Stephen's PHT Success Story

: On today's episode, Stephen's PHT success story. Welcome to the podcast that gives you the most up to date, evidence based information on PHT rehab. My name is Brodie. I am an online physio, but I've also managed to overcome my own battle with PHT in the past. And now I've made it my mission to give you all the resources you need to overcome this condition yourself. So with that, let's dive into today's episode. You wouldn't believe how many people these days have said, Brody discovered your podcast. Absolutely love it. Thank you for the resources. I especially love the success stories. So I'm grateful, blessed that Stephen has reached out. He actually emailed me. He hasn't been a client of mine as with some of the past success stories and taught me his story and said, this is what's helped me. This is where I was at. These are my highs and lows. I'd love to come onto the podcast and share it. And. If anyone else is listening and wants to do the same, I would very much love to read your email and see if we can organize a chat. I won't give too much away about Stephen's email because we talk about it on the podcast. And I think there's a lot of takeaways for a lot of people and very much enjoyed talking to Stephen. So let's bring him on now. Stephen, thank you very much for joining me on the podcast. Ah, pleasure to be here, Brody. Thanks so much. Let's dive into your athletic background and you know, what goals you strive for fitness wise before you developed these symptoms. Yeah. So I was always an athletic person, but I was really focused on individual sports. So, uh, freestyle skiing, I did a lot of hiking, um, and some team sports, but I was a pretty small, skinny kid, um, didn't really like running very much. And then into my early. 20s I got into strength sports and I was I actually first I Was feeling a little bit unhealthy. I hadn't really been doing a lot of sports and I got out of college and I Decided okay. I'm gonna take up running and I immediately got injured like really fast. I developed IT band syndrome I didn't have any knowledge of how to do mobility work. I was just unaware of how to take care of my body. And so I got injured within like six months of starting running and stopped that and said, okay, what am I going to do next? And I decided to get into the gym and start doing strength training and kind of messed around in the gym for a little while. Didn't really know what I was doing. You know, found the workouts in the back of magazines that you might do and spent some time just playing around. and not really making a whole lot of progress. About a year or so into that part of my fitness journey, I went to another gym and I was living in a rural part of New Hampshire and in the Northeast of the US. And there was the gym that I went to was a powerlifting gym. And there were a bunch of guys over in the corner who were lifting. ridiculously heavy weights. And I was always really into, you know, they had this like, this sort of rough edge to them. They, there was just something totally different about what they were doing. And I really liked subcultures. I like people who are doing things differently. And I was like, I kind of like what they're doing. And so I started talking to them and over a period of months, powerlifting into strength sports. And so they taught me how to squat properly, how to deadlift, how to bench press. I really immersed myself in it. And over a period of a couple years, got pretty good and strong at powerlifting. And then I moved to Washington DC and lived there for a while where, this was right when the CrossFit boom was happening. This was in like the 2010 to 2013 timeframe. And Crossfit gyms were everywhere suddenly. And powerlifting, which had previously been a very fringe sport, became very popular. Raw powerlifting, in particular, became very popular because it was such an important component of CrossFit. And so the gym that I went to was a bunch of CrossFitters, a bunch of strength athletes. And I picked up so much knowledge of strength training and started competing in powerlifting. and got a lot heavier than I am now. I was 50 pounds heavier than I am now and just absolutely loved it. And, but I was always kind of injured. I always had some kind of nagging injury. And then, you know, life moved on. I stopped competing, but I was still really into powerlifting. And I moved with my wife to where I am today in a mountain town in the Northeast. U.S. and there's just unbelievable amount of trails here. And when we were moving, I said, I think I'm going to get into trail running. And I had never really been into running that much, aside from experimenting with it in my 20s. And I didn't have a watch. I didn't have, I didn't, I wasn't tracking anything. I just wanted to go out and spend time in the woods. And all of a sudden, for the first time in my life, it clicked. I found so much peace and happiness in running. And I am the type of person that will throw myself into something, as I'm sure a lot of your listeners are, which can ultimately lead to injuries. And, uh, I, I just started, I was blending strength with running, um, doing a lot of fairly heavy power lifting and ramping up my running, and that is when I got injured and it was, I had actually had PHT before when powerlifting, but I got a more severe version this time through a combination of trying to max out on a particular lift, on a deadlift and then going for a long run. And I have learned a lot about how to balance my training since then. Right. What would, when that