0:00

can HIPAA contribute the most to to

0:02

to the proposal phase of other horizontal hub.

0:05

When you look at the muscle force that they measure, the solids

0:07

is by far the biggest force contributor. So I think

0:09

if you're doing a thing like half a distance test,

0:12

you're getting a good measure of explosive

0:15

qualities from the solid muscle and particularly

0:17

especially when you a bentley position because

0:20

you haven't accelerated center mass,

0:22

which is a which is sorry. It's a

0:24

it has a big role left.

0:37

Welcome

0:37

to the Paci Performance Podcast.

0:40

The podcast that dives into the philosophies

0:43

ideas and practices of

0:45

some of the best practitioners in high

0:47

performance sport.

0:49

If you're a practitioner or clinician

0:52

looking to increase your knowledge around

0:54

calf, foot strength, and calf

0:56

and foot rehab, This is definitely

0:58

an episode for you. So we

1:00

reference Colin's article

1:03

on Sports Medicine a few months ago, which

1:05

got lots of traction because it

1:07

was very in-depth in terms of the assessments and

1:10

the interventions that Colin uses for

1:13

the calf and foot So we

1:15

dive into that. We have a look at the assessments.

1:17

We go that into detail with that.

1:19

Then we look at how we use the data from those

1:21

assessments. to create interventions through

1:24

a rehabilitation process or with

1:26

a performance goal at the end of it.

1:28

One thing that I found really

1:30

interesting is the talk around the

1:32

foot. So what assessments can we

1:35

do to understand more about the

1:37

foot, more about the big toe? and some

1:39

interventions off the back of it based on Colin's

1:42

experience as well.

1:43

So a really interesting episode for all

1:45

those practitioners, all those clinicians

1:47

looking to build their knowledge in this

1:49

area, and hope you get as much out

1:51

of it as I did. This

1:54

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So

5:06

without further ado, over to the episode

5:09

with Colin. Colin

5:10

Griffin, welcome to the PACE Performance podcast.

5:12

It's good to see you. Thank

5:14

you, Rob. Great to be on. Yes,

5:17

I've been a big, big follow through podcast for a good number

5:19

of years now. So delighted to be to

5:21

be honest and hopefully have a a good conversation.

5:24

Absolutely.

5:24

Just reminiscing that it was

5:26

nearly

5:27

no, like, nearly nine years since starting

5:29

the podcast. So Thank you very much for

5:31

that. Appreciate that. So

5:34

it's great to take you on. We're gonna use like

5:36

I've done it with a couple of people recently, actually.

5:38

Use the article that you

5:40

published on Sportsman. There's a bit of a foundation

5:42

for the chat. I will delve a little bit deeper into some

5:44

of the some of the exercises, from the

5:46

principals, and the thoughts, theory

5:49

behind behind the article

5:51

in the podcast. So we're looking forward to having little

5:53

chat, calf strength, foot strength, all the

5:55

chemicals, rehab, all chemical

5:57

stuff. So just where do you guys dive into that? Would

5:59

you

5:59

mind just giving us a bit of a a buyout

6:02

on you? Yeah,

6:03

sure. I suppose

6:05

I'd begin with the present. I worked

6:07

in the sports and service technique in Dublin. I'm

6:09

a strength technician coach by trade. And

6:12

a significant

6:12

lead for a foot and I can rehabilitation stream

6:15

in our sports medicine department. So our department

6:17

kinda works in in

6:18

sort rehab stream to different areas. So

6:21

Look, I've been working there for the last

6:24

nearly nine years, eight and a half years, and over the

6:26

time it's gone. So it's been quite a

6:28

steep learning curve. worked with some

6:30

great people as well as past and present.

6:32

And, you know, it's been been a great

6:34

environment and and that's what's made a lot of

6:37

good connections. I was telling them to work as well. And

6:39

stepping back at a a better group and in a sporting

6:41

household, both

6:43

my parents were involved in athletics, my mom

6:45

is an international runner. My dad was

6:47

more into coaching and I've been sort of things, so

6:49

that was the environment I grew up in. So from

6:51

my earliest childhood memories, we're going to watch my board.

6:53

We're gonna pay completion races. She's

6:56

quite close to Qualified Olympic Games.

6:58

Especially we actually operate on quite a high

7:00

level. There's a lot of infinite things in her time,

7:03

like climatic training, outward training

7:05

and all that. And so that was that

7:07

was a very early exposure to that. My

7:10

dad then he was director of

7:12

coaching for Alex Arden,

7:14

as it was as it's known now, back in the sixties,

7:16

early seventies, and he was team coached

7:18

for the Olympic Games in seventy two and nineteen eighty.

7:20

And then not to become president of Federation

7:23

in the early '90s. So there was plenty of coaching

7:25

manuals liner in the house, plenty of magazines, plenty

7:27

of videos, so I was kind of getting immersed in that

7:29

at the young age. So well

7:31

as being an at least, which was hard to

7:33

avoid in that environment and also a student

7:35

of the sport.

7:36

And yeah.

7:37

Look at sport with parents, an an

7:39

employer family enjoyed a quite a fulfilling

7:42

aesthetics career.

7:45

At least internationally, junior level, up to senior level,

7:47

and two Lippie games. And

7:49

I

7:49

would say, like, I wasn't the most technically gifted

7:51

at least. I had to work harder to try

7:53

and acquire technical mastery even

7:55

though I could be an an an technical event. So

7:58

And that let's let me down

7:59

give me a that's what the curiosity for human movement,

8:03

whether we're trying to start injuries, whether we're trying to

8:05

improve technical volume mechanics, And

8:07

I suppose to getting a passion for I suppose to

8:09

work I'm doing now and definitely

8:10

fortunate to work with a

8:13

lot of good practitioners, physiologists, who

8:15

are scientists my own time is that issue or or quite

8:17

helpful to me. And and

8:18

also as well as to connect to people too,

8:21

as as I as well as transition into

8:23

my my professional career.

8:24

So I retired from a league sport in

8:26

twenty thirteen, probably

8:28

having, let's

8:29

say, underachieved, but at the same time, I

8:31

had my chances and opportunities. And probably

8:34

get as much as I could to the support and to my career.

8:36

And it wasn't at this stage past stage, I had that

8:38

was other career and funding decisions to to

8:40

to

8:40

way

8:43

up. Wow.

8:46

I knew you'd competed, but why did I

8:48

not know that

8:49

you'd competed at Olympic Games?

8:52

I don't know. It's

9:00

a very old chapter in my memory at

9:03

this stage, but, yeah,

9:05

great experiences. I'm I'm look at I'm I'm very fortunate

9:07

for doubling

9:09

that I had in sports, like I did at my my

9:12

event with fifty k walk. So I did I did a

9:14

technical event. your, you

9:17

know, is judged strictly enough and

9:20

a bit like refereeing quite

9:22

subjective. And, you know, I was disqualified

9:24

actually in both Olympic Games. none

9:26

was particularly difficult because it was actually in

9:28

really good shape. I was competing for a top

9:30

sixteen position and on course for BTV and

9:32

and got my courage. red card just for the

9:35

4TK mark. So so

9:37

look all those things as well as, you know,

9:40

get me the I suppose, the curiosity and and

9:42

and the hunger to try and and understand

9:44

moving better on the standby mechanics and

9:46

try to problem solve better and as well as

9:49

what I couldn't do for myself, I hopefully

9:51

can help us with trying to do for others. important

9:53

to work with. Interesting.

9:54

So where did the interesting

9:57

lower limb come from? because that's the way you've

9:59

gone for your PhD. That's what we'll chat

10:01

around today. Why why that area particularly? Yeah.

