The Run Smarter Podcast

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In this month’s Latest Running Research episode, Brodie breaks down four newly published papers that challenge common assumptions about bone health, injury risk, shoe prescription, and recovery tools in runners. 
Across all four studies, a consistent theme emerges: what feels logical—or is heavily marketed—doesn’t always align with how the body actually adapts. From bone mineral density and stress injuries to shoe “matching” and foam rolling, this episode helps runners separate useful tools from over-inflated claims.  
🦴 Paper 1: Bone Mineral Density & Ground Reaction Forces 
This study explored whether the forces experienced during running are associated with bone mineral density (BMD)—and whether this relationship differs between male and female runners. 
Key Findings 
Male runners with higher ground reaction forces tended to have higher bone mineral density at the spine, pelvis, femur, and tibia.
These relationships were present at both self-selected and standardised running speeds.
In female runners, no meaningful relationship was found between impact forces and bone mineral density.
Female runners had consistently lower absolute bone density and impact forces than males.
Why This Matters
Bone adapts to mechanical loading—but not equally across sexes.
Running alone may provide enough stimulus for bone adaptation in males, but often not in females.
Hormones, energy availability, muscle mass, and force production likely play a role.
Practical Takeaways
Running mileage alone is not a reliable bone-building strategy for everyone.
Female runners may benefit more from:Heavy strength training
Jumping and sprinting
Multi-directional loading

Bone health also depends on recovery and nutrition, not just impact.
🦴 Paper 2: Biomechanics & Bone Stress Injuries
 
This scoping review examined biomechanical factors associated with bone stress injuries (BSIs) across multiple running populations.
 
Key Findings:
The strongest prospective risk factors for BSIs were:Greater vertical centre-of-mass movement (“bounce”)
Lower cadence

Every ~0.5 cm increase in vertical motion was linked to a 14–17% higher injury risk.
Each additional step per minute was associated with a 3–5% reduction in risk.
Site-specific mechanics varied by injury location (tibia, metatarsals, navicular).
Why This Matters
Excessive vertical motion and low cadence consistently increase bone stress.
Many commonly blamed factors (e.g. loading rate) are less reliable predictors.
Some biomechanical findings may reflect post-injury adaptations, not causes.
Practical Takeaways
Small cadence increases (5–10 steps/min) may meaningfully reduce bone stress.
Reducing unnecessary “bounce” can be protective.
Gait changes should be gradual and load-aware.
Biomechanics is only one piece—training load, sleep, nutrition, and bone health interact
👟 Paper 3: Shoe Recommendations & Gait Analysis
 
This single-blinded randomised trial tested whether shoes recommended based on gait analysis actually change how runners move—or simply change how they feel.
 
Key Findings
Shoes labelled as “gait-matched” were rated:More comfortable
Higher performing
Lower injury risk

Despite this, both shoes were identical models with different colours.
No differences were found in:Running mechanics
Foot strike
Tibial acceleration

Why This Matters
Expectations and expert recommendations strongly influence perception.
Gait analysis can act as a placebo-like effect.
Feeling better does not necessarily mean moving differently—or safer.
Practical Takeaways
Comfort matters—but it does not guarantee injury protection.
Be cautious of claims that a shoe “fixes” your gait.
If a shoe feels good and supports consistent training, it can still be useful—but not for biomechanical reasons.
Long-term injury risk is driven more by load management than shoe category
 
🧠 Paper 4: Foam Rolling & the Knowledge-to-Action Gap
 
To close the episode, Brodie discusses a paper examining whether practitioner beliefs about foam rolling align with scientific evidence.
 
Key Findings
Strongest evidence supports foam rolling for:Short-term increases in range of motion
Temporary pain reduction
Acute increases in local blood flow

Little to no evidence supports:Performance enhancement
Injury prevention
Long-term structural changes to muscle or fascia

Only 2 of 15 practitioner beliefs aligned with the evidence.
Knowledge gaps existed across professions and countries.
Why This Matters
Foam rolling isn’t useless—but its benefits are often overstated.
The issue isn’t the tool—it’s how it’s explained and justified.
Poor science communication fuels unrealistic expectations.
Practical Takeaways
Use foam rolling as a short-term symptom-management tool, not a fix.
It won’t replace strength training, load management, or recovery.
If it helps you feel better and train consistently, that still has value
🔑 Episode Take-Home Message
 
Across bone health, injury risk, footwear, and recovery tools, the evidence consistently shows that adaptation is driven by load, context, and recovery—not quick fixes or marketing claims.

Understanding what actually matters allows runners to train smarter, reduce injury risk, and focus on interventions that truly move the needle.

