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Episode Summary: In this episode, we explore the fascinating role of Vitamin C in tendon recovery, collagen synthesis, and tendinopathy prevention. Brodie dives into the latest research to examine how Vitamin C-enriched supplements, when combined with exercises, can potentially enhance tendon healing and performance. 

He discusses two key studies: 
1.) Vitamin C–enriched gelatin supplementation before intermittent activity augments collagen synthesis 
2.) Effect of Vitamin C on Tendinopathy Recovery: A Scoping Review 

The conversation highlights the potential benefits and limitations of Vitamin C in injury recovery, offering practical insights for runners and those dealing with tendon injuries.

Key Takeaways:

1. Vitamin C and Tendon Health: Vitamin C plays a crucial role in collagen synthesis, which is essential for tendon repair and recovery. Collagen makes up 60-75% of tendons, making its synthesis critical for both injury recovery and performance enhancement.
2. Research Insights:
   • A 2017 study found that supplementing with Vitamin C-enriched gelatin before intermittent exercise doubled collagen synthesis in participants, suggesting a potential benefit for injury prevention and tissue repair.
   • A scoping review on Vitamin C’s role in tendinopathy recovery shows promising but inconsistent results, particularly when Vitamin C is combined with other nutrients like mucopolysaccharides and type 1 collagen.
3. Practical Application:
   • While there isn’t a definitive recommendation on the optimal dosage or timing of Vitamin C for tendon recovery, the studies suggest considering Vitamin C-enriched supplements, especially for athletes under intense training or those dealing with tendinopathies.
   • Other factors like proper nutrition, rest, and reducing alcohol intake are also critical for maximizing tendon recovery.

Why Listen? Whether you're recovering from an injury or looking to optimize your tendon health for peak performance, this episode offers valuable insights. With research-backed information and practical advice, Brodie simplifies the complex science behind tendon recovery and how you can potentially leverage Vitamin C for faster recovery and stronger tendons.

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Papers discussed on today's episode:

Paper 1: Foot Posture and Ankle Dorsiflexion as Risk Factors for Developing Achilles Tendinopathy and Plantar Fasciitis: A Case-Control Study

Paper 2:  Evaluating the Effectiveness of the Annual Physical Training Plan for Masters +45 Women Half Marathon Athletes: AGuideline Model for Good Practices for Programming Effort Volume and Intensity

Paper 3: Acute effects of the short-foot exercise in runners with medial tibial stress syndrome: A quasi-experimental study 

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Summary: In this episode, we dive into a 2023 study that examines the relationship between carbon fiber plate footwear and bone stress injuries in runners. The research is an opinion article, backed by case studies and observations, highlighting potential biomechanical shifts and injury risks that may come with these advanced shoes. We break down the mechanics of carbon fiber shoes, how they work, and their impact on running performance. We also explore five case studies of athletes who developed navicular bone stress injuries while using these shoes, providing valuable insights into the risks, symptoms, and management strategies.

Key Takeaways for Recreational Runners:

1. Carbon Fiber Shoes: Performance Benefits and Misconceptions – Carbon fiber shoes act as a lever, not a spring. While they enhance running performance by providing a more efficient propulsion, their benefits are closely tied to both the carbon plate and the high-tech foam used in the midsole.
2. Biomechanical Changes – Runners using carbon fiber shoes experience changes in biomechanics, such as reduced cadence, longer strides, and increased flight time. These changes could potentially increase the risk of injury, particularly in the foot and ankle.
3. Injury Risks – Bone stress injuries, particularly in the navicular bone, may occur due to the altered distribution of forces in the foot. Athletes in the study experienced symptoms like midfoot pain and swelling after using carbon fiber shoes, leading to long recovery times and, in some cases, surgery.
4. Case Studies – Five detailed case studies offer real-world examples of how runners were affected by bone stress injuries after using carbon fiber shoes. These cases emphasize the importance of symptom awareness, early diagnosis, and gradual rehabilitation.
5. Careful Transition to Carbon Fiber Shoes – Runners should avoid making abrupt transitions into carbon fiber shoes. It’s essential to gradually introduce these shoes into your training routine, starting with slower runs before incorporating speed workouts or races. Failure to do so can lead to severe bone stress injuries, as seen in the case studies.
6. Monitoring Symptoms – Keep an eye out for midfoot pain, especially around the navicular bone. If you experience persistent pain or swelling, seek medical advice and consider getting an MRI or CT scan early to prevent a prolonged recovery process.