10:04

So when I started working the clinic,

10:07

I was kind of

10:09

dealing in others with running in recent, a lot

10:11

of her running in with Darla Lorraine. So

10:13

I think from the hip and particularly the knee down to the ankle

10:15

and, of course, And we

10:17

saw a lot of calf injuries,

10:19

and not all of them were calf strain. Some of them are kind

10:22

of like exertional pain

10:23

injuries, like, initially an overload to a

10:25

muscle that has probably poor capacity. And

10:28

so another

10:29

competitor turned up and he's quite early on.

10:31

And sort

10:33

of taking a few on

10:36

and sort of

10:37

took an interest in the area, got some good outcomes,

10:39

definitely as well as realize the need to learn

10:42

a lot more about it. and over

10:44

this, as well subsequent few years, developed

10:46

a bit of an interest, research interest in it, and

10:48

developed few research questions, and

10:51

as well as to the point where I undertook a PhD

10:53

in the area and, hopefully, now coming to

10:55

the end of us in the next two months.

10:57

I spoke

10:58

to Phil Glasgow. Have

11:01

you you've come across Phil, I'm guessing? Yeah. Yeah. Not

11:03

Phil. Yeah. Yeah. Of course. thought

11:05

you must do. And he was talking about

11:07

in in the podcast that I did with him a couple weeks

11:09

ago that that this transitioning certainly

11:12

in his environment

11:13

from lots and lots of hamstring injuries 234

11:16

years ago. Obviously, lots of research in the area,

11:19

but that seems to be they their injuries

11:21

now seem to manifest in

11:23

in the calf and Achilles issue, into

11:25

calf and Achilles issues. Is that something

11:28

that you are seeing? And if

11:29

so, do you think that's did

11:32

a particular reason for that?

11:34

Yes.

11:34

I think that's what Phil was referring to the

11:37

– that's what the incidence of higher

11:39

incidents of cab injuries that seem to have

11:41

no caught up or surpassed

11:44

the the incidence of hamstring injuries in in Roby's

11:46

cooking. They are they are Roby set up. on

11:49

the national side and provincial side. I

11:51

think actually I was listening to the podcast and team had a very

11:53

relevant point about him, perhaps the

11:56

lack of exposure to what

11:59

a certain volume of running might be just predisposing

12:01

the calf to, that's

12:02

what's having poor capacity and maybe higher

12:04

risk of those type of injuries because

12:06

we know that the calf and the sole is

12:08

you know, they operate at

12:10

quite a high capacity of high proportion

12:13

of their muscle capacity or forced capacity

12:15

at even, you know, slow to moderate speeds.

12:17

And

12:18

Yeah. That's what was the

12:20

shift in the last ten years towards, you

12:23

know, high intensity for training. as

12:25

it means almost cheeky robotic system into getting

12:27

fit quite quickly and that it

12:30

just might be under exposed in

12:32

the calf, the musculoskeletal demands

12:35

of of those sports, even field sports, whether it's

12:37

a time in your face even though maybe a low percentage

12:39

of it might be high speed running or moderate speed running,

12:41

but you know, the time you feel does that up and those

12:43

lowering muscles, particularly the calf or they're always

12:45

on. So I think that

12:48

might be part of it. as

12:50

well as traditionally, the S and C programs haven't

12:52

really focused deliberately on the

12:54

on the on the the calf muscles, you know.

12:57

in terms of strengthening and developing capacity

13:00

and maybe relied on a lot maybe more employers

13:03

and order exercises to develop

13:05

that. I wish you do, but for some athletes or

13:07

players, there might be enough and they may need that little bit

13:09

of delivery exposure for six

13:11

to twelve week blocks in the preseason or

13:13

certain times in the year. So

13:16

just keep stay on this area, stay on

13:18

the calf. And

13:19

again, reference in the article,

13:21

assessments what assessments can we

13:24

do to identify whether this is an area that

13:26

needs additional

13:28

focus? Yeah.

13:30

And it was in last

13:32

couple years with that was more

13:34

easy access to forklift

13:36

technology and it's probably becoming more affordable.

13:38

It's a lot of clinics, and clubs,

13:41

and organizations, and universities. It's

13:43

probably easier notes, our standardizing CAF test, particularly

13:46

CDCAF wise metric test. So

13:48

that's one that we use. And obviously, when

13:50

we bend the knee close to ninety degrees, we're we're

13:52

isolating the solids a little bit more.

13:54

them

13:55

you know, the gas truck muscles across the knee joint.

13:57

So when you bend the knee, we're making those muscles

13:59

shorter and there and a little

14:01

bit more redundant. So

14:03

that's one way of assessing CAF

14:05

strength, particularly for the SOLACE, which again is quite important

14:08

for field sports. I'm even, you know,

14:10

it's printing where a truly acceleration priority

14:12

where the solids is a big player. And also, for this

14:14

is running as well because the solids is a big support

14:17

for the central mass.

14:19

and as I said, operator, quality capacity.

14:22

So that's probably one test that that can be standardized

14:24

across many areas. And again, there's a little bit

14:26

of instances as well as in terms of near angle

14:28

and leather the microcosmic flexion you

14:31

might set up with. And

14:32

them so that's

14:33

what's a few areas there that probably just need to be

14:35

fleshed out a bit more. then I suppose

14:38

to get a measure of total the planar flexor peak

14:40

torque or peak force. We use

14:42

anodesic heavy test lying in a prone

14:45

position, so face down, leg stretch.

14:47

at a speed of thirty degrees a second,

14:50

working from thirty degrees plant deflection to

14:52

ten twenty degrees door deflection. And

14:55

measured peak torque, and we kind of scale

14:57

at the body weight. And say

15:00

for our distance owners, we'd like to be, you know, one

15:02

hundred and sixty, one hundred and six and sixty percent valuation

15:04

above, but for Sprint

15:06

out needs to be getting close to two hundred percent body waste. We

15:08

don't get money hitting that, but that's what was from

15:10

the numbers we've collected over the years.

15:12

That's sort of the targets we try in such based

15:14

on

15:15

then One in

15:16

your app is we work with and also fully rehabilitated

15:19

app is that we've we've managed to progress up

15:21

to up to that. But, obviously, not everyone

15:23

has another dynamic manner. So you

15:26

can do the even a

15:28

a straight leg standing

15:30

straight leg isometric test for the four

15:32

spits. you know,

15:34

which is part of

15:37

some of Alex Materials work. The

15:39

challenge there, I think Alex actually kind of switched to

15:41

that way, you're actually using a block where you can

15:43

because when you stand on the force plates, it's

15:45

still a component movement. So it's hard not to involve

15:47

any extensors and hip extensors, and you don't

15:49

know how much of that is coming from the counter flexors.

15:52

So when you use block and get your

15:54

alignment right and get more leverage to the ankle,

15:57

you can probably get a better reflection

15:59

of the of the of the calf.

15:59

contribution to to

16:02

peak vertical force.

16:03

And again, as was a surrogate measure

16:05

of total counterclock attack

16:08

force, those are the two sort of stress tests

16:11

that we would look at. And then we'd also look

16:13

at developing – look at assessing capacity,

16:15

whether it's doing even the other kind of

16:17

dynamic dynamic, Stephanie, and had a

16:20

a

16:20

good test of the validated during its PhD.

16:22

We just do a twenty reps and

16:24

measure total work done as measure of cap capacity

16:27

or in a very, very basic clinical setting,

16:29

do

16:29

like a hearing rate endurance test where

16:31

you work off a Metro number one second up one

16:34

second down, trying to have consistency of heights,

16:36

consistency of tempo, good control of the rear

16:38

foot. And when either of those diminish,

16:40

you stop them. And if they can get to thirty reps before that happens,

16:42

that's a good measure of cap capacity.

16:44

the Maybe

16:45

minimum twenty five And if they're below

16:47

that, then there's probably it's probably need to work in

16:49

the capacity and use that to

16:51

to to to set a

16:53

programming. What do

16:55

you mind just just describing that? See

16:57

it's isometric test for as

16:59

for as again,

17:00

Colin? Yeah. Yeah. I mean, Yes.

