Q&A: Combining Rehab & Run Days/Flare-up Plans/Sciatica Symptoms/Finding a Good PT

: On today's episode, I'm answering all of your questions with another Q&A. 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. Following this particular theme, I've asked for your questions and I have received plenty. And so putting them into a series of about three episodes, last time we covered tendon flare-up confusion, how to measure progress, chronic pain, susceptibility, and also preventing PhD. So this time we're talking about a few different things coming in from... four different questions and then next time I think I'll answer four more because some of these questions are so great I can't really leave them out. So let's dive in. We have Phoebe who says, when you realize you have pushed past your adaptation zone in PhD recovery, for example, on running longer or faster than had intended, what is the best post workout plan? Anything to prevent or reduce the inevitable flare up? So we have another flare up question coming in and essentially asking once you've exceeded that adaptation zone and things start flaring up, what's the best plan? What's the best approach and how can we prevent a flare up in the future? So thanks Phoebe for your question. I think I have a couple of episodes around this and I don't expect everyone to listen to all of the episodes that I have available because I do realize that there's a lot on there. But I like to say that every flare up is different and our workout, our post flare up plan would depend on that severity. And often when I work with my clients, I'll have, if they request it, I will develop a flare up plan, but it won't just be as simple as, if you have a flare up, this is what you do. I sort of categorize them into mild, moderate and severe flare ups and each action. requires a different approach. And you can have a scroll back through the feeds and find the flare up specific episode if that's something you're more interested in. However, I'll go through this as a bit of an example. So mild flare ups don't require a lot of action. A mild flare up would be something that's like one or two of an increase against your baseline. So if your baseline is a one or two throughout the day, and it gets up to a two to three, that is a mild increase. And so what we should do on those circumstances is if you're a runner, think about some modifications that you can do when you're running. If speed work is already implemented, I'd definitely back off speed work during any flare up, even if it's just mild, but you might still be able to run. You might still be able to run at the same volume that you did previously, we're just backing off say, hills or speed. When it comes to the gym and your rehab exercises. If you do have a flare up, I often just keep everything the same, particularly if nothing within the gym setting caused that initial flare up. So if you had a mild flare up because you increased your weight on your deadlifts or you increased your range of movement, then we'd make that modification. But if it was a flare up due to your running, I would probably keep your gym exactly the same, or at least trial that and see how you respond. Unless you're doing some sort of plyometrics, because that's a bit different. If you're doing plyo lunges or wall balls or kettlebell swings, those sorts of plyometric activities, I would most likely rest for a couple of days or modify them during this mild flare-up phase. But once the mild flare-up has settled, I would then go back to resuming. what you've done pre flare up. For a severe flare up, this is when we take it quite different. We could back off most exercises for two to three days, let things settle, and then our reintroduction is where it becomes a little bit more tailored. So you might return back to running or might return back to the gym first. Usually returning back to the gym is a bit more of a safer option. two to three days rest. Let's say day three, return back into the gym at about maybe 75% capacity, like 75% of the weights that you did previously, and just see how you feel. If that's successful, then we would probably go to 85. If that's successful, back to 100. Once you're at about 85% back at the gym, maybe we might start dabbling into some cardio if the example is running. maybe let's try it 50% of the volumes you were doing pre flare up, see how symptoms feel. Again, we wanna test these things, conduct our own little experiments, see how symptoms behave, and based on how symptoms behave, make the necessary adjustment. So if you return back to 50% running, and it flares up again, or it doesn't continue settling down into a pre flare up state, we might need to have another couple of rest days from running and just continue in the gym setting, or instead of 50%, maybe we back off to 25% or back to a run walk kind of schedule and see how that feels. So everything's a bit different Phoebe. So coming back to your question around, you know, what do we do? Um, hopefully those just few examples is just something that you can create a bit more of an experiment. see how it goes and then based on that move forward from there. I will say that we can learn from our previous flare-ups. We can take a lot of positives away from flare-ups. In fact, while I don't want to celebrate when people are in pain, I do like to reassure people that it's very helpful, especially from a physio and from a client point of view, that we know where that flare-up is because that's Rehab is always about flirting with your limitations, flirting with what