between their legs. 

Rather than rattling off a laundry list of deficits, focus on what’s going well for the runner. For example, I recently consulted a trail runner who came in complaining of right kneecap pain after connecting with a new coach in March who had him running more volume and ‘vert.’ There was no specific event or incident that caused his knee pain. Rather, it was a gradual onset, likely aggravated by long back-to-back runs in the mountains. Despite having some stiffness in his foot and ankle region and being a bit wobbly on that side when performing a lateral step-down, he had several things working in his favor. So I said…

“Based on the lens that I got into your situation and our work today, you have so many good things going for you…

  • You’re getting zero pushback during the day with routine activities of daily living (ADLs).
  • There’s nothing wrong with your knee joint as full, pain-free ROM and no swelling in or around the joint.
  • You can run, hop, and squat on your right leg with no reluctance. Sure, you had some low-level pain though it wasn’t getting worse, nor did it cause you to alter your mechanics.
  • Simply bumping up your cadence during the treadmill run also took away nearly all your pain, showing you that nothing sinister is at play.
  • If I were in your shoes, I’d carry on but be sensible. I suggest having you run every other day on level ground to rolling terrain for the next couple of weeks. As you prove tolerance to the training, we can start nudging.” 

Strive to reframe feedback and data for runners in a positive light while being transparent about the reality of their situation because nothing’s worse than being given false hope. 

6 – Communication Heals

“All I did was identify with the patient and give a few encouraging words. It wasn’t anything specific, but I knew it made a difference. 

-Austin Smith

If there’s one thing I’ve learned in my 20+ years as a physical therapist and coach, it’s that empathetic communication heals. Taking the time to listen and engage with runners in a curious and non-judgmental manner is the cornerstone of effective care. 

Not only is it critical to be present, but word choice, language, tone, explanations, metaphors, and stories convey critical messages and can infuse optimism or sow doubt. 

My primary goal with runners is to ensure they feel heard while shifting their attention away from pain, fears, and anxieties and toward healing and recovery. At the same time, I am realistic and transparent about their situation. My aim is to inoculate any unhelpful narratives or thought viruses they may have about themselves and their situation while reminding them of their body’s remarkable affinity to adapt and overcome so long as we create the right ecosystem, respect biology, and appreciate the role of allostatic load.

Just as much as runners come to me for help, it’s also essential to put it back on them. They are the ones who have run into trouble and likely have the best insight as to why. As I always tell runners, “You’re the expert on you, so I’d love to get your thoughts.”

Something as simple as the phrasing of a question regarding whether or not they did their home exercises could make a world of difference. 

For example, rather than asking, “Did you do the exercises I gave you?” Try framing the question as, “How have the exercises been going?”

If you work with runners in any capacity, I challenge you to listen carefully while being surgical with your words, stories, and explanations. And remember to put it back on them by asking, “What do you think?”

And never forget, as the great Louis Gifford said,

“Reassurance is a bloody good painkiller.”

7 – Guardrails & The RTF Rule 

“Runners don’t have unrealistic goals; they have unrealistic timelines.”

-Curb Ivanic

One of the most challenging and critical aspects of my clinical work is helping runners protect themselves from themselves.

Trust me when I say that left to their own devices, runners often make bad decisions and invariably violate The RTF Rule…Rush to Failure.

This is particularly true in working with runners dealing with bone stress injuries (BSIs), commonly known as stress fractures. 

For anyone who’s dealt with a BSI you can probably attest to the fact that once you remove running from the equation, things calm down quickly, and within a matter of a few days or weeks, you’ll think that because you’re pain-free, you’re good to plug back into training where you left off. WRONG. I can think of countless occasions in recent years where runners discontinued the plan of care because they had to get back to training for a big race or to ensure they were ready for the upcoming season. Not only did their plans not pan out, but many of them went on to develop a second BSI. While we’re on the topic and to better understand how bones heal and realistic timelines to return to running as a function of stress fracture locations, check out my buddy Nathan’s posts HERE & HERE.

As much as we hate to admit it, biological healing takes time, and there’s no magic potion or elixir to expedite the process despite what’s presented in the media.