17:03

So there's a there's a I have a picture

17:05

of it in in in the article. There is

17:07

yeah. But not so sure, like yeah. So we

17:09

we set we set them at the knee around

17:12

So

17:12

the knee sort of over the the shoe laces

17:16

in about I kinda go for ten, fifteen

17:18

degrees. Dorothy Flexion. I think you need some of the

17:20

Dorothy Flexion. to get a proper measure of of

17:23

peak force in the study. So it it does,

17:26

you know, you need a little bit

17:28

of length and more than time, you need to get that.

17:30

and

17:31

then have the the knee around, you know, nice

17:33

degrees, knee flexion, and

17:36

then have the base of the first metatarsal on

17:38

the block. and then just and

17:40

then we use Russia strapping to to strap an

17:42

down, so there's very little slack in the system.

17:45

So we just make sure that we we're getting a few familiarization

17:47

trials And if there's any loosening of or any

17:50

loss of tension in the ratchet, we'll just type that again.

17:52

So that when they're when do their test trials,

17:54

it's going to tighten, they're able to maintain their dossy plexus

17:56

ankle position. and we would

17:58

go for three trial three reps

18:01

at a five second maximum asymmetric

18:04

effort and take the best out of the three.

18:06

and

18:06

it's a four foot on the block with the

18:08

block. Four foot Yeah. On yeah.

18:10

On the base of the first minute charter deliveries.

18:13

the Yeah. and

18:15

then

18:15

the block is a block on fast play?

18:17

Yes.

18:17

Yeah. Exactly. Yeah. So we weigh the yeah. We weigh the

18:19

block and we weigh the force with the block on them and and

18:22

kind of bit from that.

18:23

Yeah. It's interesting because Phil

18:26

mentioned that them using this

18:29

as a as a test, as a monitoring tool,

18:32

not only for

18:33

capacity, but monitoring fatigue in

18:35

this particular area because of the rising

18:38

in Catharine Achilles issues

18:40

in in Irish route. Well, rugby is a whole, but Irish

18:42

route being is environment. So, yeah, kind

18:44

of feeds into that description as well.

18:46

Yeah.

18:47

And it and it's when you get into a floor like it's actually quite

18:49

a quick and easy task. administer, you know, you can be done

18:51

in ten minutes. And it's not that invasive, like, you, you

18:53

know, yes, you work in half a little few seconds at a

18:55

time, but the solid is a is a predominantly

18:57

Type one fibrous muscles that's going to recover quite quickly,

19:00

and you can go on a bunch of business with rest of the day. So

19:02

and I'll let I suppose, if you are in an environment like

19:04

an impression sports, where you can do that

19:06

on weekly basis or or whatever.

19:09

You know, you you can you can be a quick test in

19:11

the morning and, you know, if someone says, little

19:13

bit off where the normally are or the baseline levels are,

19:16

it might be then AAAA

19:18

flag then to to monitor or to adjust the

19:20

training goals for that given day or a week.

19:22

So we've

19:23

taken a athlete through this testing battery.

19:25

We've

19:25

identified that things are low and they should

19:27

they don't want them to be. Next stage

19:30

is obviously strengthening

19:32

that particular area. I'm guessing

19:35

that

19:35

the vast majority

19:38

of practitioners out there, if they're doing

19:40

this kind of training, it'll be gather

19:42

raises in the seat and our stand in. What

19:44

other opportunities have we got to strengthen this

19:46

particular area?

19:48

Ideally, a

19:51

slip machine or a leg press, you know, where you can really

19:53

go heavy in the car on the car for nice sliders

19:56

and be quite stable, which is kind

19:58

of hard to get that with a free bar.

20:00

or and and it's quite hard to hold a have

20:02

you done that? If you wanna go really, really heavy.

20:05

So as far as if you have access to to those to

20:07

the logic can do, you know, you can do quite heavy

20:09

concentric, eccentric, or go heavy isometric,

20:12

the

20:12

shorter repeated holes, or you can go,

20:14

like, your your super max super maximum

20:16

eccentric. But again, you really you

20:18

need your your leg press and or

20:20

or submitting for that. But

20:23

if if someone can give a low baseline, you

20:25

know, we just do some basic stuff maybe like set

20:27

up eight to twelve, four

20:30

set to eight to twelve reps, you know, with a

20:32

two rep in reserve sort of

20:35

loading guide,

20:37

you know, just work the captive to take. They're gonna get

20:39

they're gonna get better with without any of the first start, and then

20:41

it's where do you go next?

20:42

and that might definitely should develop cap capacity.

20:45

Sometimes, again, you like to pick up

20:47

this visually. There might be luck in

20:50

It might have some actual fleet to either the

20:52

medium or natural gas truck on one side or both

20:54

sides. Or there might be there

20:56

could be natural fetal medial gastric and

20:58

one side and the lateral and the other side have a very few cases of that.

21:00

So you can benefit from position to try and

21:03

bias those muscles, muscles, muscles, muscles

21:05

heads. and workers

21:08

to fatigue and into lengths to try and get those hypertrophy

21:11

changes. And that's what's benefit the

21:13

strength a bit more. across

21:14

all three.

21:16

them So,

21:17

yeah, there will be the that's

21:19

what the main

21:21

the main exercise types.

21:24

Again,

21:25

if we have to target the solace, yeah,

21:27

we do some isolated stuff with an event. So either

21:29

very, very heavy kettlebell else

21:31

kit machine or ideally, if you got to see the cap machine,

21:33

you can go really heavy and be quite stable. And

21:36

again, with the sword, it's given the the

21:38

physiology of the muscle, you know, you

21:40

can still make good good strength changes and

21:43

even work in turn during soft motor load. So

21:45

you can still if you just make the muscle tired, it's going

21:47

to get stronger anyway. to a point. And then

21:49

it's like, you know, you might get to point then where you hit a ceiling

21:51

where you may need to go really really heavy for for

21:53

for low volume to to increase

21:55

the sports capacity even further.

21:58

But it just depends. Come on.

22:00

No. You're okay. No. You're

22:01

okay. No. I'm just saying use your your tests and

22:03

your straight leg and your bent knee, your your seated

22:05

and

22:06

half tests to you know, if you see

22:08

the shaft test, it's quite good in proportion

22:10

to your straight leg one or then, we might need to worry too much

22:12

with the solace. unless maybe in field sports

22:15

field sports where acceleration is quite important, and you are

22:17

going to use a solid little bit more in isolation, particularly

22:20

in the air leak to mid stance. of an acceleration or

22:22

a jump or horizontal some sort of horizontal effort.

22:25

And I think it's useful to to do that and untrain

22:27

it, as I mentioned, they together in synergies with the folks

22:29

and and and the hip extension. say

22:31

for distance owner and, you

22:33

know, if if the source is quite good and you test it,

22:35

and there's maybe room to improve their overall cap

22:37

strength, but then we just go straight like and

22:40

keep it simple because, again, time and energy

22:42

resources are going to be valuable to that. Well, most athletes,

22:44

but particularly endurance athletes when your your role is gonna

22:46

be tired anyway no matter. when you try doing

22:49

FMC rehab session. We'll

22:50

get on to the fight in a second. But just one last thing.

22:53

Would you be looking for a particular ratio?

22:55

between

22:55

this i the

22:57

isolated Soliris and

22:59

the general

23:01

calf complex test.

23:03

Yeah. It's hard too because there's a lot in

23:06

our in in our clinic, we're comparing

23:08

a C just you'd be

23:09

comparing a C to capitalize metric with a

23:11

with a straight leg

23:14

is a kinetic test. So in

23:16

fact, as well as the true coincidence, the number

23:18

is actually similar. We look for about for

23:20

just wanted to get at least I would even say now,

23:22

like, then we test a lot more and and we're

23:25

more more robust with our protocols getting

23:27

higher numbers now because they're more state of those conditions. So we're

23:29

seeing more people hit twice body weight and

23:31

more people and and maybe more sprint or exclusive

23:33

at least getting, you know, two point two times body weight.

