The Physical Performance Show

In episode 387 of The Physical Performance Show, host Tim Studley picks up part two of his conversation with fellow Pogo Physio physiotherapist Lewis Craig, continuing last week's deep dive into surf life saving and Ironman racing. This episode shifts focus from injury patterns to managing niggles, optimising performance, and the habits that separate top-tier surf ironman athletes from the rest. Tim and Lewis discuss the collaborative decision-making involved in managing a recurring niggle, the key training and screening recommendations every surf life saving athlete should have in place, the lessons Lewis has learned working with elite athletes in the sport, and his top tips for improving performance — from sand-specific training to fuelling properly for a demanding training load. SHOW SPONSORS: 💯 Today's episode is brought to you by Pillar Performance and Pogo Physio's telehealth consultations. If you are an endurance runner battling with bone, tendon, joint related concerns, our online Telehealth consultations are an ideal platform to help get you back to your physical best - book online at https://pogophysio.com.au. 💯 PILLAR Performance is leading a new frontier in sports nutrition through micronutrition innovation. Their new Collagen Repair formula, developed in collaboration with Gelita Laboratories, is designed to support tendon and ligament health while promoting collagen synthesis to help athletes stay healthy and perform at their best. For 15% off your first order, visit https://pillarperformance.shop (or https://thefeed.com for North American listeners) and use the discount code PHYSICALPERFORMANCE (one word, capitals) at checkout. IN THIS EPISODE YOU'LL HEAR: A recap: this episode picks up where Part 1 (episode 386) left off, continuing the discussion on surf life saving and Ironman racing Managing recurring niggles: why the decision to rest or continue training should be a collaborative one between physio, athlete and coach How timing within the season affects the risk-benefit of resting versus maintaining training load Why a first-time niggle warrants a more cautious, rest-forward approach compared to a chronic, familiar issue Practical ways to modify training around a niggle — for example, adjusting swim technique (removing paddles, adding kick, more dry-land warm-up) rather than stopping entirely The physiotherapist's role in performance: keeping athletes pain-free and injury-free so coaches can focus on skill and aerobic development Baseline recommendations for surf life saving athletes: two gym sessions per week, individual screening, consistent dry-land warm-ups, and tracking training load How swimmers can track training intensity despite the difficulty of measuring heart rate in the pool, including simple session RPE-based load tracking Why tracking training load matters most when returning from injury or time out of the sport The performance and injury-reduction upside of athlete and team awareness around REDs and energy availability The value of a collaborative support team: coach, physio, dietician, sports psychologist and massage therapist working together Lessons learned from working with elite surf life saving athletes, including individual variation in pain tolerance, treatment preferences and communication style Common themes among top athletes: professionalism, a genuine quest for knowledge about their bodies and training, and long-term training consistency Lewis's top three tips for improving performance: sand-specific training with a focus on calf and lower-limb capacity, prioritising shoulder health from a young age, and taking fuelling seriously The best piece of performance advice Lewis has been given: you can only benefit from the training you can recover from Closing thoughts on the sport deserving more attention, and interest in having surf life saving athletes themselves on the show in future QUOTES / TAKEAWAYS: "It should always probably be a collaborative decision between the physio treating the athlete, the athlete themselves, and the coach." "Can I take one or two, three days now to maybe potentially avoid a bigger block or weeks of interrupted niggling soreness?" "You can only benefit from the training you can recover from." "Eat more than you think you need." "There's a professionalism, there's a quest for knowledge, and then there's a consistency thing." "It's trying not to confuse doing more with being best." TIME STAMPS: 00:17 – Episode introduction and breakthrough experience 00:23 – Episode 387 introduction: Part 2 with Lewis Craig on surf life saving 02:22 – Managing a recurring niggle: how to approach the decision to rest or train through 03:20 – Timing within the season and its effect on rest decisions 04:20 – Why a first-time niggle warrants a more cautious approach 04:50 – Modifying training instead of stopping: examples from swimming 05:47 – The physio's role in performance: keeping athletes pain-free so coaches can coach 06:46 – Baseline recommendations: two gym sessions per week 07:41 – Screening to identify individual injury risk factors 08:06 – The value of consistent dry-land warm-ups 09:06 – Tracking training load and intensity in swimming 10:35 – Session RPE and simple load-tracking methods 11:06 – Why tracking load matters most when returning from injury 11:36 – Awareness of REDs and low energy availability 12:05 – Recap: gym, screening, warm-ups, training load, energy awareness, support team 12:32 – Lessons learned from working with elite surf life saving athletes 13:30 – Individual variation in athlete preferences and pain tolerance 13:59 – Common themes among top athletes: professionalism and consistency 15:24 – Lewis's top three tips for improving performance 16:22 – Recap: sand-specific training, shoulder health, fuelling 16:52 – The importance of eating enough to support training load 17:17 – The best performance advice: recovering from training, not just doing more 18:15 – Closing thoughts and interest in future athlete guests 18:45 – Episode close and thanks to Lewis Craig 19:17 – Recap of the two-part surf life saving discussion 19:36 – Pogo Physio Telehealth Consultations and closing details Join the The Physical Performance Show LEARNINGS membership through weekly podcasts here: https://www.patreon.com/TPPShow Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. YOUR HOSTS: 🏃‍♂️‍➡️ Timothy Studley - Physiotherapist: Instagram @timothy_physio 💪 Lewis Craig - Physiotherapist and Clinical Lead, Pogo Physio: Instagram @_lewiscraig_ The Physical Performance Show can be found at: Facebook: facebook.com/thephysicalperformanceshowpodcast X: @tppshow1 Instagram: @physicalperformanceshow Please direct any questions, comments, and feedback to the above social media handles.

In episode 385 of The Physical Performance Show, host Brad Beer sits down with fellow physiotherapist Lewis Craig for a lateral ankle sprain masterclass. Drawing on material the pair recently presented at a Gold Coast orthopedic evening, Brad and Lewis cover the burden and prevalence of lateral ankle sprains, the three-part clinical assessment process, key differential diagnoses, rehabilitation phases, and preventative strategies including bracing and taping. The episode explores why lateral ankle sprains — despite their reputation as a minor injury — carry a significant risk of chronic ankle instability, and why a thorough, structured assessment is essential to a smooth recovery. Brad and Lewis unpack the different ligament and tendon structures that can be involved, the red flags practitioners need to rule out, the impairment categories drawn from Jay Hertel's model of chronic ankle instability, and how rehabilitation should progress from protection through to return to sport and long-term prevention. Show Sponsor: Pogo Physio also offers online Telehealth Consultations for endurance athletes managing bone, tendon, or joint issues — book online at https://www.pogophysio.com.au. And... PILLAR Performance is leading a new frontier in the sports nutrition industry through micronutrition innovation. Their Performance Health range is designed to support the crucial hours outside of training and racing, helping athletes return to the start line in peak condition. One of their newest releases is Collagen Repair, developed in collaboration with Gelita Laboratories and featuring the clinically trialled collagen peptide TENDOFORT. For 15% off your first purchase, head to pillarperformance.shop or, for North American listeners, thefeed.com and use the code PHYSICALPERFORMANCE at checkout. Pillar Performance continues to lead the way in sports nutrition through micro-nutrition innovation, now expanding into the Performance Health range. One of their newest releases, Collagen Repair, was developed with Gelita Laboratories (Germany) using a clinically trialled collagen peptide (Tendofort) to support tendon and ligament health in conditions like hamstring tendinopathy, Achilles tendonitis, shin splints, and patellofemoral pain. Head to Pogo Physio also offers online Telehealth Consultations for endurance athletes managing bone, tendon, or joint issues — book online at https://www.pillarperformance.shop (or https://www.thefeed.com for North American listeners) and use code PHYSICALPERFORMANCE for 15% off your first purchase. Partners / links mentioned: Ortho Tools (Cumberland Ankle Instability Tool / CAIT): mentioned in-episode as the online questionnaire resource Contact: Lewis Craig — [email protected] In this episode, you'll hear: Episode context: Lewis Craig's return to the show after being last on around episode 109, and his progress toward finishing his Sports Masters through the University of Queensland The burden of lateral ankle sprains: why they're the most common musculoskeletal injury in sport across field and court sports, contact and non-contact alike Recurrence risk: why roughly 40% of people who sprain their ankle go on to develop chronic instability, and why the one-year mark is a key risk-reduction milestone