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For years, chronic tendinopathy has been treated as a tendon problem — load it, strengthen it, remodel it. But what if, for some runners, the tendon itself isn’t the main driver of pain anymore?
In this episode, Brodie breaks down a new 2026 systematic review that may reshape how we think about stubborn, long-standing tendon pain. The paper explores whether nerve ingrowth and abnormal blood vessels around tendons — not degeneration of the tendon tissue itself — may be the real pain source in chronic cases.
We unpack the emerging research, explain each intervention in plain language, and discuss who this may (and may not) apply to — especially runners stuck in repeated rehab cycles despite “doing everything right.”
This is early, evolving science. But it’s a fascinating glimpse into where chronic tendon treatment may be heading next.
What You’ll Learn in This Episode
Why some chronic tendon pain may be neuropathic (nerve-driven) rather than structural
How abnormal blood vessels and nerves grow into painful tendons over time
Why traditional loading programs sometimes stop working in very chronic cases
What “neural modification” treatments aim to do — and why they’re gaining interest
The six intervention categories reviewed in the paper (explained simply)
How strong (or limited) the current evidence actually is
Where this research fits alongside exercise-based rehab, not against it
Interventions Reviewed (Plain-English Overview)
1. High-Volume Injections (HVIGI / HVDI)
Large volumes of fluid are injected around the tendon (not into it) under ultrasound guidance to mechanically disrupt abnormal blood vessels and pain-sensitive nerves.
Key takeaway:
Consistent short- to medium-term pain and function improvements, especially in people who had failed exercise-based rehab.
2. Sclerosing Polidocanol Injections
A chemical agent is injected directly into abnormal blood vessels to deliberately close them down, cutting off blood supply to pain-producing nerves.
Key takeaway:
Moderate to strong pain reductions in very chronic cases, with outcomes comparable to surgery in some studies.
3. Radiofrequency Microtenotomy
A minimally invasive procedure using controlled heat to disrupt nerve ingrowth and abnormal vessels at the tendon–paratenon interface.
Key takeaway:
Very strong results in a small cohort, but higher risk and limited evidence so far.
4. Minimally Invasive Paratenon Release
Scar-like adhesions between the tendon and surrounding tissue are mechanically released to restore tendon movement and reduce nerve irritation.
Key takeaway:
Large pain reductions and high rates of pain-free outcomes in non-insertional Achilles tendinopathy.
5. Electrocoagulation Therapy
Electrical energy is used to seal off abnormal blood vessels surrounding the tendon under ultrasound guidance.
Key takeaway:
Promising early results, but evidence limited to one small study.
6. Surgical Interventions (Open & Endoscopic)
Surgery physically separates the tendon from irritated surrounding tissue and removes abnormal vessels and nerves.
Key takeaway:
Effective for some, but invasive, with longer recovery and higher risk.

The Big Picture Takeaway
Across very different procedures, outcomes were surprisingly similar.

That points to a common mechanism:
 👉 Modifying the neural (nerve-driven) pain environment around the tendon, rather than “fixing” tendon structure itself.
This doesn’t replace exercise-based rehab — but it may explain why a subset of runners with long-standing, highly sensitive tendinopathy stop responding to load alone.
This research is best viewed as a future direction, not a replacement for good rehab principles.

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Chronic plantar fasciitis can quietly strip away your confidence, your identity as a runner, and eventually your belief that running is even possible again.
In today’s episode, Jon shares his seven-year battle with stubborn plantar fasciitis—and how he went from barely being able to walk in the morning to completing trail marathons at age 59.
This is not a story about a magic treatment or a quick fix. It’s about patience, progressive strength, smarter recovery, and changing the way you think about pain. If you’ve tried everything and feel like you’re running out of options, this conversation will resonate deeply.
What We Cover in This Episode
Jon’s long road with plantar fasciitis
How his symptoms started, disappeared, then returned worse than ever
Why years of rest, stretching, and passive treatments didn’t solve the problem
What “first-step pain” taught him about whether he was improving or regressing
Why many plantar fasciitis treatments fail
Over-stretching and aggressive rehab that actually delayed healing
Why ticking “strength training” off the list too early is a common mistake
The difference between doing exercises and loading tissue correctly
The turning point
The mindset shift that stopped the injury from controlling his life
How slow, progressive calf strengthening rebuilt tissue capacity
Why learning not to catastrophize flare-ups changed everything
Strength training that actually worked
The calf exercises that gave the biggest return on investment
How he progressed from double-leg to single-leg loading safely
Rep ranges, frequency, and why patience mattered more than intensity
Recovery beyond rehab
How improving sleep quality accelerated his progress
Nutrition changes that supported training and recovery
Why recovery became non-negotiable as he got older
Where Jon is now
Running pain-free most days after years of struggle
Completing half marathons, mountain runs, and a self-supported trail marathon
How he’s approaching goals differently to stay healthy long-term

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Matt is a repeat guest from the Doctors of running and a running shoe fanatic!
Our discussion on today's episode starts with shoe expiry dates. Matt gives his opinion on when it is time to buy new running shoes and what variables play a role in running shoe wear and tear.
Next, we explore the different features of a shoe that you need to consider when buying a new pair. Matt discusses comfort, flexibility, stability, upper, drop, weight and many other features.
Matt also shares his recommendations on shoe brands for beginner runners, performance-minded runners and his take on maximalist versus minimalist.
Follow Matt's work by visiting the doctors of running website, youtube,  podcast and insta.

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In this month’s Latest Running Research episode, Brodie breaks down three high-impact studies that every runner should know about—covering sleep quality and injury risk, what actually gets injured during marathon running, and how strength training can improve running economy. If your goals are to run faster, stay injury-free, and train smarter in 2025, this episode delivers clear, evidence-based insights without the fluff.
We start with a standout prospective study tracking runners over six months, showing that poor sleep quality—not sleep quantity—significantly increases injury risk. Each one-point drop in perceived sleep quality increased injury risk by 36%, while rising fatigue and muscle soreness emerged as early warning signs in the 1–2 weeks before injury. The takeaway is clear: sleep quality, recovery monitoring, and subjective signals like soreness and fatigue deserve far more attention than most runners give them.
Next, we zoom out and examine a comprehensive review of marathon-related injuries, separating race-day injuries from training injuries and identifying the most commonly affected areas (thigh, knee, calf, foot, and ankle). The paper highlights both modifiable risk factors (training load, recovery, alcohol use, footwear transitions) and non-modifiable risks (age, sex, prior injury), offering valuable context for runners preparing for longer events or returning from injury.
Finally, the episode explores new research on strength training and running economy, focusing on how combining heavy resistance work with plyometrics (“complex training”) can meaningfully improve efficiency. The findings reinforce that strength training isn’t just for injury prevention—it directly improves how much energy you burn at a given pace, making it a powerful performance tool when programmed correctly.