23:36

So the article would have said by them, one point six

23:38

maybe twice body weight for this is an and

23:40

and maybe sprint on these respectively, but now we'll

23:42

be kinda thinking maybe one body weight

23:44

for this is an owner. who wants to create a decent level

23:46

maybe two point two in a build for your

23:48

your sprinter that teacher field support player.

23:51

the And so

23:52

It's hard to say that the proportion when

23:54

you're when you're comparing an isometric with an isoch magnetic

23:56

test. So

23:58

but again, for the isoch magnetic test,

24:01

straight leg. We're

24:02

looking at, you know,

24:03

one hundred percent six percent body weight

24:05

for your distance at least and maybe close to two hundred

24:07

percent body weight for our exposure

24:10

athletes. And then we're also able to

24:12

run a a code to

24:14

look at torque at different ranges. So someone might might

24:16

have good peak torque. But the main biggest

24:18

symmetries in either slightly kind of

24:20

flexed angles or slightly closer flexed angles, and

24:22

we can

24:23

focus on on on as well as joint

24:25

angle specific. strength changes

24:27

based on that? I don't

24:29

want to break it down to my level, but I'm sure there's

24:31

people out there. Just explain explain that a little

24:33

bit more for us. The pig talk?

24:35

Yeah. So

24:39

yeah. So

24:39

basically, like, it's like the turning force. You

24:41

you're you're you're producing. So it takes into account

24:43

the the the the the the the moment

24:45

term. So as well as the

24:47

Porsche producing. So we

24:49

scale peak torque to body weight.

24:52

So we divided the torque and you can be despite your

24:54

body weight. So and again, we're seeing good

24:56

numbers in the sort of high hundreds, so one

24:58

hundred and fifty to two hundred percent body weight across

25:00

the board. we just kind of break it down to the more

25:02

to sprint athletes and if you feel it's more

25:04

players versus your distance runners.

25:06

the Again,

25:07

we we do see there's a hybrid of

25:09

you know, we see some people you'd expect big numbers

25:11

from coming in as maybe hundred and twenty percent body weight

25:13

and maybe skinny distance from coming in across

25:15

a two hundred percent body weight. So there's a bit of hybrid

25:18

as well. But anyway,

25:20

So we measure peak torque, which

25:22

usually happens in in slight length. So it usually happens somewhere

25:25

between zero degrees neutral light because it maybe

25:27

it's between that and and maybe ten degrees torque

25:29

reflection. Obviously, you need a bit of length to produce

25:31

your peak force or peak torque. And then

25:33

we measure torque at twenty degrees counterflexion

25:36

and ten degrees towards the flexion. So particularly

25:38

for someone who's at an acute lens rupture where they're

25:40

going to be weak in an in an range counterflexion, we

25:43

see big deficits there, and it takes a long time

25:45

to to to address

25:47

and and reverse, and that's what we can probably

25:49

only get so far with that. otherwise,

25:51

you might be someone who's quite weak in a more Dorothy

25:54

Flex angles. So tend to be Dorothy Flexion,

25:56

there might be twenty percent difference. You know, the peak torque

25:58

might look symmetrical. So we can use

25:59

that false findings to

26:02

get someone if it's if it's an inter range counterreflection

26:04

deficit, do some inter range isometric work.

26:07

them and

26:08

load them there to train strengthen in that area,

26:10

or if it's a door reflection, a

26:13

door reflex angle depth test. work

26:16

them into into into into a service

26:18

centric loading scheme

26:20

or else do some long length isometric calls

26:22

to to get them stronger at that angle? I

26:24

hope that makes sense. Yeah.

26:27

I'm following. I'm I'm I'm I'm I think I'm following.

26:30

No. Thanks, mate. Appreciate that. So

26:33

you mentioned foot strength. think this is a really interested

26:35

area.

26:37

How are we assessing whether

26:39

we need to isolate or have

26:41

that isolated type of training

26:43

in our program? Or

26:46

should it be a dashboard even

26:48

without any assessment?

26:50

Yeah. No. I mean, it is quite important and

26:52

it's not something that has been done traditionally

26:54

outside of, say, it's an electronic environment.

26:57

So it's not something that's that's that's

26:59

what's typically done in S and C program.

27:02

Obviously, I see a lot of fish. And

27:04

look, mean, I've I've there's a lot of there's

27:07

a lot of there's a lot of good partitions that I never

27:09

quit and I specialize in food area that

27:11

I've pointed it as often, you know, so we

27:13

can really get can we kind of talk back and

27:15

forth as well as a good ideas can emerge

27:17

from that. So Yes. What

27:19

I've done is developed

27:21

test with a handheld dynamometer

27:24

where if you

27:26

test

27:28

them

27:29

in with a slight Dorsey flex

27:31

Ankal angle

27:32

and Dorsey flexion of the first MTP

27:35

joint to the big toe joint to the new lift the big toe

27:37

up. So there are a long length, you're getting

27:39

a measure of their flex releases longest, which is quite

27:41

a one of the important extrinsic foot

27:43

muscles that has a role to play in terms

27:45

of a toe off

27:47

the And then

27:49

we would do

27:50

the same thing with more of a plantarflex angle

27:53

to get a measure of the intrinsic foot muscle and

27:55

so we're making the flexibility as long as short and

27:57

a little bit insufficient. So we're getting more isolated

27:59

measure of the intrinsic

27:59

foot muscles, which are actually quite important. And

28:02

they have big role to play in coordination with the force.

28:04

to stiffen the foot at the right time for

28:06

a proportionate toe off, you know, especially

28:08

for acceleration for jumping, you know, with

28:11

a particularly the

28:13

most of the cost of BIGtoken are – have

28:15

quite a significant – small but significant

28:17

contribution to those type of – to performance

28:19

of them.

28:20

in sprint and jumping and

28:23

push off positions.

28:25

So there's three key muscles across

28:27

the big toe joint here. Your flexor raises gravis,

28:29

your adductor. and

28:30

add Dr. Helixis, which

28:33

are, you know, as the purposes go there, they're quite

28:35

big volume and a big physiological area.

28:37

So when we measure top

28:39

flexor strength we're getting measured up up the forescape

28:41

output of those muscles in particular. So

28:43

let's get to a quick break in this chart with

28:45

Colin Hoping Joint Power one. So hope

28:47

in part two, we discussed development reactive

28:49

strength during the return

28:52

to play process and developing explosive

28:55

strength during the return to play

28:57

process? How can we assess

28:59

if they need to

29:01

be if they don't really need to be improved? And

29:03

how can we obviously go about with that.

29:05

So a really interesting part too, coming up.

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31:11

now back to the episode with Colin.

31:14

It is something that you see pop up every now

31:16

and again on social media. And it gets

31:18

a lot of It normally gets a lot of hype

31:21

because it's relatively novel.

31:23

People don't you don't see it a lot. But

31:25

should people given

31:27

the time pressures of

31:30

people like yourself, pre-two

31:32

thousand thirteen, Colin, with

31:34

with training teams what athletes who

31:37

are getting a minimum time in the in the gym

31:39

to develop. all these different things. But

31:41

should do

31:42

you, in your opinion, should practitioners be

31:44

focusing on this particular area?

31:48

more than that?

31:50

Yes. At least, you know, a screen version

31:52

of someone is making that area and they're a history of lord

31:54

and injuries. You know, I think it's an obvious law hanging

31:57

fruit to try and address. You know,

31:59

if you've had history

31:59

of recurrent sports or ankle injuries or

32:02

even calf injuries,

32:03

I think it's quite important to reach

32:05

it to to to look at. It doesn't

32:07

take that long to a set that you can even, you know, if you're, you

32:09

know, if you have enough experience, turning experience behind

32:11

you or even the experience, you can get a manual feel of

32:13

the toll factor strength. Another time is just muscle

32:15

inhibition. They are those muscles are quite prone

32:17

to inhibition for different reasons.

