Injury Prevention For Trail Runners: Interview With Mandy

​In this episode I interview sports chiropractor Mandy from Performance Place Sports Case, who is a specialist in working with trail runners. 

Inside, she shares some insights, philosophies, and strategies around how mountaineers can prevent, reduce and manage injuries if they are using trail running as part of their training.

Trail Running For Mountaineers

Find more from Mandy here:
​

• Website: https://www.p2sportscare.com/
• YouTube: https://www.youtube.com/@Performance-Place-chiropractor

==

Episode Transcript:

​​[0:00] Many mountaineers out there, when they're doing their training and doing their

[0:04] aerobic capacity work, love to utilize trail running. It's fun, it's adventurous, it gets you out there, and it is pretty specific to the world of mountaineering. However, as with any type of endurance activity, the rate of injury, the rate of issues that mountaineers deal with in this space and with this type of training is just so unnecessarily high. I see it all the time and it's incredibly common. And it's really, really unfortunate to see because with a few simple changes in direction, a few simple changes in your programming, you can make some pretty dramatic differences in regards to your risk of pain and injury. So on that note, today's episode, we're going to be doing something slightly different. And instead of myself talking, I've got Mandy, who is a sports chiropractor who specializes in working with trail runners to come on for an interview. And the reason why we're chatting with her is not only is she a specialist on trail runners and has some really interesting insights, but she also works with people both in person, but also as a telehealth, so online, which does change some of the dynamics in regards to recommendations. So in this episode, we have a really interesting interview around her insights in regards to injury prevention for trail runners, which is super relevant for a lot of mountaineers out there. A little bit different, but I really do hope you enjoy today's episode.

[1:28] All right. Hello. Hello, Mandy. A big welcome to the show. So happy to have you on. Thanks. Great to be here. Thanks for having me.

[1:37] So to kick things off, do you just want to give us a little bit of background about yourself? And you could just let us know who you are, where you're from, and what do you do?

[1:49] Yeah, totally. My name is Dr. Mandy Reel. I just got married, so my maiden name is Wayne Fan. So if you see me around, that's why it's confusing. I am a rehab sports medicine chiropractor. So I specialize in working with trail athletes and ultra runners in specific as well. And that's the best job in the world. I get to work with people both in Southern California, where I'm at, and through telehealth and basically get them back outside, which is what I love to do. So yeah, I love it. It's a good job.

[2:25] Yeah, fantastic. And so today we're going to be diving into the trail running side of things a little bit, because as I was sort of talking to you before we started off, like the podcast background for a lot of mountaineers, they love trail running. Not every man needs to do it, but I know a lot of people are doing it. And it's something that for myself, I don't talk about a huge amount on the podcast itself. So I think it's going to be super, super interesting to dive into this and get

[2:50] your insights in a few different areas. So on that front, you want to let us know, like, what is your background when it comes down to trail running and what led you to working with so many of them? Yeah. Well, so for those of you who have heard this story before, sorry, but so I came up in cross-country and track and in high school and college. And after college, I actually wanted to continue my track career. I was a 1500 specialist, so actually more like a middle distance runner. And I was training in the summer and a good friend of mine and my now husband uh told me and they're like you're doing a long run come with us I'm like okay where are we going they're like don't don't worry about it, and I'm like how far are we going they're like just just do the loop don't worry just do the loop and the loop ended up being like 15 miles and, you know 3k avert which now is I don't know 3k avert right now maybe this is egotistical isn't that much but But at the time.

[3:51] I thought it was impossible. And by the time we got back down to the car, I was super hooked. So, you know, within a month, kind of threw away my thoughts about doing track for longer and went full bore into the trail running world. I think I was a first trail race was maybe seven months after that. So it was a pretty quick spiral, so to speak, into it. And I've been there ever since.

[4:19] Yeah, fantastic. And then when it comes down to working professionally and I guess caring for trail runners through your job these days, do you have a particular philosophy when it comes down to caring for trail runners versus maybe other athletes you may see or even the general population? Yeah, the number one thing is keep people running. So I have probably about 90% of my patients stay training during the time that they're seeing me. There's a few exceptions, but there's really cases like stress fractures or bone injuries where it's, yeah, okay, you need to rest. That's a non-negotiable.