So revel in the process and understand that biological tissue and processes take time. A good rule of thumb is that however long you think it’ll take to get you back to training, multiply it by a factor of 2. And as you plug back into training, an excellent acronym to help progress your running is F.D.D.I. – Frequency, Duration, Density, Intensity. For example, an early goal is to get runners back to running every other day at conversation pace. From there, we can start nudging their runs until they work up to one hour of continuous running. A sensible way to progress things is to incorporate back-to-back running days. And finally, so long as a runner isn’t experiencing any pushback, it is appropriate to layer in some short bouts of intensity in the form of strides or intervals or incorporate some hill work into the equation.  

Lastly, I always make it a point to normalize that you’ll feel sluggish and sore as you resume running, especially if you’ve had a more extended layoff. So be patient and forgiving with yourself, and know you’ll be back to full force in due time. 

8 – Mapping Out & Signing Off on the Plan 

Diligent follow-up and follow-through will set you apart from the crowd and communicate excellence.

-John Maxwell

At the end of every consultation, I make it a point to summarize the session and outline my suggestions regarding the best next steps.

I also make sure to get the runner’s seal of approval by having them verbally agree or sign off on the plan because it’s up to them to take ownership of their situation, and it’s critical that we’re on the same page.

Before parting ways, I also allow runners to voice any questions or concerns that may not have been addressed during the session that they feel are critical to helping them move forward.  

Following the appointment, I then email them a detailed roadmap that outlines what they should do over the next three to four weeks in terms of exercises and training-related modifications while again reminding and highlighting the things they have working in their favor and how we’ll segue them from their current status back to running in the manner they’re capable.

In this email, I also include private video hyperlinks to the exercises and any equipment they need to perform their home program. Considering the volatility around certain RRIs, this email must be crystal clear while also providing some autonomy in the way of decision-making for the runner. For example, I often say here are the exercises I want you to do. The order is not critical so long as you get them done, so feel free to plug and play as you see fit. 

Another helpful thing is to map everything out on a big whiteboard during the session so runners can appreciate the various moving parts. They can also take a picture of the board as a reference they can always return to. So between that and the follow-up email, they should have a clear path outlined.

CLICK HERE to access this template I created to help you summarize your findings and outline a plan moving forward. 

Thanks for taking the time to read this, and hope it helps improve your outcomes in working with runners. If you’re a runner spinning your wheels and want to connect, please reach out HERE, and I’ll gladly help you or get you connected with the right person if you live outside of Seattle.

6 Takeaways from Running an Impromptu Marathon

6 Takeaways from Running an Impromptu Marathon

How I ran a 2:50 marathon on a whim while staying healthy and in control throughout the race

Race pic courtesy of the Eugene Marathon

On May 1st, I completed the Eugene Marathon. While I’ve completed plenty of Ironman Triathlons, this was my first ever attempt at the distance as a standalone event. I did this race in support of my good buddy, Johnny Kvietkus. This was his first race back following a horrific car accident last summer. Although his sister and nephews would be there on race day, I thought it’d be fun to accompany him. I also had to honor a pact I made with one of my athletes, Tonya.

My friend Johnny and I at Seward Park

I promised her if she qualified for the 2023 Boston Marathon during this year’s race (which she did with flying colors), I’d toe the line with her next April. Since I’m not getting any younger, I thought I’d better get my qualifying time sooner rather than later. So I threw caution to the wind and registered three days before the race.

Outside of one 14 miler, my longest run in the past two years was the weekly 12-mile jaunt I do to my in-law’s house for Sunday dinners. I was also sidelined from running for eight weeks in late 2021 due to an unexpected knee issue, which I fortunately recovered from.

If you are prepping for your next marathon, here are six key takeaways from my experience for you to consider as you begin ramping up your training.

1) Stop trippin’ over the long run

You can’t cheat the volume going into a marathon. But to avoid leaving several critical boxes unchecked, don’t structure your training around the long run. When it comes to tackling marathon training, my friend and PT extraordinaire, Mike Studer, sums the long run up nicely saying,

Stay on your feet for the length of time you project the marathon to take. For example, if your goal marathon time is 3 hours, you may only need to cover 20 miles in long slow distance during your training cycle.

If running long and slow was all that mattered, I wouldn’t have had the strong race I did. Sure I faded a bit towards the end (see below), but I think the other types of runs were integral to my success.

The green line on this chart shows my pace, which you can see slowed toward the end of the race with several stops at aid stations before powering through to the finish. 💪

As my good friend and colleague, Joel Sattgast says,

The long run is an opportunity to demonstrate confidence, mental more than physical. If a runner can complete 20-22 miles, then what’s 4-6 more?