you can get away with, what increases can we make, what gains can we make, how quickly, how fast, and the flare ups are just a little reminder, okay, this is currently our ceiling. Let's back off a little bit. Let's train a little bit lower than our limitations right now before we continue moving forward. It's just a part of the journey. When I work with clients and rehab them, I like to explain. flare-ups, they're a part of the process. We want to make sure that everything is very closely monitored. This is kind of like the second point. So the first point I had written down is, we can all learn from flare-ups and flare-ups are a part of the journey. The second part is we wanna closely monitor and measure what we do. So if he'd be said, for example, if I run longer or faster than intended, then it causes a flare up. I would say why you shouldn't really be running longer and faster than intended because we should have a roadmap. There should be some sort of plan, some sort of monitoring, some sort of measure to make sure everything's systematically being progressed because if we don't measure it then we can't execute on it accurately and then if there is a flare up it's really hard to go back and say okay where did I go wrong. So really monitor. If you're not a runner monitor whatever cardio you're doing. If it's just rehab, monitor the sets, reps, weight, how often you're doing it throughout the week, what your rest periods are like in between those exercises. Really these sort of factors we need to consider. Also factors outside of your rehab. So like how much sitting you're doing, how do you have to go for a long drive if so, or if you had to attend a meeting, if so how firm was the surface, all those sorts of things. very, very helpful for, I guess, understanding if a flare up did take place. Why did it take place? Because then we can learn from it and we can measure it and then make sure we're a bit more cautious in the future. Why I say with clients that flare ups are just a part of the journey. While I say that, I also like to say, but if we do monitor and measure, When you do encounter a flare up, it's only for one or two days because you've only just moved a very gradual step to then discover that limitation. So we could be progressing, say, speed work. Let's just say you've built a big running base where you're running continuously for 30 or 40 minutes without any irritation. Then we start implementing really trickles of speed. which usually come in the form of strides or something along those lines. So that if that initial speed session flares things up, we know, okay, that's your limitation. But the introduction into speed has been so minute, so gradual that you only have a flare up for one to two days. Then we learn from it, we change the plan around and we're back to running and having another speed session in a couple of days. That turnaround could be quite effective and we can learn a lot from that. But if you decide, okay, I'm back to 30 to 40 minutes running slow without any irritation, let me just try 30 to 40 minutes slightly faster. And then unbeknownst to you, that's too much. It's quite a lot. And you have a flare up for five days. And you know, you have to wait until seven days until everything's really back to baseline. Then you've kind of lost yourself a week. You're not too sure to do within that week. You can lose a lot of confidence and that scenario is never great. So while I do encourage that we can learn from flare ups, we want to make sure that every progression is very minute and yeah, we just take it from there. Thanks for your question, Phoebe. We have our second question coming in from Jackie who says, do you run on your off days or strength days? Otherwise, how do you track what may cause a flare up? So Jackie, I think you answered your question. I think you already answered it within the question. Um, you're asking, okay, do we run on our off days or on our strength days? Um, and I guess my advice would be yes. Um, initially we want to separate things out. We want to, it's even just aside from running and strength, like when we introduce something new, we do want to. isolate the variables is what I would say. So sometimes when I have a new client, and they're just starting with their rehab, and we're just trying to work out what they do, I can sometimes list six or seven rehab exercises that I think will be really good for them. But if I don't know a lot about them, if they haven't had a lot of rehab experience, if we're, if there's not a lot of strength involved, and we don't believe that, well, we believe that we're kind of starting from baseline. I would assign like a strength or a rehab day for them, but initially, sometimes I like to separate out those strength exercises. So let's just say I assign seven exercises. It might be deadlifts, it might be step ups, it might be hip extension with a band, it might be crab walks, it might be hip hikes, hip thrusts, those sorts of things. Then I might say, okay, we don't know how you're going to go with these exercises. We're not entirely sure, but what we don't want to do is do all seven exercises and then have you flared up the next day. We don't want that scenario because we're not sure what exercise it was. We're not sure if it was all the exercises altogether. Was it all the exercises plus sitting or something else that you've done throughout the day? How about we take just for the next couple of days, a bit more of a gradual approach. and let's separate them out. So here are three exercises. I think maybe