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Mike James | The Endurance Physio
263 Plays6 months ago
In this episode of the #ukrunchat podcast Michelle chats with Mike James, well known as The Endurance Physio.
In a fascinating, and common sense, episode. Michelle and Mike chat about:
- why does seeking a physio tend to be a 'last resort' for many runners?
- How do we incorporate injury prevention strategies into our running routines?
- Should people be racing (or running) with an injury?
- Common trends that could be causing injury
- Tips for building endurance and more volume safely
- All miles are not equal - learning to track training based on terrain, fatigue, perceived effort rather than overall mileage.
- How many pairs of shoes does a runner need?
You can follow Mike on:
Twitter / X - https://twitter.com/theEndurancePT
Instagram - https://www.instagram.com/the_endurance_physio/
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Transcript
Mike James: The Endurance Physio Introduction
00:00:00
Speaker
Hi, welcome to this episode of the UK Run Chat podcast. Today, we're joined by Mike James. Thanks for joining us, Mike. Would you like to give our listeners just a brief introduction to you before we get started? Yeah, thanks, Michelle. My name's Mike James. I'm known by the moniker The Endurance Physio, which was a gloriously self-entitled name I gave myself when I started my business many years ago. And it's interesting because
00:00:27
Speaker
It sort of fits everything I do very well. I'm an endurance athlete, but I'm a physio and I exclusively these days tend to work with endurance athletes.
From Football to Endurance Sports
00:00:37
Speaker
And what was interesting was when I started the business, I thought about being the running physio, but it was one of them. I thought about being the triathlon physio. I was one of them. And by default, I went for this umbrella term of endurance physio, which was probably the best move I ever made because
00:00:55
Speaker
When I look at my own background and my endeavors and the type of athletes I work with, then I do see and treat everything. So it's ended up being a glorious mistake, which has worked out really well for me. But yeah, my background is that I always class myself as a failed footballer. I was like many kids. I grew up in the 70s and 80s being a football fanatic with big dreams of making it as a professional.
00:01:23
Speaker
I was a decent footballer and I had a pop. I was in an academy and I tried to go down the old YTS route as it was back in the day. It didn't pan out and continued to play football at semi-professional level, but sort of realized in my late teens, this would have been early mid-90s, that most of my strength on the football field was probably based off my fitness.
00:01:50
Speaker
that fitness was normally consolidated by running. So at about 14, 15, I'd started regularly sort of road running and doing track athletics in school.
Endurance Focus and Triathlon Journey
00:02:01
Speaker
So there was this evolution, probably early 20s, where I'd fell on a bit of love with football and just fancied something else and found marathon running, found sort of distance running and
00:02:16
Speaker
At the same time, I had just joined the Air Force as a physical training instructor. So running was a theme of work-related fitness as well. And it's probably from then, about the mid-90s, where although I continued to play football recreationally for a while, it was mainly a big switch to primarily running at the time. And I'm a very all-on-one sort of obsessive type of personality. So I tend to do lots of the same stuff for a while and then lose interest and do something different.
00:02:45
Speaker
Most of my, if I split my athletic endeavors into decades, most of my twenties were chasing fast running. It was not so much the shorter distance because I never had ultimate speed, but I could run decent marathons. Um, I did a, I've done a couple of sub two forties, but primarily was around a three hour type of runner. Um, and as a young free guy in the military with lots of time and sort of energy to burn, travel the world doing all
00:03:13
Speaker
the big stuff and chasing that. And then I got to the mid-20s, we're talking now probably turn of the century sort of time when Tracton was on his boom and that became something I was like, oh, I do like enjoy swimming and biking as well. So we added them into the mix. And I probably say that that's where I sort of spent my best years. Ironman distance was the thing for me, loved it, I've done nearly
Balancing Family and Professional Life
00:03:42
Speaker
I've done 19 now trying to step away from it in recent years, but the 20th one is ticking away at my head that it feels like a number I need to go back to. But again, follow the similar pattern of chasing how good can I be in this sort of time. I got pretty obsessed with that. And then as I hit my 30s, I saw a mid to late 30s, I'd started to work with some open water swimmers. So things like the channel swims and the big open water swims,
00:04:11
Speaker
They took over my life for a few years and then ultra runs where this boom of this multi-day long distance ultra stuff. And, and I think what I've always found is that for me, um, I've always enjoyed, cause I'm not a physiology beast. I'm not an outlier. I'm not a 1% of talent wise. My strength is the psychology of just in do we're in stuff.
00:04:34
Speaker
So the more that a race challenged you because of fatigue and mental fatigue and durability over performance, they were where I always got drawn to. So the longer the race, Iron Man slipped into double Iron Man, into triple Iron Man, all of those type of events propped up. Why would I do a lake swim when I could swim the channel or around Jersey or around a big island somewhere in the sea? Those things were always the things that drew me to them. And that's where I still am.
00:05:03
Speaker
The issue I have sometimes these days as an athlete is I'm a busy dad of two. I spend half my day taxiing them to around two places. So I am a bit torn right now with the ability to commit to some of the big things I like to do and do them properly. I never want to just do stuff for the sake of it. So I would say probably my mid 40s to now I'm 48. Now the last few years have been on the back burner where I've stepped back quite a lot.
00:05:31
Speaker
and my coaching and my clinic is taking over most of my time as well. But there's a few things still on the athletic agenda that will come on to hopefully as the kids grow up and grow.
Professional Growth and Injury Experiences
00:05:43
Speaker
But what's been nice with that journey is my professional journey is mirrored along the way. So within my time in the military, I evolved from a physical training instructor to an exercise rehab instructor. So
00:05:56
Speaker
try to break them, then try to fix them. Yeah. And then that allowed me to get degrees in sports science, in sports rehab, in sports, sorry, in strength conditioning. So all professionally evolved there. And then when I left the military about 15 years ago, it made sense at the time because of the landscape of therapy in the UK, doors would only open if you were a physio at the time. It has changed a little bit now, but going off and doing a master's in physiotherapy seemed like the logical thing.
