What are the clinical implications of hormone-driven tendon changes?

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In today’s episode, we explore three brand new running research studies that shed light on how to run faster across different terrains, optimize your fueling strategy, and understand how hormones influence tendon health. Whether you're training for a marathon, chasing a trail PB, or navigating changes in your body as you age, this episode delivers powerful and practical science-backed insights.

Research Papers Covered
1. Biomechanical Strategies to Run Faster on Level, Uphill & Downhill Terrain

Researchers analysed how runners increase speed across different gradients and where the mechanical load shifts in the body. Key findings:

Flat running: Speed increases mostly from longer stride length, powered by the ankle/calf complex
Uphill running: Speed comes from higher cadence and greater work from hip flexors & hamstrings
Downhill running: Higher eccentric quad load due to braking forces

Training takeaway: Strengthen calves for flats, hip flexors/hamstrings for hills, and eccentric quads for downhill stability

2. Under-Fueling in Endurance Racing: Carbs Are Underconsumed & Overestimated

This study tracked marathoners and cyclists during real races and found:
Actual carb intake = ~21g/hour (far below the 60–90g/hour recommended)
Athletes overestimated how much they thought they consumed
Leftover gels were high, suggesting taste fatigue or gut issues

Sleep & anxiety strongly impacted fueling success
Training takeaway: Fuel by schedule, not by feel. Practice gut training and improve sleep before race day

3. Estrogen & Progesterone’s Impact on Tendon Health

A fascinating tendon biology study showed:
Male and female tendons remodel differently
Female tendons respond strongly to hormone changes
Estrogen increases tendon repair activity, while progesterone stabilizes tissue

Hormonal changes (e.g. menopause, cycle phase, contraceptives) may influence tendon injury risk
Training takeaway: Women experiencing peri/menopause or hormonal changes may need longer recovery windows & consistent strength training