For example, I often include the following sessions during a typical week:

  1. 45 – 60 minutes at conversation pace, including anywhere from 5-15, 10-30 second strides.
  2. 45 – 60 minutes at conversation pace with a mishmash of hard intervals ranging from 1-5 minutes in duration.
  3. 60 minutes at conversation pace on rolling to hilly terrain or a 30- 45 minute tempo effort.
  4. 90 minutes of running over to my in-laws with an occasional pitstop at Fremont Brewery, turning the final mile into a beer mile 🤫🍻
  5. 20- 30 minute transition run off the bike AKA T-run (remember, I’m a triathlete).

These runs challenge coordination, heart and lung function, tissue capacity, power and confidence. As you review these workout sessions, keep this rate of perceived exertion (RPE) chart in the back of your mind.

RPE Chart

This RPE chart is from my latest project RunWell, which launches in June — check out our teaser!

2) Practice for race day and fuel like you mean it

It blows my mind how much runners and triathletes worry about factors that are out of their control while neglecting what they can rehearse such as nutrition and pacing.

Although I didn’t register for Eugene until a couple of days before, I started considering the race about two weeks out. Given the situation, I knew I needed at least one long run to rehearse nutrition and pacing. A week before Eugene, after a short walking warm-up, I put in a 14-mile effort slightly faster than my projected marathon pace. I knew if I could hold a brisk effort, I’d have the confidence to get it done on race day.

My pre-marathon 14 miler

A breakdown of my pre-marathon 14 miler

Given the energy demands required to run a marathon, I knew it was also critical to have a clearly defined nutrition strategy.

Everyone is different, but I’ll provide a window into my approach starting the day before. In reality, however, it begins well before in terms of hydration and sound fueling for energy availability.

Fueling the Day Before Eugene

After a 25-minute shakeout run with Johnny on Saturday morning, we went out for a late morning breakfast where I had a monster pancake, a plate of hashbrowns, an egg and one piece of bacon.

My breakfast the morning before the marathon.

My breakfast Saturday morning

For the rest of the day, I snacked on pretzels, nonfat yogurt, and pita during the afternoon before having a sensible pasta dish with some chicken in the evening.

Race Day Fueling

On to race morning…4:30 a.m….RISE & SHINE CAMPERS!

I made sure to get up early and start fueling at least two hours before the start of the race at 7 a.m. Giving your body this amount of time to digest is crucial to ensure everything can break down, exit the gut and be used by the working muscles once the gun goes off.

My waist belt of choice for the marathon.

My go-to Solomon waist belt

For breakfast, I had:

  • 1 cup of organic unsweetened apple sauce
  • 1 banana
  • 1 plain bagel
  • 14 ounces of sports beverage and then sipped on water to thirst before the race

For the race, I took seven Huma gels on board and stowed them in my favorite Salomon waist belt, the Pulse. The Huma gels are 100 kcals and consist of ~22-26 grams of carbohydrates.

My target for the race was ~60g of carbs per hour, so I planned to consume a gel every 20 ish minutes and then rely on what the aid stations had for the home stretch. Long story short, I nailed my nutrition!

It’s worth noting: I’ve trained my gut over the past several years and have a cast-iron stomach, so please exercise caution in adopting my exact approach because it may not be appropriate for you.

3) Strength training is essential

If there’s one thing a runner should do beyond run, it’s strength train. While running should comprise the bulk of your training as an endurance athlete, strength training ensures we have the requisite capacity to withstand the performance demands of running. This is especially true for masters level (over 35 years old) and geriathlete (over 55 years old) runners. Incorporating strength training:

  • Improves movement economy
  • Reduces or delayed fatigue
  • Improves anaerobic capacity
  • Enhances maximal speed

I don’t know about you, but what runner wouldn’t want that?! When it comes to running, our bodies need to withstand:

  • Cumulative loads given the repetitious nature of running
  • Peak loads considering certain tissues and regions need to withstand upwards of 8x bodyweight force
  • Energy storage and release since running is a plyometric activity

My strength training included some combination of the following movements and exercises based on where I was in training:

  1. Farmer’s marches (check out my recent post on marching drills)
  2. Squats
  3. Deadlifts
  4. Single leg drill (step-ups, toe taps, long lever bridge)
  5. Calf raises
  6. Push press
  7. Jump rope

While there is still a lot of research to be done on strength training, it’s something I strongly advocate for runners. I like to think of strength training as “coordination training under load.” If you don’t already prioritize strength training, any type of strength training is likely to create a positive stimulus. Aim to layer it in 2 – 3 x per week, ideally on non-running or lighter runners days.