[5:02] But pain is a signal. It doesn't necessarily mean anything's exploding or tearing. And even then, things that are tearing respond well to load. So I keep people running a lot. Um, I think rest is over prescribed and can kind of lead down a hole that's harder to get out of. Um, so that's kind of paramount for me and then more for trail runners and definitely applicable for mountaineers, like hikers, all, all of us crazy people is, um, understand that it's not just a sport for a lot of us. It's kind of how we live our life. And there's a lens that we see this sport through that's not necessarily just competition. So understanding that it's a little bit different than, say, working with a take like an NCAA basketball player who wants to go to the NBA. Totally different vibe than, hey, I want to, you know, I'm climbing Rainier next month and I, you know, my foot hurts and I can't deal with, you know, my current hiking shoes. There's different.

[6:06] Ethos on that of you get people back out there, even if their performance, so to speak, is not totally up to par as it used to be versus like a basketball player trying to make the NBA. They're focusing on totally different things. So yeah, above all else, keep people in the activity they like to do as much as possible, as long as it's safe, which it almost always is. And then understanding that this is kind of a lifestyle. It's a life outlook rather than just a sport. It changes how the language that you use with patients and how you're approaching treatment as well.

[6:40] Yeah, I think that's such a valuable thing to hear. And I think, you know, already that's probably going to resonate with a few listeners, because I can't tell you the amount of conversations I've had with people who have maybe seen someone who, you know, they get themselves in a bit of trouble with pain or injury. Um they see a professional who may not have a bit of a background in regards to trail running or whatever it is and they get told you know don't hike or don't run and it's like well i'm gonna climb eight weeks down the line i'm gonna do something and then there's this massive mismatch of communication where they're telling their therapist like i'm not doing anything but they're actually going out and smashing the miles yeah.

[7:20] Totally no i've i've seen both sides right i i I not professionally, professionally, but I also coach high school cross country, which is fun. But for those kids, I am not their practitioner and keep those separate. And so if I send them to a doctor like, hey, your foot hurts, go to someone. And often it's just like, okay, who can insurance cover? And they'll tell me, oh, yeah, my doctor told me to take six weeks off and have to bite my tongue because I'm like, you're fine. It's okay. I know you can rush me through this. It'll be fine. But, you know, they're trying to sneak mileage. I see them on Strava later, you know, like doing little doubles and stuff. So it's better to just understand that that's going to happen and work with it and understand, too, that that can actually be helpful when you're actually with a practitioner who will communicate with you.

[8:13] So you mentioned before that obviously you do work locally, but you also do work telehealth. And I think as this is an international podcast, people all around the world, that would be quite interesting to some people. So when it comes down to telehealth itself, how does that change the way you might assess and treat someone compared to having someone in your clinic or in the room itself? Totally. Yeah, I wish I could put my hands through the screen. I'm sure at some point in my career that I would love that to be possible. But no, it puts more weight onto subjective reports. So that's the I feel this when I do this. I feel this, you know, in this movement, which I actually find is can be quite a strength. And it's changed how I treat people in person, too. So often when I've had my own injuries going to practitioners, it's like you spend, you know, the first X minutes going over your history. This is what I do. This is when I feel this injury. What do I do? But for telehealth, it opens up a lot of you can be talking about that during the exam. If you remember something in the middle of, say, we're doing single leg hops and you're like, oh, wait, yeah, actually, it hurts way more if I'm on steep techie downhill, like things like that. There's a lot more room to breathe.

