Mark’s PHT Success Story

: On today's episode, Mark's PHT success story. Welcome to the podcast helping you overcome your proximal hamstring tendinopathy. This podcast is designed to help you understand this condition, learn the most effective evidence-based treatments and. bust the widespread misconceptions. My name is Brody Sharp. I'm an online physiotherapist, recreational athlete, creator of the Run Smarter series and a chronic proximal hamstring tendinopathy battler. Whether you are an athlete or not, this podcast will educate and empower you in taking the right steps to overcome this horrible condition. So let's give you the right knowledge along with practical takeaways in today's lesson. Welcome back to the podcast. Thanks for joining me for another episode. And we have another success story lined up. We have Mark who was one of my clients, um, a few months back and has made a lot of strides and a lot of success and as natural, um, asked him to come onto the podcast and luckily he agreed. Very happy-go-lucky guy, very optimistic as you'll quickly learn. And, um, as you will then throughout the podcast, learn that it actually plays a good role in his recovery. So today we discuss his initial onset of symptoms, um, the mistakes he made early on the, how we, even when we started working together, the setbacks and lessons that still needed to be learned before he could actually start. getting some momentum in terms of returning to running and returning towards, uh, his goals or moving towards his goals, which are races, fast races, um, even though he is a master's runner in his sixties. So. Yeah. We'll dive into the exact exercises, the exact, um, protocol that really helped him along the way and a lot of mistakes. And then we. finish off with a lot of advice and takeaways and lessons that he has learned in his months of rehab that will really help you no matter your situation with PHT. So away we go. Mark, thank you very much for joining me on the podcast. Yeah, great to be here Brody. Let's get people familiar with you. So, um, introduce yourself and where you're from and in particular, what sort of exercise, what sort of athlete are you? So Mark from Minneapolis, Minnesota. I'm a 60 year old competitive masters runner I've been running my whole life started running in grade school ran through junior high school ran competitively in college Was very close to qualifying for the Olympic marathon trials in the back in the 1980s So pretty high-level runner always put in, you know, lots of miles as a younger man never almost never injured even putting in 120 mile weeks and you know obviously as I've gotten older now I'm you know running up against these injuries uh pht being one of the worst I've experienced so far um and I'm one of those guys that just when I'm injured I've learned that I hate swimming I hate you know stuff in the gym like the elliptical don't like being on the bike So when I'm injured, it's tough for me because I don't like the traditional cross training that runners do. So typically what I try to do is still try to run on the injury and maybe incorporate some walking, which in a lot of cases is just exacerbates the injury. So I've listened to a lot of your podcast Brody and the mental aspect of this is huge. And when you have a sport that you've loved your entire life from childhood all the way up to, I'm 60 now. And that's your main sport. When that's taken away, the mental part is just tough. So, um, so yeah, through, through the PhD it's been, it's been a struggle. Let's talk about the PhD. So, uh, how long ago did, was the first onset of symptoms? Yeah, I I've replayed that week in my mind a hundred times. So it was the end of April, 2023. I turned 60 on April 14th. So I'd done a really heavy winter to get ready to. tried to break some American 16-over records. I was in great shape. I ran my first national competition on April 30th. And my goal in that race was basically to, it was a 10K, my goal was to go easy in the front half, pick it up in the second half and just try to get on the podium. And it was a hilly course. And I hadn't done any hills since the previous October because I was struggling with a hip, glute issue. Um, so I knew the Hills were going to be tough. So I got through the race. I did podium, um, ran a solid time, uh, felt, felt great the whole way. Um, and at that time of year in Minnesota, things had just started to turn. The weather just started to turn nice. Um, so we literally went from 30 degrees Fahrenheit to 70 degrees Fahrenheit overnight. So that, that week after the race, it was, you know, no shirt, shoes, shorts, and just flying down the trail. having a great time and great weather. So the next day after the race, that Monday, I ran way too fast, should have done a recovery day. Tuesday, same thing, ran way too fast. And even though it felt great, it wasn't recovery pace. And then Wednesday, I did my typical, you know, five minute pace workouts, about 5K of work at five minute pace. So super hard workout. So that's after a race and two fairly hard days. And then Thursday was the first day where I just didn't, you know, I was flying down the trail at seven minute pace, should have been doing 830 pace and it just felt hard. And then Friday, 10 mile run at the eight mile mark, that's where I felt it. So it was basically five days of hard work. And so I felt this pain right in the sit bone. I had two miles to go on the run, didn't think anything of it, never had felt that pain in my life. I've had many, many other injuries. So I didn't think it was anything serious because I thought I'd have had every injury in the book. It wasn't anything classic that I knew about. I had never heard a PhD in my life. So I get to do this 10-mile run and I think I'm fine. And then Saturday is my long 10K of workout at about 530 pace. So I had slated six by a mile at 530 pace and did the first mile and the dang thing just hurt. And I'm thinking this is more serious than I thought it was. Did the second mile repeat and it got worse. And then in the third mile repeat, I had to bail on the workout. And that's when I knew I had a problem. So it literally went from perfectly fine to a problem within within