emerged like... what would you describe like the onset of symptoms like for you? Cause I know PhD symptoms slightly different for everyone. How would you describe it? Well, at first it, I didn't realize what it was. So I, the, it was through a combination of two things. One, I went for a max deadlift. I didn't get it up. And then at an hour later, I went for a long run. And then the next day I went on a cross country flight. And it was only the next day when I was on the airplane, when I started to get really uncomfortable. And I thought maybe I had pulled a muscle or something. And even though I had PhD in the past, I didn't quite identify it. And I just, over the period of about six hours on the airplane, it started creeping up and I was really uncomfortable. I couldn't sit down. And then at the end of the flight, the pain was quite severe. It was over about six hours that it got worse and worse and worse. But I still didn't identify it as PHT. And I got off the plane, I went to my conference, and then I said, I'm gonna go for a run. And I ran a pretty fast, for me, five-miler along the beach. And that's when I just had the most excruciating pain. It was, and I realized right there what it was, that it was not a slightly, aggravated muscle, that there was a tendon issue happening. And luckily I knew, I was able to identify it because I had it before. And so I was able to take a pause and sort of try to attack it when I got home from that trip. But it didn't really feel it until the next day. And then of course, sitting was just terrible. And then I had to sit at a conference, sit on an airplane back and... Um, and, and it just, it's psych, it goes up and down and up and down. It's a really insidious injury. Uh, some days you feel good and other days it just seems to flare up without warning. And it seems like that combination of whole bunch of things, like you said, the max deadlift, the run, the flight, the fast run, all that sort of stuff would just be a combination of things. And I know a lot of people. Um, risk of PhD with things like speed work with increasing speed work, but sometimes they just increase it gradually and sometimes they just run further. But you know, sometimes it's a combination with, oh, then I got a desk job, or then I had a road trip, or then I had a, you know, something else that goes on in their day to day life, which puts a little bit of strain or compression on the tendon or lack of recovery because you're sitting on the tendon the whole time in between these runs that you're doing. And so. You know, sometimes it's not always just training load. Sometimes it's a combination of things, which seems like, yes, that, that those whole factors, there was probably some early signs that were ignored. But then, yeah, once things ramped up quite quickly, you said that then you realized, okay, this is more of a tendon thing. Let me take a bit more seriously. What exactly did you do at that stage? Well, Part of the problem with my recovery is that I had gone through it before, but I didn't really track anything in five years prior. I had this hazy knowledge of what I had done. What I remembered was that strength training helped it greatly, but I skipped ahead of everything and got right back into strength training. I have a lot of different kettlebells. I said, oh, well, I remember deadlifts. Carries and band work really helped me so I kind of put myself right into the where I should have been maybe six to ten weeks out and I just couldn't figure out why is this why is this not getting better? Why is it not getting better? I stopped running entirely but I went way too deep into a strength cycle and it felt really good at first I would get that analgesic effect and I would do a lot of deadlifts and it felt really good, but then it would flare up even worse the next day and I couldn't figure it out. And that was, I sort of embarrassingly did that for too long, partly because I was like afraid of losing strength. I mean, I wasn't going anywhere near max. I was just using like fairly light kettlebells, but way too heavy for what I should have been doing. And then after a while, I said, okay, I need to take a pause here. and go back to extremely light body weight work and light band work. And I went online and I should re-familiarize myself with some of the activation exercises. And I started working on those, but then I fell into the trap of focusing on those for too long and I didn't progress. And I kept... playing around with those exercises and they felt good, but I should have probably just stuck to those for a couple of weeks through that first phase, but I couldn't figure out why I wasn't improving, and that was because I didn't get back into the strength work. I was afraid because I realized, oh, the strength work had set me back. I was afraid to go too far into it. So it was a lot of self and realizations and it had been, and I was just not progressing in the way that I should have. And eventually I found your podcast, which kind of reset me to how I should think about that long progression. And that was when I finally started making improvements. But at first it was too heavy, then way too light for way too long. I think, yeah, there's like some general those who are listening because in whatever state the tendon is in, like, we want to try to find that adaptation sweet spot. We don't want to go too light or too heavy or too much. We want to try and find that Goldilocks zone that the tendon is currently in. And sometimes when it's quite flared up, it's quite sensitive. It's quite