This episode provides essential insights for any runner considering carbon fiber footwear, especially those concerned about injury risks and recovery strategies.

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Today's Episode Question:

Question 1:

I was also caring for my mom - she died earlier this year and the profound grief turned into depression/anxiety and has left me with chronic fatigue. I haven't been able to run in 20 months and I've been doing it my whole life. How does one run when dealing with clinical depression/anxiety when the fatigue is too much?

Question 2:
When is the best time to incorporate single leg exercises? Is it year-round or during a certain phase of training? How should this be balanced with exercises that use both legs?

Question 3:
I’ve run two marathons and started carb loading 2 days prior to marathon day. I’m generally a healthy eater and I really struggle with consuming the suggested 10grams of carbs per kilogram of body weight before the event, given that my carb loading diet is made up of things that I don’t like eating, ie white bread, white rice and sports drinks. I previously fuelled well throughout my 2 marathons and luckily haven’t experienced hitting the wall yet. I’ve entered Queenstown marathon in November and am considering not carb loading as a kind of experiment and just making sure I fuel and hydrate well throughout the race. What do you think of this?

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Today's Episode Question:

Question 1:
How should you go about planning running volume for the off-season?
Is there a certain percentage of reduction that's recommended?
How do you ensure you have enough base mileage at the end of the off-season to pick up the next training cycle?

Question 2:
I don't have a great strength training setup. The offseason is coming up for me in late November and I want to do more/better strength training.
What equipment would you recommend for effective strength training?

Question 3:
Why is stress a factor that affects performance and recovery? 
Sometimes stress can be good and motivate us to run more, but other times it can make us more vulnerable to injuries. 

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Alice Sanvito is a massage therapist trained in trigger point massage, remedial and sports massage. After several years of practising & lecturing the concepts she learnt, she began challenging her own beliefs and following the science.

Today we cover:
Are there benefits to promoting blood circulation, and removing lactic acid?
Does massage help with muscle lengthening & knots?
What is the mechanism behind trigger point therapy?
What traps should runners avoid when injured?
When is there a place for a runner to receive massage therapy?

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Papers discussed in today's episode:

Paper 1: Cadence matters: Influence of cadence on spinal load during running
Paper 2: Is There a Pathologic Running Motion Associated with Running-Related Injuries? A Methodological Study Using a Motion Analysis System without Sensors
Paper 3: The Prevalence of Stress Fractures and the Associated LEAF-Q Responses, Self-Reported Exercise Volume and Dietary Behaviors in Female Recreational Runners

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The Best Caffeine Strategy to Run Faster with David Hellard

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Guest Bio:
David Hellard is a passionate endurance runner, entrepreneur, and podcast host. He is the founder of Caffeine Bullet, a business that specializes in caffeine chews designed for athletic performance. David has also competed in various ultra-marathons, including the Marathon des Sables, and was the face of the Golden Trail World Series. He’s also the host of the popular podcast, Bad Boy Running, where he shares stories of running adventures rather than focusing solely on performance improvement. He successfully pitched his company on Dragons’ Den and secured investment from well-known entrepreneurs.

Episode Summary:
In this episode, Brodie Sharpe chats with David Hellard about the science behind caffeine as a performance-enhancing supplement for runners. The discussion dives deep into how caffeine can benefit runners of all levels, from improving endurance to boosting mental alertness. They explore the optimal dosages, timing, and forms of caffeine, as well as the variability in how individuals respond to it based on genetics. The episode is packed with actionable insights for runners looking to enhance their performance through caffeine without sacrificing sleep or gut health. David also shares how his product, Caffeine Bullet, was developed and offers listeners a special discount.