one day. Yep. And, you know, probably, um, the subsequent days being a factor as well. Like it seems like this all sort of was just building up and then all of a sudden manifested itself in a very short period of time and did there, you noticed pain at the sit bone area during running, was there any other symptoms outside of running that you know, started to become a problem. One of the weird things, and a couple of your other podcast members have said this, is that the initial, like when I got done with that Saturday work and was jogging around the track, the main thing that was stopping me wasn't the PhD, but it was the upper calf. So in conjunction with the PhD, my upper calf, and this is both on the left side, that was a huge factor. So I was limping around with this upper calf injury that really slowed me down. And that was the first part of the injury I really had to work through to get back into some kind of running to see how the PhD was gonna do. And so that was weird. And I noticed a couple of your other people that you had on said the same thing, that there was a calf as part of it too. So that was definitely part of my symptoms, the calf issue. So, you know, I... kind of feel blessed because the onset was Friday, Saturday. And then that Monday I went to see my sports chiropractor and I'm still thinking I'm gonna be back running within a week, right? Just a couple days off, I'll be fine, right? So I limped through a 10 mile run on Sunday, very, very slow, went to see my sports chiro and he diagnosed it as PhD. So within literally two days of the injury, I got a diagnosis. And he's like, He told me, you're going to have to be patient with this thing. You shouldn't be running, shouldn't be working out. But he didn't feel like he had the expertise to coach me and guide me into rehab and what to do. So he referred me to a local sports therapist to work with here in the States. But as soon as I got a diagnosis on Monday, I started doing my own research. So I put a blast out on Strava and I said, Hey, has anybody ever heard of this PhD? I got to know what this is and I started doing some online searching. And almost right away, one of the guys that fell to Manstrava said, hey, I had this and you got to connect with this guy Brody Sharp. He's got two podcasts. One is on this specific injury. And he sent me the link. I'm like, I'd never heard of this injury. And I'm like, you got to be kidding me. There's this guy that does a podcast only on this injury. You got to be kidding me. So I hooked up with your podcast literally within three days of having the injury. And I just binged the heck out of it. I nonstop like within probably three or four days, I had listened to like 70 episodes. So it was, um, it was extremely valuable to me because I, you know, initially I thought I'm going to keep running on this thing. It's not a problem. But then after I hadn't met with my sports Cairo and I listened to your episodes, I realized I really had to treat this thing carefully or I would, I might be in for a two to year, two to three year journey of this. Yeah. So it really scared me to the point where I treated it seriously. One thing that's so, um, different about your story, as opposed to a lot of the other stories is how quickly you've found the right information, got the right diagnosis, then started acting upon it. And, you know, you say that, um, it's probably, it would have been probably wise to not run speed session after speed session or run after run after run. When you started developing these symptoms. And yes, there could have been some decisions that you've made in that week that would have really accelerated the process, but the fact that you had a diagnosis in a couple of days and I hear almost on a daily basis, people reaching out saying, I wish I found. your podcast sooner. I've had this one year, two years, three years, six months. Um, the fact that you had the diagnosis so quickly found the podcast so quickly started jumping on the right information and the right exercise so quickly is. Very, very rare and glad that it actually happened. Um, was there when listening to the podcast, was there any major things that jumped out at you like anything that you wanted to initially do to start your treatment process. The one thing that, uh, and I forget who this was, but the one thing that really struck me that was the episode where, um, the gentleman was talking about doing his running is racing. He was working with you, I think. And, you know, it took him, I don't know, a year to figure out that he, that he had it reversed. He was, he was running, he was racing and he was doing the rehab. for his PhD kind of on the side. And he said, if I were to go back and do this, I would have forgot about the running and racing and everything which would have been about PhD rehab. And that would have been my focus. And if I would have done that, I probably would have rehabbed like a year sooner. And I heard that and I'm like, I've got to take that to heart. My focus needs to be rehab first, running second. And that was probably one of the things on your podcast that really struck me and helped me to kind of change my mindset. Because as a competitive runner, you're like, I still have to have these races on my calendar. I still have to look at, you know, am I going to reach these goals? And it causes you to train too hard and do too much and continue to aggravate the injury. So flipping that for me was huge. That really helped me a lot. Yeah. It's, it's a bit of a mindset shift because you need to sort of, um, move away from your identity as a runner in some. elements. And like you say, you're like, I've got races coming up. I've got goals that I need to hit. I want to keep running fast. I don't want to lose this fitness that I have. And like, you know, all of those emotions tend to boil up and people tend to continue aggravating this injury. Um, or they're forced to take time off. And then that tension, that rubber band just gets tighter and tighter. The more and more days they go off running, then as soon as they feel a little bit better, they're like, yes, I'm back. And they get back into running too fast, too far. And then the boom bus