Sports Medicine Project

Foot orthoses are crucial for effective patient care, moving beyond just basic materials. Their role in treating conditions like Achilles tendinopathy and tibialis posterior pain is highlighted, emphasizing the importance of foot biomechanics. Listeners gain insights into proper assessment and clinical reasoning, helping health professionals make informed decisions. The discussion encourages collaboration among podiatrists, physiotherapists, and other allied health experts, fostering a clearer understanding of orthotic prescriptions.

 Blake Withers and Jack Craigo discuss the nuances of running shoes, particularly focusing on super shoes and their suitability for different runners. They explore the importance of shoe fit, the role of retail in guiding shoe selection, and the potential injury risks associated with performance footwear. The discussion also highlights the significance of comfort and the impact of shoe technology on running performance, concluding with recommendations for runners on choosing the right shoes for their needs.Jack Crago youtube and instagram: @jog.on.cragosuper shoes, running shoes, injury prevention, shoe fit, marathon training, footwear technology, running performance, retail experience, shoe selection, running communitySuper shoes, also known as advanced footwear technology (AFT), are designed to enhance running performance by incorporating features like aggressive rocker geometry, high stack heights (often ≥35–50 mm), lightweight and compliant foams, carbon or composite plates, and minimal weight. These features aim to improve running economy and propulsion. However, their widespread use has prompted questions about whether they are the best option for all runners—especially when it comes to injury risk and biomechanical stability.Running participation continues to grow, with events like marathons selling out rapidly (Barrons et al., 2023). Many runners get their footwear advice from online sources or retail staff. Research suggests that both runners and retailers prioritise comfort, with super shoes often perceived as more comfortable than generic alternatives (Malisoux et al., 2020). While footwear is known to influence both performance and injury risk (Nigg et al., 2023), the assumption that super shoes are universally superior oversimplifies a complex trade-off.One of the major proposed performance benefits of high stack height is an increase in effective leg length, which may lengthen stride and improve running economy (Burns & Tam, 2020). However, these gains may come at the cost of reduced frontal plane ankle stability, particularly at higher speeds (Hoogkamer, 2020; Barrons et al., 2023). This potential drawback becomes even more important in longer races when fatigue sets in and motor control becomes more challenged.Recent studies have begun to test these assumptions more rigorously. Garofolini et al. (2024) and Möhler et al. (2022) hypothesised that high-stack shoes increase instability in the control of the centre of mass (CoM), and that these effects are exacerbated at higher speeds due to the added demands on motor coordination. Their findings suggest that super shoes may impose additional coordination demands that not all runners can accommodate.In one of the most comprehensive studies to date, Kettner et al. (2025) tested runners using shoes with low (27 mm), medium (35 mm), and high (50 mm) stack heights. The high stack shoes caused measurable changes in running style: increased vertical oscillation of the centre of mass (COMosc), lower step frequency, and higher duty factor (i.e., more time spent on the ground). These shoes also altered ankle mechanics, especially increasing time in eversion and eversion angles. Critically, they found lower local dynamic stability at the hip—measured using Maximum Lyapunov Exponent (MLE)—with the high stack shoes, suggesting impaired control of the centre of mass. These changes were largely independent of running speed, appearing consistently at both 10 and 15 km/h.From a clinical perspective, this evidence indicates that super shoes are not one-size-fits-all. Runners with a history of injury, reduced neuromuscular coordination, or poor fatigue resistance may be better served by lower stack, more stable footwear. Coordination and stability may be just as critical as cushioning and propulsion—especially in long races or for less experienced runners.

Dr Myles Murphy is a clinical physiotherapist and early-career clinician researcher from the Nutrition and Health Innovation Research Institute at Edith Cowan University. Myles’ works clinically at SportsMed Subiaco and has worked with or consulted for a variety of elite sporting teams. While working clinically, Myles’ completed his PhD part-time at The University of Notre Dame Australia investigating the different mechanisms related to pain and dysfunction in people with lower-limb tendinopathy. Myles’ research involves investigating the drivers of pain and impairment in people with lower-limb musculoskeletal injury and disa