00:06:24
Speaker
Hence then, the business growth into the endurance physio. So I have a lovely sort of balance right now of working with athletes in a coaching capacity, working in a clinical capacity. But then I also do a lot of, I lecture in university on a physiotherapy degree. I do a lot of mentoring to young therapists. So I have a lovely variety in my week. It means that clinically now I tend to probably only see half a dozen to a dozen people a week. I spend a lot longer with people than a lot of therapists do,
00:06:54
Speaker
Predominantly, I would see more second, third opinion stuff, people who have not responded with therapy how they thought they would, and they're looking for some alternative view. And then a lot of consultative one-off stuff. Online stuff works big for me right now. I do a lot of, I've got an issue, Mike. I just want someone to help me with a structure to what I can do myself. So we have an hour video call, help them with those type of things. And it's a lovely balance right now.
00:07:22
Speaker
So that's probably a whistle stop tour through like 30 years. Yeah. Wow. So what are you, I mean, what events have you got your eye on at the moment before we get into chatting about physiotherapy and injury prevention? What have you? So right now I'm actually nursing my first ever injury, which is our place to be. And it's a classic one. It's stuff we'll probably talk about later on, but, um, but just goes to show that it doesn't matter what knowledge you've got or what background and experience you've got.
00:07:50
Speaker
I was entered as a fantastic new event started last year on the Isles of Scilly called the Scilly 60. So it's a broken ultra. It's 60 miles split over six islands where you have timed cutoffs around the island and then you get back on the boat and move to the next one. And it fitted really nicely. We've got friends who live on Scilly and we're going to go out for a long weekend. So I'd entered that. But with work, with uni, with everything else, my training has not been able to go as it's meant to do.
00:08:19
Speaker
And I've been cramming and I've gone and picked up a little stress fracture in my foot, which I've advised hundreds and thousands of people over the years about those things. But even with what felt like a structured plan and felt like appropriate time, my body wasn't in a position to tolerate what I was asking it to tolerate. And I've given myself a bit of an issue.
Running Suits Lifestyle and Psychological Benefits
00:08:40
Speaker
It's not a major one. It's only the early stages, but because it's not a major race for me, it's not something that I'm
00:08:47
Speaker
overly invested on from a performance point of view. It makes sense to just defer it and let this thing settle for a couple of weeks and then find something else. So I have accrued a decent amount of training since sort of early spring. So we'll try and redirect that at something later in the year. We moved back to Wales when we both left the military sort of eight, nine years ago and we've moved to a part of Wales that isn't home for us. And
00:09:15
Speaker
We just seem to be in a bit of a hotbed for really good ultras along the coastlines. Okay. So there's an abundance of options that can relatively easily be diverted to. So, um, so we'll see, but it's, it's running for me now fits better, my lifestyle than swim bike runs or any long swims or anything like that. So we'll probably just stay on the running theme for a couple of years.
00:09:41
Speaker
Yeah, is that just because it's easy to fit in around family? Yeah, I'm fortunate that my clinic these days is based at home. So the garage has been converted, it's got everything you need in there to train. So worst case, no matter how limited I am for time, I can always just jump in there, jump on the treadmill, do something. We live in a lovely little town that's got lots of lanes and greenery around it. So I can always get out and do something. Yeah. Whereas
00:10:09
Speaker
bike setups and traveling and commuting to swimming pools or lakes or the sea, it's just harder these days to find the extra time. So running is always, and I think as much as I love them all, the running is the one for me that when I've only got so much time to just get something in, it's the one I certainly psychologically feel better on when I've done it.
Injury Prevention and Rehab Insights
00:10:32
Speaker
Yeah, I know what you mean, I think.
00:10:34
Speaker
Um, so let's, let's get on to kind of injury prevention, really an injury rehab. Cause you were recently on the UK run to hour and you're asking our community about the thought process that they have when they're seeking injury advice, because we get a lot of people just posting saying, I've got such a thing wrong with me. What do I do about it? And we get hundreds of people replying, which is great, but that's not always necessarily the best thing for people. Is it? I mean, what, what are the most common reasons athletes come to you?
00:11:02
Speaker
Yeah, and it's a fascinating topic that I've, I think as a therapist generally, not just working with runners, the last 10 years of my career, the first, let's look at the first 20 years, first 10 to 20 years was all about skill advancement. Let's learn new techniques, let's learn new treatments, let's become a better sort of practitioner. And the last 10 years has really revealed to me
00:11:27
Speaker
that the true magic is the psychology of it, building relationships, communicating with patients, understanding the patients a bit better. So a lot of my learning in the last 10 years has been much more around psychology and behaviour and that type of thing. And I seem to be taking my treatments that way now when I look into these type of things, I would get really frustrated
00:11:50
Speaker
for the first 10 years I was on social media with that same situation that you mentioned. It would really annoy me. I'd be sitting moaning to the wife about things like, if my car broke down today, I wouldn't jump on some internet forum and ask people about how to fix my car. I'd go and see a mechanic. If the roof was leaking on the house, I'd go and find a roofer. I wouldn't ask someone on the internet. And I couldn't reconcile a lot of the time why people would do that online with running injuries.
00:12:17
Speaker
But then this whole mindset shift of, well, I need to understand their behavior rather than judge it or criticize it because perhaps I can help more. So that's where a lot of my thinking has gone now and why the run-chat hour was so good for me to pick people's brains on that. And I think for me, to answer the first part is why do people come and see me? From a running point of view, there's two predominant reasons of bringing someone to clinic pain.
00:12:46
Speaker
or running being affected, probably by pain. So they either can't do what they want to do or they can't do it the way they want to do it. And that's normally the overarching theme. Of course, sometimes it's injury specific, but that's the reasons they come in. But what I was looking for on the, um, the, um, the rencha hour and then perhaps more, because those people are easy to work with. It's easy to help them. Well, I've always been trying to understand recently is why they won't come in. Yeah.
00:13:16
Speaker
What's stopping you coming in to see me? And that's not because I want more business or anything like that. It's more like, why are people doing what they're doing and then not getting the help? Because for me, the majority of these people at some point
Understanding Overuse Injuries and Training Errors
00:13:30
Speaker
will ultimately end up coming to see a professional. And all they've done is just delay the recovery process and prolong the frustration of not being able to run all they want.
00:13:40
Speaker
And I think for me, what I've seen there, the reasons that they don't come sometimes is fear and a lack of confidence in what they're going to get when they come. So I think that's the issues that I'd like to deal with more these days. From the predominant sort of, you know, what are the things that comes into clinic because of the pain and the confidence in their running?
