Tim Pigott

@sarahkern101 @NicolaMarshall1 @discogem @JasminKParis Definitely Emma there.

@NicolaMarshall1 @discogem @JasminKParis it's possibly Emma Stuart - another Running Vet

We have video...(and i heard a very British sounding woman saying "thank you" at '38 seconds!) #Barkleymarathons #BM100

@thefootphysio @lizbayleyphysio @DrJN_SportsMed @BOFAS_UK @AFAPUK We’re all highly experienced at worsleyphysioclinic.co.uk (although it’s rare you can get a slot with me!)

I’m looking to find a good foot and ankle physio in Manchester for a post op patient heading over there? Any recommendations hugely appreciated! @lizbayleyphysio @DrJN_SportsMed @BOFAS_UK @AFAPUK

@andrewwoodroffe @brady_h 100% I’ve got loads of SoMe ideas, but too busy working and training to make them a reality. There are those who appear successful on SoMe but in fact are not…. But then a lesson I had from a friend in another sport was that his SoMe was 90mins/day build into his work diary.

@brady_h I could try but while running my coaching business that would be impossible haha. And that pays the bills so I guess I’ll just keep training a lot! But definitely you make a good point.

One of the tough and strange things about sponsorships and social media just now is that if I was to train less, get slightly slower times but make better content, reels and posts id likely have more chance of being supported as an “athlete” I guess it’s the nature of the beast!

@inaki_delaparra @feelthebyrn1 @Roadman_Podcast Again, Lake shoes. Potentially with aftermarket insoles to support the foot depending on the flexibility / stability of the arches. One of my side projects ‘The Cycling Physios’ has some interviews on this topic if needed.

Best bike shoes for wide and flat feet? Any recommendations? Appreciate the RT or advice @feelthebyrn1 @Roadman_Podcast

@coachjorgem I’ve got a paper out for review at the moment and a project going through ethics at the moment.

@coachjorgem Good work. I’ve got a series of projects running looking at EMG data as well. The previously believed muscle recruitment patterns we know are ‘wrong’ so it’s a case of determining what the variations are for different positions.

@physiojack @AdamMeakins A pretty extreme case, but I had a patient improve their bone density with Compex, swimming and cycling! (Admittedly we started at a very low point), but even those interventions were enough to improve bone density! (She refused meds, so it really was just that!)

@AdamMeakins The LIFTMOR trial would suggest it can actually increase bone density which is pretty epic

I see the exercise naysayers are out in force again about its effects on bone density! 🤦‍♂️ Regular resistance training maintains and/or increases muscle mass and improves strength! Strong healthy muscles produce stronger healthier bones! Meaning regular resistance training promotes good bone health! Its really not that difficult to understand!

@steviea67 The other interesting question is ‘what is z2 when you are 5 / 10 / 15hrs deep into an ultra!’

Interesting paper reflecting some of our chat yesterday. @HP3_Tim

In our recent meta-analysis with trained athletes, did the athletes who improved their VO2max more also improve their endurance performance more?🤔 No! 😮 In this dataset, +1% change in VO2max was associated with only +0.04% change in TT performance. But why? 1/15🧵

@tomgoom @keithgraham I’ve actually had good results with night splits, both with patients and myself! Not usually my first line choice, but for stubborn PF / or as per guidelines - pain first few steps, it has been v.effective.

Hey Keith, I found the night splints interesting too, not something I usually suggest. Shockwave was considered ‘outside of scope of practice’ which is also surprising. It’s mentioned briefly at the end. In terms of loading that’s a good question. That would be my preference, especially with athletes but it’s fair to say there isn’t a lot of evidence to support it yet in PHP.

Lots of criticism of these guidelines on Facebook & Instagram. Sometimes it feels like social media can be a harsher judge than the peer review process. If that’s the case where do we have it wrong? Are social media expectations too high or is peer review inadequate? 🤔

Polarised🆚Pyramidal🆚Threshold Which training model is best?🏆 It might matter how trained you are🤔 Our new meta-analysis tries to answer which training intervention produces the greatest improvements in endurance performance in trained athletes Thread🧵 & 🔗links below👇

@feelthebyrn1 And as someone tagged on Strava- alter-G or lever to offload during the rebuild is also really useful. Plus don’t forget aqua-jogging. In my IM days I’d do one session a week of aquajog regardless. Long runs were all split as double days (Bill Black was my coach, wise owl).