Key Takeaways for Recreational Runners:

1. Caffeine as a Performance Booster:
   • Caffeine can enhance endurance by up to 8% by sparing glycogen stores and releasing fat as an energy source.
   • It can reduce the perception of pain and fatigue, helping runners push through tough sections of a race.
2. Personalized Response to Caffeine:
   • About 50% of people are "super responders" to caffeine, while 8% may see no benefit. It's important to test caffeine use in training before relying on it during a race.
   • Genetics play a large role in how quickly you metabolize caffeine. Brodie discusses his own genetic predisposition as a fast metabolizer.
3. Optimal Dosage and Timing:
   • The ideal caffeine dose is between 3-6 mg per kg of body weight. For a 75kg person, that’s about 225-450 mg.
   • For longer races, take caffeine when you start to tire, often around mile 18-22 for marathoners. In shorter races, it can be taken pre-race or early in the race to get an additional mental boost.
4. Choosing Caffeine Sources:
   • Caffeine can be consumed via chews, gels, coffee, or gum, but chews like Caffeine Bullet are absorbed faster, making them more effective for mid-race boosts.
   • Uncoupling caffeine from carbohydrate intake can allow for more flexibility in timing, particularly if gels are your primary source.
5. Considerations and Potential Drawbacks:
   • Caffeine can increase heart rate, making it important to monitor if you're using heart rate data during training or racing.
   • Gut sensitivity to caffeine varies; testing its impact in training is crucial to avoid gastrointestinal distress during a race.
   • Overuse can lead to disrupted sleep and reduced training benefits, so it’s essential to manage daily caffeine intake.
6. Practical Advice for Testing Caffeine in Training:
   • Experiment during training runs to find out what timing and dosage work best for you.
   • If you’ve been relying on caffeine regularly, consider cutting back to restore sensitivity and improve race-day effectiveness.

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Episode Summary: This episode delves into a 2023 research paper that examined how an 18-week program of strength exercises and foam rolling impacted the injury rates of recreational runners. Brodie breaks down the study's methodology, results, and key takeaways, offering runners actionable insights into injury prevention through targeted strength work and foam rolling techniques.

Key Takeaways:

• Strength Training Reduces Injury Risk: The research found that runners who performed strength exercises focused on key muscle groups (hip abductors, quadriceps, foot supinators) twice a week had a significantly lower risk of injury compared to those who did not.
• Foam Rolling Shows Mixed Results: Foam rolling has shown inconsistent outcomes across studies, but this particular intervention suggests that combining strength exercises with foam rolling may improve injury resilience.
• Compliance Matters: The study found that runners who adhered closely to the injury prevention program had an 85% lower risk of injury compared to a control group. Conversely, low-compliance runners were almost twice as likely to get injured.
• Foam Rolling's Role in Recovery: Brodie shares how the research shifted his perspective on foam rolling, citing that while its benefits for flexibility and recovery are not always clear, it may play a role in reducing trigger points and injury risk.
• Injury Prevention Recommendations: By integrating strength training and foam rolling consistently, runners can significantly extend their "injury-free" running days and potentially decrease the likelihood of developing running-related injuries.

Actionable Advice for Runners: Runners can incorporate strength training exercises like single-leg squats, forward lunges, side steps with resistance bands, and foam rolling sessions targeting key lower body muscles to help reduce their injury risk. Consistency and compliance with these exercises are crucial for seeing tangible results.

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In this episode, we dive deep into groundbreaking research that could revolutionize how we understand and treat chronic tendon pain. Our host explores a new paper that suggests chronic tendon pain might be driven by neuropathy—dysfunctional nerves—rather than just degenerative or inflammatory disorders. This shift in understanding opens up exciting possibilities for more effective treatments and pain relief strategies.

Key Talking Points:

1. New Insights into Chronic Tendon Pain:
   • The episode begins by exploring the idea that chronic tendon pain might be primarily neuropathic. The latest research suggests that the pain could stem from nerve damage or dysfunction rather than solely from tendon degeneration or inflammation.
   • This novel understanding could change how we approach treatment, potentially leading to more targeted and effective methods.
2. The Role of Neuropathy in Tendon Pain:
   • We discuss how the study highlights nerve sprouting and neuronal ingrowth as possible causes of pain in chronic tendinopathy.
   • Learn about substance P, a neuropeptide that may play a significant role in maintaining chronic pain through neurogenic inflammation.
3. Lifestyle and Environmental Factors:
   • Discover how chronic stress, poor diet, and environmental exposures can elevate levels of substance P, leading to persistent inflammation and pain.
   • The importance of lifestyle modifications, such as stress management, anti-inflammatory diets, and healthy sleep habits, is emphasized as potential strategies to reduce chronic tendon pain.
4. Emerging Treatment Options:
   • We explore potential treatments discussed in the paper, including radio frequency ablation, shockwave therapy, and percutaneous ultrasound-guided tenotomy (PUT). While these treatments are promising, the host cautions listeners about the need for further research and understanding before seeking these options.
5. Holistic Approach to Managing Tendinopathy:
   • The episode concludes with actionable insights on how to manage chronic tendon pain through a combination of load management, lifestyle changes, and possibly exploring emerging treatments.
   • Encouragement to focus on a holistic approach, integrating physical, psychological, and environmental factors, to achieve better pain management and healing outcomes.