00:14:02
Speaker
It's still always the big stuff for me. It's, it's tendon issues around the patella, around the Achilles. Um, more recently around some of the hamps, proximal hamstrings and glutes. It's, um, joint type pain, arthritic knee, hip pain, that type of thing. And then your good old fashioned, acute ankle inversions, muscle strains, those types of things. But predominantly it's, it's overuse, low grade stuff. That's.
00:14:29
Speaker
caused by training error normally. Yeah. And then as just manifested to the point of, a lot of the time you'll get the sort of what I call them, the dipping the toe in the water mistakes. So it's the, I've got X injury, X pain, and I've had to stop running. So I do nothing for a couple of weeks. Funny old thing, my pain settles, I'm okay. I dip the toe in the water and just try another run.
00:14:56
Speaker
And I might get away with it for a couple of runs, a week or two, or maybe dawn from the first run. Everything comes back symptoms wise, settle again, go again. And they've just been through that vicious cycle for so long that they go, right, I need to see this now and get it sorted because I'm actually getting nowhere. Yeah. But I think those, those tend to be the main things pain is affecting the way they run or affecting their ability to run.
00:15:23
Speaker
And if there's a race agenda and that thing's fast approaching, then often that expedites someone's desire to come in. Yeah. So if it's generally, it's generally overusing, Jimmy, she says. So that, that is training era, isn't it? So how, I mean, how do we prevent that first of all? What, what are the kind of early warning signs that something might be about to go wrong? What are we looking for? Yeah. And I think context is key with this one for me, like, like
00:15:48
Speaker
I've, I'm always a big fan of the mantra that, and this is a, it's a personal mantra as well when I'm training for stuff, but, but for athletes as well, that, you know, we, it's okay to have a bit of pain. It's okay to have some aches and niggles. I'm not someone who's averse to someone being in discomfort, particularly when you're training hard or training for big events that, that, you know, I use a line to a lot of people that I've got enough aches and pains to know I'm training enough, but not enough to make me worry I've done too much.
00:16:17
Speaker
So I think if we are so risk averse that we tend not to be doing enough training, that's a training risk in its own way. That's an injury risk in its own way because we're underdosing our training. And then we come into race time and we're just not ready for it. We're too undercooked. But with the overcooked side, what we normally see is, and again, it's not, you know,
00:16:43
Speaker
Overuse injuries can occur in people with perfectly planned training. It's just one of those occupational hazards. Sometimes people are just unlucky. I deal with a lot of people where I sort of class that you can get those really robust runners. The ones that sort of, they can almost make as many mistakes as they want to make and they'll just get away with it. They're just bulletproof in a lot of ways. And then you can get those fragile runners sometimes where
00:17:10
Speaker
they'll do all the right things, but they just seem to pick up injuries and they're just a bit unlucky. So there are individual differences, but generally with the training errors, if I go in, okay, someone's come in with an injury caused by overuse training error, the usual stuff is normally the classic too much too soon. They've just gone to, and I always say this,
00:17:34
Speaker
I genuinely have never met someone who's intentionally set out to make mistakes. They are best intention errors where things that seem sensible in theory perhaps don't pan out in reality. Well, it makes sense if I'm not. And it's things like too much distance. We're not in a recovery in a short period. Sometimes it's things like just trying to get to rear speed too quick. So I'm planning on running a marathon at eight minute mile in.
00:18:04
Speaker
I'll start running distance at eight minute mile in now. Surely that makes sense. And for some, those robust runners may get away with it. For some who've been through that process before and they can tolerate it, they may get away with it. But for a lot of us, it's just going, okay, let's be sensible. Let's go 10 minute mile in for a couple of weeks. Let's go nine 30 minute mile in. And it's the patience needed often that just prevents most of these things. You know,
Strength Training Myths and Personalized Plans
00:18:28
Speaker
I think, I do think a lot of the time,
00:18:30
Speaker
Um, I've probably been guilty of this in my earlier career, but we can make, I think we over glamorize and make some of these alleged injury prevention strategies a little bit too sexy. They're not as you know, some of the, a classic thing that I always talk about. I'm a massive advocate of runners doing a lot of strength work, but we still have this massive misconception that strength work prevents injury.
00:18:56
Speaker
We have really good scientific literature to see that strength work will make you perform better. But we don't have strong evidence to suggest this can reduce injury. Yet hundreds of therapists and thousands of runners will be out there going every day. You're going to reduce injuries if you do loads of strength work.
00:19:13
Speaker
Yeah. And now that narrative is out there and it is strong, isn't it? And again, probably 15 years ago, because I was trying to push back against the tide, I probably sold that a little bit more than I should have. And I'm almost on a mission now to unsell it a bit. Do I think that every runner should be doing strength work as part of their build up? Yes. Is it essential? No, because we mentioned those bulletproof runners who probably don't.
00:19:40
Speaker
But likewise, if you jump on some websites where they're selling this gold standard strength plan, for most runners, they're gonna go, I can't do that. I can't, I haven't got a gym membership. I don't understand strength work. I haven't got a coach. I can't get all this equipment in the house. And actually you strip it right back. There's probably some resistance band and body weight work that you could do once or twice a week at home within one little room of a coffee table size square, and you'd be fine.
00:20:09
Speaker
Yeah. And if you don't do it, you don't do it. And if you do, you do. And it's, it's, it's sometimes just making the things that we think will reduce injury, just far more sensible and logical than complex and complicated and adding. It's always about adding extra most of the time when actually let's strip back and just get it done, you know, for the first few weeks, let's just run, run slow, run to time. Don't worry about distance. Don't worry about speed, run to time.
00:20:36
Speaker
and run to F because I use perceived effort a lot of the time in early stage running. Because I just like, if you're tired, dehydrated, it's a hot day, running a four out of 10 effort is four out of 10. It's a variable that can change and you can monitor. It'll always be four out of 10. Yeah. But if I've suddenly got a normal shell today, you're going to run 150 beats a minute heart rate.
00:20:59
Speaker
Well, if you're dehydrated and tired and it's hot, you're going to hit that before you know it. Yeah. And you're going to suddenly come on, that was a terrible run. It was really slow and my heart rate was all over the place. Now, when we make those adjustments, we start adapting and our sort of running is a bit more consistent and solid. Maybe we'll switch to heart rate. Maybe we'll switch to speeds. The plan doesn't need to be uniformed all the way through.