cycle repeats itself. And so glad that you had that. Realization you sort of flip the script. I often refer back to there's a book called rebound by Carrie Cheadle and she says that, okay, rehab is now your sports. You're not a runner. You're an athlete. Let's focus on shifting that identity around. I am a runner. Make it, I am an athlete. And as an athlete. Rehab now is my sport. Rehab now is my primary sport and, you know, re-prioritize things. So I'm glad that you sort of had that shift as well. Yeah. And that's exactly what it became for me, Brody. It became rehab as my, as my sport, as, as the thing I was doing for, you know, virtually five months of my life. I, my focus was the rehab, not the, the running and racing. And when I ran, I considered that part of my rehab. It wasn't a run, it was part of my rehab. And you do a great job in your podcast of kind of coaching that where we're going to keep running in the routine, but keep it at the pain level prescribed, make sure you're getting rebound within 24 hours and week over week improvement. And as long as you're doing that, running is actually strengthening the tendon. But if you go out of that recovery zone into the relapse zone... then you're going to just continue to relapse. And so once I, you know, listening to you and having you coach me on this, it really helped me take running out of training and into, into kind of the rehab zone. So whenever I ran to me, it was like, okay, I'm rehabbing my tendon. I need to keep the pain level here to rehab it. And, you know, somewhere down the road, I'm going to, I'm going to get back into running, but it wasn't, it wasn't I consider that training. I considered it rehab. One of the questions I had written Dan here was, Any mistakes that you did early on that may have contributed to an exacerbation of symptoms or, you know, prolonged symptoms, but obviously talking through your week of the. PhD onset. Um, it seems like, you know, going day after day after day after day, maybe it wasn't the wisest thing. Um, any other early mistakes that you may not have mentioned? Yeah. I mean, I mean, during that rehab process, even with your, you know, you, you prescribe like. day by day what I should be doing. And even with that, that competitive runner in me, I made so many mistakes. I'm convinced, it took me about five months, five to six months to get back into some relatively normal training. And I'm convinced had I not made those mistakes, I could have been back training in probably three months. But I mean, the onset was early May, and the mistake I made in May is I ran too much. You had prescribed kind of. you know, run walk program with very slow running. I ran too fast and I ran too much. So I figured that out. And then in June, you know, my club, there was a national mile race in June and my club wanted me to come run so we could keep at our, you know, top of the podium on the national list. So I'm like, oh, I can go run a mile and 520 pace, no problem. And it won't affect my PhD. This is six weeks in, Brody, right? So I go to run this mile race. I'm like, I'm just gonna do 520 pace. And the funny thing about that race was, it was straight up a street, you make one turn and another turn, and you go straight back down the street. So I go straight, the gun goes off, I go straight up the street, about a quarter mile into it, I hit it about five minute pace, it felt fine. As soon as I took that first left-hand turn, the PHT blew up just like that. So it just took a 190 degree turn to blow up the PHT, and I lost the whole month of June, because I went to run this mile race. I was basically the whole month of June, I took a step back. So May, too much running, June, I ran a race I shouldn't run. And then July, the big mistake I made I think was I rehabbed too much. I focused on rehab and I was doing rehab. You gave me exercises that we split up amongst three days. I was doing all three days every day, six days a week. So I just, you know, I wasn't in the recovery zone, you know. May, June, July, I was kind of learning the ropes on how to rehab the PhD. And once I got the handle on it, and once you and I started working together well, you coached me in some form stuff in the gym, which helped tremendously. And once I got that down and realized I really had to pace that out, that's when the recovery really started to accelerate. So those were the mistakes I made early on and through the first three months of rehab. So just to recap for people, um, so we started working together and I got a information about your history, about your running, about your, your injury and all those sorts of things. And, you know, straight away, people, it doesn't take a genius to work out that you're a go getter, you know, very passionate, very excited to, to dive into a lot of things and do so with a lot of enthusiasm. And so quickly realize those and needed. quickly realize that we need to pull the reins on you a little bit. Cause if we give you a little bit of slack, you're going to take that as an opportunity to do more, do faster things, you know, do heavier things and go for it. So what, what I did was sort of cap your pace and I don't, you know, sometimes people I'll say, oh, just run slow, just make sure it's an easy job. And that's all the information I'll give them. But for you, we had very clear instructions on pace to keep to, or don't go any faster than this. And. Granted, that was like a really slow for something that you would consider. Um, and I just remember assigning the week and coming back on another chat and you'd be like, yeah, I know you assigned this, but this is what I actually did. And it was a bit further. It was a bit faster and, you know, quickly learning through a few mistakes that yes, injury is not really getting better that, you know, maybe we should stick to the plan or maybe we should, you know, make these adjustments and. those sorts of things. Would that be accurate to say? Oh yeah, no, it's exactly right, Brody. Well, and once, you know, so that was the first three months. Then once I really started following the program and, and did the prescribed paces and cut things back to the point where you had, you know, basically you put a