32:19

You

32:19

the

32:20

know? So oftentimes, I just build

32:23

in some puts foot exercises, more of an activation.

32:25

It's a warm up. So you've got better

32:27

contribution of those muscles in in those bigger sort

32:29

of comfort movements.

32:30

them sometimes

32:32

you might might use your muscle to

32:34

reinstallation to to try and increase

32:36

their conditions of those muscles.

32:39

yeah, look, I think it's just been an overlooked area

32:41

and as well as it's starting to with the help

32:43

of some good resources come out of a a couple of

32:46

labs across the world, particularly

32:50

in Queensland, Australia, New Kelly, and his team

32:52

have done a lot of good work on foot research. And

32:54

and this was Traditionally, you

32:57

know,

32:57

we would have always thought that's,

32:59

what we

32:59

call, the windlass mechanism. So when you dorsey touched the

33:01

big toe, that stiffens the erection, stiffens the foot.

33:03

So it's more of a

33:05

you know, it has to be stiffened.

33:08

Of

33:08

course, I think, you know, with the

33:10

suppose that they

33:12

That's what the emerging research from from the

33:15

group I mentioned. You

33:17

know, the actual court the activation

33:19

of the footballers are probably more important or probably

33:21

the big players in terms sticking the foot of the right time,

33:23

projecting and and so off. And when

33:25

when less mechanism is is is is certainly

33:27

because of all, but it's probably not there. It's not the

33:29

deal breaker. So definitely

33:31

important that we have good foot strength and been able to

33:34

activate it at the right time during the

33:36

gets, like, particularly as we as we go to tow

33:38

off. because

33:39

I think JB. JB McRinn's got

33:41

a PhD student or a couple of

33:43

PhD students in this area as well. Yeah.

33:45

Yeah. Roman Turlan. Yeah. We we actually got

33:47

ready to watch it for him. He has some really good

33:49

work in the next couple of years when he gets

33:51

to work later stage at a PhD. I'm

33:53

testing the life out of him for for

33:55

an hour on this area. He's gonna think he's gonna

33:57

point out that in couple of months.

33:59

So

33:59

yeah. We're we're looking forward to that.

34:02

I think it's a super interesting area. So we've

34:04

gone through that assessment how

34:06

are we training it? Yeah.

34:08

I mean, have you simply go to, like, just

34:10

doing some Bandwidth, just a big toe

34:13

curls. just

34:14

getting the foot set up with the big toe joint

34:16

on the block and the rest of the toe hanging off it.

34:19

And maybe bringing it to a little bit

34:21

of plant reflection, so you're taking out the contribution

34:23

from the tip be absent anterior or anterior

34:25

should muscle.

34:26

the And

34:27

you can, you know, start up with with the foot flush just

34:30

with the knee sort of sitting behind the ankle to be slightly hyper

34:32

flexed. And

34:33

then you can actually just do an active hearing aid

34:35

to really activate or maximize the the activation

34:37

of other foot and gelling muscles. And you wanna feel like a

34:39

a burning or a manifestation of the arch

34:42

So we do that more so as an

34:44

activation exercise. But, like, when

34:46

when you're doing single encafrases, particularly

34:49

with shoes off ideally, at

34:52

that sort of position. If you do lift a shot, it's a

34:54

vertical on the top, you know, you're you're getting good recruitment

34:56

with the foot muscles anyway and also

34:58

tip post and and your peroneal. So you're getting everything

35:00

in that that one lift. So If someone is limited

35:02

in that in that particular movement or that particular

35:05

position, we just

35:05

work back from that. What's limiting factor? Is it the

35:08

lack of foot strength of That's not allowing them

35:10

to be stable there.

35:11

And if it is, we just we bring in those stated

35:13

exercises to

35:14

to support them to to get that point.

35:16

But, look,

35:17

well, you wanna get the point where that

35:19

can get

35:19

a lot out of as

35:21

few exercises as possible, you know, especially in the busy

35:23

part of the season. So last thing someone

35:25

to do is spend an hour and a half or two hours, you know, doing a

35:27

whole lot of rehab exercises when there's what

35:29

are demand and the time and under energy

35:32

resources?

35:33

Gas. So for someone that's quite

35:35

well versed in this area and speaking to a lot

35:37

of people, in terms of the groups that we've mentioned

35:39

JV in the the Queensland,

35:41

did you say? Yeah. Yeah. Yeah.

35:44

What what is what do you think is going down the line for

35:46

this particular area? In

35:48

terms of research?

35:49

Yeah.

35:52

No.

35:52

I think I think what's come up in the last few years, I mean, there's

35:54

been been several papers since twenty fourteen

35:57

from Luke Kelly's group that are really supposed to

35:59

change people's thinking around this area. So

36:01

I think there's a lot already done. as

36:04

well as just maybe

36:06

being a bit cleaner or tighter with some of our ways

36:08

of assessing foot strength

36:09

and maybe coming up with some sort of solution with a

36:11

with a force place or a strain gauge where you can do

36:13

it properly.

36:14

you know, Han has done monitor. If

36:16

I'm

36:16

doing it myself all the time, I'm probably

36:18

confident in my own reliability. But as soon as I see what

36:20

I was doing, it might be very reliable. So if

36:22

that's why it can be hard to compare numbers.

36:24

the So maybe

36:25

having some sort of a, you know, a

36:28

a cleaner solution might might be better. And then as

36:30

well just being being a bit more creative with some of our exercises

36:32

to target certain muscles in the foot.

36:35

And I still feel like I have a lot more

36:37

need to learn about the area. I'm only

36:39

discretion

36:39

service?

36:41

In the in the article, just moving on

36:43

from the the footsteps in the Eldar, I think that's

36:45

super super interesting. And

36:48

looking

36:48

forward to getting a piece

36:50

on spots with the buy. But

36:53

back

36:53

to the rehab, developing

36:54

reactive strength during

36:57

the

36:57

return to play process. Interesting

36:59

for a second half

37:02

of the article that you wrote, focus

37:04

on this area and then develop an explosive strength

37:07

again during that pretend supply process.

37:10

So the reactive strength first,

37:12

moving through a rehab,

37:15

how can we understand how

37:17

much emphasis we need to put on

37:19

this particular phrase during a particular rehab?

37:22

so we can spend the time

37:24

or or

37:25

take the box and kind of move on. Is there

37:27

any, again, move back to the assessments? Is there any

37:29

assessments that you would do to

37:31

get help you guide whether you

37:33

need to spend that time on this particular

37:35

area in terms of reactive strength? Yes.

37:38

Well, look, I think every at least

37:41

probably the spent time on this and probably

37:43

should be the mainstay of any

37:45

sport involves running or somewhat of

37:47

impact or reactivity, it

37:49

should be nearly a I mean, instead of the

37:51

program. But in rehab, I think it's a key link between

37:53

your your your your gym base. We have stuff on your your

37:55

return to sports. another feeling on the tracker

37:58

on the road.

37:58

Exposing

37:59

the Boston unit to those high, as

38:03

well loading rate demands,

38:05

you

38:05

know, the the the the the the fast stretch

38:07

that the killer ton has to has to accommodate and

38:09

the ability to coordinate run run the ankle and

38:11

knee and the hip quite quickly, you can react to it

38:13

for a contact.

38:14

So yeah, it's quite important. You know,

38:16

we talk a lot about rate of force development,

38:19

early versus late phase rate of force development and more

38:21

sports where the reactions evolve. you know, the

38:23

earlier early phase, which is, like, how much,

38:25

you know, the biggest change in force in those first

38:28

fifty to one hundred milliseconds, and it's

38:30

quite important. And, you know, you're gonna you

38:32

pre activate before you hit the ground is actually quite important.

38:34

the So you're

38:35

relying a lot on pre activation of the lower

38:37

leg muscles and the elastic properties

38:40

of the of the kind of tenant in particular. So

38:43

reactor strength is is closely linked to that.