00:21:23
Speaker
And I'll often give a lot of people in the early stages of a plan, just sort of cross training sometimes, you know? So we're doing a lot of exercise in a week, but we're not loading it up. The issue we've always got with running is just that mechanical force on the body compared to some of the other sports. You know, running at very slow paces will be a minimum two to three times your body weight through your joints and on the tissues. You start running at speed and we're talking four, six, eight times body weight.
00:21:53
Speaker
And that's, that's tough. You know, if, if I said to some people, right, what I want you to do is you're going to start a new year's fitness program in a gym and you go in, you join the gym, you see the trainer and on day one, he gets an 80 kilo person to put 800 kilos on their back and do sets of 10 squats. They're going to look at him going, are you crazy? That's not sensible. Yet we often think, well, I can run five miles now at six minute mile in or whatever I want to run first run of the program.
00:22:22
Speaker
And you're like, that's probably not sensible. We need to be a little bit smarter with it. Likewise then, I think from an athlete's point of view, particularly if you're a self-coached athlete or an athlete using a plan of the internet type of thing, then I'm a massive advocate for reducing injury risk of just appreciating the athlete that you are today, not the athlete that you were or want to be. You know, I'm chatting about my injury now earlier and
00:22:50
Speaker
something that's a massive factor there is when I was in my 20s and 30s and I was single and I didn't have kids and exercise was my life, I genuinely was training on average 15 to 20 hours a week. I'm lucky these days, some weeks, if I get three hours in and as a result, I'm older and I'm less active and I'm probably a bit lazy with my nutrition. I'm carrying a good two to three stone over what I would class as my fighting weight from back in the day.
00:23:19
Speaker
And it's gone on so incrementally over the last 10 to 15 years that I don't really notice it unless I go and put like a pair of trousers on from 15 years ago. Yeah. Now when I'm out running and I think my naked running weight is okay. Oh my God, I'm just not fit enough. I need to run more. I need to run harder. In reality, if I think back to my military days when we used to do a lot of heavy weighted walking with big backpacks on.
00:23:44
Speaker
That's what I'm now trying to run with that extra 23 kilos on my back. That's a good point. Yeah. And that all has this effect on these mechanical forces. Now, if I suddenly just put that into perspective and go, yeah, I can't do it right now, I can't do what I used to do, or I can't do what I want to do. So for me, sometimes those, those training risks and those training errors, being honest about ourselves and where we are versus where we want to be is sometimes just a simple thing of going, okay,
00:24:14
Speaker
I know you said that you normally do a 12-week marathon plan. But perhaps we want a 16-week plan this time. And the first four doesn't even need to be part of our 12-week plan. It's a where do we need to be to be able to start week one? Yeah. And let's just backtrack a little bit and build up. And if that has to be quite a humbling
00:24:38
Speaker
walk, run, plan, couch to 5K type thing, then do you know what? So be it. We just need to deal with that.
Dangers of Rigid Training Plans and Social Media Influence
00:24:45
Speaker
So I often write my marathon plans with athletes by retrospectively going back. Yeah. When's the race day and what's your goals? Cool. How many weeks do we want to train for this? Because I think that's massively important. It's no matter what level of commitment you've got, it's hard sticking to a plan. Everybody will lose interest at some point in their plan. So if you said to me, yeah, look,
00:25:06
Speaker
12 weeks is all I really want to commit to this. It might be external factors in your life that govern that. And within that 12 weeks, I can realistically only do three runs a week. I know we want to do five, but three is all I can do. Okay. Factor all of that in and let's work backwards now and find, okay. So I know the race is in September and I know you really want to start late June, but from May, we need to be doing something that builds us to be able to tolerate that when we start. So it's easily enough to, I think that easy mistakes to make,
00:25:36
Speaker
but they're really easy mistakes to fix as well. Yeah. Yeah, that makes a lot of sense. And I think we are seeing, we're seeing a lot of people who do just download generic plans from online and follow them to the letter as well, aren't we? So can we just, I saw something you posted recently about if you miss a session, just let it go.
00:25:59
Speaker
Yeah, because that can cause injury cancer if you're trying to catch up. And it's that classic stuff again. And it's all best intentions. You know, like a really nice example, you've got a runner and he's due to do, or she's due to do three, five mile runs in a week. And their longest run to date is maybe four miles. Yeah. So let's say they're going to run Monday, Wednesday, Friday, Monday comes along late, getting out of work after get home, feed the kids, go shopping, do whatever it is.
00:26:29
Speaker
Suddenly now, time constraints kick in and they can only do three miles. Wednesday comes along, something else has crept up, they can only do four miles. So now they get to Friday and they go, right, okay, I missed three miles in total this week. Tell you what I'll do, I'll add it on to Friday's run. Let's do an eight mile a Friday, because I've still done my 15 miles for the week. But they've now doubled the longest run that they've done from four to eight.
00:26:54
Speaker
And it feels innocent and I get why they do it, but it's those little mistakes sometimes in a plan. And that's the problem sometimes. This is when people come to me with downloaded generic plan injuries, nearly always it's the fact that you go, right, that plan's been generated for some algorithmic robot almost. It has no context of you, your physicality, your lifestyle, your environment, your previous injuries or anything.
00:27:24
Speaker
And it's just going, if you can run five or six days a week and you can run at this speed for this many weeks, you're going to get to the rear score. Now, if you'll see a lot of people download that plan and go, okay, cool. I get the template. However, I work Saturday, so I can't do the Saturday run. I might need to shift that to another day. It wants me to run two back-to-back long runs. My ankles don't like it when I run back-to-back long runs.
00:27:50
Speaker
So what I basically do is I take their generic structure and I tailor it a bit to myself. More often than not, you'll probably get away with it then. That'll probably work. But runners being runners and being the committed athletes that they normally are, they don't see the plan as being the problem. They see themselves as the problem if they can't stick to the plan. I'm just not good enough. I'm not committed enough. I'm rubbish if I can't do every session that's on the plan.