[9:34] And people are less likely to hide things, frankly, over telehealth. And in the sense, like, you know, you don't get white coat syndrome. You're not like, oh, if they feel something, they're going to tell me to stop doing what I want to do. So there's an ease to it once you get past the little objective strangeness of getting treated over telehealth. But I find it very useful to be able to talk to people for longer on what they're feeling because details come out that wouldn't have otherwise. Now in person obviously helpful to have hands on people you get a little bit more information about say like passive range of motion you can't, shove someone's hip in a passive position and feel it if you're not there so there's a tactile sense for it but, for almost all the cases telehealth works pretty dang well for the for the exam part and the subjective reports coming in more and more is super super useful all.

[10:33] And then a lot of the listeners on this particular podcast, like they're interested obviously in training for mountaineering. That's the name of the podcast. But a lot of people are kind of figuring things out for themselves or self-coaching or whatever it is. So in your experience, what is one thing you would sort of say the trail runners tend to get wrong when it comes to managing their own bodies? Yeah, you will hear this a million times from me. So apologies in advance for the repetitiveness, but strength training needs to be happening. Whether you are trail running, hiking, mountaineering, if you're outside moving your body in weird ways and demanding lots of effort from it, you need to be strength training.

[11:16] Prevents so much. I always have my patients end our treatment with that. So by the time that we're, you know, they're feeling good and I'm going to kick them out because they should just be going and having fun, they need to be doing strength training so that they don't land back with me. And then the kind of secondary thing, one, if you're doing strength training already, great, you're better than most people in this, but it needs to be heavy. So I've caught, especially the runners um they're like oh yeah i do strength training and it ends up being something kind of more like hit workouts where it's a ton of reps it's lightweight your heart rate's super high, like that can be useful if used um in certain scenarios but, for all of us for mountaineer hikers trail runners you don't probably don't need more cardio uh, particularly for trail runners obviously but if your weight lifting is cardio you're not getting the strength gains that you need to to prevent injury and just to have more longevity in the sport you know there's the whole your knees will explode if you go downhill too fast and all that crap which you know i'll spare the rant on but, the strength training part of it is what creates resilience in your body so i i will hammer you guys over the head over and over and over again strength training needs to be heavy and then.

[12:38] The other thing and I'm guilty of this I'm currently guilty of this is letting things go too long, All of us can push through pain. We wouldn't be in this sport if we couldn't. We're all a little sadistic in that way. So a little bit of knee pain, say, is not really a big deal. But things that stick around for a long time or are moving a lot is weird. There's something happening that's triggering that over and over. If your foot hurts for two weeks and you're fine, you're not limping, whatever. Whatever but for me why i say it's current i have this knee problem, um that i had leading up to my last 100k i ignored it because my training was going well and i'm like whatever i'll do with it afterwards and it has actually progressed to the point where.

[13:26] You know it's a i have to be different it's not a standard like tendon thing but i actually created a little bone spur in my knee by ignoring this for so long. So that's something you just have to get a little surgery for. So leaving things that you dig a lot deeper of a hole that you have to climb out of eventually, and then you end up like me and I haven't raced in two years and that sucks. So don't be like me, just get it dealt with. If it's been there more than a couple of weeks, have someone take a look at it. Even if it's, you know, I will tell people, this is no big deal. You don't need to see me by Let me know if it doesn't go away, but you need to have someone lay eyes on it if it's been around for a few weeks.

[14:09] Yeah, fair. And that's such an important point. The classic health professionals dilemma there, the do as I say, not as I do. Yeah, totally. Oh, it's horrible. We're our own worst patients, honestly.

[14:22] So to take a little step back to a couple of follow-up questions on one of the things you pointed out, said there. So you mentioned, obviously, the strength training, big part of it, you know, big advocate for that. And you also.

[14:38] Using the word heavy, to give a bit of context, what would that look like or feel like or what sort of boundaries would that land when you're using the word heavy? Yeah, we'll go from technical to not technical. My general target, for those of you who are familiar with RPE or rate of perceived exertion, if you are literate in lifting, so you have some experience, you've been coached before for your big lifts, so to speak, so your heavy stuff, deadlift, squat, your last set should be getting towards our P8. So that means you could do two more reps without your form totally breaking down. And then you'd be tapped out. That's by your last set. The steps before that you're getting into your working weight, you could probably do maybe 10 reps of something, but it would be hard. But.