In this conversation, Blake Withers and Kelly Kortick host Esther Keown and Dr Claire Badenhorst to discuss the importance of understanding female physiology in sport, particularly running. They explore the challenges young female athletes face regarding body image and performance, the significance of individualised training programs, and the role of communication in supporting female athletes. The discussion also highlights the launch of Femmi's membership, which aims to empower women through education, community support, and personalised training that considers the unique physiological needs of women. The Femmi app is available for download on iOS and android: iOS: https://apps.apple.com/au/app/femmi-running-plans-for-women/id1672881899Android: https://play.google.com/store/apps/details?id=com.femmico.femmi&hl=en&pli=1Femmi: https://tinyurl.com/c7r732bsEsther: https://www.instagram.com/estherkeown/?hl=enClaire: https://www.instagram.com/claire_bades/?hl=enTakeawaysUnderstanding female physiology is crucial for optimizing training and performance.Communication about body image and performance is essential for young female athletes.Individualized training programs are necessary to accommodate the unique needs of female runners.FEMI provides resources and support for women to understand their bodies better.The menstrual cycle significantly impacts training and performance for women.Empowerment through education can enhance confidence in female athletes.Community support plays a vital role in encouraging women to participate in running.Research on female physiology is still evolving and needs to be more inclusive.FEMI's membership offers personalized training and expert guidance for women runners.Tracking menstrual cycles can help women understand their bodies and improve performance.Chapters00:00 Introduction to FEMMI and Its Mission01:29 Understanding Female Physiology in Training02:17 Optimizing Communication and Support for Female Athletes02:44 The Impact of Societal Norms on Female Athletes04:21 New Chapter04:36 The Role of Coaches and Clinicians in Body Positivity07:24 Understanding Female Physiology and Injury Prevention10:04 Research Insights on Female Athlete Well-being13:08 The Importance of Open Conversations in Sports Medicine15:45 Celebrating Progress in Female Sports Education24:24 Understanding Menstrual Cycle Research Limitations30:16 Individual Variability in Menstrual Cycle Symptoms33:13 FEMI: Tailoring Training to Female Physiology37:24 The Complexity of Hormonal Impact on Performance42:52 Recognizing Luteal Phase Defects and Their Implications51:31 Empowering Women Through Cycle Tracking56:12 Understanding Your Body and Hormones57:12 The Importance of Iron for Female Athletes01:06:43 Debunking Foot Strike Hemolysis01:11:30 The Dangers of Generic Training Programs01:14:35 Maximizing Performance for Female Athletes01:17:54 Introducing the Femi MembershipKeywordsFEMMI, female physiology, running, training programs, women's health, empowerment, communication, performance, menstrual cycle, community support

TakeawaysMetatarsal stress fractures are common injuries in athletes.Understanding the remodeling process of bones is crucial for recovery.Subjective questioning can reveal important clues about the injury.Palpation techniques are essential for accurate diagnosis.Systemic factors like energy availability can influence bone health.Imaging, particularly MRI, is vital for diagnosing bone stress injuries.Treatment should focus on offloading the affected area.Recovery time varies significantly between individuals and injuries.Communication with patients about their condition is key to effective treatment.Injury prevention strategies should include monitoring training loads. ** You should always see a medical professional for diagnoses and assessment. This is not medical advice and is for educational purposes only.SummaryIn this episode of the Sports Medicine Project, hosts Blake and Kelly delve into the complexities of diagnosing metatarsal stress fractures and bone stress injuries. They discuss the importance of understanding the clinical assessment process, including subjective questioning, palpation techniques, and the role of imaging in diagnosis. The conversation emphasizes the significance of systemic factors and adequate recovery in preventing these injuries, as well as the need for effective treatment strategies. The hosts share insights from their clinical experiences, making the discussion both informative and engaging for listeners interested in sports medicine and injury management.Chapters00:00 Introduction and Overview of Metatarsal Injuries03:01 Understanding Bone Stress Injuries05:46 Diagnosis and Clinical Assessment09:04 The Role of Training Load and Recovery12:06 Systemic Factors Influencing Bone Health14:49 Imaging and Diagnostics for Metatarsal Injuries18:01 Palpation Techniques and Patient History20:53 Conclusion and Key Takeaways25:35 Palpation Techniques for Metatarsal Assessment32:06 Clinical Decision-Making in Bone Stress Injuries37:54 Differentiating Between Tendon and Bone Injuries48:02 Imaging and Diagnosis of Bone Stress InjuriesKeywordsmetatarsal stress fracture, bone stress injury, diagnosis, clinical assessment, imaging, treatment, sports medicine, recovery, palpation techniques, systemic factors