00:28:17
Speaker
And that's when these bolt-on sessions or these, you know, oh, I've added on last week's to this week's. And now they've done seven days back-to-back running. Those type of errors are often the biggest mistakes with downloadable plans. And for me often, perhaps the only difference when I coach athletes, perhaps the only expertise that comes in is that external voice that's just going, let's write the plan for you. You tell me what you, because that's how I, how I coaches,
00:28:46
Speaker
you tell me about your life and I'll make the plan fit you. I'll write a perfect plan for you versus the perfect plan. Yeah. And we hope in then that we can tick off at least 80 to 90% of those sessions because life will still pop up. Yeah, you're never going to have a perfect cycle. Perhaps the nicest relationship that I tried to cultivate with my athletes is that ability that they feel comfortable to message me on a Wednesday going like someone's popped up,
00:29:14
Speaker
this has happened this week, what should I change for the rest of the week? And I almost get like, when I get to that warm and fuzzy bit with an athlete, that's very much where I'm like, you're very much at the point you don't even need me anymore. Now, you've found that little sweet spot. You're already thinking what do I need to edit and tweet? Yeah, sorry. And the journey that I often go with a lot of my athletes is that
00:29:40
Speaker
Some evolved from a patient into a coached athlete with me, but somehow they just find me and we start coaching. And often they've come from a generic plan or something that they just want a little bit more specific input. And over the course of however many cycles or years that we work together, we normally end up getting to the point where the conversation comes of, you don't really need me anymore, do you? Just go away, save your money, go away, coach yourself. You don't really need it. You don't need that.
00:30:09
Speaker
And I'm quite a sort of arms length, hands off coach. So sometimes people do prefer the sort of more on top of you dictatorial type coach. That's not how I like to coach. I like it to be a collaborative sort of relationship. But some will step away because they do prefer someone to be very prescriptive, very deliberate in, you must do this session and there's no flexibility in it. But yeah, if they hit that sweet spot to me, then I feel completely comfortable.
00:30:39
Speaker
that they could take a generic plan offline and just tweak it for themselves and go, no, I understand me. I understand the flaws and strengths of that plan. And I'll make it work accordingly. Yeah, that's fascinating. I saw something else that you posted as well about all miles are not equal. Can we just touch upon that as well? Yeah, yeah. We do tend to look at mileage. And we did mention that earlier, didn't we? Total mileage in a week. Yeah. And again, it has to be caviated that
00:31:08
Speaker
As much as I say, sometimes perceived effort, time on feet, those things are super important and sometimes more important than mileage. I think we can't swing the pendulum too far, like some do, and go, it doesn't matter mileage. You know, there's, however you base your metrics, there's a level of training that needs to be done to prepare you for the event that you want to do. There's a speed that you need to run that to be able to run at a certain speed.
00:31:36
Speaker
and all of those variables. So that in miles matter, perhaps just the attention to the miles needs to be a little bit less. But that particular post was just inspired around the sort of, I'd had an athlete come to see me, one of my online patient consults, where couldn't really understand why he'd started getting this sort of grumbly achy Achilles pain when he followed the same training plan progressively for a period of weeks. And suddenly this thing had come on.
00:32:06
Speaker
And when we dived into it effectively had been out in Spain on holiday and had done some runs along the beach. And his plan looked, you know, still sticking to the plan, ticking everything off. But the forces needed to control soft tissue around that sort of soft surface is fundamentally different to on a road. And that probably was the catalyst for his little aggravation was that
00:32:34
Speaker
the same amount of volume, the same amount of miles he had just had in his mind. If I do more miles or more runs, that's going to be my issue with miles. So we just have to be aware with that sort of phrase of all miles aren't equal, that you've got to think of your environment, you've got to think of your terrain, you've got to think of your fatigue. If you're coming off a really heavy big block,
00:32:58
Speaker
and you've not had a big down period or recovery period, then what you would feel like light mileage a week after can bite you a little bit more. So it's just very much about terrain elevation, sleep, sleep and deprivation and recovery, the intensity and the speed that you're running some of these races or runs. They're all very influential. We've had our usual Wednesday summer in Wales. It came on Wednesday, went on Thursday.
00:33:28
Speaker
But if you were out running last Wednesday, those miles will not feel equal to what you're running on Tuesday. And those are all variables, which we just have to move past that, suck it up. You've got to toughen up and you've got to just dig in and get it done. Of course, there's bits and plans where, yeah, you have to dig in and get through certain blocks. But as a go hard, go home, you've got to suck it up or you're going to just not get there.
00:33:58
Speaker
as a mantra for every run you do, as runners, we just need to just be a bit more common sense of, no, that there's a reason that was harder or could be harder when I'm planning my runs. And it's likely to be affecting the distance that I'm running. Yeah. And yeah, this brings me on to my next question, actually, because
00:34:19
Speaker
Social media has a lot to answer for, doesn't it? With encouraging people to do workouts that are perhaps beyond them. So trying to train like a pro, there's lots of influencers posting the workouts that they do. So I thought that was probably just worth mentioning as well. Yeah. And of course, you know, you shouldn't believe after stuff you see on social media. That's the key with these things. Even in the most genuine terms, what more social media posts lack is context.
00:34:49
Speaker
You know, if someone's sharing a session they've done, and it's a genuine session they've done, we don't know what they've done before that. We don't know what their training base is like. We don't know what the training history is. There are some fantastic elites out there right now who do share a lot of the context. I would suggest anyone follows Camille Herron.
00:35:08
Speaker
She is so open and honest. When you see these wonderful achievements that she does, she'll show you what she doesn't do for the 10 days after. She'll show you how she returns to run. And you'll be gobsmacked how light she starts and how long it takes for her to build back up. She's fantastically honest about how many years it's taken to accrue the regular volumes to cope with the distances she does these days. But most of us don't have that context. We suddenly just go, oh, cool. That's a good session, and I do that tonight.
00:35:35
Speaker
And I've shared, I'm guilty sometimes of sharing suggested sessions that I've done. I tried to put context onto it of, you know, this is for this type of athlete on this type of, of base. But I'll often get comments going, Oh, thanks for sharing. It's going to try this tonight. Yeah. I always reply to them going, Oh, maybe do 50% of it because it's not, it's not for you right now, potentially without knowing your plan. Yeah.
