Trevor’s PHT Success Story

: On today's episode, we have Trevor'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. We have found another one, another success story coming out of the Woodworks and everyone loves hearing these. So can't wait for you to hear Trevor's journey. He actually jumped on a free injury chat with me, which is in the link to every podcast in the show notes. Just click on the link, send you to my calendar. You can book a. 20 minutes slot and have a chat about your injury, have a chat about, um, if there's any missing links in your rehab, what might be the most appropriate tweaks to make. And if you want to work together, um, via online physio, then those options, we can have a chat about those options and exactly what they look like on that chat as well. Um, so that's what Trevor did. He was investing his knowledge and wisdom into the podcast and jumped on a chat and told his story and had. a lot of success after that chat. And I thought it would be good for him to share. So let's go. Trevor, thanks for joining me today. Thanks Brody. I'm glad, I'm really glad to be here. Yeah. Likewise. Um, we're going to get into your success story and your rehab journey in a second. But before we do that, could you just introduce yourself and where you're from and kind of your athletic background up until this point? Sure. Um, I live in. Washington DC, the political capital of the United States. Originally from California and I'm a runner. I've played a variety of sports and been kind of active person generally throughout my life. But the last couple of years, I've put a lot more time into running, including races. What sort of races would they be? Like any particular, would you hone in on a particular trail or terrain or distance? I've mostly done marathons and half marathons, but I'm actually excited to, this year maybe devote a bit more time to things like 10ks and 5ks. I just, I'm actually excited to try some of those shorter races. Um, which don't, aren't, aren't such a slog. Um, you know, the marathons are pretty, pretty long fence. Um, it takes a lot of preparation. Um, so I'm looking forward actually now that I'm coming off, um, having PhD to devoting some time to those faster, shorter races. Yeah. Sounds like you're looking at upping the speed work. Yes. Okay. Well, we'll, we'll see. It might be quite a challenge. Looking forward to seeing how that goes over the next couple of months and into 2023. Um, Initially, you had like this onset of PHT. Can you just talk us through like how long ago that was and what that onset of symptoms look like? So I initially developed it in the run up to a marathon last April. So maybe I can just share a little bit of background about it. I had a marathon planned in late April and I had been training for that. And I did a couple of what I'll call B races, just, you know, tune up, so called tune up races before that. And I believe my... major mistake and what sort of caused this injury was running one of those tune-up races too hard. So I mean, I think races are races and you should run them fast if that's what you want to do. But I went out at a speed and I kept running at a speed that I hadn't trained for in that tune-up race. I mean, just to give you an example, like I'd run a half marathon just a couple of weeks before that. And then I ran a 10-miler. at a pace of about 15 seconds faster, which is, I mean, a 10-mile is basically, you should be running that at roughly your half marathon pace. And so, you know, I ended that thinking at a great PR, almost doing a 10-miler in under an hour. And I think that was kind of the triggering event, because over the next week, I started to notice this, you know, this pulling sensation in my right hamstring where the obviously where the hamstring connects with the glute. And so I went on and I kind of took a couple of days off and I was just trying to figure out what was happening after this pulling sensation. Of course, I did a couple more runs, as many of us do, instead of just stopping or trying to figure out what's happening with this nickel. and ended up getting a little bit worse. And finally, about a week before the marathon, because I couldn't actually get in to see a PT, I saw a medical doctor and he basically, he didn't diagnose it properly, told me it was some kind of tendonitis in the calf. And I wanted to highlight this Brody because, so I had symptoms all the way down into my calf and actually it was stronger. and more painful at that point in my upper calf than it was in my hamstring. And I hadn't heard a lot about this in your, in, in really in the literature or what people, when people talk about this injury. So I just wanted to flag it because ultimately for me, I ended up figuring this out because I did find there were some articles which talked about severe cases of PhD ending up in the, you know, going all the way into the calf. So that started my, my unfortunate journey of getting a diagnosis, this doctor told me, I probably just had a little bit of tendonitis in the calf. Unbeknownst to me, it was the fundamental problem was in my hamstring. Ran the marathon that I had planned. And actually, it didn't feel bad because I had taken a couple of days off and the injury had not really progressed. So ran that marathon, did pretty well, and then tried to go. back to running after that. And that's where the pain kind of came back. And, um, you know, then I got onto my journey of trying to figure out what this injury was. Um, do you want me, if you'd like, I can sort of take you through that, that process. If that's helpful. Yeah, let's, let's