[15:30] Getting out of the technical aspect of it, heavy needs to, one, feel heavy, but two, most things you shouldn't be able to really do more than, say, 10 reps per set for four sets. Now, that's not the case for everything. If you are, say, a trail runner who never uses poles, you could do dumbbell flies for 20 reps with a lightweight. That's fine. You're not going to get much out of it. But for the really good bang for your buck stuff, deadlift, squat, carry, get towards where the last set has about two reps left in the tank. Make sure your form is good throughout. And then general ranges, four sets-ish of six-ish reps. You can play with that a little bit, but that's usually the sweet spot for most of these activities. But other kind of rule of thumb for those of us who actually uh get muscle soreness some of you don't i'm jealous but um, you should be sore the next day you should probably be sore two days after you shouldn't be sore five days after but if you're not sore at all the next day you probably didn't go heavy enough but should should feel heavy shouldn't be any doubt about like is this enough.

[16:44] And then to follow up on that, like you mentioned squats, the carries, the deadlifts, all great options. If you had a trail runner who came to you and said, okay, in this situation, a bit of heavy strength training is going to be beneficial, but I don't really have gym access and I'm only going to be training at home or maybe locally.

[17:05] What would you recommend in that situation to still kind of get a similar stimulus, I suppose? Yeah. Yeah, I deal with this all the time, like through telehealth, right? I have some people bring me into their gym, which is fun. But at home, you can MacGyver a lot of stuff. So yesterday, for example, I had a patient who I needed her to get what the equivalent of a kettlebell deadlift would be, but her kettlebells only went up to like 30 pounds. She could probably deadlift 150. And so what we ended up doing is putting all of her lighter dumbbells and kettlebells into a tote bag, layered another tote bag on top of that so it didn't rip and had her choke up on the straps and actually worked really well for a kettlebell deadlift. It just requires some setup. The easiest thing for things like carries is you go to Home Depot, you get a ton of sand and a bucket. Congratulations. You now have about a 80 pound, depending on how big the bucket is, 80 pound kettlebell essentially. So you might MacGyver a lot, but the weight is non-negotiable. You can't really recreate it with bands all that well. Doing dynamic stuff like plyos is a completely different category. It's basically putting heavy things in things that carry lots of weight. So buckets, bags, things like that.

[18:31] And then we've touched on, obviously, the strength training, big part of what you believe maybe not done enough. Beyond that, like when you're looking at, I guess, either runners themselves, or even practitioners who treat them, is there anything else that you feel like is just not really done enough in the trail running community? Yeah, I, I will actually, I'll, I'll answer both that and the flip side of it. The not done enough is letting the athletes run through pain. And I know we've, we've touched on that already, but, um, I think as practitioners, we get scared of pain because people are coming to us in pain, wanting to get out of pain. So if we say, Hey, you're in pain, we're figuring out why keep doing the thing that hurts, that feels counterintuitive. Now, if you know the demands of the sport and stuff, you can make an informed decision about, yeah, you can actually run or hike or do stuff with this. But I think more practitioners need to let athletes run or hike or mountaineer through their pain.

[19:33] It's not as big of a deal as people think. Now, the only thing is you have to clear the red flags, right? If you think somebody's bone is going to break, you know, then you can't let them keep doing what they're doing. But for most other people, you can work through pain. So I think that's not done enough, just letting the athletes keep doing what they're doing and adding more stuff to make them actually feel better. Things that are done too much, I think there is a huge emphasis on stretching. This is a hot take. This is controversial. So if you get comments and emails about this, I'm sorry. But I've had people come in and they're like, yeah, I stretch an hour a day. I've done that for 10 years. I'm like, that's great. You ended up here though. So something's not lining up. Like you wouldn't be seeing me if stretching was the answer. Stretching is great. It makes you feel good. It's a nice little endorphin release. It can help mobility, which is fantastic. It really doesn't solve much. So I think that's overemphasized and it's pretty rare that I see someone fix a problem with stretching. It might modulate the symptoms a little bit, like might make you feel a little better or worse temporarily, but it's rarely something that actually kicks the problem.