00:35:59
Speaker
But the darker side of social media to me a lot of the time is that, yeah, most of the, we don't even know, you know, I've been fortunate enough over the years to work as a therapist and a coach with elites. And I've been on, I remember being on a training, a triathlon training camp in Lanzarote. This is about 17, 18 years ago. This was before the professional set ups where they had their own therapists and stuff.
00:36:27
Speaker
And the way it would work at the time then would often, if you knew or an elite coach knew you, it sort of go, Mike, I'm taking my athletes to Lanzarote for a week. Can you tag along as the therapist? So you're just sort of freelancing a little bit. And I remember going out on one of these and there was professional triathletes on it. One of which was a well-known athlete. They'll stay anonymous, but people would know him. And I was around them for the whole week. So every session that they did,
00:36:56
Speaker
We were waiting in the airport to travel home at the end of the 10 days. And he's furiously typing away on his laptop. And I'm watching what he's doing. And he was writing his training log. And he added minimum 30% volume to what we did that week. Everything we did was added on. All the intensities were added on. And I was like, what are you doing? He goes, I'm writing a magazine article that's going to be published in a well-known travel magazine about my training camp.
00:37:25
Speaker
And I said, but that's not what we did. And he goes, I know, but my, my opponents don't know my rivals don't know. So there was a professional psychology element where he was a bit like us, the famous sebco steve of X sort of rivalries, where there was a performance edge trying to be gained of psyching out his opponents by all the play in his now that's fine. And I understand why he's doing it.
00:37:50
Speaker
But what that doesn't factor in is Joe and Jane Bloggs, who were just introducing themselves to novice running or traffic, or whatever it is, who now look at that and go, oh my God, look how much I need to do.
Therapist-Runner Relationship and Injury Management
00:38:02
Speaker
My brother in the mid 90s, growing up in South Wales, as his standard, got himself into the bodybuilding world. And he would come home from school every day at 15, 16, with his Muslim fitness or his flex magazine.
00:38:18
Speaker
And he would look at Arnold Schwarzenegger's bicep plan. And he'd be in the shed with his little plastic dumbbells trying to do Arnold Schwarzenegger's bicep plan. And even then, I always say to him, you don't actually know if that's Arnold's bicep plan. And even if it is, if Arnold's bicep plan is not your bicep plan, you probably shouldn't be doing it. And that's where I'm very much at with some of these runners. They're like, it's fine to be inspired by these people and see them and go on.
00:38:47
Speaker
And then perhaps the third area of this, which is more controversial and I felt more inclined over the last few years to call out a little bit, are these influencer types or run-fluencer types where they don't have a background in coaching. They don't have a background in therapy. They are often associated with promoting things for other reasons than just good advice.
00:39:15
Speaker
And they get carried away a little bit with some of the things they've said. I've had a couple of these influencers, I run a one day sort of education course, like a workshop around running. And I've had some of these guys on my courses and they've been brilliant and attentive and engaged really well on these courses. And a couple of weeks later, I'll see them post something, a video or a social media post, particularly Instagram. And I'm going, that's not what I said.
00:39:40
Speaker
Oh no. You've completely tweaked what I've said there and then bastardized the scientific literature by default because that narrative fits whatever you're selling or whatever you're trying to promote or whatever your mantra is that gets you all of these followers. So you have to be very sort of critical sometimes and sceptical what people are seeing. All the glitters isn't always gold.
00:40:03
Speaker
Yeah. And social media like social media is fantastic. I love it. It's been great for me and my business. And I have I'm a full supporter of it. But I think particularly for a novice runner who's looking for inspiration and guidance can be a bit of a minefield. Yeah, definitely. And again, then sort of I think when we were going back about why runners perhaps don't look for a therapist sometimes is
00:40:31
Speaker
there's a very positive attitude on social media of you can do it, you can keep going, you just need this or that and you can keep running. Where I think the therapy world needs to be better is that we've built a reputation largely for telling you to stop running. And I think as much as running is such a popular activity, I would generally say that the therapy industry as a whole is pretty poor at dealing with runners.
00:41:01
Speaker
And therefore what the default answer to do no harm is, Oh, well, if it hurts when you run, stop running. Like I can't think of a lazier piece of advice. If a runner comes to see me saying they run in pain and they want to keep running and they've got a major race coming up and this is everything they want to do for the next few months. The worst thing I could say is stop running. I need to find a way to modify or keep you running or at least put context into, we need to stop running for 10 days and then build you back up or whatever.
00:41:30
Speaker
So I think that's also why social media perhaps gets the support it does from runners sometimes is because we've dropped the ball a little bit ourselves. Certainly where I live now in South Wales, there's three or four running clubs that I'm sort of associated with locally. And I've been fortunate enough now because of the way I try to work where most people understand that Mike's going to try and keep you running.
00:42:00
Speaker
If Mike, so they come to me because Mike's the guy who runs, he understands running, he'll try his hardest to get you to your race. But similarly, if you're one of the unlucky few once in a while when Mike says, stop running for a while, I really need to stop running.
00:42:17
Speaker
Yeah. And I only tend to stop people running when it's something more sinister, bone stress type things like that. Or like a chronic tendon inflammatory type problem where we have to break the cycle of irritation for a period of time. It'll be as short as we can and I'll get you back as quick as we can. But I've built that safe space, perhaps for runners by being the way I am, where they feel comfortable going, yeah, Mike's a positive on my running versus
00:42:47
Speaker
Oh, if I go and see this physio, it's just going to tell me to stop. Yeah. And that does probably prevent me. When I first left the military and we were in the process of moving back home, I sort of just paused the business a little bit for convenience. And I took a job in the NHS. And I always remember, um, two, two really good physios, but they weren't experienced runners asking me to come and look at a person they were seeing who was a runner.
00:43:17
Speaker
we can't find anything on this guy. So basically they'd have this guy on the treadmill. He was running an easy run for five, 10 minutes. And they were trying to see if there was anything by mechanical or anything obvious about it. And they were like, can't find anything, nothing there. So I just spent longer with him and charted to him and understood his background a bit more. And within about five or six questions, he'd sort of gone, well, my pain only comes on after 10 miles. And it only comes on if I run at this speed.
00:43:47
Speaker
And their answer at this point was, well, we can't really find anything. So perhaps just give running a rest for a while. And it wasn't lazy advice intentionally, but they just didn't know any better with runners. So straight away, I could just say, dude, listen, as long as you run below 10 miles and you run slower than this, crack on, dude. Crack on running because that's not an irritant for us. But what I want you to do the next time you come and see me is try to run that far at that speed.
