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with Dr Pat Vallance In this episode: Bent knee versus straight knee calf raises for Achilles rehabWhy calf position changes muscle activationAchilles tendinopathy and tendon strainTendon stiffness and why it mattersWhether plyometrics build tendon stiffnessWhether running should be stopped during rehabLoad monitoring and pain guided rehabMuscular endurance testing with single leg heel raisesNormative values for calf endurancePsychological factors in tendinopathyKinesiophobia and pain catastrophisingCortical versus spinal inhibitionHow rehab may differ for Achilles compared with patellar tendinopathyResources mentioned: Tampa Scale of Kinesiophobiahttps://www.physio-pedia.com/Tampa_Scale_of_Kinesiophobia Where to find Pat: Tendinopathy Circuit Breakerhttps://tendinopathycircuitbreaker.com/ Instagramhttps://www.instagram.com/tendinopathy_circuit_breaker/ Supercharge Your Tendon Rehab coursehttps://events.humanitix.com/supercharge-your-tendon-rehab-cutting-edge-tendon-injury-rehab Pat's recent publications: Vallance, P., Kidgell, D. J., & Malliaras, P. (2026). Greater endogenous pain facilitation is associated with lower spinal excitability and maximal knee extension strength deficits in athletes with patellar tendinopathy. European Journal of Applied Physiology, 1-14. Vallance, P., Malliaras, P., & Kidgell, D. J. (2026). Temporal motor evoked potential decomposition reveals that cortico-reticulospinal excitability is increased in athletes with patellar tendinopathy. Preliminary evidence of compensatory adaptation for diminished motor drive. Journal of Electromyography and Kinesiology, 103142. Vallance, P. (2025). Neural deficits relevant to pain symptoms and functional impairments in individuals with Achilles or patellar tendinopathy (PhD Academy Award). British Journal of Sports Medicine. Vallance, P., Siddique, U., Frazer, A., Malliaras, P., Vicenzino, B., & Kidgell, D. J. (2025). Transcranial magnetic stimulation and electrical stimulation techniques used to measure the excitability of distinct neuronal populations that influence motor output in people with persistent musculoskeletal conditions: A scoping review and narrative synthesis of evidence. Journal of Electromyography and Kinesiology, 103011. Vallance, P., Kidgell, D. J., Vicenzino, B., & Malliaras, P. (2025). Endogenous pain modulation is not different in basketball or volleyball athletes with patellar tendinopathy compared to asymptomatic athletic controls. Musculoskeletal Science and Practice, 76, 103280.

Every major osteoarthritis guideline in the world lists weight management as core care. Ben Steele-Turner's scoping review pulled together 79 records on what physiotherapists do, and the picture is messy. Clinician surveys have 60 to 94 per cent of physios saying they include weight management. Notes audits and patient interviews put it closer to 8 to 22 per cent. Ben is a physiotherapist and PhD candidate at the University of Portsmouth, and he joins me to talk through why that gap exists and what to do about it. We get into scope of practice and why so many clinicians find the conversation awkward. We also cover the part I've always struggled with. Osteoarthritis is a whole system condition, inflammatory, metabolic, psychological, and yet the mechanical side is the bit I know how to do. Sets, reps, load, progression.. Ben and I dig into whether the lifestyle side actually outperforms what we're already doing, what someone can be offered for faster relief in the first few weeks, and where taping, footwear, orthoses and injections sit. Then there's the steroid question. If a knee is angry and inflamed we know what that environment does to cartilage, but the drug that settles it is itself chondrotoxic. Do we steer people away from it or put it on the table and let them decide? And can we really blame someone for wanting the pain gone now, when most of us wouldn't accept "just live with it" for our own injuries either. Ben finishes with how he selects exercise for someone with knee OA, whether he starts local or zooms out, and the one thing he wants every patient to walk away understanding about their knee. Papers discussed: Steele-Turner B, Gonçalves AC, Shepherd AI, Drummond H, Allison K, Bennell KL, Exell TA. Physiotherapist-led weight management for people with osteoarthritis: A scoping review. Osteoarthritis and Cartilage 2026;34:121-138. https://pubmed.ncbi.nlm.nih.gov/41276008/ Moseng T, Vliet Vlieland TPM, Battista S, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024;83:730-740. https://pubmed.ncbi.nlm.nih.gov/38212040/