the deadlifts might be the most challenging. So let's do deadlifts, then hip hikes and crab walks, which aren't, it's sort of strengthening the glutes, those other two exercises. So we'll know if the hamstring sort of flares up after that day, we'll know it's the deadlifts and we can make a gradual approach. Maybe we reduce the weight or reduce the reps or reduce the range of movement and learn from that. But then, Once you've done that, those exercises, and you've returned to baseline, and we know you're safe with them, then the next day, let's try the other four exercises, which aren't as demanding, probably some, a lot of them are hamstring focused, but they're kind of light to moderate exercises. So give them a try. And then once we know you're okay with those, okay, in two days time after that, we're gonna do all seven exercises all together to see what that's like. And we learn from that. Sorry, Jackie, I'm probably going off on a tangent on your question, but this just illustrates my thinking process when it comes to isolating the variables. So back to your question of do you run on your off days or do you run on your strength days? I would say have confidence on the isolate the variables first, have confidence with each variable. But then you can start combining them once you have confidence. So let's just say you want to try increasing your running. Uh, let's say you want to go from a, uh, 15 minutes continuous run to a 25 minute continuous run, and you also have, um, some strength days throughout the week. I would isolate that particular run because that's an increase. That's a change in a variable. So let's do that on a separate day and see how you feel the day afterwards and leave all your other strength days. But if throughout the week, you know, that you're really confident with a 15 minute run and you know, you're confident with a strength, with your usual strength rehab days, let's combine those and see how you feel after that day. And if the combination of those two are fine, then maybe we can do the combination of those two once or twice a week. So the week might look like you might have some isolated strength days, you might have some isolated running days, but then you might also have a combination of the two, maybe once or twice a week. But when you decide to increase your strength, you would increase your strength, if you decide to increase your strength on one of those combination days, you wouldn't increase your strength or and increase your running on the same day. because then if you flared up the next day, we're not too sure what it was. So we're just learning from that process. So let's just say you had a combination of those days. Okay, let me keep to my 15 minutes of running, but let me increase my weights of my deadlifts on that day and see how I feel. That increase in deadlifts is only just gradual, but I wanna see how the combination of those two go, run that little experiment, and then just move forward from there. They're all just little lessons. And hopefully, you listening to this now are realizing that you do need to put your scientific hat on, you do need to treat yourself like a scientist and run these little experiments. They do need to be documented, monitored and gradually progressed. And in the process, you learn more about yourself, you learn more about what your capabilities are, which is always a good thing. This podcast episode is sponsored by the RUN SMARTER Physiotherapy Clinic. which is my own physio clinic, where I help treat a wide range of PHT sufferers, both locally in person and all over the world with online physiotherapy packages. In the years I've been self-employed as a physio, close to 70% of my entire caseload has been helping people with proximal hamstring tendinopathy, which is why I decided to launch this podcast. So if you're building upon your own rehab knowledge through the podcast, but still require tailored assistance, I'd love to be on your rehab team. Whether you are a runner or not, head to runsmarter.online to see your available options for working together. If you're still unsure if physiotherapy is right for you, or if you need a rehab second opinion, you can always schedule a free 20 minute injury chat with me. Find the free injury chat button on my website or in the podcast show notes to be taken to my online calendar to book in a time. Moving along now, we have our next question from Mary. Mary says, how does the sciatic nerve factor into this injury? The nerve is next to the tendon. Um, can, how can you determine if the injury is hamstring or sciatica? And this is a very good question and something that I hear a lot on forums and I'm not quite definitive with my answer, but let me just talk through my thought process. Um, yes, the sciatic nerve is very closely related to the tendon. They just run parallel to one another in very close proximity. And it can be very easy to assume that the sciatic nerve can be impacted if the tendon itself is impacted. There's a lot of talk about scar tissue, a lot of talk about tears, a lot of talk about you know scar tissue covering the sciatic nerve and trying to release the two. And This might lead to more kind of confusion, but I haven't yet seen compelling evidence sort of linking the two. I sort of haven't seen enough compelling evidence that scar tissue really has an impact or really is, I guess what, painting the picture of the tendon itself being torn or like recovering or undergoing a lot of degeneration or something, and it creates some sort of scar tissue that attaches