do a bit of a recap. So you were doing some prep races, looking back on it now, a lot more speed work than had prepared for. So there was an abrupt change in speed work there. But initial symptoms seemed quite mild, just tightness or pulling. And it would have been like in the, the glute area, but then going down into the calf and so not necessarily, um, concerning enough symptoms to stop running or, um, really be proactive with treatment. You just thought you'd get a diagnosis and then continue running. And then once you completed the marathon, the symptoms started to increase. And like, okay, now I need to take this more seriously. Is that right? That's right. And, you know, the unfortunate thing about it is, um, had I figured out when I first started to develop that sensation and even within the first week when I was trying to see somebody, if I had gotten a proper diagnosis, um, seen someone like you who able to figure it out, I probably would have saved myself months of, of trying to figure out, and then also would have saved it from becoming a much more chronic problem. Um, um, But that's not your recap is absolutely right. We can see, you see that sometimes in tendons and like plantar fasciitis and that sort of thing, like when it becomes overloaded, particularly if it's very strong and very, um, like, you know, you're running marathons. So you're very fit and the tendons had a pretty strong capacity, you would say, uh, these gradual onset of symptoms could be very common. And tightness is a very common initial symptoms so that it doesn't really raise much concern with a runner or heighten their level of severity because, you know, people can put up with tightness. It's the same with plantar fasciitis. A lot of times it's morning symptoms, and it's just a little bit of tightness and not much for concern. But then you continue doing what initially cause that tightness and then it slowly tends to drift towards a little bit of pain, then a little bit more pain. And then, by the time you're like, okay, let me get this sorted, you've had it for two, three plus months. And at that stage, when you've had it for that long, it's harder to overcome. So it seems like that very gradual onset, um, was sort of what got the, you know, I guess with those gradual onsets, the level of severity didn't really spike enough to, you know, trigger action immediately. What was the Was there a certain moment where symptoms did start to increase or like, what was that moment like where you started to take it more seriously and active actively look for treatments? Yeah. I mean, I do want to say, um, that I mean, I did try to see obviously a doctor. I will never probably see a medical doctor again, um, for something like an overuse injury, cause there's a complete waste of money and time. The only reason I went to see him was because I couldn't get into another PT. So, um, you know, I think just, uh, you know, it's, it's been, it's been nice to be able to speak to you quite quickly when I've, and so I, there's, I think there's a lot of benefit from your kind of virtual platform, but, um, so after my marathon, I, um, yeah, I took a week off. I started to come back to running. I felt the symptoms. They weren't, they still weren't like so severe, but I, you know, wanted to get it addressed. So I saw another, I finally got into see a PT within about a week and a half or two of running the race. Um, and, um, he also failed to kind of properly diagnose this. He, at this time I was complaining also about my hamstring, but I still felt like even more pain. I was more focused on the calf because I, that had been the initial, um, I had actually felt more pain there than the hamstring. It almost felt just like, yeah, it's just like, like I explained earlier, the tightness in the hamstring still, whereas I actually, I recall waking up in the middle of the night with the calf pain and I had to like take like some Advil or a painkiller basically, ibuprofen, just to get it to calm down. So the PT that saw me, you know, thought I had like a calf, I pulled. called pulled a calf muscle or something. That's what he was convinced after his talk with me. And basically said, yeah, take some time off and do some, it gave me a few kind of exercises, but obviously it wasn't the right diagnosis, which I raised because I think it also underscores, like if you're gonna see a PT, see one that works with runners, is a runner, is a trained certified running coach. Um, this guy, I've, I've seen him before. He helped me out with like ITBS. And, but the IT of it, ITBS is a relatively, in my, in my experience, a relatively easy injury to treat. Um, and this, this is much more tricky. So, um, I'll never see that person again. I mean, not no ill will towards him, but he didn't have the right experience. Um, and so that's, so now we're probably three weeks out and I've got an improper diagnosis. I'm doing the wrong exercises. Um, trying to kind of do some running, still feeling the pain, thinking it will eventually just go away. Um, and that, that kind of takes me to about June of last year. A lot of, well, some people with PhD report like sitting becomes uncomfortable. Did you ever notice that particular symptom at all at that stage of your management? I started to notice it in about June or I think I want to say June. Um, yeah. And then I actually did a road trip, which was probably the worst thing for it. And that's where I started to notice even like the loss of power, like the, the strength deficit in the, in the hamstring, um, in, in about July. Um, and then it came back from that