irritated, which it might've been after those series of events that you had that your sweet spot, because it's quite sensitive. might have been that lighter stuff. And the, you know, people say, Oh, yeah, but I couldn't have lost that much strength in that period of time. And that's true, you're probably very strong. But at that particular moment in time was probably quite sensitive. And so there's that's the difference between strength and sensitivity, we want to try if it's really sensitive, we can't do the heavy stuff, because then it just irritates it further. But if we can find those lighter exercises in the moment that helps settle things down without irritation. Then over the course of days and weeks, the sensitivity settles and then we can get back into, you know, preserving and restoring a lot of that strength because your journey is like feeling things out in the gym. But a lot of people like they feel things out with their running. They feel things out with their, you know, cycling or whatever their sport of choice is. And they have a fear of losing that fitness. And so they run, they continue to run too far, too fast, et cetera. But after finding that adaptation Goldilocks zone, it's then following those pain rules. And so rule number one, generally speaking, pain during an exercise should be less than a four out of 10. Second pain rule would be that we wanna make sure it settles down in less than 24 hours. And so the guidelines that you're following before discovering the podcast, yes, it's good that you've tried the... heavy stuff and notice that analgesic effect, kind of feeling better about yourself in the moment. But like you said, you felt worse the next day. So that requires reevaluating being like, hey, maybe I just haven't hit this sweet spot yet. Cause we don't know that Goldilocks zone until you test things out and try. So quite obvious that wasn't the right thing. But then the third pain rule that people often forget is that like symptoms need to improve week by week, month by month, that like long-term trend. And so that's probably the rule that you might've been not focusing on when it got to that drastic switch to the two light category, because you've gone the two light and that might've been good at the, at the moment. And you might feel like that's more within your zone because symptoms might've been more settled, but were you seeing improvements week by week? I'm guessing not. Yeah, at first I did. And then I was not. And then it just stayed in. the same state of pain and I couldn't figure out why I wasn't seeing the improvements. I was staying off of it. I was not running. I was not doing the strength work and I just wasn't going through a proper progression. And so yeah, I saw some immediate improvements as it settled down, but then it just didn't improve after that. Yeah. And I was so thankful to hear your takes on what that long progression looks like. And that was when I reset myself. started thinking about how to... I was at the point where I could integrate strength back in. And then you had this episode on a 2020 study about a power lifter who had gone through a strength progression, and I forgot how many months the study went for, but I think he increased like a low 10% a week or something like that. And... It was a really helpful foundation for thinking about my strength progression. And I followed those same principles and saw really strong week by week, month by month improvements until I fell into another trap, which I can talk about, which was all of a sudden feeling no pain and then saying, I'm ready to go. And then I went way too heavy. And I was like, this is it. I'm healed. And then I did. I jumped up. you know, 40 or 50% in weight and then reset myself back to the beginning. And it was so demoralizing, but I knew that I was on the right track. And so I had the reason this was a year and a half of dealing with this. And the reason was because of the early problems that I just described. And then there were a couple of moments where I got really excited and either lifted too heavy or went out on a run and didn't do a... run walk progression and just ran the whole thing. And, um, that happened a few times until I really learned how to be patient. Can you just give us a bit of like a time scale, like generally speaking from, you know, that onset of having, okay, this is PhD. Let's take this quite seriously. Let's start some heavy lifting, then realize that was too heavy, went to too light, then moved into something that was a bit better, got a bit better. Like. How many months are we talking? We, the injury was in February of 2023 and I fully healed with no symptoms in July of this year. So it was about a year and a half. Okay. How long do you reckon you tried the two light for? Two months or so. Okay. Yeah. So really just, um, keeping stagnant at that stage, I think. Like it'd be good for, uh, people who are listening to, for me to sort of remind them progression should always be a top of mind. Like as soon as you are tolerating one phase, you are progressing, but it's just by a minute amount and then just seeing how symptoms are, um, and just constantly reevaluating, like when I work with clients, I have the, people know I have these like long progression charts. It's like. When you're ready to progress, this is what you move to when you're ready. This is what you move to and you just work your way down this list. And I have a, um, certain protocol of when to progress. And it's essentially every single session. If your symptoms allow, like if your symptoms