Matt Pearson

@GregLehman @tim_roozendaal Agreed. I even recently invested in a pair of barefoot shoes 🤯

@MPearsonPO @tim_roozendaal That being said I like the idea of building other attributes. They might be helpful for performance/rehab. We just can’t speak with any certainty and should have this debate.

Carbon plates and high stack shoes have been a game changer for training volume, as your legs can handle just a bit more without the same fatigue. But the foot suffers. Research shows that the foot function is basically out of the picture and the shoe geometrys and stiff plates take over what the foot would normally do. This makes your feet weak and vulnerable, which can cause stress fractures or just pains. What you Will mentioned here, is the right way. A proper shoe rotation for maximum performance while running and a wide toe box daily shoe. Foot health 🤝 Performance

@GregLehman @tim_roozendaal I realise I’m preaching to the converted

@MPearsonPO @tim_roozendaal Agreed

@GregLehman @tim_roozendaal But if the logic is that the foot behaves differently/ is at risk of deconditioning etc then I’d argue these are attributes that are not needed to run under this condition (carbon plate)

@MPearsonPO @tim_roozendaal The goal task might not be optimal. So resistance exercise/plyos are helpful so perhaps the same with the foot. Remove the tech and train barefoot with a different gait for different adaptations that MIGHT carryover.

@GregLehman @tim_roozendaal Yeah sure. Train around your running too. But in terms of getting better at the task, practice the task.

@GregLehman @tim_roozendaal I find the line of reasoning interesting. If the aim is to perform in a carbon shoe, why would you not train in one?

@tim_roozendaal The foot is still working though. And if it’s a stimulus more than being sedentary then we will have adaptations.

@BillingMartin @dan_egidio 🦊

@dan_egidio It wouldn’t be any fun if clinicians weren’t able to “diagnose” then apply a fox though would it

I’m sure this is true for most clinicians who think normal human variation is a problem

@DrJN_SportsMed I did not know about the link between Gh and entrapment. Thanks Doc. Every day is a school day

Consent ✅ Bodybuilder using Growth Hormone Nocturnal bilateral hand pain, aching and parasthesiae - not able to sleep Carrying over to affect ADLs, including holding phone in front of him and keyboard Blamed on bilateral stenotic CSp changes Very positive Tinel's test at Carpal Tunnel POCUS video - US guided Carpal Tunnel and Median nerve (MN) hydrodissection Needle just under transverse carpal ligament (TCL) - (feels very tight with normal syringe pressure versus other CT injections) - opens up 2with slight bevel and needle adjustment Wouldn't accept more than 4ml, so I wouldn't push harder - I don't want to add unnecessary perineural pressure and ? compromise nervi nervorum and vasorum.... there is a balance to be had Note how the nerve is subtly thicker at point just before entry to CT- "dumbbell sign" Also note how the deeper digital flexors are gliding better than the MN as the pt involuntary clenches fist as needle enters 95% improvement at follow up ("its now 0.2/10") 😆 Growth Hormone use a well recognised cause of peripheral entrapment neuropathies - ask any Gym Bunnies about use of PEDs

@DrJN_SportsMed @lizbayleyphysio expecting big things (are you a pro yet?)

What is this sonographic phenomenon?

@DrJN_SportsMed @Tiago_MOC80 Changing to test ATFL in this way vs open chain anterior draw was a massive development in my practice.

@Tiago_MOC80 CFL - talar tilt / inversion - pt side lying ATFL - foot fixed on bed, knee 90deg, posterior glide / drawer

Consent ✅ Stuntwoman poorly managed ankle dislocation 10 years ago Recurrent ankle sprains on ADLs Heavy strapping for work US videos demonstrate nicely the assessment of dynamic instability 1. Chronic CFL tear & talar tilt - ‘nodding head’ sign 2. Old ATFL avulsion fracture & ligament incompetence

Check out my latest article: Manual modelling of femoral shaft stresses linkedin.com/posts/matt-pea…

@DrJN_SportsMed Definitely more effective than the non-ambulatory canine lead pulls

Dual ambulatory canine ‘lead pulls’ Fantastic low impact, functional spinal rehabilitation - with unpredictable, asymmetric isometric / concentric truncal & core muscle challenge Progress to eccentrics with larger, less well behaved dogs 🐶🐕🐕🦮🐕‍🦺

@DrJN_SportsMed I’ve heard the turmeric good to get on too. Or maybe it was another spice.

Woman on the self checkout at M&S (whom i see frequently) - “You’re limping - have you hurt your foot?” “No, i’ve had quite a bad spinal injury & infection” “Have you tried a hot bath with salts?” Now rushing home to get in the bath - fingers crossed

@DerekGriffin86 @BennoNigg Great share, not come across this pod before.

As always, great insights from Prof @BennoNigg open.spotify.com/episode/2qqhZe…

Tell me you have 2 young kids without telling me you’ve got two young kids

@DrJN_SportsMed Have missed these

Consent ✅ Professional dancer Persistent deep seated medial ankle pain post microfracture for talar dome osteochondral defect Predictable 'catch' through mid range active movement esp under load Surgeon "happy" with procedure - MRI relatively un-exciting But POCUS with foot in full plantarflexion (a dancer, so the advantage of the typical hypermobiity / increased ROM!) to expose more posterior joint surface shows effusion, local medial synovitis & persistent defect (cortical irregularity) Seems reasonable target for US guided CSI initially

@BillingMartin I wonder if it even is possible to make a significant impact here. Very complex (and fascinating) issue

Current tools to fight health misinformation online are fragmented & short-term. The review says real progress needs coordinated, multi-level action beyond simple fact-checks.

@adamdobson123 @k8purcellphysio @lizbayleyphysio All the best

@MPearsonPO @k8purcellphysio @lizbayleyphysio Reframing the antiquated takes of others is not at all the nature of this discussion. All I would suggest is you zoom out from your work at the foot & look at the literature on the topic. Have a nice day/evening.

Teaching🦶🏼 This foot was asymptomatic, but showed signs of FHL tightness/weakness. These tests are a slightly crude measure of strength/function, but can be useful as a cluster to help understand the tissues in & around the big toe when teamed with a thorough subjective history.

@adamdobson123 @k8purcellphysio @lizbayleyphysio “I can see what (other clinician/ you) are seeing, but for me, that’s not a cause for concern, not the cause of your symptoms”.

@adamdobson123 @k8purcellphysio @lizbayleyphysio … the important part, not the label itself.