Greg and Alex delved into a wide-ranging discussion about the science of endurance and fitness, with a focus on injury prevention and treatment. They explored the effectiveness of strength training in injury prevention, the inconsistencies in the research, and the debatably importance of stretching in the prevention of injury.    Alex shared his personal experiences with a hamstring injury and his approach to running injury prevention and some of the limitations of our current research base. As usual, we also talked about the role of technique in injury risk reduction.  Greg did get confused and brought up technique and performance so that was nice accidental discussion point.   Alex's Outside Magazine Profile  Alex's website

Dr Neil Meigh is a physiotherapist and associate professor at Bond University (Gold Coast Australia).   Neil conducted a pragmatic exercise intervention in insufficiently active older adults.  The intervention was a hard style kettlebell program in those aged 60-80.  These people were not life long athletes but many of them thrived in his program.  They got the type of results and improvements in fitness where an independent observer could be skeptical.     We talk details of the program and the resiliency seen in this population while performing high intensity exercise.   Neil's paper is here

Jo Nijs, PT, MT, PhD,[1] is a Belgian professor of physiotherapy at the Vrije Universiteit Brussel and physiotherapist/manual therapist at the University Hospital Brussels.  He has published more than 200 peer reviewed journals and has been strong proponent of some of our favourite topics on this podcast. We talk about: - classifying pain based on mechanisms (nociceptive, neuropathic, nociplastic) - what nociplastic pain is - the utility of understanding nociplastic pain  - how lifestyle interventions (sleep, stress, diet) can influence pain - how we can tailor those interventions to individuals in pain - how traditional "motor control" exercises can be reframed and help with pain Dr Nijs can be found at Pain In Motion Relevant Papers LIfestyle and Pain Another paper on a lifestyle management approach to pain Cognition Targeted Motor Control Exercises RCT  Sleep and Pain Nociplastic Pain Another paper on Nociplastic Pain and CS

One of the hardest discussions to have with people in pain is shifting our focus from trying to "fix" pain to living well with pain.  Because, if we are very honest there are a huge number of people who might always have pain.  Sometimes the goal for healthy rehab is to shift from eliminating pain to living well with pain.  This is a fundamental of Acceptance and Commitment Therapy (ACT). Dr Bronnie Lennox Thompson is an expert in this area and she takes us through the importance of this approach and how you can have this difficult conversation with your patients. Bronnie's webiste is here

Dr. Jordan Feigenbaum discusses orthopedic costs of training, specificity in workouts, impact of excess body weight on health, and importance of healthy debate. Addressing technique, injury risk, exoskeleton technology, and debating evidence-based arguments

Dr. Pak discusses deadlifting for individuals over 50, optimal approaches to improving strength, and the importance of training technique for injury prevention and performance gains. The podcast also explores the minimal effective dose of training frequency for significant improvements in strength and hypertrophy gains.

Physios have been lambasted awhile for not understanding the basics of strength and conditioning principles. I reject this idea.  There two areas we explore in this podcast. 1. The idea that strength and conditioning basics are relevant for rehabilitation 2. Whether physios actually know these basics. I make an attempt at trying to understand the arguments againsts physios and try to provide a competing view.   Here is how the AI summarized it (not really accurate but I don't want to piss off the robots):   Recovery Mechanisms in Rehabilitation Programs Greg discussed the importance of understanding what facilitates recovery in rehabilitation programs, emphasizing that it's not always about building strength. He argued against the judgment of programs based on arbitrary ideas of what needs to change, as the actual mechanism of recovery can vary. He also addressed the concept of tolerance, suggesting that improving a person's ability to tolerate loads can lead to recovery, even without necessarily building strength. Greg rejected the idea that physiotherapists don't understand the basics of strength and conditioning, stating that they do and that the judgement often comes from bias. He also highlighted the need for more research to better understand what mediates recovery. Strength Training Program Design Debate Greg discussed the flexibility and options in designing a strength and conditioning program. He highlighted that the basics are simple and the key is to progressively overload the muscles. Greg also addressed the debate around whether to push to failure during exercises and suggested checking in to see how close one is to their failure zone. He further stated that there's no need to obsess over specific exercises, as the principle of progressive overload applies to them all. Greg concluded by stating that he'd like the debate to shift towards understanding when specific attributes are important and how to achieve them, with a focus on patient-centered care.  

Today we take a bit of a detour and talk a little bit about the business side of Physical Therapy.  We don't do justice to our speakers knowledge but I hope that if this a topic you need to know more about I've introduced you to the right person.  Karen Litzy is an excellent physical therapist out of New York City, owner of a concierge physical therapy business, host of the very popular podcast "Healthy, Wealthy and Smart" and she is the creator the Strictly Business Blueprint. Links Karen's Website

Antony Lo (aka The Physio Detective) is an elite physiotherapist with a special interest in the pelvic floor and the female athlete.  Antony is an amazing clinical educator and provides a lot of insight into how our profession can keep moving forward. We discuss: his evolution from the kinesiopathological model to movement optimism the role of movement technique in injury risk reduction (he hates this question) when we need to be clinically specific in our interventions (specific examples related to the pelvic floor are discussed) his views on behaviour and opinion change. Future Teaser! - we are going to have Antony on again to dive deep into behaviour change.     Relevant Links   More about Antony's courses here Antony's clinic page here Antony's popular The Female Athlete LITE course And The Female Athlete Full course Global Pelvic Health Course Diastasis Done Differently course     Greg's Links (Blogs, courses, Recovery Strategies Workbook blah, blah, blah) Website