are telling you, I tolerated that, then I want you to progress. And so that's when it sort of, it might lead to sort of like a gray area where it's like, okay, symptoms were a little bit more elevated than usual and symptoms, you know, maybe hovered around for. Maybe 12 hours, but it's settled within 24. And like, you know, if we're starting to find that that's maybe your upper limits, then yes, we might spend a couple of sessions, maybe a week or two at that phase before them progressing. But I think people are a bit too shy to progress a bit nervous or anxious to progress and it's a part of rehab. We can't raise the capacity of the tendon and restore function in any other way. So, um, that's one message. And I think that's one lesson that. you've learned throughout that moment of your rehab for the thing, getting into the heavy stuff. Um, what did it look like? So when you were doing this protocol that was working for you, um, what are we talking in terms of exercises, sets, reps, weights, that sort of stuff? Well, it's interesting. Um, the, all of the exercises that you talk about, particularly the deadlift were really helpful. But what I found early was that deadlifts. We're not as. helpful to me at first as the low bar back squat. The low bar back squat for me, for whatever reason, gave me the biggest analgesic effect and the most steady improvement. And when I dead lifted, even very, very light at first, when I was in my rational strength progression, it still aggravated things a bit more than I would have liked. And so I learned that I should cut out dead lifts for, and this is very person specific, I cut out deadlifts for like a month. And then when I had made a lot of progress using mostly low bar back squats, I integrated deadlifts back in and they did not aggravate and I was able to ramp up there. So I found that quite helpful. Interestingly, if I did a high bar back squat, so the bar, for those who are not totally familiar, high bar, you're using more of your quads, the bar is up kind of up on your neck and the low bar, you're using your glutes and your posterior chain more. I actually would aggravate things a little bit more with the high bar back squat for whatever reason, but the low bar back squat was just, it felt so good. And so that's what I really chose as my progression lift. And then deadlifts certainly helped, but I had to be a little bit more patient with those. And then when I started, I mean, I was literally at the bar and then I worked up maybe 10 or 15% each week. And then when I was on a steady progression, I was able to make slightly more jumps over time. And so maybe three months in when things felt really good, I started making... bigger jumps, I would go up maybe 20% or so. But I had learned that I had to be really, really patient. And that was a big part of the mental process. So many of my setbacks were getting excited, feeling like I had healed just because I didn't have symptoms for a day or two, and then getting on the trail for way too long or going up too much in weight. So I think most people come to light to that. you know, need, I think when the longer you're injured for the more there's like tension of like, this is how, like, I want to run symptom free. I want to run long. I want to run fast. I want to lift heavy. And then when you get one or two days of that moment being like, is this the moment? You know, you can tell the longer you've been injured for and waiting for that moment, the more tension there is there. And then the more the band snaps and then you're like, yep, I'm back. Let's go. And let's, you know, run a marathon or something like that. So, um, I could definitely see how that would happen. What about. like sets and reps, what was your rep ranges during your rehab phase? Uh, sets of six, usually be six to eight. Um, so what I would do is I would warm up and I would do, I would do, um, some eccentric pistol squats and that was a really nice way to warm up the tendon. So, um, I wouldn't do the full with pistol squats. How would you describe them? Um, it's a single legged squat where You're essentially doing the squat movement with one of your legs out in front of you so they call it a pistol squat because it kind of looks like looks like a pistol with your leg out like the barrel of a pistol and It's a very difficult movement when you're just standing on the ground, but if you stand on a bench elevated you don't have to stick your legs so far out in front and so It makes it a little bit easier. And that's what I did in order to get a really nice, slow, eccentric movement while keeping my balance. And it warmed up the tendon beautifully. And then I would go into three to five sets of six with low bar back squats. At the beginning, it was only three sets, and then I would slowly be able to ramp up to five sets. And then I would go into some kind of lunge movement. Lunges definitely helped, very light lunges with a foot elevated. And then I would also, I started integrating in more hamstring curls as well. And what I found was I used, I mean, maybe some people are familiar with them. They're called monkey feet. They have, they're like, you buckle the weight to your foot and you can. do standing leg curls or lying leg curls. So I started with banded leg curls and then I was able to put a bit of weight on the monkey feet. And what I found was, and you had mentioned this in a podcast too, that laying down, I think you had mentioned it, laying down with those wasn't really effective because like in the middle of the movement, you don't like sort of the