Gregs social: https://www.instagram.com/greglehman/Pro version Heidi AI Scribe (time saver) Link: ⁠https://scribe.heidihealth.com/?via=SMP⁠Support the show: ⁠https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLinkGregs Website: https://www.greglehman.ca/Chapters00:00 Evaluating Shockwave Therapy in Tendinopathy00:44 The Role of Exercise in Rehabilitation03:43 Understanding Patient Ecosystems and Health06:23 Case Studies: Practical Applications in Treatment08:49 The Complexity of Pain Management11:43 Research Critique: Shockwave Therapy and Evidence14:10 Psychological Factors in Pain Perception17:02 Clinical Decision-Making in Patient Care26:00 Trusting Experts and Knowledge Translation27:21 Challenging Established Beliefs28:30 Comparing Treatment Philosophies31:03 The Role of Patient Understanding33:35 Exercise vs. Alternative Treatments34:26 Load Management in Rehabilitation35:54 Creative Approaches to Running Rehabilitation37:06 Resistance Training for Runners40:12 Skepticism Towards New Research42:50 Understanding Bone Stress Injuries54:53 Understanding Pain and Structural Changes58:59 Navigating Risks in Running Injuries01:04:20 The Role of Social Media in Health Information01:09:39 Strength Training and Recovery Insights01:12:24 Research Aspirations and Future DirectionsKeywords:shockwave therapy, tendon rehabilitation, exercise, pain management, sports medicine, patient education, metabolic health, case studies, research appraisal, individualized treatment, training protocols, bone health, stress fractures, plyometric training, rehabilitation, pain management, social media, health information, research ethics, performance.Summary:This conversation delves into the complexities of sports medicine, focusing on shockwave therapy, exercise rehabilitation, and the importance of understanding patient ecosystems. The speakers discuss recent research findings, the role of exercise in pain management, and the need for individualized treatment approaches. They also explore the psychological factors influencing pain and the critical appraisal of existing research in the field. In this conversation, Blake Withers and Greg delve into various aspects of training protocols, bone health, and the complexities of rehabilitation. They discuss the importance of flexibility in training, the role of frequency in plyometric exercises, and the nuances of managing pain in relation to structural changes. The dialogue also touches on the ethical considerations of pain in research, the impact of social media on health information, and future directions in rehabilitation research.takeawaysShockwave therapy may not provide additional benefits compared to exercise.Exercise should be critically evaluated just like other treatments.Improving a patient's overall health ecosystem is challenging but essential.Patient motivation is crucial for successful rehabilitation.Understanding the mechanisms of pain can enhance treatment outcomes.Research in sports medicine often lacks strong evidence for certain treatments.Individualized treatment plans are necessary for effective rehabilitation.Psychological factors play a significant role in pain perception.Exercise can positively influence peripheral nociception.Critical appraisal of research is vital for informed clinical practice. People can improve despite not following traditional protocols.Flexibility in training is crucial for optimal results.Frequency of training may be more important than intensity.Understanding bone health is essential for preventing stress fractures.Pain is not always a reliable indicator of injury severity.Social media can be a double-edged sword for health information.Research ethics play a significant role in studying pain management.The relationship between structure and pain is complex and often misunderstood.

We discuss the latest review PMID: 39704142 with Prof Peter Malliaras✅ Identifying early responders – Can we predict who will benefit?✅ Effect – Does it work?✅ Diminishing returns – When does adding SWT to exercise stop being beneficial?✅ Types of shockwave therapy – Why radial shockwave was chosen in this study✅ Sham treatments – Do they still have a therapeutic effect?✅ Mechanisms of action – Neuromodulation, therapeutic alliance, and tendon adaptation✅ The ‘Big Machine Effect’ – Is patient belief in SWT part of its effectiveness?✅ Comparisons to exercise – Would fewer appointments with exercise yield similar outcomes?We also discuss clinical implications—will these findings change how shockwave therapy is used in practice?🔗 References & Studies Discussed: • Alsulaimani et al. (2024) - Achilles tendinopathy & shockwave RCT • Benli et al. - SWT vs. exercise alone • Heide et al. - Shockwave therapy for plantar heel painFind out about Peter and upcoming course:https://www.tendinopathyrehab.com/homeSocials: https://www.instagram.com/tendinopathyrehab/https://www.linkedin.com/posts/petermalliaras_my-new-tendinopathy-rehabilitation-framework-activity-7296743926009368576-GNRW/?utm_source=share&utm_medium=member_ios&rcm=ACoAAAexDmkBlV5e4jGTX2E4X9J6s8ZitO8yX0M&fbclid=PAZXh0bgNhZW0CMTEAAabnnAaDDYH_S3We7eJaZZbOHWHxrtGYC_5AiRO-rDUtmh29GdmHqrWh9fI_aem_FLbCehDnORljxK3cgMA8fQ