Why You Should Listen: This episode is a must-listen for anyone dealing with chronic tendon pain, as it uncovers new research that could significantly impact your treatment approach. Whether you're a runner, athlete, or someone struggling with tendinopathy, this discussion will provide valuable insights and practical advice to help you better manage your condition.

Takeaways:

• Understanding the role of nerves in chronic tendon pain could lead to more effective treatments.
• Lifestyle changes, such as reducing stress and adopting an anti-inflammatory diet, can play a crucial role in managing pain.
• Stay informed about emerging treatments, but proceed with caution and consult with healthcare professionals before trying new therapies.

Tune in to explore these exciting developments in chronic tendon pain research and learn how you can apply these insights to your own recovery journey!

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Episode Title: Unraveling the Mystery of Muscle Cramping with Jeff Sankoff

Guest:
Today's guest is Jeff Sankoff, an emergency physician and seasoned triathlete with over 50 finishes at the 70.3 distance, six Ironman completions, and six 70.3 World Championships under his belt. Jeff is also the host of the Tri-Doc Podcast and a coach who specializes in guiding triathletes, runners, and cyclists through his Tri-Doc coaching business. His unique combination of medical expertise and extensive experience in endurance sports makes him the perfect guest to discuss the complexities of muscle cramping.

Episode Summary:
In this episode, Brodie Sharpe and Jeff Sankoff delve into the elusive and often frustrating topic of muscle cramping. Jeff shares his personal experiences with cramping, particularly during his endurance races, and discusses the scientific theories behind what causes muscle cramps. The conversation covers potential causes such as dehydration, electrolyte imbalances, and the newer theory of neuromuscular imbalances. They also touch on the related condition of hyponatremia, exploring its dangers and how to prevent it during long endurance events. Throughout the discussion, Jeff emphasizes the multifactorial nature of cramping and the importance of personalized strategies for prevention and treatment.

Key Talking Points:

• Personal Experiences with Cramping: Jeff shares how cramping has affected his races, sometimes costing him podium finishes, and the frustration of managing cramps throughout his athletic career.
• Causes of Muscle Cramping: Exploration of the two main theories behind muscle cramping: dehydration/electrolyte imbalance and neuromuscular dysfunction due to an imbalance between excitatory and inhibitory nerve impulses.
• Hyponatremia: Understanding the dangers of hyponatremia, how it can be mistaken for heat stroke, and the importance of balancing water and electrolyte intake during long endurance events.
• Prevention and Treatment: Discussion on the effectiveness of various cramp remedies, such as electrolyte supplements, spicy drinks like pickle juice, and the importance of training at race intensity to prevent cramps.
• The Role of Fitness and Strength Training: How better fitness and strength in targeted muscle groups might reduce the risk of cramping during high-intensity efforts.

Key Takeaways for Runners:

• Experimentation is Key: If you’re prone to cramping, try different strategies such as electrolyte replacement or spicy liquids to find what works best for you.
• Listen to Your Body: Pay attention to how your body reacts in different conditions and intensities. Adjust your training and race strategies accordingly to minimize the risk of cramping.
• Stay Hydrated, but Smartly: In hot conditions, ensure you're not just drinking plain water but also replenishing your sodium levels to avoid hyponatremia.
• Strength Training: Incorporate strength training into your routine to enhance muscle endurance and potentially reduce the risk of cramping during races.
• Know the Warning Signs of Hyponatremia: Be aware of the symptoms like confusion and imbalance, and ensure you're adequately replacing sodium if you’re sweating heavily during long races.

Where to Find Jeff Sankoff:

• Website: Tri-Doc Coaching
• Instagram: @tridoccoaching
• Podcast: The Tri-Doc Podcast available on Apple Podcasts, Stitcher, Spotify, and more.

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