top end of the movement, you're not getting a lot of resistance. And I found that it wasn't that helpful, but standing, hamstring curls were really effective. And I would do probably three sets of 10 to 15, depending on the weight there. And then over time I progressed, I would increase the weight 10% and then I would add a set each time. And then I would maybe experiment with another exercise. And that experimentation was key. And if I was going to add a new exercise, I wouldn't change anything with weight or set ranges because I wanted to see if adding that exercise without any other variables was going to aggravate something. I was very cautious about how I would integrate other stuff in and make sure I controlled for all the variables. I had certain exercises that aggravated me at first. kind of painful for a month. And then I started experimenting with them again and they felt great. And they think they really, uh, pushed me into the healing process much faster. So, um, I think that's really important as you start to experiment with stuff, just add one new element, each workout, because then you'll never know what caused the aggravation, if you've got multiple things, music to my ears, Steven, you're putting on your, your scientific cap on, and then your. Controlling one variable at a time and seeing what works for you. And yes, the low bar back squat, like Ivan, I've never heard of that being as a good analgesic exercise or to, you know, proceed getting up to your dead lifts, but you've experimented with yourself and found it really effective. And then you've applied it. So that's like perfect. That's exactly what we want to do. And then it, when things do progress, changing one thing at a time, just to make sure. Just in case, if you really saw the next day, you know exactly what that variable is. Uh, it's great. That's exactly what we need to do to gather more data about this injury. Cause that's what we're doing. We're sort of learning and say when I'm working with clients and I say, okay, try these exercises, these sets, reps, weights. We don't know how someone goes with the hundreds and thousands of people I've talked to with PhD. I'm still yet knowing for sure what might be the best exercises for them and the best dosage, but it's an educated guess. Give it a try. We see how things feel. If that's okay, then we try one variable at a time thereafter. So you've gone through that process and you're, you're learning each step of the way, which is great to hear. Uh, one thing I wanted to get back on, because I know you emailed me about your journey and, um, some little insights about your rehab, you did mention that, like, emotionally speaking, you fell into quite a depressed state based on how long you had it for. And I know this particular condition can be very emotionally and socially taxing on people and just wanted to get your experience with that whole thing. Yeah. I actually was really, um, motivated to hear about some of the folks who have grappled with some of the psychological elements of this, of the healing process on your podcast. And. I realized how much of this was mental. But before I get into that side of it, I mean, it was very draining. And what was draining about it was the length of time. And obviously some of the annoying things like I can't really sit at dinner for too long or I was worried about work travel. I was really afraid of sitting on airplanes, sitting on the couch and watching TV at night. I had to prop myself up in weird ways. I brought a towel that I could roll up everywhere I went so I could sit on it. I mean, that was just really annoying. But what's insidious about the injury is that it's not a catastrophic injury. You don't look injured outwardly. I was constantly obsessed with it. But... it doesn't look like you're injured. And so people are constantly like, hey, are you healed yet? You want to go on a run? You want to do this? And it's like, no, I can't do it. And it starts to weigh on you. And the amount of time that you spend thinking about this injury, it becomes an exhausting obsession. I just was obsessed. It was always in the back of my mind, feeling it out. And every time I got up, every time I was moving around, I was thinking about it. And... it started to really wear on me in very negative ways. And then as I got removed from the things I like to do, I wanted to be out in the woods running long distances. I wanted to be throwing weight around because those are my hobbies. Those are the things I love more than anything in terms of my hobbies. I just slipped into a really dark, frustrated place. And... I had to find ways around it. I put this big sign up in my basement gym that said, focus on the things that you can do, because there's a lot that you can do. I mean, first of all, I have a very like happy home life. I've got a wonderful young kid and wife. And so all the other things in my life are really good. But when I'm not able to do my hobbies, it really wears on me. But there are a lot of things related to my hobbies that I can do. And so I put this big sign up that says, focus on things you can do. And I found little ways of challenging myself. So it was going out on walks with a weight vest and doing sort of modified rucks. So I wasn't hurting my, really taxing the hamstring too much. It was finding ways to challenge myself by like improving my overhead press or my bench press. It was experimenting with hip style workouts that weren't gonna aggravate the hamstring and trying to get new ways of taxing myself and taxing my cardiovascular system. And