38:45

Yes. I think it is quite

38:47

important. And it

38:49

was just how you go about programming because, you

38:51

know, you you you take different classes of athletes and

38:53

they all got different we have to spend profiles.

38:55

Some are more like to use more ground and maybe spend

38:58

a bit longer on how to get their impulse to get good jump

39:00

fight for them. They're quick and springy. And maybe

39:02

maybe you might need to try and get a bit higher with that

39:04

same sort of you

39:05

know, short content time, and then

39:06

you gotta force that a bit in between.

39:08

You know, and then it's what you work the spectrum

39:10

of, you know, short

39:13

contact sources, maybe slightly longer

39:15

contacts, getting more impulse, and maybe work in the

39:17

contracted properties of the muscles a little bit more.

39:19

And then maybe you know, so as

39:21

well as as I mentioned in the article and and again,

39:23

purely from experience

39:24

and as well as other people who have done a lot of pioneering

39:27

work in this area and some of them you whom you've had on

39:29

on on your podcast. know, starting off with

39:31

just some basic coordination patterns and, you

39:33

know, and I have pushed a few exercises from from different

39:35

people as you do, but, like, just doing

39:38

basic workshops really like the, as I mentioned, the

39:40

the rudimentary that

39:41

I'll test and and have have

39:44

have used and boost it

39:46

boost Schneider.

39:49

I really

39:49

like that. By the way, just to try and get

39:51

some basic coordination patterns go on, particularly people who are

39:53

not as experienced at play metrics, just

39:55

getting their alignment between Ekinli and hip and shoulders.

39:58

minimize the need the need better

39:59

contact.

40:01

Trying to get the active door suppression when

40:03

they cut off the ground and

40:04

then progressing on the single leg and trying to keep

40:06

those qualities going and then you've got a bit

40:08

of a background behind you and it's it's, you know, where you go

40:10

the next, you know, de

40:11

intensified or de add

40:13

more more challenges

40:15

or more complexity to it or or go a bit

40:17

more volume or capacity work.

40:19

the

40:20

And, yes, so, like, you

40:22

were going to hear your job jumps.

40:25

hurdle hops. And then, particularly

40:26

for calf and Achilles injuries or ankle injuries in

40:28

general, I'd I'd like to bring in, like, in sign hopping where

40:30

to talk of steps in in a stadium or a

40:32

top up a header and interline where you really

40:34

kind of have

40:36

to concord it on the end a little better. And

40:38

you're really sort of

40:39

working on the on the contractor

40:41

machinery of your craft vessels as well. So

40:44

I'm trying to get back to those craft engines. I think

40:46

the MX forged is quite useful.

40:48

the supposed

40:49

to minimize the risk them breaking down again

40:51

when they get back running at those sort

40:53

of moderate high volumes again. What

40:56

kind of athlete would you call in Were

40:58

you in the spend a little more time on the ground

41:00

to get the high? Or

41:01

were you more reactive? I

41:03

was needed, so it's all good. Well,

41:06

I'm as race worker, so I I never left a

41:08

ground. I'm

41:10

really only figuring out now in the last ten years.

41:15

Yes.

41:17

No. But as a transition, I don't know, like, I've

41:19

been running for the last, whatever since I retired from

41:21

Reswork and I've been running now and particularly for

41:23

longer distances and

41:25

then

41:26

Yeah. So, actually, a very funny story.

41:28

One sorry to sorry to say to our team much. I was over in in

41:30

in monocor for a conference back in

41:32

twenty seventeen at the ISC conference. And I was like, extending

41:34

at least just begun working with JPMorgan.

41:36

That's my he's my PhD supervisor. So

41:39

staying in in the central room and

41:41

on the prom night one morning, person just come up

41:43

and come in the car, you know, give me a bit a beef and

41:45

I looked around at the JV. And he was actually driving

41:47

to monika or to monika to the conference, and we met

41:49

Afrezza. He was, yeah, you know, I promise you because

41:51

you run like a race speaker. Obviously,

41:57

that's a good thing in his Yeah.

41:59

But that was really

41:59

it. But I've probably got a little bit puncture since then, but

42:02

I'm yeah. Yeah.

42:03

Yeah. Well I didn't I didn't realize was

42:05

What? Remember did actually when I think about it?

42:07

He was your PhD supervisor.

42:09

He is. Yeah. Yeah. Yeah. Yeah. Yeah.

42:12

because I'm I'm registered to University

42:14

of Kotuzor. which is,

42:16

like, a doctor school that I think takes in University

42:19

of Nice and Marseille.

42:21

So yeah. So JV is my supervisor

42:23

a lot of his you can move back to University

42:25

of Sanofi at the end since then, but that doesn't

42:27

change. Yeah. It

42:29

doesn't change things for me. But yeah.

42:31

How many

42:31

times you've been out there?

42:33

hey Maybe

42:35

once a twice a year, pre pandemic, whereas

42:37

now we're also able to manage things remotely. The

42:39

only only work is done in double only direct action is

42:41

done in clinic. So

42:43

if you guys then can be done through through Zoom or whatever.

42:45

So I'm hoping next time I'm back there would be for my

42:47

my PhD defense and hopefully

42:49

before the end of year. It's beautiful

42:51

out there right now. Yeah. It's gonna

42:52

be part of the country. Yeah. It's a

42:55

really nice special summer. Oh, yeah.

42:57

Absolutely. So explosive

42:59

strength, Moving

43:00

on from reactive strength to explosive strength,

43:02

again, something you mentioned later in the article.

43:06

Assessment

43:06

during the return to play process,

43:08

how much time we need to spend on this? are

43:10

we just ticking the box? What assessments

43:12

would you run your athletes through

43:14

to

43:14

guide this next part of the return to play process?

43:18

Yeah. I I think even as simple

43:20

as saying, like, hopper distance because, you

43:22

know,

43:23

we we know from some of the paper that came out of a group in

43:26

Aspen Tower, but in the last two years

43:28

and is more focused on

43:30

the

43:33

the usefulness or lack of for using

43:35

us, I think, like, half a distance in ACL rehab,

43:38

particularly

43:38

during the proposal phase, because there's probably

43:41

a lot less knee contribution the proposal phase. A

43:43

lot more, maybe during the landing phase, so the need is more of

43:45

an absorber. But from that,

43:47

when they looked at the joint work contribution,

43:50

that's what the anchor hitler contributed the most

43:52

to to the proposal phase

43:54

of other horizontal app. When you look at the muscle

43:56

force that they measure, the solids is, like, far the biggest

43:58

force contributor. So think if you're doing a thing

44:00

like hopper distance test, you're

44:02

getting a good measure of explosive

44:06

qualities from the solid muscle and particularly

44:08

especially in the movement bendy position. could

44:10

you have an accelerated center mass,

44:12

which is a – sorry, is the

44:14

– that

44:15

has a big role in that.

44:16

So that's probably one way.

44:19

probably

44:19

the simplest way to do it

44:21

as an assessment. As

44:23

part

44:23

of my PhD work, I've tested the reliability and

44:26

ended up with some of the biomechanic features of a of a thing

44:28

like horizontal rebound. So it's like a that's what

44:30

the double single, like, hubs. So we hop out on the forest

44:32

bit rebound for distance. And we

44:34

looked lot of variables, like,

44:36

And we we we actually looked for I suppose

44:38

trying to recall is that, we somewhat

44:40

kind of touched on it before. I'm not saying we didn't pioneer

44:42

this, but just trying to maybe strength

44:43

in the case, we're using horizontal reactive strength

44:46

index as

44:47

horizontal alternative to a vertical

44:49

reactive

44:49

strength index measuring rebound, dividing

44:51

rebound distance by the contact time

44:53

them So

44:55

we looked at that and

44:58

we looked at us like

45:00

vertical and joint stiffness we look

45:02

to just hit the ankle joint power

45:04

and joint work and all and

45:06

the joint angle changes. And similar

45:08

to the hopper distance paper in Aspirator,

45:11

the ankle,

45:13

m you know,

45:14

had the ankle and slightly slightly

45:16

lesser degree, the hip had had the biggest contribution

45:18

to to joint work

45:20

and power. And then he obviously

45:22

had a lower contribution, but it was it had

45:25

highest it was the one joint that highest higher stiffness

45:27

than San Diego. or

45:28

the hip.