road trip. Um, and I was sort of like leaning the whole time and just kind of leaning on the other glute when I'm sitting. Um, And what was interesting is I remember around this time in July, I was doing some exercises, like just basic glute bridges or other things for just general strength. And I noticed, I remember distinctly that actually kind of revved up the pain. And I was like, oh, I overdid this. And the next day I felt great, because obviously it had this sort of analgesic effect. And that's when I started to, I thought, you know, I did not get a, I don't have a proper diagnosis. I thought, I thought it might've been like piriformis syndrome at this point. Went back to that same PT. He kind of tried to, he validated that, but again, this guy didn't know what he's talking about. And then I finally, in about early August of 2022, I was, I had a heating Cause I had the pain like all the way in my glute as well. And it sort of, I remember after having a heating pad on it for a couple of hours, like it, it almost like went away from the glute and I was just left with that. Just the hamstring and the insertion point. Um, and I, I sort of was like, okay. I just figured it out on myself having after like some Googling of running injuries and I finally gave myself a proper diagnosis and then went to see. Another PT. in August who understood the injury a little bit better gave me some of the exercises correctly, but as I think I explained to you, um, at a different point, like, um, it wasn't, it wasn't all the, like the best exercise, I guess, so to speak, like, um, it was only after like listening to your podcast and having spoken to you where I think I got the best, I've kind of figured out the best rehab approach, um, and that was around. Yeah. Go ahead. In that stage was. the calf issue, was that still producing symptoms or had symptoms sort of like, um, localized itself more to the glute and upper hamstring. They had localized to the glute and upper hamstring. The calf pain really went away quite quickly. I want to say by June, I wasn't getting that anymore. Okay. And so based on the location of symptoms and doing some Googling, you said, you know what the upper hamstrings probably the most. prominent source of the symptoms. So maybe there's a diagnosis around there. And then you've said, so you've actively sought out another therapist and said, I think it's this. Um, what should we do? And then they assigned some exercises. Yeah. And he did an assessment too. He was a, um, a certified running coach, uh, runner had also dealt with tendinopathies and did an assessment and agreed that made sense. And that's when we got like a rehab program. going. Yeah. And what were the exercises? What did that look like? So it was single leg RDLs, reverse lunges, bridges, various iterations of bridges, marching, single leg, and just some hip. strengthening work, which is just good all around, but not necessarily critical for this entry. And when you say reverse lunges, that's like a lunge, but you step backwards instead of forwards. Exactly. Yeah. Okay. And were you seeing initial success? What, what was the response like? I did see some improvements, but this time in August, obviously the pain was probably at the peak, um, cause it really deteriorated and I saw some improvements. Um, but. When I, so when I had sort of figured this out, I had also started some of these, started experimenting with these exercises. And so I saw some improvement for that. And then I started adding even light weights at that point. And I, um, you know, the, the PT kind of, um, guarded warned me off on the weights, I guess, um, and which I thought was interesting because I was, had already started to progress to the adding some weight to my single leg RDL, not a lot at that point. And then I explained to him that, and I had done some, of course, I like to understand these injuries, so I had done some Googling, of course, and the concept of progression of weight. And then he understood where I was coming from. And I think maybe there was just a miscommunication about him not realizing that I had already started with some weights. But the thing was he didn't... And this is where, again, I'm not... There's just not a great understanding of the injury by a lot of people. He really didn't hammer home the importance of, you know, a gradual progression of weights and resistance, which obviously you do in all of your podcasts. And so that's where I, there was a kind of limited utility, I think, from that initial PT. He also, I mean, just as an example, I just kind of realized the limits of his knowledge, even as a great guy he was. He, when I told him I had tried. some squats in September and it produced some flare-up basically, and he couldn't figure out why that was. And as I started to learn more about the injury and what causes flare-ups, I realized that was a mistake at that point of my rehab, for instance. And then I just started, you know, I continued with some of those exercises. At that point in October, I think I had a chat with you. I was listening to your podcast and trying to get as much information as I could about of continue on my own rehab, essentially. It seems like you're throughout this like months and months, you slowly like working your way there, you're almost getting to the solution, you started off nowhere near hitting the mark with someone like diagnosing a calf issue, then you're doing a bit of research yourself, you go get another assessment, do a bit of research yourself. And like, you know, it seems like you're slowly becoming more and more effective, but