4) Prioritize consistency and moderation

Despite many athletes being enamored by heroic or jaw-dropping workouts on social media, nothing promotes physiologic adaptation like measured training day in and day out. If you get overzealous and trip something off such as a muscle pull or tear, be prepared for your training to get derailed.

While adding intensity to a training cycle is important, make sure to get into a rhythm before revving the engine. Furthermore, when preparing to layer intensity into your sessions, be sure to come into the workout centered and ready.

Full disclosure: My marathon performance was the culmination of years of consistent and moderate training while peppering in calculated intensity, which ultimately allowed me to go deep in the well.

5) Focus on what is in your control

Speak to any marathoner, and you’ll learn about the dreaded 20-mile mark. Of course, the “goin’ gets tough,” but don’t let it get to your head. Every course is different and the conditions always vary. The main thing you can control is how well you pace the race leading up to the last 10K.

My mantras for the Eugene Marathon.

Mantras are an important tool to help keep you focused throughout your race.

Stay conservative early at the start, avoid going out too fast and focus on nutrition. Study the course and race accordingly. For Eugene, I made sure to write mantras in permanent marker on my hand to keep me honest but anchored for each segment of the race. There were two hills that hit during the first half of the race and so it was important to stay sensible early on. From there, the course was relatively tame. While my mantras were generally spot on, I should’ve labeled the fourth one GRIND because it sure as hell wasn’t a PUSH at that point.

6) Find a shoe that gives you a boost

Although I typically downplay the role of shoes, if you find a supershoe that feels comfy, springy, and light, you’d be silly not to use it. Worst case scenario, you’ll have a psychological advantage on race day.

My shoes of choice for the Eugene Marathon.

My shoes of choice for Eugene, the Saucony Endorphin PRO 2

Having done a lot of personal testing comparing various metrics (heart rate, pace, effort) between traditional running shoes vs. those with carbon plated technology, I’m someone who undoubtedly benefits from the latter.

For this race, I went with the Saucony Endorphin PRO 2, and they were divine.

If you want to experience what it feels like to run on mini trampolines, this shoe has you covered. Rumor has it that the ASICS METASPEED, the next shoe I’ll introduce into my rotation, is also the cat’s pajamas. I promise to report back.

Aim to find a shoe that weighs less than 440g (pair), feels comfy and has a carbon plate. Otherwise, be prepared to hit the F8 recalculate button post-race, wondering how much faster you could’ve gone and the precious seconds you left on the course.

Huge shout out to Rachel Lee at the Run Shoppe, who takes care of my running shoe fetish.

Final Thoughts

The most obvious takeaway from the race is how much less of a logistical headache a marathon is relative to an Ironman. I’ll continue to race long course triathlons, but the marathon was a much more enjoyable experience and vibe. You also don’t have to deal with a bunch of stressed out type A triathletes staring at your calves and quads trying to size you up going into the race. There’s nothing relaxing about racing a triathlon. I sometimes wonder why I do them in the first place. Based on my first marathon experience, I can’t wait to race Boston and put in a focused training block to avoid running a second impromptu marathon.

Burnout in Physical Therapy | Where Passion Collides With Reality

Burnout in Physical Therapy | Where Passion Collides With Reality

It’s become clear a good chunk of physical therapists have become disenchanted with the profession and are suffering burnout.

Can’t imagine it has anything to do with the insurmountable levels of debt and pressure from employers who lack core values and prioritize patient churn out.

How can this already be happening,” you think to yourself as I’ve only been practicing for a couple of years?

I must confess the situation has me distraught to the point where it’s brought me to tears.

Is what I’m experiencing normal or are these unjustified fears?

I went into this field to help others reclaim a life of movement and get back to the things they love.

I thought this was gonna be rewarding but I’m starting to feel like I’ve had enough.

Every day I run around a clinic throwing tips and tricks at complex, volatile situations.

Then I have no choice but to stay long after my shift writing notes, which are nothing more than overexplaining.

How in Sam Hill am I ever going to pay off $100k+ in loans and where does starting a family, enjoying some leisure reading, and pursuing my hobbies fit in.

Please throw me a lifesaver because I’m drowning in all these nonsensical explanations patients are given about why they’re in pain…what a sin!