Muscle injuries remain one of the most challenging conditions in sport. In this episode, sports physiotherapist Murray Leyland joins us to discuss the latest evidence on muscle injury diagnosis, rehabilitation, and return to play. We cover muscle injury classification, the role of MRI, load management, eccentric training, calf and hamstring injuries, and how clinicians can make more informed return to play decisions. This episode is packed with practical, evidence-based insights for clinicians working with athletes and active individuals. Murray's Practice Below: https://www.valleyphysiotherapy.au/

Paper: https://bjsm.bmj.com/content/early/2026/05/03/bjsports-2025-110986 In this episode, Professor Joanne Kemp discusses the latest evidence on femoroacetabular impingement (FAI) syndrome and challenges common assumptions about hip pain. We explore why structural findings such as cam morphology are often seen in pain-free individuals, how imaging should be interpreted alongside the clinical picture, and what the new PhysioFIRST randomised controlled trial tells us about strengthening versus stretching. Joanne also shares practical advice for clinicians on patient education, treatment decision making, and translating research into everyday practice. Whether you're a clinician, student, or interested patient, this episode provides an evidence-based perspective on the assessment and management of hip pain. Professor Joanne Kemp is a physiotherapist, researcher, and Professor at La Trobe University. She leads internationally recognised research in hip pain and femoroacetabular impingement (FAI) syndrome, with a focus on improving non-surgical management through high quality clinical trials. Joanne has authored more than 150 peer reviewed publications and is the lead author of the recent PhysioFIRST randomised controlled trial published in the British Journal of Sports Medicine.

Follow Kim https://www.linkedin.com/in/kim-hebert-losier/ Summary Dr. Kim Hebert-Loser shares insights on calf muscle function, footwear technology, injury prevention, and the future of personalized shoe design. Discover how research, biomechanics, and individual preferences shape optimal running and rehabilitation strategies.

Stress fractures feel like they're everywhere lately but I don't think its changing disproportionately. I dig into why, what's really going on, and which bits of the "epidemic" narrative I think hold up. Refs: Bennell KL, Malcolm SA, Thomas SA, Reid SJ, Brukner PD, Ebeling PR, Wark JD. Risk factors for stress fractures in track and field athletes: a twelve-month prospective study. American Journal of Sports Medicine. 1996;24(6):810–818. Knapik J, Montain SJ, McGraw S, Grier T, Ely M, Jones BH. Stress fracture risk factors in basic combat training. International Journal of Sports Medicine. 2012;33(11):940–946. Changstrom BG, Brou L, Khodaee M, Braund C, Comstock RD. Epidemiology of stress fracture injuries among US high school athletes, 2005–2006 through 2012–2013. American Journal of Sports Medicine. 2015;43(1):26–33. Rizzone KH, Ackerman KE, Roos KG, Dompier TP, Kerr ZY. The epidemiology of stress fractures in collegiate student-athletes, 2004–2005 through 2013–2014 academic years. Journal of Athletic Training. 2017;52(10):966–975. Shi BY, Castaneda C, Sriram V, Yamasaki S, Wu SY, Kremen TJ. Changes in the incidence of stress reactions and fractures among intercollegiate athletes after the COVID-19 pandemic. Journal of Orthopaedic Surgery and Research. 2023;18(1):788. Bergman AG, Fredericson M, Ho C, Matheson GO. Asymptomatic tibial stress reactions: MRI detection and clinical follow-up in distance runners. American Journal of Roentgenology. 2004;183(3):635–638. Kiuru MJ, Niva M, Reponen A, Pihlajamäki HK. Bone stress injuries in asymptomatic elite recruits: a clinical and magnetic resonance imaging study. American Journal of Sports Medicine. 2005;33(2):272–276. Hoenig T, Ackerman KE, Beck BR, Bouxsein ML, Burr DB, Hollander K, Popp KL, Rolvien T, Tenforde AS, Warden SJ. Bone stress injuries. Nature Reviews Disease Primers. 2022;8(1):26. AusPlay (Australian Sports Commission). National participation data on running and jogging, 2015–present. https://www.clearinghouseforsport.gov.au/research/ausplay