45:30

So

45:30

yeah. Any sort of horizontal

45:34

jump we'll give you good measure

45:36

of low limb exposure to some qualities. And

45:38

I mean, you will get from Vertical too, like, sort of something

45:40

like a Scott jump or And currently

45:43

with junk, you're probably getting a good measure of exposure

45:45

quality as well from the low

45:47

limit, particularly the calf. So

45:48

though and

45:51

Yeah.

45:51

I think either either or. I mean, there might be

45:53

some logic using

45:55

maybe one vertical or maybe one horizontal one depending

45:57

on the on the sport you're working with.

45:59

just the horizontal RSI

46:01

So hopping onto the fast play

46:04

and going for distance on the -- Yeah. --

46:06

on the rebound. Okay.

46:07

Yeah. And twenty and twenty minutes ratio.

46:10

Okay. Thanks. Copy. Yeah. Yeah.

46:12

Is

46:12

there has that got any

46:15

I know you said you are not there's been other

46:17

work before you in this area. But has that

46:20

got more

46:23

performance related information

46:25

that could be taken on further by you

46:27

sell for others?

46:29

Look, it's screwdrivers. I think I think it's something

46:31

for it's it's something for someone to

46:34

take up and maybe maybe, yeah, investigate

46:36

further. We don't abandon it to coordinate

46:39

with those type of outcomes with performance,

46:41

but

46:42

again, if you're a jump at lease,

46:44

if you're a long jumper, triple jumper,

46:46

think for acceleration,

46:48

I think there might be some yeah, there

46:50

might be some potential there to to to

46:52

think both qualities and and use it as as measure

46:54

of it.

46:56

So it's just I process. Didn't

46:58

the assessment expose the strengths of the aim,

47:01

where we're going with it to to build this

47:03

athlete back up

47:04

to then back

47:05

into back into training.

47:08

Yeah.

47:08

Yeah. I mean,

47:11

you know, as soon as they can run,

47:13

do some basic engineering running, we we bring it in.

47:15

even

47:16

if they're only at basic sort of plan metric level,

47:18

we wanna make sure that the house is in order, you know, so

47:20

that they're they're they're quite proficient

47:23

at the plyometric. They can handle a a good amount of

47:25

plyometric volume, single leg,

47:27

multi direction if if we need to

47:29

pivot the field support player. before we try to

47:31

bring in some, you know, phase

47:33

of volume

47:35

running. And because it's return to run

47:37

phase, particularly for car injury, and where where things

47:40

can clear up again, you know, and there's all that risk of

47:42

the of the

47:42

cabinetry because you're dealing even with the most lintry,

47:45

it's primarily tenant issue that's involved and tenant

47:47

issue takes a lot longer to remodel. And

47:49

so there's a long game and you always have to

47:51

it's easy to if you if you're if

47:53

you're just pure to use symptoms

47:55

as a guide, you can be pain free, you can

47:58

be functionally well, but there's

47:59

ongoing

47:59

remarketing going on there in the background that you don't see.

48:02

And that could be up to six months based on and once

48:04

the reason who who who

48:06

retrospectively or who ended did

48:09

MRI follow ups in in in in in lost of injuries.

48:11

So that that's that's that's gone up for several months. So

48:13

if you have quick corners get back playing or performing

48:16

and you've kind of back up a little bit in your rehab thinking you're

48:18

out woods, you know,

48:19

you're still at a you're at very, very high risk of

48:21

reoccurrence.

48:22

So I think

48:24

it's really important that we we expose

48:26

them to good level of reactor strength

48:28

work and

48:29

a level of volume running. So maybe

48:31

tens and sport obviously, but

48:33

this is something

48:34

that's going to be look at volume anyway, but for field sports,

48:36

maybe having exposure to a

48:38

moderate amount of volume at impasse, moderate to

48:40

high intensity

48:42

for a phase before we can be.

48:44

That's what's comfortable returning back

48:46

to the competition.

48:49

How how important is it to be

48:51

super careful post cat

48:53

injury in that introduction

48:55

back to running unlike something like

48:57

a hamstring where you get

48:59

into high speeds to to get into that

49:01

danger zone. Yeah. Car. Yeah. You're

49:03

in it straight away? It's almost

49:05

like the reverse. So, like, obviously, with a hamstring,

49:07

you probably get away with, like, low low intensity,

49:10

moderate intensity running. I mean,

49:12

again, but I didn't get too much out of hamster injury before

49:15

Martin back three years ago, four weeks out.

49:17

And it's a great 2b. So it was a my

49:19

attendance junction and vice and

49:21

the and I was

49:22

quite aggressive with with rehab and because I was

49:24

rehab

49:25

and myself, and I was I was going to take risks.

49:27

And if I didn't make marathon, you know, it was

49:29

not a big no big deal as soon as they could. managed

49:31

to get it resolved, managed to run a PV that that day,

49:33

but I know it was a sprinter. I wouldn't have got

49:35

away with it because I wouldn't have had it I

49:37

wouldn't have just been able to handle it. Maxim

49:39

has been running, but he didn't have to go find a few things

49:41

for marathon. So yeah.

49:43

But for the calf, injury pretty solid. You

49:45

can probably kinda go short along

49:48

with with with your progression, maybe bring them bring in

49:50

some, like, shorts. Not always a sprint,

49:52

but, like, maybe, working eighty to ninety percent

49:54

of their maximum velocity over, you know, fifty,

49:56

sixty meter repeats.

49:59

They can

49:59

probably handle

49:59

that. And while you're trying to build

50:02

capacity concurrently,

50:03

then you can also start to increase the volume

50:07

gradually over a week

50:09

or two.

50:10

the So

50:11

you can kinda go

50:12

short to long with those

50:14

cabinetry scores in home screens, but you have to go sort

50:16

of, you know, gradually slow to fast.

50:19

you know, and making sure I think the order before we bring

50:21

in high speed running. Cool.

50:23

And your PHD in

50:26

Okay. The added of a killers, a

50:28

killers rehab? A killers

50:30

rehab. Yeah. Northern biomechanics. Yeah.

50:33

the So

50:34

I'm sorry comment towards the

50:36

end. Sorry,

50:36

mate. Twin towards the end? Yeah.

50:38

Come

50:39

towards the end. Yeah. So I'm I'm I'm I've I've one study

50:41

to finish off, and I'm breaking my thesis

50:43

at at moment. So

50:44

hoping to have it submitted in the next

50:47

over the winter months and hopefully have it have my

50:49

defense. Before

50:51

the end of the year, So, yeah, it's been

50:53

been a five year journey.

50:55

So, yeah, the the the broad topic

50:57

we need to learn in biomechanics. So

51:00

if we have

51:02

couple of chapters in it, so two

51:05

papers. Well, one paper would be the horizontal

51:07

rebound test that I mentioned. testing reliability

51:09

and looking at the biomechanical features of that, which

51:11

we have paper in in submission at the moment. And

51:13

then another liability paper for CDK via the

51:15

metric test that we're trying to finish and

51:18

get ready for submission. And then our main

51:20

study would be RCT and

51:22

unrunner's participants

51:24

who take part sports and above running,

51:26

so not just discerning, it's it's field sports, so any

51:28

sports and above is running,

51:29

them who

51:30

have chronic mid portion, it can have turned it up at least.

51:32

So having symptoms more than three months,

51:34

paying

51:35

in the in the mid portion of the tender

51:37

as opposed to the run the heel insertion.