just not effective enough to see substantial changes, but you're sort of Um, you know, honing in on something that might be eventually effective. Yeah. And I should have mentioned also, I saw in, I think in June or July, I found it. I had found another PT that was a certified running coach. I forgot about this. Um, and she was telling me that, um, you know, there was some issue with my back and had me doing, trying to do some like, um, what do you call them? Cobra's exercises and things are just going to make no difference. And so. I mean, I raised this just because, you know, I saw one medical doctor and two PTs, one of which was a certified coach. And I'm not trying to like, you know, um, speak, I don't have any ill will towards these people, but like, then I understand there actually are assessments that they should have been doing, right? As a PT, there is an assessment that you can do in person to identify an injury. And when I'm complaining about my hamstring. You know, these assessments were not done. And so I think that we all need to take responsibility as athletes and runners about, be proactive about trying to understand your own injury. But like, you know, that's what PTs are for as well to like help, you know, support people in properly diagnosing and getting people on a rehab plan. So looking back, I am a bit frustrated that, you know, I spent some money and time with some of these people that. Um, that I think should have been able to figure this out a little bit. And I, then I wouldn't have gotten so bad by August or September. It really, the pain had really increased to the point, you know, it was very difficult to sit in meetings, um, for my work and, um, it just got quite painful. And, um, so, I mean, obviously I wish I had found you sooner. I, um, and I wish I had diagnosed the injury sooner, but I don't know, you know, I'd never heard of proximal hamstring tendinopathy. Um, before like June of last year. So, um, I, it's, it's not one of the most commonly known injuries. Um, and so I don't, you know, that that's kind of, for me, that was the journey of self discovery, finding out about this injury. Yeah. Well, this is one of the reasons why I start the podcast in the first place. It's because it is so not really well understood and because there is often misdiagnoses and people struggling to find answers and. Hence why I want to create this resource, but you know, yourself listening to the podcast, a lot of the success stories is I went to X, Y, Z misdiagnosed, misdiagnosed. I went to three PTs, two Kairos, two sports specialists, and they could never figure it out. And you know, it's, it's an unfortunate circumstance, but it's very common, unfortunately. And, uh, so you're on these single leg. deadlifts you're onto these lunges, but, uh, your PT is very, uh, apprehensive to apply load, just do it very light, very easy. Um, were you still doing some running at this stage? I had started to, um, I had taken a little bit of time off in July. Also because, I mean, there are a lot of running entries. Um, they don't, I mean, they, they w there will be some healing effects. Right now I understand with tendinopathies, they don't really heal themselves. You leave it alone. It makes it worse. So I came back in August and started running again, a very small amount to what I had been running as I was trying to do these rehab exercises. And so, and it wasn't, I mean, when I first started, obviously the pain was as I could run a little bit, mostly did a walk run for a couple of weeks. Um, but then by September, October, I'm back to running, um, you know, upwards of somewhere between 25 and now up to 40 miles a week. Um, so yeah, I was able quite by August, September during my rehab, I started to run again. Okay. And so you started listening to the podcast and getting a bit more insight into what might be a more effective strategy. Um, but you also booked in for one of the free 20 minute injury chats. What prompted you to make that decision? I just, I mean, I, I. In September and October, when I started listening to the podcast, I just found so much value, um, in, in sort of what I, what I heard and, um, I think what's really useful Brody about like the way, I mean, um, I don't mean to sound like a sycophant, but I, I. I think what's useful about what you bring is that you make this stuff very accessible and easy to understand and easy to actually make practicable. So I just got so much value after listening to a variety of episodes and trying to then apply those lessons to my rehab. And as I was explaining earlier, I just felt like the previous PTs I had been working with had not... I didn't get as much value. So then I figured, well, I should have one of these chats. Also in October, I think I was sort of reaching, I was reaching a plateau actually, now that I'm recalling correctly. I had started, because I was upping my mileage and I sort of, I didn't probably up my weights as much. I started over a couple of weeks, started to feel like the pain was actually plateauing or even slightly sometimes getting worse. And so that's when we chatted in late October and Yeah, you gave me a couple of really helpful lessons or guidance, I guess. Okay. Well, what were the major takeaways about our discussion? What did you implement that sort of enhance the effectiveness? So, I started, you told me basically to switch from single leg RDLs to double. Well, first and foremost, I think I went over the weights that I was using and it was kind of still fairly moderate. So I increased the weight. And I actually, so I don't, you know, I have a