so I'd find these little challenges in order to get through the depths of despair. And I wanna be really careful about how I characterize it. I mean, it sounds very dramatic. I feel for people who are really like dealing with catastrophic injuries who, you know, truly they're life altering injuries. And so I always tried to keep perspective, but being a year and a half removed, you start to think, am I ever going to like heal from this? I mean, is this, am I ever going to get back to doing what I want to do? I had just found this deep passion in trail running. I was just getting into it. I was at the peak of my fitness and like, I'm, I don't know if I'm ever going to get back to that again. And that was very, very discouraging. And I, I had to find small ways of getting through it. And those little challenges helped a lot, but the obsession is exhausting. It's, it's the mental. And then I realized like, I then I thought to myself, am I in, am I hurting here because I'm obsessing over it? Or am I actually injured? And then you start to really question whether your own mental obsession is exacerbating the injury. And so I had to let go. Toward the end of it, I actually let go completely. I stopped listening to running podcasts. I was still listening to your show, but I stopped listening to all the ultra trail running podcasts I was obsessing over. I stopped going on social media and looking at trail runners and weightlifters. I just let it all go. And I said, like, I'm just going to... free myself of a lot of this mental burden. And it actually made the last few months of recovery a lot better when I let go of a lot of things. And then eventually I did heal and I worked my way through my progression and I was back at it. And one day I found myself doing a 20 mile run and like couldn't believe it, had to pinch myself that this was actually happening. But I really, I'm sure so many of your listeners right now are in the middle of it and it does get better. Like you can heal yourself and the principles that you've outlined here like do work. And I totally feel for you if it feels like you might never heal. I know that thought process. I'm glad that you've explored the... Physical sides of recovery seems like you very much dialed into finding the right exercises, progressing and seeing improvements there. But, you know, there are a few flags when I talk to clients and some of them, one of them is like, I asked them like, how often do you spend thinking about your pain? How often do you spend thinking about, you know, will I ever get better? How is my pain? This is what I used to be like. This was my level of fitness and now. I am this, it's definitely a hindrance towards recovery. We definitely know that obsessing over pain, constantly thinking about pain reinforces this neural connection that is sensitizing the nervous system that leads to more pain and poor recovery. And yeah, often when I ask, how often do you think about the pain? People are like, yeah, I obsess over it. It's every minute of my waking day. How can I not? Because I'm in constant pain major disruption to my life. And that can be really, really tough. And it can be really tough to work your way out of. And some people when they're running every single step that they take, how's my hamstring? How's my hamstring? How's my hamstring? And that is afterwards, they're really, really sore. And that's no wonder because it's leading to a lot of that reinforcing that neural connection, that sensitivity. I've had a lot of people say, you know what, I actually went with a run with my friend and I was talking to my friend the whole entire time, or I called a friend and I was just talking to them on the phone and you know what, I just ran for 15, 20 minutes, I didn't think about my hamstring once and actually feel a lot better afterwards and it's because they weren't obsessing over the pain and a lot of times when people are starting to enter that phase of recovery, they're like, you know what, I just sat here for an hour and I didn't think about my hamstring at all. not once. And that's a great sign that you're moving on physically and mentally from this. And I think a few of your tips about, you know, giving yourself little goals to work on outside of the hamstring, like you say, those hip classes, the upper, upper body strength type of stuff, uh, no doubt that you're having a sense of accomplishment, but also when you're working on those goals, you're not thinking about your hamstring at the same time, because if you're listening to ultra running podcasts, where's your mind's going to go? Oh man, I wish I was doing that. Oh, I used to be doing that and I used to have all these goals and will I ever get back there? Like that is a medium that's putting you into that space, that negative headspace. So a lot of tips that you've highlighted there, which a lot of people can apply to their own life, maybe in slightly different ways, if they have slightly different goals and strategies, but yes, extremely helpful. So thank you for sharing that. Yeah, and I really appreciated the episodes where you went into the mental side of things because it was helpful for me to figure out how to let go. I just had such a grip. The obsession had gripped me. And once I loosened that grip a little bit, it did help with the pain management and make the last part of the healing process a lot easier. So it is extremely important. From the... I guess the initial signs of you seeing improvement to actually feeling like you've accomplished full resolution of symptoms. How long