whole Excel spreadsheet together with exactly what it was supposed to do every day. And once I started following that and also got the right form in the gym. then things really started to improve quickly. And one of the biggest things for me was understanding the deadlift form and doing that right. I think that literally took me three months to get that down. And I remember you and I were talking and I'm telling you Brody, I'm doing the deadlifts and I don't feel it in the tendon. And he's like, you're like, send me your form. And so we worked back and forth on the form and once I got it, I got to the point where that was the best exercise in the gym for hitting the tendon. I could really feel the tendon when I did that, that deep squat on the deadlift, but it took me three, I'd never done a deadlift in my life, right? It took me three months to figure that out. Once I figured that out, there were two exercises, exercises in the jam that really started to help accelerate recovery. And that was one of them. For the listeners, let's go through. What was it about the deadlift that you think you were doing wrong to start with and what, what changed, what, what sort of What cueing did you use or what were you thinking about or how were you moving differently that made it so effective? Yeah, I think it was too much back initially. I was bending forward too much and not sitting and squatting enough. And once I learned to keep the back straight and kind of squat and sit back, that really helped because it's that sitting that really starts to compress the tendon as you go down. hit the tendon and start bringing the pain level up. One of the things I learned in the gym is I could handle higher pain levels in the gym. I could get up to a five or six on the deadlift and within an hour, the pain would be gone. Whereas if I was out on a run and I got up to a four on a run, 24 hours later, I'd still have pain. So I had to really be careful on the run part. But in the gym, I could really stress the tendon and it would be fine within an hour. So I, so I really pushed it in the gym and deadlift was one of the ways I did that. Yeah. Some people, you know, like to adopt a stiff legged deadlift, which would be similar to what you were doing previously, which is like, yeah, hinging a lot at the back and not really sitting back and pretending like you're going to sit into the back of a chair as you, as you deadlift forward and A few things with that one, like you say, it probably doesn't stretch the upper tendon or like provoke the upper tendon too much with that, that first initial technique. But the other thing that I've found is that if people try to do a straight leg at a deadlift, they, some people can do it, but once you start progressing the weight, you can't really do that heavy. Um, once you have a bit more knee bend, you sit back a little bit more, your weight is balanced a little bit more. You can progress up to, you know, 70, 80, 90 pounds, a hundred pounds. You can start doing that at a really, you know, you're more balanced in a more compact position. Whereas if you're trying to dip forward, like a drinking bird and try to also hold onto weight, the it's very, very hard to do that. And as we know on the podcast, slow, heavy progressive load is always the top of mind and you, you limit yourself and you restrict yourself way too much. If you try to attempt that. straight legged deadlift. So glad we've had some, um, glad we made that correction. You saw that benefit and you in particular, uh, because we were clearly dealing with a painful yet strong tendon. Like you had a really high capacity. You hadn't had a year of that pain rest weakness downward spiral because you were injured only to six weeks prior and you were running. really fast, really far and doing all that sort of stuff. So you were strong, which is probably why you found yourself could get away with a lot more in the gym. You could load it up and yes, it'd be painful, but you would return back to baseline relatively quickly, um, only because you had that foundation strength there and probably why you responded so well, was there any other exercises that you think might've been beneficial aside from the deadlift? Yeah, there was one other, just, just one other note on the deadlift and you, you helped me work. this was, as a 60-year-old athlete, this is mainly a runner and not a gym rat, one of the things I learned quickly was that there were other parts of my body that had to be strengthened in order to be able to build the weight on the deadlift, and the back was a big part of that. So I complained to you that I was having back pain, and you gave me a back extension exercise to do, and that was miraculous. I literally, I think I... I WhatsApp to you the next day after you gave me the first session and my back pain was 90% improved after one session. It was like a miracle, you know, exercise. I couldn't believe it. So you know, as a 60 year old just building up the infrastructure around the body so I could do the deadlifts at the weights I needed to strike the tendon. was a big deal. So that's why it really took me some time to build that deadlift up to a point where it could impact the tendon because I had to build up my back, I had to build up my glutes, I had to build up my abs. You know, all those things that maybe a 30-year-old or a 20-year-old doesn't have to do. So there was a lot involved in getting that deadlift right. The other one that really hit the tendon was, and I'm going to call it like a kickback where you basically have a kind of semi straight leg and you're on a kind of a nautical, you know, a weight attached to a wire and you're kicking that backwards behind you. Um, and that really targeted the tendon well, and I don't know if you have a, you know, an official name for that Brody, but there isn't really like, I call it standing hip extension because you're standing and you extend your hip backwards and you do so under resistance. So there's no fun name for it, like a crab walk or like a scooter or something like that. But yeah, standing hip extension. If people want to Google that, that's the exercise that will pop up. Okay. Yeah. So, so actually we had, I don't