pretty busy life. I don't have the ability to get to a gym. So I didn't, I just had a set of adjustable dumbbells that I was using. So I had to wait, I bought a weight set for my kind of home gym, barbell. And so I was kind of waiting for that for a couple of weeks, but then I started implementing um, uh, the double leg RDL, um, and almost immediately from going from a single to a double, I noticed like within two sessions, like the biggest leap forward that I had felt, um, I got up to a hundred pounds on single, which is still a lot for a single leg RDL, but I wasn't able, I think you had highlighted that it's really hard to balance and make it slow, heavy load element when you're doing a single leg. at that amount of weight and so moving to the double leg and even not, not even necessarily going right to doubling that weight, I was, I just noticed almost instant improvement in the, in how the tendon felt. Um, the other thing we had a chat, additional chat a couple of weeks ago, and, um, you mentioned the importance of the, um, kind of the hip extension exercise, which I only recently implemented. I think I'm at a point in my exercise where I don't really feel pain during that exercise. So I tried it out nonetheless, and I've continued to do it kind of, but I think probably that for me, the three most important exercises during my rehab process was the RDL and then gradually increasing the weight, the Nordic curls, which I had already gotten into myself but just as such an important hamstring strengthening exercise. And then I was also doing bridge sliders, single leg bridge sliders, because you can just keep a lot of tension on the hamstring. And I've kind of stopped doing that just because I'm at a point in my exercise where I'm just trying to add more weights. Sorry, a point in my rehab, I mean, where I'm just trying to add more weight and I can do more effective use of my time. But the main... piece of advice you gave me was just about increasing the weight load. And I noticed after our call that it just started to feel a lot better after I did that. This podcast episode is sponsored by the Ransmata Physiotherapy Clinic, which is my own physio clinic where I help treat a wide range of PhD 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. And I know like after our injury chat, you emailed me early November. I've just pulled it up in front of me and. You mentioned the straightaway success. Like you said, after two sessions, you already noticed that your pain had subsided and just goes to show, you know, we talk about on the podcast, we talk about tendons undergoing this analgesic effect, sometimes not every time, but some people can experience this, um, significant and prolonged reduction in symptoms when they do a slow, heavy load. You can almost treat it like pain medication. So a double leg. deadlift that's slow, heavy controlled in some cases, like three seconds down, two seconds up for, you know, maybe a half range of movement. If you do that slow and controlled, the tendons can actually respond really well to it. And if your symptoms beforehand were like a three to four, it can come down to like a one to two, sometimes pain free in some circumstances and last for, you know, four to six hours, sometimes longer. And That seems to be what the, the double leg deadlifts did really well for you that your previous exercises weren't necessarily serving nor could they, because like you say, if it's a single leg exercise, you're sort of a bit off balance. It's sort of, it's hard to engage the hamstring in a slow controlled manner. And it's very, very difficult to foster the right environment for the attendant to respond in that way. And so just implementing the right conditions for that tendon to undergo the analgesic effects seem to have a very immediate and profound improvement for you. Yeah. And I mean, I was giving that the analgesic effect earlier with the single leg RDL, but I just couldn't keep up with the amount of weight. So yes, I had that immediate sort of positive response and I definitely am someone that benefited from that. There were some days where I almost just because my tendon was so achy where I was like, I'm really looking forward to my rehab exercises just because I wanted to get that improvement in feeling. And I found that I mentioned this to you a couple of weeks ago, I think, when we last chatted that it surprised me a little bit that nobody, I mean, you look up the people that do know something about this injury and everyone seems to recommend the single leg RDL, but like, I mean, based on what you said, and then also just based on my own experience, I just can't understand why more people wouldn't recommend that exercise over the regular RDL over the single given what you explained. But I guess it comes back to the fact that there's not a great understanding about this injury by a lot of people. And this idea, which I had initially had, which is like... Oh, single leg is more important for addressing strength deficiencies, right? Um, cause you, you can't rely on the other leg. I've, I've had that sort of in my mind as well. Yeah. And I've had a lot of chats with people, seen a lot of clients who started off with single leg RDLs and displays them up straight away. It's just too much. It's too much load and it's, um, the wrong conditions for treatment, or they start with double leg and they go. From. pounds to 15 pounds and then they think the next progression is okay, let's go from double leg to single leg and that flares them up just because that carry over from double leg to single leg is too much. And I