In this episode, we explore questions such as: Why does pain persist despite multiple high-quality treatments? What does it actually mean to say pain is multifaceted, and how should that change clinical decision making? How should clinicians communicate about pain in a way that is accurate, validating, and actionable? What should clinics stop doing, start doing, and measure if they want to improve care? In this episode, we speak with Dr Nardia-Rose Klem, a physiotherapist and research academic at Curtin University whose work focuses on young people living with persisting pain, particularly the relationship between pain, mental wellbeing, and access to appropriate care. She is involved in several important clinical translation and public education initiatives, including young painHEALTH, painHEALTH, and the Musculoskeletal Clinical Translation Framework, all of which aim to improve the way pain and musculoskeletal conditions are understood, communicated, and managed. Her research spans young people with chronic musculoskeletal pain, co-existing mental health conditions, pain care experiences, and qualitative work exploring patient experiences across musculoskeletal healthcare contexts.  Links mentioned Profile and socials Curtin University staff profile Instagram: @physio_nardia Websites and resources young painHEALTH painHEALTH Musculoskeletal Clinical Translation Framework Örebro Musculoskeletal Pain Screening Questionnaire, short form Publications Characterizing phenotypes and clinical and health utilization associations of young people with chronic pain: latent class analysis using the electronic Persistent Pain Outcomes Collaboration database  “It’s kind of just like a never-ending cycle”: Young people’s experiences of co-existing chronic musculoskeletal pain and mental health conditions  Lived and care experiences of young people with chronic musculoskeletal pain and mental health conditions: a systematic review with qualitative evidence synthesis  A Prospective Qualitative Inquiry of Patient Experiences of Cognitive Functional Therapy for Chronic Low Back Pain During the RESTORE Trial  What Influences Patient Satisfaction after TKA? A Qualitative Investigation

In this episode of the Sports Medicine Project, Blake Withers is joined by Dr. Gerald Yeo, a renowned foot and ankle orthopedic surgeon, to discuss the intricacies of foot and ankle surgeries, particularly focusing on Achilles tendon and navicular stress fractures. Dr. Yeo shares insights from his extensive experience, discussing the challenges and advancements in surgical techniques, and the importance of a multidisciplinary approach in treatment. Dr. Gerald Yeo emphasizes the complexity of foot and ankle surgeries compared to other orthopedic procedures.The discussion highlights the importance of a multidisciplinary approach involving physiotherapists and podiatrists.Dr. Yeo explains the traditional and modern approaches to treating Achilles tendonitis.The episode explores the challenges of measuring surgical outcomes for foot and ankle procedures.Dr. Yeo shares insights on the use of Richie braces in managing foot conditions.The conversation covers the role of imaging in diagnosing and planning surgeries.Dr. Yeo discusses the potential of minimally invasive techniques in foot and ankle surgery.The episode addresses the common misconceptions about Haglund's deformity and its treatment.Dr. Yeo talks about the importance of patient education in managing expectations post-surgery.The discussion includes the future of orthopedic surgery and potential advancements in treatment options.Keywords: Achilles tendon, navicular stress fractures, orthopedic surgery, foot and ankle, multidisciplinary approachTakeaways: Dr Gerald Yeo is a Queensland trained orthopaedic surgeon (BMedSci, FRACS (Ortho), FAOrthA) with subspecialist fellowship training in foot and ankle surgery. His clinical interests include minimally invasive and arthroscopic techniques, total ankle replacement, and lower-limb trauma, with a focus on supporting recovery through early, functional rehabilitation and multidisciplinary care. He consults and operates in Brisbane, including at Brisbane Orthopaedic Specialist Services and St Vincent’s Private Hospital Northside, and also consults at North Lakes and operates at North West Private Hospital. (drgeraldyeo.com.au)

Confused by all the ASICS “Blast” shoes? In this video I break down the entire Blast family and help you match the right shoe to your running.Megablast – max stack, FF TURBO SQUARED, ultra-bouncy long run and easy day optionSonicblast – dual-foam midsole with Pebax plate, built for tempo and faster long runs Superblast 2 – the super trainer sweet spot for daily training, long runs and some workouts Novablast 5 – the classic bouncy daily trainer, 8 mm drop, big stack without feeling unstable  Dynablast – more affordable, lower stack, flexible Blast option that still feels fun underfoot Which models suit higher weekly mileage and long runsWhen I might lean towards Megablast or Superblast?Where Dynablast and Novablast fit for newer runners or those not used to very high stack shoes?