know, half a dozen exercises that you had prescribed. Um, and those two hit the tendon so well that today now as maintenance work, I'm only doing those two exercises. Um, and it seems to be working really well to maintain the strength of the tendon. At some point, I think probably what I'm going to do, I'm kind of at the racing cycle end of my season. I've got a race tomorrow and then two more weeks of racing and then I'm going to back off for the winter. In the winter, I think I'm going to cycle back, add in those other exercises and focus on the strength of the tendon through the winter so I can come off the winter and have a healthy spring. So I think I will have to add those back in. But right now, I'm doing 75 miles a week. and I wanted to back off on the weights to get the mileage up. And having those two exercises in seems to have worked really well. But I do, there's still pain there. It's not 100%. I would say the tendon is probably maybe 85, 90%. And I wouldn't want to race beyond these three races without going back and circling back and strengthening the tendon. So, um, so December 9th, um, 2023 is going to be my last race. It's kind of the Superbowl of racing. All the top runners go, I'm going to run that race and then cut it off for the year and, and focus on the tendon for three months. Yep. Okay. Anything else that you found positive in your rehab that might've been in the running, might've been strength training, might've been outside of all those things. Anything else that you found helpful for your recovery? Yeah, there's. There's, and we'll get into this maybe when we talk about things that I learned, but one of the biggest things to me was keeping the same routine. You're injured and I was running 10 miles a day before we connected, it would take me 75, 80 minutes to run that 10 miles a day and I have a whole routine around that. It's getting ready for the run, it's eating the right things, it's cooling down properly, it's getting the right electrolyte drink afterwards. sleeping right, proper nutrition, all that stuff, you know, when you're injured tends to go away. So one of the things that I did in this injury was I kept the same routine. I mean, I wasn't running the 75 minutes, but I was jog walking the 75 minutes and I kept the same warmup routine. I kept the same cool down routine. I had the same electrolyte drink when I was done. I slept the same amount. I kept the same routine as if I was running my 10 miles a day. And that really helped me maintain just the mental health of being an athlete and being a runner. So I would highly recommend anybody, I mean, maybe it's biking for you, maybe it's swimming, maybe it's whatever that is for you, but do that same block of time and don't change anything. Don't change your sleep, don't change your nutrition. Because in the past, what I would do is if I was injured, I'd be like, oh, I don't have to eat, right? You know, I don't have to sleep right. You know? So, and that just causes a mental spiral. So this time I did it differently and it worked out really well. Yeah. I often talk about the pain, rest, weakness downward spiral, which is very much like physical attributes, like, you know, physically weakening, but there's something to be said for, I should come up with some sort of spiral that's on the mental side of things, because one thing I was going to mention is just coming across and like having chats with you. You seem very energetic, but overly positive at the same time. Like you would even making very, very small improvements. You'd just be over the moon and you would, you know, ready for the next thing. And that you just saying that really highlights the, the approach that you take trying to keep as still keep your head in the game, still keep positive, still keep that same routine, still treat yourself like an athlete, still do the same. positive mental elements, because people can easily say, oh, damn, I'm injured. No one likes being in pain very, very easily to think negative thoughts, have negative outlooks. Pessimism in general, just when you're in pain, people just naturally do that, but they stay in bed longer. They eat worse foods. They don't drink like water like they used to. Their nutrition suffers. Their stress is negatively impacted. And that's has such a handbrake on your recovery. There's so many elements, so many different avenues that, um, control how quickly you can return back to and how fast that tendon can heal. And if your mental and everything outside of that is being negatively influenced, it's just putting a handbrake on your recovery. So glad that you mentioned that. Yeah. Maybe, I mean, it took me five months to recover five, six months to get back to. relatively normal training and maybe that, I actually felt blessed through the whole process and part of the reasons I felt like that was just listening to the journeys of all of your, the podcasts that the people you've had on your podcast and some of them have had it for two years and three years and 10 years and misdiagnosed 10 times and it's been such a long journey for these people and I just feel blessed that I had it diagnosed right away. I got on it right away and I just always felt like I was on the right path to recovery. I always thought it was going to be next month, but it was next month, the next month, the next month. But five to six months for this injury is just, I mean, I just feel blessed that it took such small amount of time and I got on it right away. I got to the right people right away because if you get misdiagnosed or you haven't been been able to treat it for a year, then it's going to be a little bit of a longer journey, you know, so I had the positive attitude the whole way. I just felt like I was on the right track and we were doing the right things. Yeah, anything, any elements in your recovery that you didn't think was helpful or you think was a waste of time or detrimental and, you know, it could be some of the exercises I assigned or some of the advice I offered. Oh, you know, my feelings won't be hurt, but anything you can think of. Yeah, I think the main thing was just my desire to move the rehab faster than my body was ready. You know, I ran too