Here’s an image I post a few times each year when I get a rise in athletes thinking they need, asking for, or being unable to move on with their conditions management following a scan.

Many people seek imaging as a means to finding a diagnosis for their injury / pain.

1/6 🧵 Although sometimes appropriate, the current evidence informs us that many people without injury/pain will present with similar findings to those in pain.

Here’s a picture highlighting this, this illustrates common findings of “pathology” in people without pain or symptoms.

2/6

Here’s an interesting question that seems to be getting asked more often these days.

General awareness around bone density and bone stress injury has definitely increased in recent years.

1/4 🧵 There is evidence that elite swimmers and cyclists can sometimes suffer with bone density issues due to the reduced loading that their training predominantly incurs.

But these days most have measures in place to address this risk.

2/4

Over the last few weeks I worked with lots of runners about to race a marathon with knee pain.

One strategy that helped many to reduce pain and continue with their goals was to increase their step rate

1/5 (which ultimately shortens the stride length) and reduces the magnitude of the forces absorbed at the knee.

This can be a great strategy (although it may need some focus and discipline) for helping people get to the start and finish line.

2/5

In one of my recent mentoring sessions with a group of students, we discussed all things exercise prescription.

It involved some everyday role play scenarios which could and would occur regularly in clinic.

1/8 There was some fantastic stuff going on, but one common theme that popped up was the over cueing and over coaching of exercises.

All too often 5-10 cues would be thrown at the “patient”…..

2/8

Assessing someones running mechanics can be a very relevant part of helping to diagnose the problem and find a solution to reducing pain and / or enhancing performance.

1/4 However, sometimes, because of expectations from all involved we can zero in on assessing them and become tunnel visioned that this is the cause / solution and lose focus on things that in essence could have a much bigger effect on the runner.

2/4

Whenever I speak to athletes who predominantly self coach or follow generic, downloadable plans, the limiting factor to performance and improvement is the conscious or unconscious pull towards sessions they want to do (enjoy, find achievable or think will help)…..

1/4 more than the ones that they need to do (address deficits, target race specific needs etc).

Sometimes there’s a sweet spot where both can be achieved at the same time, but often, the things we need to do won’t align with the things we want to do.

2/4

“Don’t you get frustrated Mike when an athlete ignores your advice but listens to Dave in the FB running group?”

Here’s a question that I definitely get asked lots, and in truth one that I definitely used to say yes to.

A 🧵……..

1/12 Truth is I don’t anymore, I’ve learned that offering advice and guidance on the things to do, more than the things an athlete wants or thinks they need won’t always be received well at first.

2/12

I know for some, discussing race strategies may not be something you are considering at present, however Its something I regularly review and discuss with my coached athletes and patients as it helps shape the training plan.

1/8🧵 What’s often discussed is a singular, fixed goal that doesn’t have room for adaptation and deviation if needed.

I try to get them to always have 2-3 strategies that could be used.

2/8

One of the primary concerns that most athletes I speak to is to simply receive a label/diagnosis for their injury.

This is closely followed by those who have often seen therapists who have given a label or diagnosis, but haven’t spent any time whatsoever explaining

1/4 …..the long term plan and outcomes.

Often the diagnosis in and of itself isn’t a factor in moving forward beyond peace of mind and reassurance.

Of course there are times we need to act on a certain diagnosis as a specific path of treatment may be preferred or indicated.

2/4

I’m always surprised how many triathletes say they are going to “work on their swimming “ through winter but don’t have a plan of how or what they will do to do this.

🧵 1/5 Implementing some simple self administered tests can help shape your off season & identify areas that you can dedicate time to become a more effective & efficient swimmer.

Over the next few posts I will share some ideas & rationale behind some of the tests I think may help. 2/5

A golden oldie for this weeks repost:

It’s difficult trusting the process and accepting that success is earned over prolonged periods of consistency.

When we have bad sessions or bad weeks, we can often let it affect us.

1/ We double down on training, play catch up with missed sessions, add extra onto sessions which weren’t planned for, and this can lead to performance being affected even more or worst case, injury.

2/

Something I discussed during a recent course which stirred a lot of debate was a theory I have relating to physiological vs psychological ability and endurance sports.

A 🧵…

1/14 I truly believe that only a limited percentage of the athletic population have the capacity to achieve the top couple of percent of performance.

2/14

I was asked a brilliant Q today in an online chat with some newly qualified coaches.

What’s the key to success in endurance sports??

A thread……

1/11

#ukrunchat #uktrichat #success #endurance #physio It didn’t take me long to answer to be honest, I think it’s the same secret for all sports (and life in general!)

the key is simply to be consistent over a prolonged period - sustained / maintained consistency.

2/11

Just thought I’d share this study again in response to a patients Q earlier today regarding running in one shoe only vs rotating multiple pairs.

I’m a big fan of rotating between multiple “different” types of shoes to “ spread the load”.

1/4 #ukrunchat #run #Shoes #physio We can’t remove forces and physics but we can be smart with them.

It’s a strategy I use myself.

Of course there are runners who use one pair and don’t get injured as well, there’s far more to this puzzle than simply changing shoes as I talk about often,

2/4

Many endurance athletes will be looking forward to returning to group and club sessions.

It’s an exciting time, it’s been too long for most of us since we trained together, with friends and team mates.

1/6 @IronmanAthletes #UKRunChat #UKTriChat But please take a moment to just assess where you are as an athlete right now?

We’ve probably all grown tired of that phrase “the new normal”, but it’s actually appropriate here when we think about returning to group sessions.

2/6

I really wish therapists and coaches would stop fear mongering by telling healthy people their “glutes don’t work”.

1/ They may be weaker than optimally wanted in some cases, but, and it’s a big but, glutes don’t work ONLY in the case of spinal cord injury, neurological deficit and extreme invalidity occasionally.

2/