Early predictors of chronic ankle instability: the Doherty 2016 study on single-leg landing and drop-jump testing at two weeks post-injury The three priorities of assessment: ruling out red flags and fractures, forming an accurate diagnosis, and identifying impairments Screening for fractures: mechanism of injury, the Ottawa ankle rules, weight-bearing ability, and key bony landmarks to palpate Differential diagnosis: ATFL and CFL sprains (70–80% of ankle sprains), peroneal tendon injuries, bifurcate ligament sprains, deltoid ligament tears, syndesmosis injuries, and talar dome injuries Why getting a clear mechanism of injury from the athlete is critical to an accurate diagnosis Identifying impairments: the ROAST consensus and Jay Hertel's updated model of chronic ankle instability — pathomechanical, sensory-perceptual and motor-behavioural impairments Clinical and objective testing: balance progressions, calf raise endurance and strength benchmarks, and power tests including triple hop, crossover hop and timed lateral hop The role of patient-reported outcome tools: the Cumberland Ankle Instability Tool (CAIT) and FAAM, and why they're useful for tracking progress and motivation Rehabilitation framework: protection and appropriate early loading, followed by strength, stability and mobility phases Managing specific injury types: use of moon boots, orthotics, low-dye taping and ASO ankle braces depending on the structures involved Addressing dorsiflexion loss: why regaining ankle range of motion is often one of the hardest parts of rehab, and the Torillin infographic on identifying the source of restriction Late-stage rehab and return-to-sport: hopping, change of direction, and integrating exercises into an athlete's normal training week for ongoing prevention Bracing and taping as secondary/tertiary prevention strategies to reduce recurrence Long-term consequences of poorly managed ankle sprains, including links to post-traumatic osteoarthritis and eventual ankle surgery The biggest mistake athletes make: assuming rehab is "done" once they can run, despite still having deficits in power, change of direction and stability Lewis's top tip: get every ankle sprain properly assessed, no matter how minor Quotes / takeaways: "It's just a simple lateral ankle sprain... and then someone who goes missing for months at a time." "Four out of ten people who have an ankle sprain go on to develop a chronic instability." "The better quality of the assessment, the more likely there's an accurate diagnosis." "It's really hard to sprain your ankle when it's really well strapped or with an appropriate brace." "Once someone gets running... you can run in a straight line really well and have really considerable deficits still." "Get it assessed. Understand what you've done and understand what impairments you might have." Time Stamps: 00:17 – Episode introduction and breakthrough experience 00:23 – Episode 385 introduction: lateral ankle sprain masterclass with Lewis Craig 00:50 – Sponsor: PILLAR Performance and Performance Health 01:15 – Collagen Repair: formulation, TENDOFORT and collagen health 01:44 – 15% PILLAR Performance discount with code PHYSICALPERFORMANCE 02:19 – Welcoming Lewis Craig back to the show 02:48 – Lewis's tenure at Pogo Physio and progress on his Sports Masters at UQ 03:45 – Introducing today's topic: lateral ankle sprains 04:37 – How common and burdensome are lateral ankle sprains? 05:36 – The "she'll be right" attitude and why it's changing 07:02 – Lewis's personal history with recurrent ankle sprains 08:02 – Impact on Lewis's own running and trail running 08:28 – The one-year mark and recurrence risk statistics 09:26 – Predictors of chronic ankle instability: single-leg landing and drop jump 09:53 – The Doherty 2016 study explained 10:51 – The three priorities of assessment 11:21 – Ruling out red flags and fractures 12:45 – Why assessment quality drives rehab outcomes 13:14 – Screening for fractures: mechanism, Ottawa ankle rules, bony landmarks 14:39 – Deciding on imaging: x-ray or MRI 15:06 – Differential diagnosis: the many subcategories of ankle sprain 15:35 – ATFL and CFL: the most common ligament sprains 16:35 – Peroneal tendon injuries 17:04 – Bifurcate ligament sprains 18:04 – Deltoid ligament tears with lateral ankle sprains 18:33 – Syndesmosis injuries and mechanism differences 19:31 – Clinical tests for syndesmosis 20:01 – Talar dome injuries and other easily missed diagnoses 20:30 – Why getting a clear mechanism from the athlete matters 21:29 – Identifying impairments: what it means and why it's important 22:51 – Jay Hertel's model of chronic ankle instability 23:48 – Balancing patient education without causing fear 24:17 – Motor outcomes: strength, power and kinetic chain 24:43 – Assessment time and thoroughness at Pogo Physio 25:08 – Objective testing: dynamometers, balance and calf tests 25:38 – Balance test progressions as return-to-sport criteria 26:37 – Strength testing: inversion, eversion and calf raise endurance 27:07 – Power testing: triple hop, crossover hop and lateral hop tests 27:33 – Using objective markers to guide return-to-sport decisions 28:01 – Patient questionnaires: Cumberland Ankle Instability Tool (CAIT) and FAAM 28:57 – Coping vs non-coping athletes and objective scoring 29:25 – Moving into rehabilitation: individualised management 29:54 – Protection and appropriate early loading 30:20 – Moon boots and protecting specific structures 31:16 – ASO ankle braces for lower-grade sprains 31:45 – The strength, stability, mobility rehab framework 32:14 – Early loading phase: range of motion, balance and strength 32:43 – Addressing dorsiflexion loss 33:13 – The Torillin infographic on restriction sources 33:40 – Progressing balance and strength exercises 34:10 – Preventative efforts and integrating rehab into training 34:40 – Late-stage rehab and return-to-play criteria 35:39 – Bracing and taping to prevent recurrence 36:08 – Long-term consequences: osteoarthritis and ankle surgery risk 37:34 – Lewis's own experience with taping and bracing 38:02 – The biggest mistake athletes make in managing ankle sprains 39:29 – Lewis's top tip: get every ankle sprain assessed 40:27 – Where to reach Lewis Craig for questions 40:52 – Episode close and sponsor reminder 41:20 – Pogo Physio Telehealth Consultations and closing details THE TEAM: Join the The Physical Performance Show LEARNINGS membership through weekly podcasts here: https://www.patreon.com/TPPShow Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Your Hosts: 🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAu 💪 Lewis Craig - Physiotherapist and Clinical Lead, Pogo Physio Instagram: @_lewiscraig_ The Physical Performance Show can be found at: Facebook: facebook.com/thephysicalperformanceshowpodcast X: @tppshow1 Instagram: @physicalperformanceshow Please direct any questions, comments, and feedback to the above social media handles.

Physical Performance Show – Episode 383 Show Notes In episode 383 of The Physical Performance Show, host Brad Beer sits down with Professor Franco Impellizzeri, one of the most influential and outspoken voices in athlete load management research, for a wide-ranging conversation on why "load management" is an old concept dressed up in new data, why the acute to chronic workload ratio (ACWR) never held up to scrutiny, and why context — not more metrics — is what separates good decision-making from noise. Show Sponsor: Pillar Performance continues to lead the way in sports nutrition through micro-nutrition innovation, now expanding into the Performance Health range. One of their newest releases, Collagen Repair, was developed with Gelita Laboratories (Germany) using a clinically trialled collagen peptide (Tendofort) to support tendon and ligament health in conditions like hamstring tendinopathy, Achilles tendonitis, shin splints, and patellofemoral pain. Head to pillarperformance.shop (or thefeed.com for North American listeners) and use code PHYSICALPERFORMANCE for 15% off your first purchase. Pogo Physio also offers online Telehealth Consultations for endurance athletes managing bone, tendon, or joint issues — book online at pogophysio.com.au. Professor Franco Impellizzeri's work can be explored here: https://profiles.uts.edu.au/Franco.Impellizzeri And... https://scholar.google.com/citations?user=z35F1WAAAAAJ&hl=en Listen in as we delve into the following: What "load management" actually means, and why it's a relabelling of concepts coaches have wrestled with since the 1930s–40s The double-edged sword of the data revolution: from heart rate monitors to today's GPS, wearables, and AI-driven analytics Commercial and career incentives behind pushing metrics — both from tech companies and researchers Confirmation bias and why interpreting data without a theoretical framework is "like reading tarot" The case against the acute to chronic workload ratio (ACWR): its lack of scientific support despite IOC endorsement A landmark runners' study showing the opposite relationship between ACWR and injury risk — and what that reveals about the field Why meta-analyses and systematic reviews in load research can be manipulated to "find whatever you like" The difference between using a metric personally versus promoting it as scientifically validated Why the most skilled clinicians tend to hold their conclusions with the least certainty A real-world case study: a soccer training drill "failure" that was actually a video-monitoring blind spot, not a bad drill The expanding role of data scientists in sport, and why interpretation — not collection — is the real skill gap Whether AI and machine learning can (or should) replace the sports scientist's judgement Individualised and personalised training approaches — and why even these are still built on group-level generalisations Distinguishing signal from noise, and why one "failed" intervention doesn't mean an athlete won't respond next time Practical advice for coaches and practitioners: accept uncertainty, treat training like a "trial of