much in the first month. I rehabbed too much in the second month. That created setbacks. I ran a race six weeks into it that created setbacks. So I was just trying to move it along too quickly. I mean the... And this is pervasive across all your podcast episodes, and I'll repeat it, you just have to be super patient with this injury. If you think it's gonna take a week, it's gonna take four. If you think it's gonna take a month, it's gonna take four months. It just takes time for this injury to come along. And one of the things that actually I did in my recovery is the recovery is so incremental that... sometimes you don't feel like you're making progress. So Strava really helped me keep a journal of where I was a month ago, where I was two months ago. Because if you're looking at week by week, it's so slow that you just sometimes look back and say, ha, I'm not recovering, right? So I started to do, instead of one week increments, I would do two week increments of kind of looking back where was I two weeks ago. So. I did two week increments of where am I, and I kept a journal through Strava of everything I did, how I felt, what the pain level was, what the pace was. Doing that, you're able to look back and say, man, a month ago I could only do nine-minute pace and I was walk-running the whole thing. Now I'm doing eight-minute pace and I'm running. That really helped me see that there was progress there. That's to me something that was a huge help. But the stuff that, I mean, the stuff that didn't work, I created that myself by just pushing it too hard. Well, that's what I was thinking. Like you mentioned jumping on a diagnosis quickly, jumping on the right rehab quickly, and then you say, yeah, but it still took five, six months to, you know, get to a stage that I was happy with. And people might be thinking, damn, if he had such a quick reaction to doing the right things and it took him six months. But part of me thinks like, how long would have taken if We didn't have a month of running too fast and we didn't have a month of, you know, rehabbing to too much. And we followed. We, we progressed at the rate of what your body was telling you. We should progress listening to your body to see how much running was acceptable, how much speed was acceptable, how much rehab was acceptable. If we did that from the get-go, part of me thinks of how quick that process may have been because it's not just as simple as, okay, we did. We overloaded things for the first two months. Let's start from a clean slate and then see how things go and, you know, maybe it would have been two months quicker. I think it would have been even quicker than that because not only are we dealing with two months of mistakes and setbacks, but that is compiling two months of irritation, like that takes longer to settle down because the longer you've had the injury for generally speaking, the longer it takes to get rid of. So maybe there was some sort of. compounding effect and it might even been sooner if we would have jumped on and done the right things earlier. I totally agree with you, Brody. I mean, I don't, I mean, the way I look at it is I had onset in early May, but I didn't start rehabbing this thing until late July. I mean, I didn't even know how to do a proper deadlift, right? So now that's one of the main things that was, you know, the help by rehab. So I think we could have rehabbed this thing and inside of three months had I done everything properly, but you know, I mean, you know, live and learn and. Um, here we are, but I feel, I mean, I feel great that I'm here and, you know, at the end of my season, able to get out and do the races I want. So I'm happy with the way it went, but yeah, had I, if I were to go back and do it again, I think we could have done a lot. I could have done a lot better and probably been out there, you know, in August, September, and yeah. But yeah. Like you said, you've still got some symptoms. You're probably at 85, 90% recovery. You're running races. Um, I have the question of like what you're able to return back to like in, do you feel like you have any restrictions in terms of the amount of speed or distance that you want to cover? I don't think so. I haven't fully tested it yet. I'm, I'm running. I haven't, um, had, I haven't had to do anything different with my workouts than I would normally do this time of year. Um, I think I'm in probably 90% of the shape I was in before I got the injury. But it's cross-country season, you need more strength and speed, so I've been working mainly on strength. The two things I really haven't worked into my program in an intensive way yet are hills and the five-minute pace workouts that I was doing back before I got injured. I'm doing plenty of 520, 530 pace workouts. I'm doing hills at a training pace, but no hills at a workout pace. I just didn't feel the tendon was ready for that yet. I don't need it for the races I'm running. I've been able to do the entire training program that I outlined for myself in the fall. I've been able to do the entire thing without compromising any of it. Once I get into winter and I've strengthened the tendon even more, I'll work hills in and some of the faster paced stuff in, in the spring. But, um, but yeah, that's, I'm basically back to, you know, where I would, what would want to be this time of year. Excellent. One thing I want to touch base on is the calf. You said that initially your onset of symptoms were, well, mainly what stopped you running was calf symptoms. How did that play out as the rehab went on? That was fairly short-lived. That probably lasted two weeks. So it was pretty tender for two weeks. I have a massage therapist that worked on it. And I know some of that is controversial, whether that helps, but it seemed to have helped the upper calf to loosen up that muscle and get that corrected. So that was literally a two, maybe three week thing. And then it was just on to the more critical injury of the PhD. Um, but I did think that was interesting that there were several people besides me that had the same, you know, co coinciding symptom. Yeah. So, and I have had people develop PhD and then develop an Achilles tendinopathy afterwards and