itself onto the sciatic nerve. I am yet to see that. I'm yet, I'm not saying it doesn't exist. I'm not saying that the surgeons that talk about it and the health professionals that talk about it are wrong, but I am very cognizant to know that a lot of threatening language that does exist, does it, that is still circulating a lot of the rehab community just doesn't really exist. And this is just another example of. threatening language that surgeons and health professionals like to use to get people on board or to spark them into action or to take a surgery or to have a scan or to do this rehab or shockwave or have these injections. I am, like I said, I'm yet to be convinced is what I will say. Not to say it doesn't exist, I'm yet to be convinced because tendinopathies themselves, the actual pathology, doesn't really show too much like on scans. You can have like a tendon, let's just say it's the size of your thumb, and the portion of that tendon that's causing the pain is only just 10% of that tendon. In the most severe cases, I would say close to 50% of that tendon is unhealthy, and there's still 50% that is really healthy and behaves the same way a normal tendon does. That is in the worst case scenarios. and in most cases you can have a really sore tendon. It doesn't like the level of degeneration or the level of severity doesn't really correlate a lot to pain. So you can have a really sore tendon and only one to five percent of that tendon be affected, negatively affected, but you can also have like 25 percent of a tendon be affected that is pain free. we've seen in Achilles tendons all the time, like a really poor, vascularized, disorganized tendon, which doesn't have any pain whatsoever. And we usually see say like a 50 year old male who's been sedentary for two decades, then tries to sprint and then ruptures his Achilles. Pain-free, he was pain-free for, you know, his whole life. but all of a sudden has a complete rupture of his Achilles and look at the scans and show that was actually a really unhealthy tendon with a lot of degeneration and pain-free. And so on the opposite side, you can have a really sore tendon with not a lot of damage. And if you've had scans and it has shown tears and all this threatening language and you think that scar tissue might be impacted, I think tears are somewhat normal. I've had a client a few months ago have her proximal hamstring tendon scanned and it shows that she has a tear in her proximal hamstring tendon. They measured out the dimensions of it. They said it's a, you know, four mil by six mil. I can't really remember the dimensions. And she thought, okay, do I need surgery or not? And sort of weighing things up. And then a couple of weeks later, they... the imaging place rang her and said, we actually scanned the wrong hamstring. It was actually the other side that was scanned and that hamstring itself was asymptomatic, perfectly strong, perfectly like well functioning and hadn't had an issue with that hamstring in the past. And so they're like, well, what's this tear that they found? Well, maybe that's just incidental finding. Maybe that was there all along and it's completely normal that that's there. So we need to be very careful with how we sort of interpret these. And again, sorry, Mary, I've gone off on a tangent, but these are the things I think about when we ask these sorts of questions. I go on a whole bunch of different tangents. Hopefully you're enjoying this journey of my ramblings and we're sort of, it's all being kind of valuable, I guess. But then we're coming back to the talk about scar tissue and you know, what's that like? but these scans show this, so surely there has to be some sort of scar tissue and surely it has to be impacting the nerve. Look, I'm not sure. It's all, the gray area is a bit too much. Your next question or the next part of the question Mary was like, how can you determine if the injury is hamstring or if it is cytokine? I do think cytokine is very overprescribed. I think anyone with probably about 10 years ago, anyone with sort of back pain, glute pain. back of the leg pain, calf pain, foot pain. It seemed like they were just being diagnosed with Cytica and off they went. But what I would say, if you're unsure if it does have Cytica symptoms, there are some, what I believe to be sort of common symptoms associated with Cytica. Symptoms below the knee would definitely be one of them. If you have symptoms that are just high localized high up on the hamstring and the glute area, it's probably not cytica. If it's symptoms radiating from the hamstring or from the proximal hamstring down the leg and past the knee, then maybe. If there are pins and needles burning or numbness around the feet and you also have low back pain and glute pain, then maybe. If it's concurrent with low back pain. if you have pain in your hamstring and you also have pain in your lower back, and on the days where you have increased pain in your lower back, you also have increased pain around the hamstring, then maybe again, that is, that could be contributing to Cytica. If another reason that you might suspect it is if you're non-responsive to PHT rehab, Um, sometimes we're not too sure. Sometimes we can't do all the tests under the sun because it is through an online forum, but if it's, if we're unsure if it's fitting one or the other, we can treat it like a PhD and see if you respond to that treatment. Because if you respond to that treatment, then it increases our, um, confidence in the theory that it's PhD, because if it's not responsive or if it