[20:51] Yeah, fair. And I'll tell you what, like, that is the topic. I probably have like four topics that I occasionally talk about over the years that brings a bit of hate. And that is definitely the one that gets the emails and the comments in. And especially, I'm sure you've seen it, like the big old systematic review that looked at strength training for injury prevention and looked at stretching and this and that. And whenever I talk about that, yeah, a lot of people are a little bit hesitant. Yeah, pretend I don't see it, you know.

[21:24] Yeah, so, ah, fine. Totally. Well, there we go. So, let's sort of dive into, you sort of mentioned a couple of times, obviously, trail runner has a bit of pain, has some issues, don't always have to stop running or, you know, a lot of the time can kind of move through. In that type of context, like if someone was dealing with this type of reoccurring niggles or re-returning discomfort or whatever it may be, they just didn't really want to stop training. How would you go about that? How would you navigate that conversation, that adjustment? Obviously, everyone's different, but as a general whole, how do you adjust things to help them move forward?

[22:03] Without stopping altogether. Totally. Yeah. There's a few different ways to attack it. One of them is categorizing what's dangerous and what's just painful. So part of that, right, the classic, you'll hear it from every practitioner, see somebody, make sure they clear you, et cetera, et cetera. Obviously do that. But if you're like me and trying to fix things on your own because I don't want someone to tell me not to run. Having categories of signs and symptoms that differentiate what is dangerous versus what is just painful or sensitive is super useful. So off the top of my head, just the big ones are if it is super bruised and swollen, probably some structural damage. If it hurts, but there's nothing that you can, like you can't rests on the area that hurts that's usually okay if you're not seeing any visual visuals of like hey there's a bone sticking out of my leg that's fine that's you're probably okay to continue um.

[23:06] And if you're on the other end like i said bruising swelling um, if you're getting weird temperature stuff i've actually heard of more of like traumatic injuries where you twist your ankle and you think it's fine and then all of a sudden your body feels really cold like weird stuff so to speak, is a sign that perhaps this is time to pull back. So categorizing things like that can really, really help. And then categorizing more specifically what flavor of pain you're dealing with, is harder to do on your own. It's really hard for your own brain to assess your own body to the point where if I'm injured, I go to other people. I don't treat myself, but no, I try not to it's usually unsuccessful because I'm overthinking it um.

[23:54] But trying to categorize what flavor of pain you're feeling, so something like sharpshooting or really stabby or it's dull or it's tingly, that will help your Dr. Google searches. It'll help your doctors kind of narrow down what's happening, and it'll help you determine if it's something you can keep going through. So like dull stuff that doesn't get worse, probably fine. If you're noticing trends like okay you go out for a hike or a climb and it's it's kind of crappy for the first hour and then it gets better it's probably fine um, so yeah kind of differentiating the dangerous stuff versus just the sensitive stuff and it's a little hard to do on your own but um, you can do some pretty good logic checks on it of if it warms up right if it gets worse and worse and worse throughout my activity, probably not great. But other kind of thing I like to put out there is if the pain is moving around, like say the really common one I've been seeing recently is plantar fasciitis. So heel pain that's just on your right foot. And then all of a sudden it's on your left foot. And then it's on both feet. And then it only is on your right foot. Like, oh, and now actually my Achilles hurt, but my plantar fascia doesn't.

[25:10] That's weird right like that doesn't make sense so if it's moving around there's actually a better probability that it's sensitive and not necessarily damaged because damage would imply it doesn't move around because the damage is in one spot like if you hit your foot with a hammer, there's damage in your foot it's not going to switch feet so moving around pain is actually probably a good sign that you can keep doing what you're doing uh which feels very counterintuitive so i always like to put that out there.

