What you need to know about adaptation

: On today's episode, what you need to know about adaptation. 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 of course, bust the widespread misconceptions. My name is Brodie 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. mentioned at the start of this podcast that I will be using snippets from the run smarter podcast and just trying to apply it as best we can to proximal hamstring tendinopathy. It is in different order than in the original podcast. But today I am introducing my ebook. It is the ebook itself contains 10 universal principles to overcome any running related injury and While this podcast itself isn't necessarily about running, there are some key chapters within that book that I'd like to extract and teach to you guys. So season or chapter one within that book is called adaptation education and it is crucial when it comes to identifying how this injury happened or identifying. how adaptation can help within your rehab. And so decided to put this in as episode five today. Once you have essentially learnt a lot of the basics around proximal hamstring tendinopathy, and we'll play a snippet from that episode now. And then I'll dive back in to teach you some proximal hamstring tendinopathy specific lessons. Principle one being adaptation education, give it time and the body will adapt. So throughout this ebook we follow a character that I have created and his name is Injury Prone Pete and Pete discovers these 10 principles throughout his running career as he starts running and a couple of years into it he goes through these different chapters, learns different skills and hopefully through this parable you can pick up these ideas yourself and relate to your own running injuries. So why adaptation? Why is adaptation important? You need to learn this for all of your injuries. Like if you put your body through a certain load under certain conditions, if it's under the right conditions, it will get stronger. It will adapt. It will become more resilient and lessen your chance of injury. Usually when there's injury, it means you've done too much, too quickly. and you haven't given the body enough time to adapt. So this is why this is principle number one. It applies to a lot of things, even if you're in the gym just wanting to work your arms and get stronger, or if you wanna run, or if you wanna play tennis, all of this applies. So I'm not usually good with reading things out loud, but I'm gonna read this chapter, and then we're gonna discuss the principles, okay? So within the e-book, so we start with meet injury-prone Pete. Approaching his late 30s and once quite active with team sports, he finds himself becoming quite lazy. As full-time work and life got in the way, exercises were less of a priority. Years went by and injury-prone Pete began to put on some weight and his doctor didn't like the health trend he was heading down. A friend recommended running for fitness and even though injury-prone Pete was nervous, don't blame him with a name like that, he decided to give it a try. He started running at night so no one could see his initial attempts. Just jogging to the end of the block his calves started burning and his runs started turning into a shuffle until he collapsed with his hands on his knees gasping for air. The jog back home was no better but persistence prevailed and the next day he could run a little further. After three weeks of running injury prone Pete realised he could jog at a continuous pace without needing to stop and catch his breath. His calves were still a little bit sore the next day, but the rest of his body was recovering well. His running routine was no longer hidden by the night. Congratulations. And although he didn't admit it to anyone, he was starting to enjoy the feeling of running. So what's happening here? After the chapter, I post a lesson, and it's a little bit more of a physio term and debriefing what he's going through. So let's go through adaptation education. Give it time and the body will adapt. The people who say running just isn't for me will usually run for one to two weeks and hate the entire experience. Like Pete's first attempt, they were discouraged by the lack of untrained talent that they possess and they move further onto another form of exercise that they enjoy or that they're better at. Once someone breaks through this trial period, the body adapts quickly until it reaches a comfortable steady state without the need to gasp for air and stop. So I want to, in this book, there's a couple of illustrations and graphs, but I'll explain it as best I can throughout the podcast and just trying to explain it. So we're looking at a graph. If you were to think about a Y-axis graph and you have the daily load that you go through, and it's just a line that follows. As soon as you do a run. that load spikes up because you're putting your body through more stress. If you go gardening, that puts your boy through a little bit of stress. If you run a marathon, it shoots through the roof. So that you just follow that load through the graph. And as it goes through the graph from left to right, you go through certain zones. So if you do a little bit, say housework, it only just moves that load. line just a tad. It's not enough for the body to adapt. If you go for a run, which is a little bit more, we break this threshold of the minimum load required for adaptation. So the body needs to go through a certain threshold in order to start getting adaptation. It won't get stronger if you lift a 1 kilo weight once. That's not going to cut it unless you're a very frail old lady. This podcast episode is sponsored by the Ransmata 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. So we need to hit this adaptation zone in order for the body to start responding. However, if you do too much too quickly, you're going to exceed this third zone, which is the maximum, the max line. So it's the maximum amount of load that can be tolerated. And if you exceed that, the body's going to become stiff, sore, and you can result in injury. So if I follow in this chapter, it says, let's have a look. at the graph through Pete's Journey. We want our bodies to get stronger in order to tolerate more load when running. In other words, your body needs to adapt. The graph illustrates the blue line indicating the amount of stress the body receives over a selected period. We also see that red maximum line, which if exceeded will result in tissue breakdown and injury. We also have the minimum load required for adaptation. You do encounter some stress to the body when you walk the dog, go to work, clean the house and for these examples most individuals will not surpass this minimum threshold for the body to adapt. You will not get stronger by cleaning the house. As you can see Pete's participation in activities that fall within the adaptation zone, that max line begins to elevate. This means that his tendons, his joints, his muscles will be able to sustain more load in the future without damage. So this is the first chapter. We have a look at the load that Pete's going through as he goes through some runs. He starts to hit that adaptation zone, that nice adaptation zone that we want to get to. And he's not exceeding the maximal capacity line, so he's not getting injured. But as he reaches that adaptation zone more and more, that max line starts to creep up. So in other words, the body can tolerate more load in the future without any tissue breakdown and injury. So let's look at a real