therapy," and reassess If he could track only one metric: heart rate (or perceived effort) over power The push for more honest scientific debate — including a proposed on-air "intellectual sparring" series with dissenting researchers Quotes: "Understanding the quantity of training for athletes has been a hot topic since training methodology started... managing load is not new." — Professor Franco Impellizzeri "When you don't have a theoretical framework and an a priori idea strong and supported, it's like reading tarot, to be honest." — Professor Franco Impellizzeri "There's zero evidence that this metric can either help or can actually reflect some sort of mechanism." — Professor Franco Impellizzeri, on the acute to chronic workload ratio "Don't take yourself too seriously." — Professor Franco Impellizzeri Timeline: 00:00 – Introduction: host's specialist physio training and the load management "viva" question 01:04 – What is load management? An old concept, relabelled 02:31 – From heart rate monitors to GPS: the rise of training data 06:14 – Commercial interests and the risk of becoming "slaves of data" 08:05 – Why load management matters: the drug-dosing analogy 09:24 – Load management as a decades-old coaching concern 10:23 – Confirmation bias and interpreting data "like reading tarot" 13:17 – Championing methodological rigor in sports science 16:33 – Meta-research, honesty, and acknowledging uncertainty 18:22 – Why the most skilled clinicians express the least certainty 19:18 – Origins of the critique of the acute to chronic workload ratio (ACWR) 20:09 – Takeaways for contemporary practitioners on load management models 21:34 – Why the ACWR lacked scientific and conceptual support 23:02 – Training load, time-at-risk, and reframing injury risk 24:24 – The contradictory runners' study and what it implies 26:43 – Cherry-picking and overfitting in load-injury meta-analyses 28:34 – Taking a stronger public stance on social media 30:34 – Science as a self-correcting process 31:31 – The discipline required to properly read and critique research 33:58 – Why data alone can't tell you what to do 34:24 – Case study: the soccer drill that "failed" — until the video told the real story 36:49 – The role (and limits) of data scientists in sport 38:46 – Could AI replace the sports scientist's job? 40:42 – Advice for coaches and practitioners: accept uncertainty 42:09 – Individualised approaches are still a form of generalisation 44:31 – Separating signal from noise — and why not to give up early 46:56 – If only one metric: heart rate over power 48:21 – One piece of advice: "don't take yourself too seriously" 48:51 – This week's physical challenge: swimming without pain 50:16 – What's next: meta-research projects and replication studies 51:43 – A proposal for public scientific debate, and Ian Shrier's work on consensus 56:32 – Why genuine debate is hard to find in science communication today 57:59 – Episode close THE TEAM: Join The Physical Performance Show LEARNINGS membership through weekly podcasts here: https://www.patreon.com/TPPShow Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online at pogophysio.com.au. Your Host: 🏃 Brad Beer - Instagram & X @Bradbeer and YouTube @PogophysioAu The Physical Performance Show can be found at: Facebook: facebook.com/thephysicalperformanceshowpodcast X: @tppshow1 Instagram: @physicalperformanceshow

In this episode, Olympic triathlete Hayden Wilde shares a powerful 2025 update. Just days after running a blistering 27:38 10K in Tokyo — one of the fastest ever by a triathlete — Hayden was involved in a high-speed cycling crash that left him with a fractured scapula, five broken ribs, and a punctured lung. Hayden shares the emotional and physical rollercoaster of his injury, including emergency support from his sponsors, a medical evacuation, and career-saving surgery in Belgium. Now deep in rehab, he opens up about the mindset, team effort, and small wins guiding his return to racing. This is a must-listen for anyone interested in elite performance, resilience, and the real journey behind recovery at the highest level. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.

In this episode we're syndicating a conversation originally recorded for the Physio Network podcast with Dr Rich Willy and host Sarah Yule. We delve into the art and science of injury prevention and recovery for runners. With a focus on mastering running injuries, this conversation is packed with actionable insights tailored for endurance athletes. Dr Rich Willy, Associate Professor at the University of Montana and Director of the Montana Running Lab shares his expertise on managing persistent running injuries, the critical role of education and load management in treatment, and the impact of footwear—including clinical insights on "super shoes." We also explore the challenges of Relative Energy Deficiency in Sport (RED-S) and effective strategies for managing bone stress injuries in runners. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.