do you think that took? That was about three to four months. And in that three to four months, would you say that your progress was fairly linear? Was there bumps and hiccups along the way? Yeah. At that stage. it was becoming more linear. But yes, with this injury, there are always surprises, something might aggravate it in a way that you didn't expect. So I saw some bumps, but once I got to a certain level of strength and I was being careful, I felt like it started to become more linear than it ever had been. It was certainly not a linear process through most of it, but at the tail end of it, because I was smart, I wasn't I was doing walk runs, then I was doing short runs and my strength progression was really stable. Um, it started to feel like everything was pretty well locked in and linear. I would say that makes sense. Cause one, like it's just more and more time of you gathering data and learning more and more about what works for you, where your capacity lies, what the progressions might be, but also as you move on, as you improve more and more. there's less and less of that mental burden, that obsession, all of that sort of stuff just would fade away over time as well. And then I guess symptoms would start becoming a little bit more predictable. What I see with clients is when there's a lot of things that are wrapped up, a lot of pain that's wrapped up in the psychosocial elements of pain, that can be really erratic. Flare ups can last extremely long periods of time, be very like unpredictable. But with a tendon, tendons are actually really predictable, but it's just the symptoms are complex because we're not just talking about the physical tendon itself, we're talking about, you know, everything else that influences pain, which, you know, you're, you're well aware of, but, um, that would make sense. I would say, you know, probably towards the tail end of that recovery, we're more just talking about tendons and that's probably why it became so predictable and linear. Yes. But in the lead up to that, it was not predictable. Yes. I need to remind people of that. Yeah, absolutely. Is there any other elements of your rehab that we haven't covered that you thought might've been effective for your, you know, what you've achieved? Well, I think that everything that you have talked about really worked for me. One thing that I will be I would urge people to be cautious about is, there were a lot of physical therapists on YouTube who talk about this injury and they might give some stretches and they might give some early recovery protocols that could work for some people in the beginning of the injury, but most of the information I saw out there was... not that helpful, not focused on strength work. And I think it kind of put me into that early trap of not progressing. And so you're lucky that you've found this resource. I would just be really careful about the kind of information you're ingesting out there because there was a lot of sort of, I wouldn't call it bad information, but it didn't give the full picture. And... I just be discerning and also understanding that everybody's recovery journey is a little bit different. And so you'll see YouTube videos out there of someone saying like, this is the exercise that worked for me. It's going to work for you. And it just, that's not the way it is. There are sound principles that you need to follow, but everyone is a little bit different. And so, you know, there's just a lot of not great information out there and to be careful about that. And I fell into that trap. And the other piece is, I just, I'm, you know, it's pretty obvious that I'm passionate about strength, but this is a really good opportunity for runners or other endurance athletes to explore strength work. And it's so great to see that the endurance world generally is embracing strength work and resistance training. But if you have not experimented with it, and you're facing this injury, it is such a good opportunity to start experimenting with something that is unequivocally good for your longevity and your cardiovascular work. And so I just, I cannot stress enough how important strength work is generally and what a miracle it can be if used properly for healing many different types of injuries. And so you don't have to be like me, you know, a powerlifter trying to max out on my lifts. You know, you can use strength training in all sorts of ways, but it is a really important opportunity for those who may not have played around with it to get into it more, because it is the thing that you need to incorporate to get rid of this injury. And I think it's, you know, the research shows how important it is for improving performance, longevity, and all sorts of other important biomarkers. Well said, uh, going back to about like other advice that you might run into on the internet about, I don't know, one exercise that works for everyone or stretches, like as long as we go back to those pain rules that, or guidelines that we follow, okay, what's the pain during, what's it like after, are we getting better week by week, keep experimenting, keep learning, gathering data, like you'll easily. work out what works for you. Maybe stretches does work for you. Maybe deadlifts don't work, but you know, if we keep following those pain rules and keep following the trend and see if that trend is on the right path and continues to be on that path, then you'll eventually find what works. And so, yeah, I can show or, you know, share what exercises I think are the best, but I don't know, um, for the individual and. That's