world example. When I first started running, I say the calves in the first chapter because that was exactly me. As soon as I started running, my calves were so tight and I wasn't getting injured. My Achilles were pretty strong from a history of basketball, so I could tell that my maximum quite high with my Achilles. But after months of travelling and not doing a lot of exercise, I would jog for 3k, a bit of a walk jog, and afterwards my calves were so tight and sore if I pointed my toes up, if I pointed my toes down, they were just burning. And they simply needed to adapt. It took probably about two months before I didn't feel the need to stretch for two hours after a run. I was more of a four foot runner, so a lot of strain was going through those calves, but eventually they adapted, and now I have no issues with calf tightness. The other adaptation was my cardiovascular response, my aerobic capacity. I was sweating, gasping for air, needing to walk, feeling sluggish, all that sort of thing. And probably in about two or three weeks, I got into a steady state where I could jog continuously and not feel like I need to stop and take a rest. My body could adapt, keep breathing, and could keep going. So that was very encouraging. So there's some real world examples, and you can probably relate to a bunch when you started running, or if you had some extended time off and then getting back into running. I have this analogy that I've created. and I'll be applying to a lot in these episodes. I'm gonna call it the iceberg analogy. So, if you were to imagine your iceberg floating in the ocean, this iceberg is your buffer. The bigger you get your iceberg, the better. If your iceberg starts breaking down and cracking, that is a sign of an injury. If you get that iceberg as big as you can, This signifies resilience and just a buffer. Your maximum capacity line is through the roof and your likelihood of injury is significantly lower. So you have to nurture this iceberg as much as you can and you need to get this iceberg as big as you can. How do you do that? Well, if you can imagine this iceberg is being super cold, and I know this doesn't happen in the real world, but if you were to imagine a wave in the ocean, that hits that side of the iceberg and sprays water up along the wall of that iceberg. And as that water trickles down, the iceberg freezes that water and it joins that iceberg, becomes ice and overall becomes bigger. Now for that iceberg to become bigger takes a lot of time. And those waves that hit that iceberg and spray on the wall need to be in the right conditions. need to be at the right height, need to come at the same frequency for it to slowly start getting bigger and bigger. If it's a big wave that crashes into the iceberg that can break pieces off and it can structurally damage the iceberg, we don't want that whatsoever. Also if you have a smaller iceberg to start with, medium waves can break into that iceberg and create disruption, its structural integrity and can break pieces off. having a big iceberg to start with, not a lot of people do, but having that big iceberg to start with is probably a better situation for you. Not only is the iceberg relating to the entire body, but it can also relate to certain parts of your body. Like I was saying with my running, my Achilles work quite strong being in a basketball background and doing a lot of jumping and conditioning those Achilles. Even though I was just starting out as a runner, my Achilles iceberg would have been quite substantial. My knees on the other hand, probably not as much, and a couple months in I actually started getting a bit of knee pain. Reflect on this in your current running capacity. How strong do you feel? How weak did you feel when you first started running? How vulnerable were you to injuries? How slow did you need to take things? This analogy I'm gonna be applying to a lot of these chapters in the future episodes. So if you can create, so if you can visualize this analogy, it's going to apply it not only for your entire body, but for certain body parts and certain injuries. So work on that iceberg. Nurture that iceberg, put it in the right conditions, allow it to adapt, get bigger without chipping away at any pieces or damaging its structure. This chapter doesn't have all the answers, I understand that. It is a core foundation principle, okay, that everyone needs to understand before we can move forward. So this is why this is episode number one. This is why it's chapter number one in the ebook. Okay. We are back and we are concluding today's episode with what I think you need to take away when it comes to managing your proximal hamstring tendinopathy. First, understanding these adaptation principles leads to first understanding how this happened in the first place. If you can identify some key factors within your training or with at the time of your first developing this, you can get better clarity, get better understanding that you may have exceeded your capacity. So maybe you've over trained or maybe you've under covered or somewhere along those lines. Usually tendons hat will fit a pattern. It'll happen for 85 to 90% of the people that I see. So give you some clarity because that might take some lessons away or maybe some training errors that you might have had in the past, training approaches that might have steered you astray. So keep that in mind. The second thing that you need to think of is currently while you are managing this hamstring. The adaptation process still applies while you're doing these exercises. We still need to hit your sweet spot within the within your rehab exercises in order to trigger adaption in order for that tendon to start tolerating more capacity and getting stronger. We can't under do it and continuously be doing say bodyweight exercises or continuously be doing double leg bridges and expect the tendon to adapt and constantly get stronger. It doesn't work that way. We need to continue following that adaptation sweet spot and continuously progressing without exceeding its capacity. And This iceberg analogy does come into play through the whole body, but it also depends on certain areas within the body. So your hamstring iceberg, you could call it, or your hamstring adaptation sweet spot will be different to the rest of the body. It'll be different to your other hamstring, it'll be different to your calf, it'll be different to your hips. So we need to hone in on what that adaptation sweet spot really is like for that specific hamstring and that tendon. Also keep in mind that the adaptation sweet spot can vary. It can vary wildly depending on the condition of the tendon. So different times, maybe on Monday, a sweet spot will be different from what it's like on Friday. If it is flared up, the sweet spot might be a bit different. If it's quite stable and you're having quite a good week that sweet spot will be different also. So keep that in mind and factor that in when you're doing your rehab exercises and perhaps ask your health professional for guidance if you're doing bodyweight exercises for a couple of weeks and you need to progress to follow that sweet spot. So that's what I have to conclude with today's episode. Next time we're going to be interpreting your hamstring symptoms and trying to accurately understand what's happening with pain signals. So that's another chapter out of the ebook, very similar format to today's episode. So I look forward to bringing that to you then. 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.