Before I forget, do you know how I can get out of a non-compete?

Is it something I’m locked into because I’m on the verge of conceding?

I don’t know bout’ you but I can’t sit through one more compliance meeting.

If you haven’t figured it out yet, I feel like it’s time to switch professions or jump ship.

And don’t get me started over the fact some states still require a PT script?!

Why is it that when we know there’s a leak in the ship we sit there and watch it sink (thanks Johnny!)?

I don’t know about you but if we stay on the current trajectory, I’m genuinely concerned the physical therapy profession could go extinct.

Now more than ever physical therapists are looking for purpose and patients desperately need individualized care.

Unfortunately, clinicians are having their passion(s) crushed thanks to a soul-sucking system and employers who’ve created a sense of despair.

It’s time we stop feeling sorry for ourselves, reclaim our profession, and get back to the things which matter most?

What happened to creating an unparalleled patient experience, clinical excellence, and simply being a gracious host.

Let’s take a moment to revisit the wise words of George Patton, who once said, “Courage is fear holding on one minute longer.”

I’m sure you probably feel like things are going bonkers.

Now’s the time to double down on your situation so you can position yourself to break through and conquer.

Do your best to put your fears and worries aside while getting crystal clear on your core values then rework your narrative as a person and clinician.

I’m excited for you to discover the opportunities that await and look forward to following your mission.

Remember to immerse yourself in and connect with your local community while pouring your hands, heart, and mind into your craft.

Only then will you get established as a trusted resource at which point there’ll be no looking back.

Please stop worrying about all these new-age marketing platforms characterized by suspect strategies and tactics.

At day’s end, they’re nothing more than a racket!

Rather, focus on doing the best job you absolutely can day in and day out.

Remember in case you forgot…the best marketing is still word of mouth.

By no means will this be an easy journey as you’ll surely encounter some obstacles along the way so remain patient and revel in the process.

A final reminder…YOU GOT THIS!

The Runner’s Despair

The Runner’s Despair

One of the greatest challenges I face in working with runners is what I refer to as “Runner’s Despair.” So, I decided to write a poem about it…

“Why me?”

“Will I ever run again?”

“This isn’t fair!”

Please don’t fret as this is a classic case of “Runner’s Despair.”

You’ve likely tried pulling back on training and resting without any luck.

Maybe you’ve resorted to pulls, injectables, and/or surgery while having parted with several hundred bucks.

Please put your mind at ease and try your best not to freak out or worry.

Look…as much as I wish we could rush biology it often creates a strike against us to be in such a hurry.

This situation has arisen for reasons you’ll likely never fully know though it demands some reflection.

And believe me…I’m well aware of your running predilection.

Take this time to pick up a book, phone a friend, or tend to things that you’ve put on the back burner and need your attention.

Appreciate that perhaps you’ll have to confront some challenging issues and face adversity so it’s normal to have some apprehension.

Do know that you WILL get on the other side of this turmoil and once again take flight.

This will not be an easy process and could very well take all your might.

And never forget that you’re best running lies ahead.

So chill out and power off as it’s time to get to bed.

I’ll see you bright and early and be ready to get to work.

For the record, let it be known that you’ve been put on alert.

Never forget that you’re only as good as your last injury and the extent to which you rehabbed it.

And please don’t gimme this shit that you’re gonna quit.

It’s time to saddle up…are you ready to commit?

How to Apply the Science of Step Rate to Your Running Using the RunCadence & Spotify App

How to Apply the Science of Step Rate to Your Running Using the RunCadence & Spotify App

Over the past several years, a wealth of research has emerged pertaining to the myriad of benefits of step rate (AKA cadence) manipulation when addressing various running related injuries (RRIs) and lower extremity pain.

The fundamental principle behind step rate manipulation is that by keeping running velocity/speed constant and taking more steps per minute, one is able to effectively reduce their stride length, and in turn the magnitude of each individual loading cycles at the expense of taking more loading cycles. This is readily apparent when stopping to consider the following equation.

Speed= Stride length X Stride frequency

Furthermore, research shows that music serves as a great external auditory cue, especially for endurance athletes, as it results in spontaneous entrainment to the tempo or beat with a greater effect noted in women. One approach to help you apply step rate manipulation to your running involves making use of the RunCadence and Spotify App.
Below I will take you through how to use the combination of these Apps to reduce the magnitude of loading of each individual gait cycle if that is indeed the desired goal. Research has shown that as little as a five percent increase in step rate while keeping running velocity constant can reduce shock absorption at the level of the knee by upwards of 20 percent. That’s astronomical!!!