Summary In this conversation, Blake Withers interviews Aidan Rich, a sports and exercise physiotherapist, about his research on proximal hamstring tendinopathy and the recent randomized control trial comparing physiotherapy and shockwave therapy. Aidan shares his journey into the field, the challenges of designing the study, and the importance of education in treatment. They discuss the nuances of exercise rehabilitation, patient experiences, and the surprising results of the trial, which showed no significant difference between the two treatment methods. Aidan emphasizes the need for individualized care and the potential for future research in this area. Paper links: Main RCT: https://journals.sagepub.com/doi/10.1177/03635465251391134 https://pubmed.ncbi.nlm.nih.gov/41037932/ https://pubmed.ncbi.nlm.nih.gov/40469642/ https://www.jsams.org/article/S1440-2440(25)00275-0/pdf Aidan Rich: PhD Candidate | APA Titled Sports and Exercise Physiotherapist | State ManagerA dedicated and passionate physiotherapy professional with extensive experience in both academic research and clinical management. Currently pursuing a PhD with the topic of 'Physiotherapy for Proximal Hamstring Tendinopathy,' where he has conducted two randomised trials. In addition to his academic pursuits, he oversee the clinical, financial, and cultural performance of a network of 20 physiotherapy and sports medicine clinics across Victoria. His role involves ensuring the highest standards of patient care, optimising financial performance, and fostering a positive and collaborative work environment. Chapters 00:00 Introduction and Background of Aidan Rich 03:48 The Evolution of Tendinopathy Treatment 08:30 Shockwave Therapy: Insights and Experiences 13:13 Designing the RCT: Methodology and Protocols 18:20 The Exercise Program: Structure and Rationale 23:07 Education in Rehabilitation: Importance and Implementation 28:39 The Benefits of Resistance Training 29:52 Qualitative Insights from RCT Participants 31:36 Surprising Strength Outcomes in Rehabilitation 33:42 Effect Modifiers in Treatment Response 35:20 Clinical Applications of Shockwave Therapy 37:01 Patient Preferences in Treatment Choices 38:00 Individualized Treatment Approaches 39:04 Evaluating Shockwave Therapy Effectiveness 41:22 Challenges in Designing Effective Trials 43:22 Comparative Outcomes in Tendinopathy Treatments 45:43 Acute Responses to Shockwave Therapy 48:36 Key Takeaways for Clinicians 50:59 Future Directions in Research

Audio a little quiet last 54 mins. Ian is a sports podiatrist and educator who helps people stay active and reach their goals through evidence-based pain and injury management. A keen runner himself, he pairs lived experience with top-tier credentials—degrees in Podiatric Medicine and Sports Injury, postgraduate training in Sports Podiatry and Academic Practice, and Fellowships of the Royal College of Podiatry, the Royal College of Physicians & Surgeons of Glasgow, and the Higher Education Academy—while lecturing at Queen Mary University of London and holding adjunct roles at Monash and Ziauddin Universities. He has presented internationally and supported elite teams including the PGA European Tour, England Rugby 7s, Surrey Cricket, GB Men’s Hockey and Arsenal (including London 2012), but takes greatest pride in helping everyday athletes stay healthy, resilient and able to enjoy their sport.