same, same complex, same calf Achilles complex. Um, will I, will I say that I know what's exactly the mechanism of what's going on? I'm not going to say that cause there could be. A number of things that could be some like nerve irritation that travels further down the leg. And maybe it's like pushing yourself too much. Maybe when you're doing, maybe there would have been like a, hypothetically, if you were doing all those sprint sessions and even though the symptoms in the tendon in the hamstring tendon weren't manifesting as pain just yet, maybe there was some lack of force production around the glute hamstring area, which meant the calf had to pick up some slack and I very, very hard to say. Um, and almost impossible to know for sure, but, um, I just thought I'd put it out there because you did mention that earlier and if someone's going through a similar thing, I thought I'd just let them know that I don't know exactly what's going on and that, um, yeah. Yeah. I think there, there is a lot to be said about compensation when you're, you know, you, when you have an injury and you have pain, you, you think you're running your normal stride, but you're, you're still compensating for that pain. and that puts extra stress on other parts of the body. So it may have been a huge factor in the calf being an issue. One of the other things I'll mention was you have a lot of podcasts on increasing stride frequencies, shortening your stride and increasing turnover. And with the PhD, that helps tremendously if you have that short, high turnover stride. So throughout that five month journey, I've developed this kind of short, high turnover stride. that I've never had in my toolkit before that I don't use during races, but I've used it plenty of times on my training runs because it just reduces the pain and reduces injury risk. So I'll be on a training run now. I mean, my stride turnover was 165, 170. Now I can do 200 and still hit the same pace and really have, it just feels better. It feels, I feel lighter on my feet. It feels like the PhD tendon isn't stressed. So one of the things this has done for me is just added this new stride to my toolkit that I can kick in anytime I want. If I want to reduce stress on my body, you know, so that's been huge. Glad to hear. And probably something that, you know, runners with PhD can, can try out. Um, I'm glad that you said that you've tried that. It feels really good for you. It feels good for the tendon, feels good for your efficiency, feels good for your, um, you know, just running form in general and You know, maybe someone hears that and tries that out, tries bumping up their cadence and seeing if that has the same effect. So thanks for sharing that. Um, yeah, no, it's worth, it's worth trying. And you had a couple of tips about maybe putting on some music with the same beat that you're trying to emulate with your stride and that, that worked for me. I had my hair, but then I had the beat going and that really helped me learn that new, that new turnover and that new stride. So, so yeah, no, it's just another tip that I learned during the journey. Excellent. Well, As we sort of wrap this up, is there any other final bits of advice, um, tips, tricks, you know, reminders that you might have for people who are struggling with PhD? To me, the, the first and foremost thing that, that helped me was getting professional help. Um, you know, initially I got on your podcast within days. Um, it's a great place to start. Um. If you end up with this injury, look for the best there is out there. There's a lot of Facebook, Strava, non-scientific rhetoric out there that you have to weed through to get to the real scientific factual ways to rehab the tendon. So initially, I weeded through some of that stuff. You and I talked about this, Brody. There's... a guy in my club that claims PRP, helped cure his symptoms, and he has no scientific data. There's no scientific data to support that. There's other wacky therapies out there that don't work. So get professional help, do your homework, study it, and find somebody that knows what they're talking about to help you. And for me, finding you, Brody, and having somebody who's dealt with this for decades and had... you know, thousands of PhD cases was huge because I, you know, I'd never heard of it. I, you know, the guys around here didn't know how to rehab it. And for me, I mean, my goals were to break some American 16 over American records and I wanted the best rehab advice. So you know, that to me is the biggest thing. Find somebody that you can go to that has scientific based, you know, information that can help you, help guide you through it. I think another thing is, we talked about this earlier, treat the injury first and foremost. Take all the races off your race schedule. If you have a race schedule for the year, just eliminate it. The focus should be on the rehab. The more pressure you put on yourself to make a race or to get to a race, the worse it's going to be. You've got to be patient with this and the focus should be on just rehabbing the tendon. So that was a huge thing for me when I took all the races off my schedule and just focused on the rehab instead of the racing. That's when things really started to improve. Be super patient. To me, patience was tough. And there's a lot of ups and downs. I mean, there were days where I thought, oh, the thing's fixed. It's solved. I've got no pain. And there were days where, you know, the next day it would be, you know, six pain trying to run. So Don't get caught up in the ups and downs. It's a long journey. Don't get too excited over the good days. Don't get too depressed over the bad days. Just keep at the rehab and look at week over week improvement and it will improve. Let's see, what else? We talked about keeping the same routine. That was huge for me. Don't change your routine. keep the same nutrition, keep the same amount of work you're doing if you were running for an hour, then bike for an hour. One of the things that really helped me was surrounding myself with just super positive people that were supportive. People like you, Brody, to help me through this. I've got a whole community here that was just really positive