It should be noted, however, that the information presented in this post should not suffice nor serve as a substitute for professional medical advice in the event you are dealing with pain and/or functional limitations. In such instances, we advise you to seek consultation with a trusted medical provider, who specializes in the rehabilitation of runners.

Equipment Requirements:

  1. Calibrated Treadmill
  2. Iphone with the RunCadence App
  3. Spotify App

Let’s Get Started

The first item of business it to determine your step rate or cadence for a given running velocity. To do this, you will have to complete a one-minute test. We suggest conducting this on a treadmill to obtain the most accurate results provided that you are comfortable running on a rotating belt. This is where the RunCadence app comes into play. Prior to completing the test we encourage folks to start with a 5′ brisk walk followed by a 6′ run to get familiarized with the treadmill. From there, stand on the runners of the treadmill and open up the RunCadence App (assuming it’s already been downloaded) on your smartphone and click “TEST.” You will be given a 5s countdown before the test officially starts though we encourage folks to start running once the countdown ensues to settle into your running gait. You will have to hold the phone in your hand for the duration of the test. To avoid compromising the accuracy of the test, we encourage you to avoid looking at the timer on the App. Rather, simply use the treadmill timer and make a note of when you start the test and plan for 70-75s of continuous running to ensure that you fully capture your foot contacts for the entire minute.


How to Determine Your Step Rate for a Given Speed Using The RunCadence App:

Tap the RunCadence App

Select “Test”

Tap Ready & Start Running

Run for 1′ w/ phone in hand

Once you have finished the one-minute test, this screen will appear which shows your average step rate as well as +2.5, +5, +7.5, and +10% above your avg step rate. We generally recommend starting with +5% when it comes to gait retraining. This is the value that you will plug in to the Spotify app when prompted. We’ll cover this in more detail below. In the event that you are able to readily adopt the +5% step rate, feel free to increase it to +7.5% if not +10%. While you can increase your step rate above 10%, apppreciate that doing so occurs at a great metabolic cost.

How to Use the Running Feature on Spotify and Plugging in Your Step Rate:

Step 1:

Once you have downloaded Spotify from the app store, simply tap the icon to open it.

Step 2:

When the homescreen of the Spotify app appears, tap the search button centrally located at the bottom of the screen.

Step 3:

In the searchbox, type in “running” then click the search button at the bottom of the screen.

Step 4:

Scroll down until you see “Genres & Moods.” Tap the icon with the running man.

Step 5:

You will have the option to select various types of music so pick the one that suits your fancy 🙂 We often encourage folks to select a style of music with a distinct beat as it lends to better sychronization in terms of your foot contacts.

Step 6:

When you arrive at this screen and are prompted to start running, simply click the “skip” button at the bottom of the screeen and plug in the value obtained from using the RunCadence Test. Consider starting with the “+5%” value.

Step 7:

You are ready to roll/run! Aside from periodic advertisements, you will now have a continuous playlist based on the beat frequency you plugged in. Bear in mind that maintaining a consistent/steady step rate for a given running speed is most easily accomplished on level ground. Hills and softer surfaces may cause you to deviate from the target.

Wishing you HAPPY, HEALTHY, & STRONG Training. Please reach out if you have any additional questions regarding how step rate can be applied to your training. Onward!!!

Disclosure: RunCadence is a for profit IOS App that I developed along with my good friend and business partner, Ben Wobker. It is currently priced at $2.99 and can be found on the App store.

How to Create a Pain Problem & Opioid Addiction

How to Create a Pain Problem & Opioid Addiction

I recently received a call from a young guy (late twenties), who was recommended by his friend to contact me as he was in need of acute post-operative rehabilitation following a recent knee menisectomy. Upon asking him, “What instructions were you given to manage your situation until your first follow-up appointment with the doc?” He responded by listing off the following recommendations given by the physician’s assistant (PA)…

  • Take pain pills as needed (prescription for 40 percocet)
  • Don’t do anything that hurts or causes pain
  • Don’t bend your knee past 90 degrees

This represents a microcosm of our current state of affairs in relation to pain management and opioid addiction. The potential societal repercussions of this situation are disconcerting. I’m hopeful we can do better!

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