Breakdown of Relative Energy Deficiency in Sport (RED-S), what it is, why clinicians and athletes should care, key stats/facts that often get missed, and practical screening you can use tomorrow in clinic or with your squad. What you’ll learn What RED-S actually is (beyond “under-fuelling”) Why it matters for health, performance, and injury risk Prevalence, red flags, and common pitfalls How to screen in real life: which tools, when to use them, and how to interpret results When to refer and build a multidisciplinary plan LEAF-Q (Low Energy Availability in Females Questionnaire) https://bjsm.bmj.com/content/bjsports/suppl/2014/02/21/ bjsports-2013-093240.DC1/bjsports-2013-093240supp1.pdf LEAF-Q Scoring Guide: https://bjsm.bmj.com/content/bjsports/suppl/2014/02/21/ bjsports-2013-093240.DC1/bjsports-2013-093240supp2.pdf • LEAM-Q (Low Energy Availability in Males Questionnaire) 6 https://www.mdpi.com/2072-6643/14/9/1873 (see supplementary material) • RST (RED-S Specific Screening Tool) 7 https://assets.cureus.com/uploads/original_article/ pdf/30734/1612430181-1612430175-20210204-18268-i9k6n7.pdf (Questionnaire in appendix C, scoring guide in appendix B) • SEAQ-I (Sport-Specific Energy Availability Questionnaire and Interview) 8 https://bmjopensem.bmj.com/content/4/1/e000424 (see supplementary material) • EDE-Q (Eating Disorder Examination Questionnaire) 9 https://socialwork.buffalo.edu/content/dam/socialwork/continuing- education/documents/Eating-Questionairre-EDE-Q.pdf • SCOFF (Sick, Control, One (stone), Fat, and Food Questionnaire) 10 https://www.nutritionhealth.com.au/site/assets/files/1064/scoff- questionnaire.pdf • EAI (Exercise Addiction Inventory) 11 https://doi.org/10.1080/16066350310001637363 (see appendix 1) • EDS (Exercise Dependence Scale) 12 https://www.personal.psu.edu/dsd11/EDS/EDS21Manual.pdf

Stress fractures are one of the most common running injuries (up to 20% of them), but what actually are they, why do they happen, and why do some take longer to recover than others?In this video, I explain: • What a stress fracture is and how it develops • Why taking time off running is often essential for healing • Why not all stress fractures are the same (location and severity matter) • What runners should know about recovery and reducing riskI’m a Sports Podiatrist and PhD researcher candidate in running injuries, and my goal is to give runners clear, evidence-based information to help them train smarter and stay injury free.

Find Gabriel: https://www.researchgate.net/profile/Gabriel-Moisan https://www.linkedin.com/in/gabriel-moisan-a382aaa7/ In this conversation, Blake Withers interviews Gabriel Moisan, a podiatrist and researcher, about his journey in the field of podiatry, the evolution of foot orthoses, and the ongoing debates surrounding their use. They discuss the challenges of research in podiatry, the mechanisms of foot orthoses, and the differences between custom and prefabricated devices. Moisan shares insights on how to determine the appropriate dosage of foot orthoses for patients and critiques the terminology used in describing conditions like adult acquired flatfoot. The conversation emphasizes the importance of understanding both the mechanical and psychosocial effects of foot orthoses in patient care. In this conversation, Blake Withers and Gabriel Moisan delve into the advancements in podiatry, particularly focusing on foot orthosis, 3D printing technology, and the importance of clinical outcomes. They discuss the role of footwear in treatment, the evolution of materials used in orthotics, and the integration of technology to enhance patient care. The conversation also highlights the significance of teaching and learning in podiatry, the challenges of research, and the future directions of the field, including the potential of AI in predicting treatment outcomes.takeaways Gabriel Moisan's journey in podiatry began with a desire to understand foot orthoses.Research often leads to more questions than answers in podiatry.The traditional view of pronation as 'evil' is being challenged.Alignment theories in podiatry are being replaced by a focus on function.Research needs to control for biases to accurately assess treatment outcomes.Foot orthoses work through mechanical, somatosensory, and psychosocial effects.Comfort in foot orthoses is not always the priority for effective treatment.The debate between custom and prefabricated foot orthoses continues.Determining the appropriate dosage of foot orthoses is crucial for patient outcomes.Terminology in podiatry needs to evolve to better reflect current understanding. 3D printing has revolutionized the manufacturing of orthotics.Clinical outcomes are prioritized over biomechanical outcomes.Footwear plays a crucial role in the effectiveness of orthotic devices.Material science is evolving, but significant changes are still needed.Technology integration in orthotics could improve patient outcomes.Patient feedback is essential for effective treatment.Teaching students about orthotic modifications is vital.Research in podiatry is often limited by funding and resources.The evolution of foot orthosis has been slow but necessary.Future research may focus on AI to predict treatment success.Exploring the World of PodiatryThe Journey of a Podiatrist: Gabriel Moisan"Pronation is evil.""I just want to see it.""We should think outside the box."titlesSound BitesChapters00:00Introduction and Name Pronunciation00:32Gabriel Moisan's Journey in Podiatry04:33The Evolution of Foot Orthosis Understanding10:33Research Challenges in Foot Orthosis16:40The Mechanisms of Foot Orthosis20:15Clinical Applications and Effectiveness of Foot Orthosis32:49Understanding Foot Orthosis for Adult Acquired Flatfoot39:44The Debate on Terminology in Podiatry46:54Long-Term Use of Foot Orthosis: A Patient-Centric Approach51:35Advancements in Foot Orthosis Manufacturing56:15Customizing Foot Orthosis for Specific Conditions01:04:08The Future of Foot Orthosis: Technology and Innovation01:09:29The Role of Technology in Podiatry01:12:25Understanding Foot Orthosis and Patient Outcomes01:15:29Predicting Biomechanical Effects of Orthoses01:18:26The Impact of 3D Printing on Orthotic Modifications01:22:36Future of Foot Orthosis: Research and Innovations01:26:05The Need for Comprehensive Resources in Podiatry01:26:41Influential Figures in Podiatry and Research Aspirations