00:44:18
Speaker
as you get to clinic and maybe we'll see something that we can make a, something to do with fixing it later on. And that's what happened when you watched him running at that speed and that time, lots of things you could work on. And we did, and he was fine, but it was just that little bit of, okay, he probably wouldn't have gone back to see another physio. If I, hundreds of people could have done it, of course, but if it had me me at that particular moment, going into, understands runners, understands the psychology of running, understands,
00:44:47
Speaker
how things can breed themselves and then be fixed as well. Danny might well have just left there going, what a negative experience. They looked at, I'm an ultra runner and they looked at me run for five minutes on the treadmill. I've sort of alluded to them that it doesn't come on until 10 miles, but that's just been dismissed. And again, like I know for a lot of therapists, they see it as well. It's just this hobby. And I know dozens of therapists who are fit and active, but they don't get, they can't understand why people run.
00:45:18
Speaker
Why would you run? It doesn't make sense. And I always try to bounce back at them when I'm talking to groups of therapists about working with runners. Say, if a carpenter came in who said, after five hours in work, I get a bit of tennis elbow coming on or a bit of wrist pain, your answer to them isn't stop working. You're not going to say to them, well, you have to quit work and not earn any money or you have to change your jobs. You're going to find a solution to have them run as a sim. Just find a solution to manage what they're doing.
00:45:46
Speaker
Because actually, then if you think then a lot of the literature I read these days around that exercise has always been my default rehab sort of setting very hands off these days. But the biggest problem with giving exercise plans to most people is getting them to do them. Yeah, it's not the exercise plan is people doing them. So if I've got a couple of exercises I need someone to do, then if I'm able to keep them running in a modified way, they're probably likely to do the exercises I give them.
00:46:17
Speaker
But if I've given you four exercises and told you to stop running, they're probably going to lose complete motivation and not do those exercises. And then that cycle just gets stuck and we're in the same place and not moving forward. So, so yeah, keep them running as much as you can. There's very few times people can't run at all or do something different. And as I say, it's only normally in a real, like a sinister injury, as I call it, something that's threatening your health versus temporary pain and affecting your quality of running.
00:46:47
Speaker
Yeah, well, yeah, that is music to my ears, actually. Yeah, that's really good advice, Mike. Thank you.
Running Trends, Gear, and Patience in Training
00:46:55
Speaker
Just a quick point, then. Any trends we're seeing at the moment that runners are changing about the running that could be causing injury? I'm thinking specifically about things like heel striking is bad and change your biomechanics become a more efficient runner. Yeah, those particular ones have always been around you. That's a big myth about heel striking.
00:47:16
Speaker
Most people heel strike, it's normal, it's natural. The elites are big heel strikers. So perhaps education around those rather than changing trends is the key. Trying to get people to understand. And again, what I'd never want to sound like when I'm talking is I'm critical of other things or other people. But there are multi-million dollar industries to shift products, whether it's orthosis, whether it's shoes, whether it's kit or clobber of some way.
00:47:46
Speaker
And most of those work better if we try to put a, there's a good and bad anatomical concept with running and we can change things to be better or worse. Of course, sometimes I will try to alter someone's biomechanics to reduce stress or reduce pain in the short term. I very rarely ever tried to get people to run better or stuff. So, so some of the things that the trends where these things tend to lead to,
00:48:16
Speaker
Things like changing to be a barefoot runner, a minimalist runner, these type of things. They're deep rooted in an unproven science, because humans are all different. Humans are variable. We're all slightly different. So we can't all have the same fix for the same things. So we have to understand people are different. But naturally, runners go, I'm going to go for a running gate assessment, and I'm going to see which type of foot strike I am and all those
00:48:44
Speaker
They're perhaps not the weight that we need to put on them. Certainly in the last couple of years, I get more and more people coming in because of super shoes. Yeah, okay. Oh, because they're injured while wearing them. From a soft tissue structure, they're mechanically efficient shoes that help people propel the cells forward, but they come with a metabolic cost. They make the muscles work harder, fatigue them more. So if you're suddenly just jumping into them,
00:49:14
Speaker
then you could often spike a little bit of irritation and stuff. I think a lot of the time then, some of them are all variations of the too much too soon stuff. So, you know, you'll grab a super shoe and then suddenly you go out and you don't know what you're trying to manage in it, or you never wear it till race day. And then suddenly you're trying to run 26 miles in a shoe that you never won before. And, and all of the issues that potentially come with that. But,
00:49:43
Speaker
But a lot of them are age old themes, like the biomechanics, like the heel striking. But I think generally for me, it's nobody, and this is the world at large. It's not just runners, but we've lost the ability to be patient. Everybody wants this one-click culture now. I want it now. I was ordering something off Amazon yesterday and I ordered it in the morning and there was a click option to get it delivered that day. And I'm like, I don't need it today.
00:50:13
Speaker
I say it comes today, but I don't need to pay money for it to come tonight. Tomorrow's fine. But with us, everything is about let's get there now. I don't want to wait. I don't want to serve my apprenticeship. I want to get it now straight away. So I think a lot of the time most of these trends are everything's about expediting and accelerating your time to get to whatever it is you want to get to. So they become like
00:50:38
Speaker
tricks or cheat codes that's how they seem pitched a lot of these things and actually they're not there's no such thing and we just need to take our time and get to places sensibly yeah you've mentioned shoes that can i just ask briefly what your kind of general advice is when choosing shoes yeah that's a really important thing that we wear all the time yeah so this should be um this should be music to most people's ears go out and buy more shoes but lots of different we know from what we're seeing in the literature right now that
00:51:08
Speaker
There's some fascinating sort of studies coming back. So probably the number one factor that reduces injury risk from footwear is comfort. Yeah. Those people who run in shoes that they find comfortable versus what they think they do into their biomechanics or performance generally tend to pick up less injuries. We even see things, some literature where if you buy shoes based on your favorite color, it can reduce
00:51:37
Speaker
the type of injuries or injury incidents versus people who are given shoes that aren't their favorite color. So I tend to be very, by multiple pairs of shoes that are all different brands, all different makes. And I know everybody now who's listening who's gone, I've run in the same model. I've had 10 pairs of the same shoe for the last 10 years. What nonsense are you talking about? I get it. Some people are happy and it's fine. And if they work well with those, I'm not saying you have to change things. But for most of us,
00:52:07
Speaker
Having a number of shoes that are all different types of shoe and just rotating through them on a regular basis is probably the best advice with the theory behind it that when we run and we mention those forces that we apply through the body, we can't remove those forces, it's physics. But what we can be smart on sometimes is dissipating them to different structures regularly.