[25:42] And then for the listeners, I know there's a lot of listeners out there who, you know, have been mountaineering for years and years and years and been trail running for years and years and years. But I also know there's a decent population of people picking up this podcast when they've kind of first transitioning into mountaineering. And I know a lot of people with that sort of first objective in mind, they're also first transitioning into a bit of trail running as well. So I guess if someone was very early days in their trail running journey, and they did want to avoid some of the common injuries, common pitfalls you often see, what would you recommend they're doing from day one? Yeah, we talked about strength, but more specifically, if you have 20 minutes in the gym, All you can do is say like three exercises. You need a deadlift. You need a squat. You need a carry. They all have to be heavy. Work into it safely, obviously. But if you do those three, you will take care of like 90% of the pitfalls that people get into. Now, that being said, you need someone to lay eyes on you so you're not doing anything weird. But if you haven't really been injured before, if you know that there's no weird abnormal, you know, morphology, like your bones grew fine and all of that.

[27:01] You can probably get a lot through YouTube. We also have resources on our website you can check out, but you can look stuff up and say, how do I do a deadlift? And you'll get most of the way there. If you're injury prone and you've been injured before or you have other health stuff like heart stuff, then you need some you need to hire someone so you don't get in trouble. but squat, deadlift, carry. If you're doing that, you're golden.

[27:24] And then hiring someone specific to work with you. Obviously the logic check, yes, a doctor if you're injured, but being a coached athlete is completely invaluable. So knowing somebody that has been doing this for a long time and knows how to advise other people is amazingly useful. So my, the athletes I work with, the patients I have, a lot of them are coached. And I get to work with the coaches too on our care and our training, which is awesome. But having a coach to allow you to have the information to avoid the pitfalls, right? Like, Hey, I have these crampons and they end up being like two sizes too small and now your foot's messed up, things little things like that just having someone who's been there and possibly made the mistakes that you have or are, you know so into it that they're diving into the research about strength versus stretching right uh having that is just a total game changer i i think if more people had coaches there would be less patients in my office.

[28:33] And then just for context for some listeners who may not be aware, you mentioned squat, mentioned deadlift. I'm sure everyone knows about that. You mentioned carry as well. So for someone who hasn't actually heard of that term before, that type of exercise, talk us through what actually is it? Yeah, it's fairly simple. The general concept is pick up at least one heavy thing and walk around with it. Where people get it weird is that heavy thing means something different to every person. Uh, my usual guideline is you need to be able to walk with it for a minute, but you really should not be able to get to 90 seconds. So if it's heavy enough, you actually, your failure point will be your grip strength. Um, if you look up strongman competitions, you'll see them in big hex bars doing farmer's carries, um, or with the specific farmer carry implements. Uh, but they are straining, like their veins are popping out of their neck and their foreheads. So a carry yeah pick up something heavy walk around with it if you don't have equipment but you have a seven-year-old child guess what that's a carry you just you know hang on to them.

[29:43] But it's really not something you need to overthink there's not a lot of technique that you need to coach for most people as long as it's something you're carrying is heavy great you can carry it down by your side you can carry it overhead you can carry it kind of hugged into your chest. It can be one side holding a weight. It can be both sides. It can be unequal weights. I like putting variety in there. So I just have a general umbrella of do carries. But just playing around with it and just deciding on any given day, like, I feel like doing a one sided carry or I feel like doing a carry where one of my arms is overhead with 30 pounds and the other one is by my side with 40. Great. Cool. Do that. The more variation you get with heavy load. Fantastic.

[30:31] So to follow up on that, and I know you've already said it, but I'm going to ask you to repeat yourself a little section in there because I know a lot of people gloss over it. I know a lot of response. People hear that. They're like, cool, that sounds great. I already do lots of load-a-pack walking where I put on a pack and I go for a hike for hours or I put on a pack and do like 60 minutes on a stair climber. I'm already doing that. If someone said that, what would the next words out of your mouth be? Yeah, that's good. But it's not enough. so walking with a pack say on a stair machine fantastic great training it's also really good training if you're going on a really well-groomed trail with no rocks and no turns so like.