gets worse, then we know that it might be something else. If it does get worse, it probably helps increase the likelihood that it is PHT as well. Because if you do deadlifts, and that increases the symptoms, we know that, okay, deadlifts increase the demand on the proximal hamstring tendon. Maybe it is the proximal hamstring tendon, we've just done too much. But it's those that are non-responsive that maybe starts to make us scratch our heads and think something else. And I know I hear a lot of people say, I've tried everything. I've tried strengthening, I've tried XYZ, I've tried all this PHT treatment and I'm still not getting better. So maybe it's something else. But then I dive into their strength. I dive into what they've actually done, the specifics that they've done. And in my high standards, I don't think what they were doing was actual effective treatment. effective rehab because they've done body weight bridges for the last 12 months. And so, um, when I say not responsive to PHT rehab, I would say, you know, make sure it's the right way, make sure it's, you know, what you've listened to on this podcast, like you're following all the advice on these episodes. And if you're still not seeing some advice, I recommend maybe booking in for our free 20 minute injury chat, which is in every podcast show notes. just to see if there is something that could be more effective. And if you're doing everything possible and meeting, I guess, my standards of what rehab should include, and you're still not seeing that response, maybe it's worth considering some other factors. Maybe it's worth considering pain sensitivity or psychosocial factors or another diagnosis. But to answer the question as well, if you are seeing someone that's in person, there are some tests you can do. If you're, there are some tests that are nice to do for PHT that if you can reproduce that test and it brings on your symptoms, then it's most likely to be PHT I've mentioned the shoe off test and I've mentioned the heel press test on the podcast before, and if that's positive, meaning that it elicits your symptoms, that's most likely it's going to be PHT, but there are certain nerve tests that you can also do. And if those nerve tests. are positive and produce your symptoms, then maybe it's Cydica. So a in-person assessment may be warranted, um, if you're suspecting as such. And yeah, I think that's all I have to say on that. Thanks for that, Mary. The last one I have is from Jackie again, Jackie, who also asks, um, what's to look for in a good PT or a therapist? And she says, I am struggling with this one. Great question. Um, And something that is very common. It's hard to do. It's like, I've just moved to a new area. It's like trying to find a good dentist, trying to find a good car mechanic. It's really hard to find. Um, you have to go off people's recommendations or, you know, but I think for a PhD, um, someone who's very proficient in PhD, it could be, it could be even harder than finding a good dentist. Um, so. I have some dot points written down here, just like me just running my thoughts like I usually do. And hopefully this helps. So I've got written down here, one who is research and evidence focused. So you would always have a leg up listening to the episodes of this podcast to know what's evidence based and what isn't and what sort of direction you would like your rehab to go because I've done the research and I've laid it out for you in this format. And so hopefully the therapist that you see is on the same wavelength. I've had a lot of people reach out to me and say, yeah, I'm seeing my PT and actually gives me confidence because my PT seems to be on the similar wavelength to what you're preaching. And that's, I would say is a pretty good sign. Um, the other one is one who adapts to change one who can change their method. I have seen therapists that provide 20 shockwave sessions to people or someone who does 20 massage release work and every time or every week, not much better, but they persist with this treatment for three months. So someone who is not seeing improvements and is not willing to change their approach and say, Oh, let's just give it a few more tries. That's someone you really want to sort of you raise a red flag on. If you've been following them for a long time, like on social media, or you follow them on YouTube or something, one who changes their views and opinions based on the evidence in front of them. I've changed my opinions and views on a lot of different topics, just because I learn new things and I talk to interesting people. I talk to people in different spectrums like pain specialists or dietitians or podiatrists or Kairos and I just grasp their opinions. I respect their opinions and sort of change my ideas on what new research comes out. And yeah, it sort of means that I've sort of changed a lot of that. And that comes with, I guess, humility if someone is willing to do that. Just honest, honesty, people are willing to do that. But some therapists, if you challenge their narrative or challenge their thoughts, they sort of get defensive and sort of push their views stronger. I've seen it a lot of times, especially if you sort of challenge what they've believed for so long. I used to work in a private practice and my boss and other physios that have been there for a very, very long time didn't really like to change their views. We would go to seminars and we'd go to personal development sessions where a speaker would talk about the latest evidence and it would change our narrative, it would