00:52:32
Speaker
Yeah. So if I'm using a particular type of footwear that always sends the forces through my Achilles, it's not going to be a surprise in a period of time when my Achilles starts to tell me it's not happy. But if my other shoe sends those forces more to my knee, my hip, my ankle, then suddenly that Achilles is having a bit of a break. You'll always have a favorite pair. You'll also, for me now, I know
00:52:57
Speaker
that if I go and run long in a, if I do a double digit run in a minimalist shoe, my calves really feel it for a couple of days. Yeah. So I tend to not do my long run. I tend to do my long runs in a more hawker type, maximalist shoe, but they will irritate my hips and knees if I wear them only. So I'll swap around and I'll just buy multiple pairs of shoes. And what I say, you know, I know people like to have expensive ratios, but
00:53:24
Speaker
These days there's so many sales on and there's so many places selling shoes that for the amount of people who go and blow 200 pounds on a pair of running shoes, maybe you'd be better off having three to four pairs of 50 to 75 pound shoes and just regularly rotating through them in different types of runs, in different types of terrain. And then you'll just find that you share those forces around your body better. Yeah. And potentially reduce the risk of injury and, and
00:53:54
Speaker
problems coming later down the line. Yeah, that leads us nicely into our kind of final question really, which is just a summary of, so we've mentioned that shoes, rotating shoes can help prevent injury. We've mentioned that strength training isn't necessarily a panacea for preventing injury either. What else can we be incorporating into our routines then to prevent injury generally? Yeah, I think again, it's all variations on that same topic. I think
00:54:25
Speaker
Generally, I think an attitude change is key. Yeah. It's go hard, go home, rest is rest type of attitude. There will be periods in a training plan where that might absolutely apply. I've got athletes that I'm working with now that are training for things like the Dragons back, training for things like Cape Wrath. We've had blocks in our training where, listen, you're going to be a bit stiff and so this is going to be hard. You're going to have to run when you don't want to run. But the whole plan hasn't looked like that.
00:54:53
Speaker
there's been very easy periods. So I think generally learning to not run quite hard all the time is probably the big thing. Steven Seiler, who's the guy behind periodized training and 80-20 training, he has this phrase of zone two abusers. So these are the people now where, and again, it's this best intention mistake. I've only got an hour, four days a week to run.
00:55:21
Speaker
And I want to make the most of that hour. So I run quite hard all the time. I'm running at seven or eight out of 10 effort. So I'm always out of breath-ish. I'm always sweating and working hard-ish. I never do longer, slower, easier ones. And I never do much shorter, sharper ones. Those are the ones now where just restructure your training a little bit. Maybe add 30 minutes, negotiate with family, friends, work colleagues, whatever.
00:55:50
Speaker
you get an extra 30 minutes on one day. Make that a 90 minute session that's dead slow. Three minutes a mile slower than your race pace. Even the Kenyans are doing 12 minute mile in when they do their slow minute runs. That's literally from four minute mile into 12 minute mile indifference. Let's make it a walk run even. Walk and running is so underrated. I get all my athletes to do walk runs. It builds easy volume, time on feet, and can really compliment your overall distance.
00:56:18
Speaker
So you might not do any more runs, but you might add a walk run into your week. A little bit of cross training sometimes, you know, if you can stick an hour on the cross trainer or the bike or something after a run, you've done a two hour session or a one hour session. I think those things are key for me. Then the sort of trying to put a bit more value on rest and recovery. We can only recover from the training that we've done and we can prepare for the training coming. We don't make adaptations when we train. We make adaptations when we recover from that training.
00:56:48
Speaker
But again, we are psychologically quite fragile normally as a run-up population of appreciating that I can get better by doing less sometimes. And that might be at early stages in your program or certain stages in your plan where you just go, no, I need, you know, I'm a big fan that recovery should be periodized. In the early portions of someone's training, I might not put any rest in. They're not training enough to warrant rest. It might be that it's every other week instead of every week.
00:57:17
Speaker
But at heavy training blocks, I've got one of my athletes now, we're just going into like a three, we've done four months of base building. We're doing three months now up to Dragon's back. We've now switched to, because of the nature of that multi-day event, we switched to back-to-back days for three-day blocks, and then a two-day recovery. So we were on a seven-day-a-week training plan. We're now on a five-day plan, three on, two off, three on, two off for a month.
00:57:43
Speaker
So he's now got two complete days off in a row, which we didn't need before, but we do need now. So I think just reframing our understanding of those type of things. I'm a big fan of broken runs. Yeah. So these, these, I get a lot of my runners, even in like a marathon plan, instead of Sunday, always be in the long run. That's a double digit nonstop run. One week it might be 10 miles. The next week it might be two, five miles. Yeah.
00:58:12
Speaker
on the same day, one in the morning, one in the evening, or split over the weekend. Week three is back to a 12 mile long run. Week four is two six miles. We still accumulate in the volume, but we're just insulting the body less and fatiguing the body less all the time. So I think most of the stuff for me to get better without getting injured is just being novel in the ways. And those are the things that don't pop up on algorithmic plans offline. So we just need to break from that
00:58:42
Speaker
You know, there's only one way to prepare for some of these things because there's not, there's hundreds of ways.
Where to Find Mike James Online
00:58:47
Speaker
Yeah. Oh, well, Mike, this has been absolutely fascinating. Thank you so much for your time. Where can our listeners find you if they want to get in touch? It's at the Endurance Visio most places. The website right now, endurancevisio.com is being overhauled to upload a load of the video content. So that's down at the moment, but you'll be up in the next few weeks. But at the Endurance PT on, um,
00:59:10
Speaker
Twitter and The Endurance Physio everywhere else. Yeah, thank you. I hope that everyone out there listening has enjoyed this episode. Do let us know your thoughts.