why we always have to fall back to your own tailored individual experimenting and following simple guidelines. And the back to your point about the strength training, like I like to say to clients, you know, at the bare minimum, if it doesn't make things better, Hey, you're getting stronger and strength training does so much for your. General health, mental health, bone density, fat burning. Like you can just list so many different things that strength training is good for. And you're just reaping those benefits, uh, as a bare minimum. So yes, uh, I think that's a very good point to highlight, um, where are you currently at? Like what, what's, what are your symptoms? What is your capacity endurance? What goals are you working on at the moment? What races are you preparing for? Can you give us an update on that? Yeah. So, um, I am now basically at full capacity. I am. training for an ultra marathon. I'm going to start with a 50k in the spring. And I'd like to put a few 50k trail races under my belt next year. And right now I'm currently in... So I wrapped up an ultra marathon training cycle headed into the fall. And now I am working on a strength cycle. I lost some weight. My work schedule is really busy, so I can't get on a long runs. So I'm focused on a fairly heavy strength cycle, maybe put on a couple pounds of muscle. And then after the holidays, really ramping into an ultra marathon training cycle and headed toward race season in the spring. And I cannot tell you how good it feels to have that on my horizon. So I'm feeling like I am operating at a very high level strength. I've learned a lot of lessons about how to balance my strength training properly with my running. And I've actually reduced my weight considerably in my strength training, but I've increased the volume a bit. And so, and my mobility is, I'm devoting as much time to mobility as I am to strength training. And that doesn't mean that I'm going down into the gym and doing an hour of mobility. I'm doing a lot of mobility snacking. So if I'm, I just, I'll do four or five different mobility snacks throughout the day. And some of it might be, you know, 20 minutes in the morning. If I'm down on the floor playing with my daughter, I might sit in some positions or get, you know, get some good hip positions. I always have a ball around to do some footwork with. And so I'm always thinking about now that I'm 40 years old, I'm putting as much time into my mobility and recovery as I am anything else. And that has really helped me a lot. So I'm at full capacity and I'm finally headed toward a real race season. And this is all new to me. Honestly, I haven't, I found a love for the trails. And before I got injured, I really, I really. realized that I wanted to get into ultra running and that injury set me back, but I still kept that in the back of my head and now I'm at a place where I can explore that side of me. What about symptoms, sitting capacity, all that sort of stuff? Everything is fine. Yeah, everything is back to normal. Sitting was the last thing. I was fine running, I was fine lifting, but sitting would sometimes be uncomfortable, but now sit normally and I have no symptoms whatsoever. Great to hear. And as we wrap up, do you have any other final advice for someone who's listening, who does have PhD, who is suffering, anything that we may not have covered or maybe something you want to repeat that might've already been discussed? Yeah, I'll just reemphasize, focus on the things that you can do. There are so many things that you can do to create challenges for yourself. And if you reframe the challenge, you can find things that your body can do that you may not have experimented with. And it's a chance to experiment, try something new, and incorporate. You necessarily have to incorporate strength training to heal. And it's a great way to find new ways to bring strength training into your routine. So every challenge is an opportunity. And sometimes it can be hard to find them, but I promise you there are some, and it's all about reframing it. Well, it's been a delight having you on. I'm very grateful for you reaching out and emailing me. A lot of these success stories have been past clients of mine, but very few podcast listeners that haven't been a client of mine have actually reached out with an email, giving me an update of how things go on. And I'm glad you did because your story, you know, has entwined with it and a lot of the principles, a lot of mistakes, a lot of lessons that are learned and a great result at the end. So like I said, I'm delighted that you have... reached out and glad we could do this. So thanks very much for coming on. Yeah, thank you so much. And genuinely, you're putting out some really good information. And as I listened to the podcast, I was like, he's talking about me. I really heard myself and my experience in the types of guests and principles that you were outlining. And so I really appreciate it. And it was so fundamental to my recovery. So thank you. You're very welcome. Congratulations on all you've done and accomplished. Thank you. If you are looking for more PHT resources, then check out my website link in the show notes. There you will find my free PHT 5-day course, other online content and ways you can personally connect with me, including a free 20-minute injury chat to discuss your current rehab and any tweaks you might need to make. Well done for taking an active role in your rehab by listening to content like this, and together we can start ticking off all of your rehab goals and finally overcome