would just really want people if they are struggling with PHT, I'd rather just keep them at double leg and just progress the double leg until they're up to doing their own body weight in a deadlift. And that's the what I. try and strive for, for a lot of the athletic population, for someone who's like just, um, sedentary, but just has PhD, probably not those endeavors, but that's the goal. I think slow heavy load and the heavy stuff can be even beyond your body weight in, um, the deadlift and honing around the three to four sets of eight to 10 reps is, um, a pretty good condition. Like I say, as long as it's slow controlled, it, it tends to be the most effective. I don't, I've never, I think in the 95% of the PhD clients that I work with, no matter how severe this symptoms, no matter how long they've had it for, I start them with at least one variation of a deadlift and, um, that's because I know that it's just so crucial to people's rehab and you're an excellent example of that. Yeah. I mean, it seems like the most crucial exercise. So once you started implementing this stuff, Um, obviously you send me the email and say that you've had a dramatic improvement in your symptoms straight away after two sessions. Did you see any carryover into sitting? Did you see any carryover into running into any other, um, elements of your lifestyle? Um, yeah, I mean, the, the sitting has, uh, right around, I would say around sort of Thanksgiving, um, so like late November here in the United States. is when I started to really feel like, okay, I can actually sit for a couple of hours even at a time at this point, or even an hour for a meeting without feeling uncomfortable. And so that was nice, just because we need to be able to do that as human beings. And that's also when I was starting to increase my mileage. In December, I tried to start doing some speed work, as I told you. Maybe something to flag also is that I think I tried, I actually had to go back and listen to your episode on speed work because I tried to do like some tempo runs thinking that, okay, longer runs, but maybe not like a 5K pace is gonna be less stressful for the hamstring. But in fact, as you inform me, you wanna do something much shorter to start out. So now coming to. coming to the present, I'm working on kind of building strides and, and we'll start doing some short, very short intervals in the next couple of weeks. Um, yeah. Well, that's a good lesson. And it seems like you're, you're returning back to at least setting some sites on some really high end goals. Like you say, you want to start doing some more sprint work, some shorter distances, and that's only the fact that you have those goals is a good sign that you're on that right trajectory and symptoms are. responding accordingly and managing to tolerate those initial successes and initial introductions. Yeah. And I guess I should have said, um, the reason why I want to start re-integrated speed work is because I'm, I'm running Boston in April, and so I, um, that was a real delight out of, I qualified less during this race that during the run-up to this race where I got injured. Um, so I wanted to be able to, you know, try to, uh, try to do some, some speed work and some training this spring. Um, but I'm pro I will be taking that gradually because I'm really prioritizing the recovery over the PR. Um, recognizing I'm probably not going to get a PR this race. Yeah. Well, um, good to have those realistic expectations. Um, if there's someone who is currently struggling with PhD, um, You know, you're not, you wouldn't say that you've totally 100% overcome this, but I, you know, rarely the success stories I have are not what I expect them to be. But do you have any particular advice or guidance or reassurance for, for those who are particularly struggling and, you know, needing some encouragement? I think, I mean, for me, half the battle was getting the right diagnosis. And it's really unfortunate because I think that if you're able to figure out this injury relatively early on, I mean, you're the expert on it, Brody, but I suspect it would have been much easier to manage in the matter of a couple of weeks or whatnot, not half a year as it took in sort of my case. And I know people struggle with this for much, much longer than I have. So obviously that's the most important thing is getting the diagnosis. The second thing is just, yeah, patience. It will, I mean, this works, your strategy is slow having loading and getting the right exercises. It definitely works if you have the patience. And there was definitely times early on in kind of September, October, where I was, yeah, I was generally frustrated because it's such a slow... process for this injury to get better. But then once I started to see those improvements within, I mean, I think you've highlighted kind of, you have to give yourself at least six weeks and then maybe up to three months to see the real significant improvements. And that was certainly the case for me. So really just patience, trusting the process, as I think other people have said, and figuring out the right set of exercises. And then don't stop challenging yourself. I'm still, as you said, I'm still healing. I'm hoping that in the next kind of couple of weeks, next month, next six weeks, it will all see this kind of disappear. But I'm still gonna continue to challenge myself in these exercises because I wanna make sure it fully improves. And I'm gonna be doing RDLs and Nordic curls. for the rest of my life, probably at least once a week. So I mean, I think you just have to work hard to get rid of this