Find Luke: https://www.instagram.com/sportschiroluke/ Luke is a titled Sports & Exercise Chiropractor, Running Coach, and Strength Coach with over 20 years of experience in private practice in Melbourne. He has lectured extensively across Australia and internationally on sports injuries, with a focus on running-related topics. As an avid fitness enthusiast, Luke has completed 11 marathons, an ultra-marathon, and two Ironman triathlons. In recognition of his expertise, Luke was awarded Fellowship status by the Australasian Institute of Chiropractic Education in 2019, inducted as a Fellow of the Australian Sports Medicine Federation in 2024, and honoured as the 2022 ACA Chiropractor of the Year for his contributions to the profession.Luke Nelson Sports & Exercise Chiropractor Director Health & High PerformanceB App Sci (Clin Sci.)/B Chiro Sci, ICCSP, Postgrad.Dip.Sport Chiro, M.Sport.Sci, ASCA Lev 1, FAICE, FASMF w. https://www.healthhp.com.au/ Chapters 00:00 Introduction to Podiatry and Chiropractic Practices 00:58 Evolving Perspectives in Healthcare 03:36 The Journey of a Chiropractor 06:47 The Role of Social Media in Healthcare 09:32 Strength Training and Injury Prevention 12:37 Plyometrics in Running Training 15:24 Individualized Training Approaches 18:34 Managing Tendon Injuries 21:11 Patient Education and Communication 29:06 Effective Communication in Consultations 33:14 Understanding Running Programming 40:23 Assessment Techniques for Runners 47:14 The Importance of Strength Assessment 53:47 Managing Bone Stress Injuries 01:01:24 Reflecting on Gratitude and Perspective 01:01:48 Foot Strike Patterns and Gait Interventions 01:04:59 Sustaining Changes in Running Technique 01:06:35 Programming for Return to Running 01:10:57 Adding Intensity to Training 01:11:59 Managing Pain and Progressing Training 01:16:52 Mechanical Interventions in Running 01:20:03 Favorite Running Shoes and Recommendations 01:23:09 Interviewing the Greats and Research Aspirations 01:27:06 Future Endeavors and Closing Thoughts Takeaways The breakdown of traditional silos in healthcare is beneficial for patient care. Interdisciplinary collaboration leads to better treatment outcomes. Social media can enhance the dissemination of healthcare knowledge. Strength training is crucial for injury prevention in runners. Plyometrics can improve performance and aid in rehabilitation. Patient education is essential for effective treatment. Understanding patient goals helps tailor treatment plans. Assessment techniques are vital for identifying issues in runners. Research translation is important for evidence-based practice. Healthcare professionals should continuously evolve their practices. Strength parameters should be assessed in context, not isolation. The act of doing training is more important than just numbers. Weakness can be a precursor to injuries, but it's not the only factor. Criteria-based rehabilitation is often more effective than time-based. Managing bone stress injuries requires careful progression and monitoring. Runners often need mental support when facing injuries. Foot strike patterns should be assessed but not always changed. Easy running builds the foundation; speed work enhances performance. Individualized programming is crucial for effective rehabilitation. The future of injury prevention research is multifactorial and complex.