Patreon: ⁠https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink 1. Keep Intensity the Same This is the biggest and easiest mistake. If your Achilles is sore, what will aggravate it most is higher rates of loading—formally, this happens more when you run faster. Yes, it might warm up during the run, but you’ll pay for it 24 hours later. You need to stress it just a little, see how it responds, and build from there. 2. Rest, Then Go Straight Back to Full Load You shouldn’t completely rest and then jump straight back to the same training load. If you usually do speed work on Tuesdays, and you’ve had a week or two off, that first run back shouldn’t be the same session. Don’t do that. Start gradually—try something like 6 x 1-minute efforts and progress from there. 3. Wear Flat Shoes Heel pitch helps Achilles tendon pain. A higher heel reduces both tensile and compressive forces by limiting dorsiflexion. Achilles pain isn’t just about the run—it’s about everything you do throughout the week. If you’re on your feet all day, even if it’s not sore at the time, that will contribute to your pain during training. 4. Not Question the Diagnosis Sometimes, it’s not Achilles tendinopathy. Yes, if you’ve had it before, you can get it again—but not always. Other things mimic Achilles pain. Be sure. 5. Keep Training Load the Same If you’re dealing with Achilles pain, take something away. Reduce intensity or volume—adjust something. If you’re not sure how, see someone who can help you make it graded. 6. Think the Adjuncts Are the Answer They can help, but they’re not the solution. Shockwave, massage, needling—useful, sure. But if you’re not loading appropriately, nothing else will fix it. 7. Not Load It Properly You have to load it. Strength, plyometrics, progressing appropriately—it all matters. 8. Smash the Anti-Inflammatories and Think That’s Enough Anti-inflammatories aren’t bad, but if that’s all you’re doing, you’re missing the point. This isn’t an inflammatory condition—it’s a load issue. 9. Think Injections Are the Quick Fix Too many people jump to injections too early. They can have a role in specific cases, but they’re not a cure. 10. Ignore the Psychology Behind Injury This is huge. Achilles pain isn’t just about the tendon—it’s about the mental load of not running, the frustration, the identity shift. Understanding this can change everything. Achilles tendinopathy, injury management, running injuries, health professionals, rehabilitation, load management, resistance training, anti-inflammatories, psychological impact, running performance

Mr. Ian Reilly qualified as a Podiatrist in 1988 and became a Podiatric Surgeon in 1996. Over his career, he has performed more than 11,000 surgical procedures under various anaesthesia types, showcasing his extensive expertise. You can out more below by clicking the link on his website. From 2001 to 2024, he led Podiatric Surgery at Northamptonshire Trust, significantly advancing podiatric care. Now retired from NHS practice, he focuses on private care, operating weekly at Three Shires Hospital in Northampton and treating patients across self-pay, insured, and NHS pathways. Mr. Reilly specializes in: Injection Therapy: • Cortisone Injections Podiatric Surgery: • Cyst and ganglion excision (soft tissue lumps and bumps) • Morton’s neuroma surgery (trapped nerves) • Subungual and other bony exostectomies (bony bumps) • Lesser toe correction (hammer toes) • Metatarsal surgery for forefoot pain • Surgery for hallux limitus (arthritis of the great toe) • Surgery for hallux valgus (bunions) • Haglund’s deformity (heel bumps) • Plantar fasciitis (heel pain) • Flatfoot surgery Minor Surgery: • Verrucae, corn, and skin surgery • Nail surgery Dr Ian Reilly website: https://podsurgeon.co.uk/ Youtube: https://youtube.com/@ianreillypodsurgeon?si=rDK6BHAwRGBu4L3F What it takes to become a Podiatric surgeon? file:///Users/blakewithers/Desktop/ian%20pod/The%20Royal%20College%20of%20Podiatry.html Mary PoppinsProbably Needed Orthotics article https://podiatrym.com/Highlights2.cfm?id=3286 Patreon: https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink 00:00Introduction to Dr. Ian Riley02:07Career Progression in Podiatry05:53Surgical Experience and Case Studies07:24Injection Therapy in Podiatry13:55Managing Neuritis and Injection Guidelines18:43Understanding Osteoarthritis and Injection Therapy23:41Patient Case Study and Emotional Impact26:50The Role of Podiatry Post-Surgery32:22The Evolving Perspective on Orthotics35:12International Standards in Podiatry37:06The Importance of Imaging in Diagnosis39:42The Forefoot Examination Process42:28Understanding Morton's Neuroma46:02The Role of Imaging in Treatment Decisions48:31Surgical Indicators for Forefoot Conditions01:03:10Understanding Patient Concerns and Predictions01:05:14The Role of Orthotics in Treatment01:06:53The Importance of Communication in Healthcare01:08:57Navigating Conflicting Opinions Among Clinicians01:11:18Injection Therapy and Its Efficacy01:15:29Challenges in Treating Mid-Foot Osteoarthritis01:22:33Research Aspirations in Injection Therapy01:24:45Interviewing Historical Figures for Insight01:26:24Future Teaching and Learning Opportunities

We get so many questions each week that need more then a voice note or instagram post to answer so we're doing it here. Casual yarn about what it is being a health professional with questions we get asked over the week. Support the shoe - new content out on Patreon. How to assess the 1st MPJ (30 min how-to video) + how weekly video realises on the treatment of those common big toe pathologies, joint/sesamoid/adventitialbursa/met stress/FHL, PF. https://patreon.com/SportsMedicineProject?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink Cheers, Blake and Kelly (sub 20 parkrunners)