injury, which is frustrating. But these strategies do work. I thought about doing dry needling and all these other things. But then I also listening to your podcast, it gives you cosmetic or short term improvements. And so I just stuck with all the slow heavy loading stuff. Hmm. A few other takeaways that I thought of just from listening to your story. The first one being like just seeking your own knowledge. Like don't just take, put all the, the power into the therapist. Like you've actually gone away from that and, you know, invested in your own knowledge about this condition or trying to come up with a diagnosis yourself or just being like, things aren't right. Let me do some research. eventually honing in on something that, you know, you started seeing the effectiveness. So I think investing in your own knowledge is a big one. The other one, which you sort of alluded to was change things that aren't working. Like, yes, you do need patience to see if something is working, but generally speaking, you should notice a very small trend on the improve, like at least every couple of weeks. And like you said, as soon as you went to double leg deadlifts, bang, you've found something on the right track. It only took two strength sessions to make significant difference. So then you're like, yes, I'm on the right path here, but you know, doing calf exercises initially and saying, you know what, things aren't right. These symptoms are moving into my glutes. It's still the problem with the hamstring. I'm not really seeing this much improvement. So you've made the decision that things aren't working. Things need to change. And then you've gone and changed those, which is I think crucial for. people trying to hone in on the best, most effective management. And so, um, the other thing that sort of combines all that is just, you're very empowered in your own management. You're not taking someone else's guidance. You're not just having, um, you're not just taking my word for it. You're not just taking your health professionals word for it. You're being involved in the decision-making process and you're doing your own research and sort of, um, you're being your own guide. where just, you know, you seem to be very much in control of your destiny. And so I think that's very important for a lot of people because someone might say, okay, double leg deadlifts are the answer. And then it flare them up and they say, okay, why is that? Why isn't that working for me? And you have to go back to the drawing board and sort of come up with your own solutions and find out what's working, what isn't working because everyone's different. But. those management principles and those guidelines, I think, are still warranted for everyone. Yeah, no, that's, thank you for saying it more eloquently. That's a really important point. I, the other thing that maybe slightly silver lining, slight silver lining out of this injury is that like, I was doing strength training before this, but I, I think, I mean, I think that the fast racing is what ultimately did me in, but, um, I also think I needed probably a little bit more variety. And also I wasn't lifting as heavy as I am now for the kind of running I want to do. So that's also a little bit of silver lining. I've introduced a bunch of new exercises. I'm also just, I mean, I'm just trying to injury proof myself basically, because I want to, I like racing and I like pushing myself. And so I've listened to your podcast, the other podcast. Um, where you had also, you were talking about Achilles tendinopathy and I'm just like, okay, well, I'm just going to start throwing in soleus raises because I know that's critical to preventing that. And I haven't, the only injury I have not had is anything in my, in my, um, like my ankles or calves. Um, I've, I've had a few injuries in the sort of glute hamstring now. Um, and so I don't want to have those in the future. So I'm just trying to, um, I really kind of upped my game a little bit on the strength side and all. You know, I'm doing this all now just in two rehab, two sessions, two strength sessions a week, basically, um, about an hour or an hour and 15 minutes just because of the, approximately because of the, the work I'm doing on my hamstring every single time, um, and then I do some like core and other stuff at other points. But I think the main point is that like, you don't have to dedicate a ton of time to this stuff when you're healthy. When you're rehabbing, of course, you have to, you have to dedicate a lot. Um, but it's just a couple of hours a week and you can really, really reduce your injury risk, um, if you're doing racing and, or just a lot of running. Um, so that's something that I, for me, it's been a silver lining. I've now got a number of different exercises. Started doing kettlebell swings per your guidance, never done them before. So, um, yeah, I don't know. I'm excited to see also how this additional strength might play into. Just my running in general. Yeah. Injury prevention and also performance as well. If you're doing some plyometric power based stuff, it's going to really, um, carry over to running faster, improving your marathon times, improving your 5k, 10ks. So looking forward to seeing where that takes you. Um, thanks for coming on and sharing all this knowledge. Um, good luck for Boston. Um, looking forward to seeing how that goes and. Like I say, your journey has been full of insights and full of nuggets for people trying to negotiate this, this condition. So thanks for coming on and sharing. Thanks Brody. 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.