[31:14] This might get you emails too if you're hiking mount whitney up the portal and there's nothing technical about it, that's pretty good prep uh if you have any scrambling if you have any ropes involved if you have any quick descents for the trail runners if you're doing something that's longer than you're used to or multiple days and you're not used to camping for that long, you need variation so pack is great it's really specific you should absolutely be doing that, you don't even need to replace it with anything you just add so you can have the pack and also carry a 30 pound kettlebell while you're on the stairmaster, you'll get really weird looks in the gym but you'll be way more prepared um, so yeah keep doing that for sure your shoulders will thank Thank you. But add in variety as well. And you'll find that you're not, you know, twisting your ankles as much. You're feeling like you're falling over when you step on a weird rock that moves.

[32:09] So I know a lot of trail runners and a lot of mountaineers, whether they're using trail runners themselves, or whatever, they follow a relatively similar approach in the sense they'll have a particular date in mind, whether it's a race, an expedition, whatever it may be. And they'll follow, like it's pretty common to follow up phases of training where they'll do their base building, they'll do their peak weeks, they'll taper off, and then they'll have their event or expedition and then afterwards have a bit of chill out time. In your experience is there any particular phase of this type of journey or this type of training where you see the most people really needing your help, Yeah, there's a there's kind of a transition right between base building and the peak weeks where, say, for trail runners, you're adding in workouts than previously. You've just been doing mileage, trying to build mileage. You have your double long run on the weekend, and then now you're doing tempo runs uphill.

[33:04] I'm sure there's analogous for hikers, mountaineers. It's it's probably less the technical part, right? Your your technique is not very high load or high speed, usually. Um correct me if i'm wrong but uh getting out of the base phase and into the intensity phase for lack of, a better word is usually where we're running into problems now the the sneaky thing is you're usually good for like two or three weeks if there's a problem, and it's showing up in that transition you can usually get away with that problem lying in the background for a few weeks and then it'll really really start hampering things after you've started workouts for a few weeks, uh this is really frustrating for a lot of people because for most, races and for most climbs you're training on the scale of months uh so your base building is you know a few months and then you're transitioning into workouts all of a sudden, you're getting pretty close to the date we're not talking a week out but you're within say three months of it so if your training goes to crap then it you need to start panicking um.

[34:13] Especially you know if you've been doing those workouts for a few weeks and then all of a sudden you're out of commission so that, not only does that timing kind of suck load wise but then you panic and you start doing things you shouldn't be doing like oh no i missed a week of training now i'm gonna like double my my training the next week uh it's It's an unhappy combination.

[34:35] Usually base training is OK, as long as you're not doing anything super dumb. And then taper, usually fine. Hard work's in the bag. Your body's pretty happy. It's adapting. It's getting plenty of rest. Post-race kind of depends on what's going on. Post-climb, same thing.

[34:53] You know, if the descent was way more technical than you were prepared for and your quads are just absolutely shot, it's different than, say, a race that you're overprepared for. So post-race it it can vary but post-race injuries are usually they look a lot different than pre-race injuries they're more like, acute overload of i did something on the day versus something's been lingering in the background maybe i don't feel it yet and then all of a sudden it's it's overloaded chronically to the point where there's breakdown, so yeah really that transition between base building and kind of getting into intensity phase and then post-race, post-climb, it's pretty much only if you're underprepared and something happened or if something totally out of your control happened and you overloaded yourself.

[35:44] Fair. No, that makes total sense. And I feel like we've covered some really, really, really useful stuff today and definitely some very clear cut points, which will be super relevant for a lot of the audience. So I think a lot of

[35:57] people we're going to get a lot of value out of this. I guess before, as we get into the tail end of this episode, was there anything that we haven't had a chance to cover on the training side of things which you feel like would be worthwhile touching on? That's a good question. Yeah.