51:39

them

51:40

So we we give

51:42

them we we we randomize them into into one or two

51:44

groups. So one program one group

51:46

follows program that we put together that's

51:48

based on two or three

51:50

high

51:50

intensity sessions a week and multi

51:52

factorials are working on cast strength and

51:54

play metrics and guiding

51:57

the running and then another group follows

51:59

program that's

51:59

kind of by

52:02

it's a silver naga protocol. So

52:04

current silver naga is a prominent researcher

52:07

based in University of Delaware. And

52:09

per

52:09

protocol,

52:11

it's kind

52:12

of similar nature. And that it's it's it it

52:14

it has multi exercise types of, you know,

52:17

combined concentric, e centric, and so on, bring

52:19

it in planck. But probably a little bit less specific

52:21

in terms of how you progress So it's kind of – it's more

52:23

kind of based on symptoms, whereas we're kind

52:25

of hit certain strength targets

52:27

to collect progression.

52:29

to a maximum level

52:31

of tolerable pain as opposed to just relying on

52:33

pain to progress. And

52:34

we test them at start and then at

52:36

week six and week twelve and then we do long term question

52:39

or follow ups. So we look at the running mechanics

52:41

and using three d motion capture,

52:43

and we test our cap strength, hypothetically,

52:45

straight leg and bentley, and

52:47

then we look at their vertical drop jump and single car

52:49

rental rebound.

52:50

So that's been a big study. And they've also got

52:52

single case report that I'm preparing to just submit

52:55

on a football player

52:57

in Ireland who sustained indicators rupture.

52:59

And

53:00

last spring time when

53:03

intercounty training resumed

53:05

after after the restrictions, so the first week

53:07

back and hit a surgical repair. So we're able

53:10

to collect some data on him over the nine

53:12

months is my nine month rehabilitation journey and also

53:14

mapped out his rehabilitation. So, yeah,

53:18

there's four papers in that study. Everything that

53:20

nothing data in my thesis, and hopefully,

53:23

will be useful.

53:26

One last question.

53:29

Biggest mistakes either

53:31

you have made or others make

53:35

when we have been and

53:37

Achilles.

53:39

Cool. Yeah.

53:42

I'll

53:44

put you on the spot there. Sorry, mate. You have. Yeah.

53:46

I've not done that. We all make mistakes. I've

53:48

missed you.

53:54

Yeah. I I think it's actually quite important because, you know,

53:56

so with with attendance, it's it's not just

53:58

the tissue, it's not just the the structural

53:59

damage and

54:01

you

54:02

see in their my scan doesn't always match up to the pain response

54:04

and all that. You know, there's a lot of other factors going on

54:06

that we can't see and it's very hard to

54:08

quantify. Even

54:10

the pain responses to get from a good attendant, a lot of that

54:12

is just chemical noise in in in the attendant. So

54:14

you've got the cells that reacts. You've got

54:16

an inflammatory process. That's not the normal part

54:18

of exercise. We get in the foundry response and normally,

54:20

it resolves itself. And when when

54:23

the sometimes your response kicks off, the the the the the

54:25

sellers in the attendant, the team decides to become active.

54:27

You've got that sort of battle

54:30

between release of roxavendamib, that

54:32

breakdown in tender tissue and then the roxavendamib to

54:34

head to repair us. I know you got your own your

54:36

your inflammatory mediators and then your

54:39

information is resolving

54:41

mediators. And

54:42

oftentimes

54:44

when you have them, when the tenant becomes more

54:46

chronic, you've got extra growth

54:48

of blood vessels. Normally,

54:50

the tenderness that the actual collagen fibers

54:54

don't have much blood supply, direct blood supply

54:56

or nerves of by normally, the northern blood

54:58

supply is on the periphery in in that sort of synovial

55:01

space. But when you've got a chronic

55:03

tendinopathy that you you can actually engross the blood vessels

55:05

towards it that that core of the attendant. And then with

55:07

that, you've got a sprouting of the not the nerve endings.

55:09

And those nerve endings are quite exposed on

55:11

my own edges for their quite exposed

55:13

and noisy area. and it just becomes sensitized

55:16

to those sort of that chemical noise, and that's what kind of drug

55:18

for pain.

55:19

So that's

55:20

a tricky one. And then you've got,

55:22

you know, you've got you know, there's nice

55:24

paper there by, guess, in in

55:26

in Sean London last year. He's part of the current

55:28

seven Eagles Group in Delaware where he categorized

55:31

treated in subgroups of of patients who can

55:33

attend update, those were more structured dominance.

55:35

So it's pretty much like a mismaturing loading

55:37

capacity. And those who were twice

55:40

like a social dominance. So again, there's

55:42

lot of fears and catastrophies and

55:45

beliefs around the early symptoms and thus can

55:48

increase

55:49

towards the sensitivity of the tissue and

55:51

those nerve endings, and then maybe those were more metabolic,

55:53

which probably the less forty people because

55:55

the time it can be sensitive other things go on the body.

55:57

So I think as well as get back to my main point,

55:59

one thing

56:00

that will be learned over the years is to try and

56:02

understand what the patient thinks or the only things that's going

56:05

on, what they're understanding of it is, their processes.

56:07

because now most fear that they're gonna rupture.

56:09

And sometimes, you know, yes, when

56:11

you're rupture, there there probably is some

56:13

pathology there that you might see that

56:16

might be make them a little bit more vulnerable.

56:19

But when you are sore, you're probably not gonna do things that

56:21

are gonna cause you to actually, doing fast and explosive.

56:23

So that pain can be a little bit protective. So trying to

56:25

break down that barrier.

56:28

But, yeah, just definitely trying to involve the patient a lot

56:30

more, and as well as That's one thing I probably

56:32

learned over the years, try to understand what way they're thinking.

56:34

And if it's a rational try in

56:36

a very careful and centered way, try to break that

56:38

down and work through

56:40

it.

56:42

Lavette. Sorry

56:44

to put it on the spot there, but dealt with like

56:46

a dream professional. No, no.

56:50

But not. Thank you for coming on card. If

56:52

anyone wants to keep it to date what you got going on,

56:55

PHD wise, other stuff

56:57

going on, running, etcetera. Where's the best place

56:59

Twitter, Instagram?

57:01

Both. Yeah. I suppose you use Twitter a lot more

57:03

for professional stuff and just find

57:06

a good resource. So, yeah, a lot

57:08

of a good

57:09

resources there. Not actually like to like to try

57:11

and that's what share it is and, you know, it's it's it's a

57:13

good two and two and you're limited with with with characters

57:15

in space to try and get you on pause together precisely. And

57:18

try

57:18

to use it for that purpose and share and

57:20

and as well as learn to motors and

57:21

try and steer the things that don't need to get involved

57:24

in. So in Twitter, yeah, my handler is a common

57:26

person like, like, good in there, good in there, even though it was get

57:28

my own needs and that's other

57:31

characters to it. With the blood check as well?

57:34

Yeah. Yeah. That was Manavonics was here. Yeah.

57:36

We all got out of the bonus back in in none in twenty

57:38

twelve. Did you

57:39

mention I forgot it. So was

57:41

that just a thing that went if you're in the Olympics,

57:43

you know, will take in two thousand twelve? Yeah. That

57:45

time. Yeah. Yeah. Yeah. Yeah. Nice. Yeah.

57:48

I'll take it. And the

57:51

Twitter or LinkedIn

57:53

as well. I often use that more as

57:55

well as for more for professional stuff. But

57:57

Yeah.

57:57

Look, I mean, if we're spot ways, look, I've

57:59

people have been very generous with their time to me over the

58:02

years and have grown up on them. And if someone comes to me with

58:04

a question, I'm always trying to try to have

58:06

them and if I kinda have them join point them in the right direction.

58:08

So

58:08

yeah. always

58:10

happy to take a few free tours.

58:12

Awesome. Well,

58:13

thank you for the last hour.