@feelthebyrn1 Unlucky- I’m on the rebuild from a pelvic stress injury last year (on top of a very complicated orthopedic history to start!). Give me a shout if you want to bounce ideas. I’d maybe start lower on the run rebuild - my protocol begins walk-run (5:1)

BSI Thread - femoral shaft BSI => bone stress injury I'll build this out as my recovery proceeds BSI isn't confirmed by imaging, yet In the early days, it presented like normal soreness and would warm-up like tendonitis - wasn't aware bone injuries did that Pain would arrive after exercise and was inside knee/hip/groin - it moved around and cleared after a night's sleep This had me thinking it was normal post-exercise soreness, with muscles relaxing as I slept When pain increased and stopped clearing overnight, I suspected it was something else. Pic 1 - injury summary from last week's PT visit Pic 2 - rehab protocol. Monday's swim (5500m) caused tightness (like early days of injury). Will try masters again Feb 10th and see if I'm asymptomatic afterwards. Push offs are lower risk to assess than running. Imaging scheduled for Feb 10th. MRI as x-ray unlikely to see if stress reaction still present. That will be 4 weeks off running. Able to 🚴🏼 🏋️‍♂️and use X-Trainer without any discomfort. Can go heavy on my legs without issue in the gym (unexpected). Swimming with gentle turns favoring non-injured leg is also fine. Julie and I have built in some guard rails to avoid reinjury. Shared those in an earlier post and wrote them up for my personal publication. I'll link the post in the replies

Congrats to @UoS_Physio lecturer @HP3_Tim who has received a special commendation from @thecsp for his evidence-based content for physios in the world of ultra running and cycling 👏 Read more 👉 salford.ac.uk/news/salford-a… Picture credit: Steve Ashworth Media and Scarpa_UK)

@stevemagness Because then we get pubmed.ncbi.nlm.nih.gov/38724071/ who ‘accidentally’ found the control group who did stretching were less likely to get injured than one of their intervention groups! Oops.

@stevemagness Not a bad summary, but made the same mistake all the recent SR’s have done which is not explore the original data. The °1 studies stating stretching doesn’t reduce injuries were does a 30sec calf stretch reduce ALL lower limb injuries in military recruits. Funnily enough/ no.

The sit and reach was my nemesis. I always failed the presidential fitness test because my flexibility sucked. It turns out...that was a good thing. Worse flexibility correlates with better running economy. A deep dive on flexibility on my new YouTube: @ SteveMagness

@stevemagness Doesn’t mean that the conclusions are ‘wrong’, but we can’t say the data shows stretching doesn’t reduce injuries because the methodology used in the primary studies is flawed. We need better primary data, not more SR’s repeating the same poor conclusions.

@andykirkland71 “I love deadlines, I like the whooshing nose they make as they go by” (Douglas Adam’s)

Immovable deadlines are remarkable in providing focus! Things that we've spent inordinate amounts of time trying to make sense of come into focus as the deadline approaches...but the apparently wasted time is essential to get that focus. Why? Anyone know?

🌟 Congratulations Tim Pigott for being awarded a CSP commendation! 🌟 Tim has been producing evidence-based content for physiotherapists in the world of ultra running and cycling. 📸 Steve Ashworth Media

@GregLehman @BiomechMax A deeper question is “what is ‘core’ stability / strength” - where does the ‘core’ begin and end? Is there even such a thing? We used to do a great debate with our MSc students on this.

@BiomechMax Agree with you there. Probably over programmed if people choose ab work over the basics

A term I find annoying in the fitness/training world is “core work”. If a program incorporates basic lifts (eg, squats, hang cleans, DL, etc…) athletes are getting plenty of “core work”. 2 birds…