change how we think. But after that session, they'd go back to their practice and they'd practice the same way they have been doing for 10 years without changing a thing. Um, sometimes to the detriment of the patient, um, just cause is that that's what they know and that's a pretty bad sign. But you won't know that unless you follow a particular therapist for a long period of time, or follow them on social media and they express their views and those sorts of things. So I guess that's a hard one, but something I think about. Someone who gets results or points you in the right direction of someone who will get you the results. So if I want, I'd like to see for someone who has PhD. A meaningful change that might not be pain, there might be confidence levels, that might be sitting tolerance, that might be exercise tolerance, a significant change at least once every two weeks. Like every two weeks you should see a trend on the improve. If you're not getting those results and that therapist still wants to continue doing what they do without any significant change or refer you or point you in the right direction to get those changes, then that's a bit of a red flag. Um, someone who is reassuring, someone who removes a lot of threatening language, someone who is encouraging you just to exercise and, you know, general wellbeing, I know a lot of therapists aren't runners or, you know, very fit individuals and they'll just say, I'll just stop running or just stop cycling, just stop exercising. Um, and, um, you know, just do some stretching instead. You want someone to encourage you to move for general wellbeing and health. It's just trying to come up with modifications and being resourceful enough to find out what's the solution for you to stay active without, and still be on the trend for recovery. The threatening language is an interesting one because some doctors, surgeons, health professionals, some of them like to use threatening language to get you primed to take action. Um, let's just say if we talk about a surgeon, they'll use a lot of threatening language and use these scans to show you how bad your condition is. Just so that you prioritize surgery or that a therapist might say X, Y, Z, um, scar tissue trigger points, um, tears, detachments, all these sorts of things. So you need shockwave and you need 15 sessions of shockwave. That sort of. delivery I would definitely be very questionable about. Other things that are really, really important is make sure that your questions are answered and make sure you have a ton of questions. If you have a session with a therapist, write down your questions because in the session, a lot of things might be going on. They might ask you questions, a lot of new things are developing you might forget, or it's all a little bit rushed. Make sure you have your questions answered. and make sure your questions are answered in a way that you understand. Because sometimes whether it's consciously or unconsciously, um, some health professionals might deliver something and have a lot of technical jargon or just spin something in a way that leaves you a little bit puzzled or not that clear on. So, and then in that scenario, a lot of patients would then say, Oh yeah, okay, I get it, but not really get it. They're just being polite. And very few would say, actually, I don't really know what you mean by that. Can you rephrase it in different ways? So that, you know, maybe I understand all that term that you use. I don't know. I didn't really understand that. What does that mean? Make sure the therapist answers your questions, answers every question that you have, but answers it in a way that you understand. Lastly, I have a PT who creates a long-term path and shares that long-term path with you rather than just going session to session. and something that's using treatments that are a little bit more short-term focused. So originally, if you are in a lot of pain, they might do some passive treatments and something that is short-term focused, such as massage, trigger point release, dry needling, those sorts of things that are designed to help reduce symptoms. But as your symptoms reduce, we then wanna slowly turn. the wheel towards something that's long-term focused, which is strength and conditioning. The stuff that we learned on this podcast. So make sure that your therapist is, does have the long-term trend in mind and isn't just selling you to go to the next session, to the next session, to the next session with every time to short-term focus. I've seen do those, and I'm not saying this is every Cairo, because some physios do it as well. Say, oh yeah, you're out of alignment. Here you go, crack, you're realigned, you're feeling better, come back and see me next week. That's not very long-term focused. People become more reliant on those adjustments and become more fearful that they're out of alignment and then all of a sudden they're seeing that therapist twice a week for, you know, that short-term relief. So just keep that in mind. We want to have long-term plans in mind and that is it. Thank you. Thanks Jackie, Mary, and Phoebe for those questions. Um, I'll have another episode in two weeks time answering another four questions. And hopefully you took a lot away from this episode. It was a bit more ranting than what I usually do, but hopefully you took a lot away. Good luck with your rehab over the next two weeks and we'll catch you next time. 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 towards an empowering, pain-free future. And remember... Knowledge is power.