about supporting my recovery. And I think that's huge for recovery and for mental health. that really helped me just keep positive and keep the people around me that were positive. Keeping a journal was huge. I mean, I did it through Strava, but if you do it through a notebook or whatever, just a way to look back and see your improvement. I mean, when I look back at what I was doing five months ago, I can't believe it. I mean, I was like running 10 minute pace, walking and running five months ago and now I'm. I could go out there and run 530 pace. So the journal is important, because the week on week improvement can be so slow that being able to look back is important. One of the things that worked for me on the journey was staying on soft, flat, straight trails. No hills, no pavement, minimize the turns. I learned in that mile race that all it took is one 90 degree turn to blow the thing up. So I've got some great trails by me that are groomed, that are flat, and I would just do out and backs on soft, flat, straight trails. And that helped me tremendously. One of the things I did a little bit different during the learning process is I learned that the pain level in the run for me had to be a one or a two. If I tried to... If I did a three or four pain level on the run, I wouldn't get that week over week improvement that we talked about. And I don't know if it's because I have a high pain tolerance or I'm just fooling myself that it was a three and it was really a six, but I had to take the three or four off the table and I had to, on the run part, it had to be a one or two. And once I did that, then things really started to improve. So I had to be super careful on the pain level on the run. And this may sound weird, but I mean, intuitively, I could tell if I was in the recovery zone and the rehab zone when I was running or if I was in the relapse zone. I just, I don't know why, but I could just tell and I just ignored it. So I'd be out there running with pain level four, knowing that wasn't a healthy pain and saying, Oh, Brody said I could go to a four. I'm going to a four, right? But once I started listening to that voice that said, this isn't healthy pain and backed off to a one or two, that really helped me. So, listen to that inner voice. If it's telling you it's too much, it probably is. One thing I want to mention as well is, um, your deadlifts, how heavy, how many, how many sets and reps are you doing at the moment? Yeah. On the deadlifts, um, I didn't have to get too heavy to get the results. So right now I'm at 70 pounds and I do three sets of 10 reps. All right. Good to know. It's a good reference point for a lot of people to, um, to hear. And I think big overarching, uh, theme. benefit that's really helped you is, okay, finding that adaptation zone. What does that look like in your running, whether that be speed, whether it be volume, what does that look like in your strength training or cross training? Um, finding what that zone is and training within that, and then progressing that adaptation zone at the rate that your body is going to allow. And there was a lot of trial and error in the early days. There's a lot of lessons to learn in those early days. But. Like you said, things really started kicking up a notch and things started really progressing quite quickly. Once we found that adaptation zone, we found out, okay, what speed can you tolerate? What days there were some slow days, slow running days with some slightly faster running days and that balance tended to work out well symptom wise, the deadlift action, um, trying to stimulate that right area and then progressing that at a rate that your body would allow. Once all those things kind of clicked into place, um, things magic started happening quite quickly and the journey or the goals that you had were far superior to a lot of other athletes. Um, you know, you've got really strong pace goals, high mileage races, you know, big ambitious goals, all that sort of stuff, which is really exciting. Just means our, our reference point is so much higher and the rehab would take longer with it being such a, such. big goals, but I think that's a very overarching theme. And I think a lot of people, no matter how severe their PhD is, no matter how long they've had it for, no matter what their goals are, I think retreating back to, okay, what can I tolerate? How much can I tolerate? Almost doing as much as you possibly can tolerate and then moving and progressing at the rate that your body will allow. And it's all about trial and error, tuning in, listening to your body, accurately interpreting symptoms. I think that this success story really encapsulates that quite well. Um, anything else before we wrap up? Yeah, I would just say that that's exactly right Brody. Once I learned to stay within the adaptation zone and not step outside that, that's when, that's when things really started to accelerate and it just took me a while to, you know, with your help, rein that in and also learn where that app to edit tape, edit tape, adaptation zone was, but that was the key. I would sum up, sum it up as. You know, staying within the adaptation zone and, and that was really, that was really when things kicked off. Excellent. Well, good luck with your upcoming races. Good luck with your, um, rehab that still continues to this day. And thanks for coming on and sharing your story. It's going to help a lot of people. Yeah. Thanks Brody. I appreciate it. Thank you. Thanks for sharing your expertise with me and you know, the work you're doing is definitely, um, out there because I was able to find you with a within a few days of getting injured. So you're doing some great work, man. You're very welcome. Thanks once again for listening and taking control of your rehab. If you are a runner and love learning through the podcast format, then go ahead and check out the run smarter podcast hosted by me. I'll include the link along with all the other links mentioned today in the show notes. So open up your device, click on the show description and all the links will be there waiting for you. Congratulations on paving your way forward. an empowering pain-free future and remember knowledge is power.