[36:15] In general, I think we talked about most things that people need to know. I do think I do want people to be aware, say, if they're dealing with an injury, and it's not going away even with treatment, that's weird. So I've seen people, unfortunately, that come into my office and they're like, yeah, I've been to five PTs and two chiros and nobody I've done three years of rehab and it's still there. That's weird. So most injuries should take care of themselves on the order of a few weeks. And if that's not happening, even if you're getting treatment, something needs to change. So I do want to put that out there. Obviously, if you're working with a practitioner, ask them what their expectation is for timeline. But yeah, if things aren't changing in a handful of weeks, something needs to change. And then throughout training, actually on almost the flip side, you should kind of feel like crap, probably about a third of the time. If your goal is appropriate, as in it's more challenging than things you've done before, but not a total Hail Mary, let's just see if it works.

[37:24] You should kind of feel like crap a third of the time. So rule of thumb, rule of thirds. If your goal is appropriate, you feel like crap for a third of the time, you're going to feel okay for a third of the time, and you're going to feel great for a third of the time. So don't get too caught up if you feel like crap and just a training sense of like, oh, I'm fatigued. I'm on the couch all day. That's okay. If it's every single day for three months, that's not. But going with the flow and understanding that your body's strong and resilient and can probably take care of itself, I think that's worthwhile to know for people who are perhaps kind of nervous getting into their first big climb or big race.

[38:06] So I know a lot of people listening will be interested in kind of what you do after hearing all this. And obviously, we talked about the telehealth a little bit before. So as we wrap things up, could you just tell us a little bit more about your practice, like just how your telehealth model works for people and how if someone did want to work with you? Yeah. Yeah. I like to remind people I'm not just, you know, someone like behind the microphone. I my my passion is working with people I love doing this too but um you can find some info in the link uh in the description of this podcast and uh.

[38:44] To find out more about what we do if you're like I don't know you're just talking at me like I haven't seen you I don't know, what this looks like um we actually have a really successful youtube page that goes over a ton of advice You might be able to fix your own stuff just by looking through those videos. But about the practice, yeah, the telehealth stuff is awesome. I'd say at any given time, something between 40 and 60 percent of my patients are through telehealth. And if we're not in a if I'm not in a state where you're licensed, I work kind of on a personal training side. So certified medical exercise specialist, which just means I can't diagnose you, But I can basically make it so you get to the climb okay and strong and able to do it. So I'm really lucky I get to work with people around the world. I have people in Switzerland and France, which is awesome. They do super badass stuff. But the way to get to me, check out the link. We have a form on our website now where you can apply to do a consult. So it'll just be a little bit of information and telling us what's going on in a brief sense. And then I'll give you a call or an email back and we can get to chatting, but usually pretty informal to start. So if you got something, even if you're not really sure if you're going to go for like getting it treated, always good to chat and I can point you in the right direction, even if it's not with me.

[40:10] Fantastic. Well, I'll make sure all of those links are in the description below. For anyone actually who may just be listening to this on the go and will miss a link, what's the name of the practice if they're just committing that to memory? Yeah the name of the practice is performance place so our website, um well if you look up performance place you'll find it but uh the website is p the number two sportscare.com but easiest way look at performance place youtube, that's the first result that comes up usually and then all the the stuff will be under there, fantastic well i'll as i said i'll make sure all those links are uh are in the show notes below and um and yeah and if anyone wants to check them out, they'll all be there. But yeah, fantastic, fantastic. Well, I feel like today has been awesome. I feel like we covered a lot of really, really interesting points and really, really relevant points for a lot of the audience. Because as I said, there's definitely a big crossover between the mountaineers and the trail runners.

[41:11] So yeah, well, thank you. Thank you so much for coming on. I really do appreciate it. And I really do think a lot of people are going to get a lot out of this episode. Awesome. Now, Rowan, thanks so much for having me. And I would love to come back and talk about this stuff all day. So this was a joy. Thank you. So there you go, guys. I really do hope you've enjoyed today's episode. Now, if you were wanting to learn a little bit more about Mandy, potentially see what she does and potentially work with her, I'll leave all of those links in the show notes below. So you can check that out, check out the content, potentially look at their services or whatever it may be. But with that being said, thank you so much for listening. I do hope you've enjoyed this. I hope it's been insightful, and we'll talk to you very, very soon. Bye.