Show Notes
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 Identifyin
More from The Physical Performance Show
In episode 388 of The Physical Performance Show, we're syndicating a conversation from the Physio Network platform's Physio Discussed podcast. Our own Brad Beer, Sports and Exercise Physiotherapist and Principal Physiotherapist at Pogo Physio, joins Dr. Brady Green, physiotherapist and researcher, and host Sarah Yule for a deep dive into calf muscle strain injuries. Brad and Brady explore where research and clinical practice meet: how to profile physical capacity after a calf strain, what strength and reactive qualities need restoring before running, how to make return-to-run decisions, and how much attention footwear and imaging deserve. Brad brings the view from the clinical coalface, and Brady brings the latest research from high-performance sport. A special thanks to the Physio Network platform for their generosity and collegiality in sharing this episode. SHOW SPONSOR: 💯 Today's episode is brought to you by Pogo Physio's telehealth consultations. If you're an endurance runner battling bone, tendon or 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. IN THIS EPISODE YOU'LL HEAR: What we understand better about calf strains than we did 5 to 10 years ago, including pathology, return-to-play timeframes, recurrence susceptibility and physical capacity profiling How the soleus vs gastrocnemius distinction has changed return-to-run prescription, including avoiding plodding on return to a soleus-based running program Why modifiable factors like strength, force production and stretch-shortening cycle proficiency matter alongside non-modifiable risk factors like age and prior calf strain history Brad's top three clinical mistakes: not clearly establishing the mechanism and training load context, progressing too quickly, and not impressing on athletes the need for ongoing preventative loading Why recurrence risk stays elevated long after return to play, and why preventative loading and load management may need to continue for the rest of the season Longitudinal AFL data showing athletes can build soleus strength from pre-season to early competition and maintain it through the season, and why a decline in strength is a flag to act on Why profiling the individual matters: a strong athlete may have strained their calf because of a stiffness deficiency or load management issue rather than weakness Brad's three-legged stool framework: repeated force (endurance), peak force, and reactive strength/plyometric qualities How to differentiate a gastrocnemius from a soleus strain using mechanism of onset, and why gradual, non-specific onset injuries are less likely to involve significant connective tissue disruption The clinical assessment toolkit: observation, progressive loading tests, RPE, palpation, pain on contraction and stretch, and differential diagnosis (bone stress, deep flexors, plantaris) Quality markers during calf testing, including eccentric control, long toe flexor clawing, rep counts and visible shakiness Home-based repeated force exercises such as single-leg calf raises, stair walking and pulsing, plus cueing tips like using a metronome and watching line of force through the foot Progressing from vertical to horizontal force production, including sled and Prowler pushes, step and box drills Return-to-run criteria: symptom resolution, performance readiness, 20+ slow calf raises, and 20 to 30 single-leg pogo hops with symmetrical quality Why holding your nerve for a few extra sessions at the end of rehab rarely costs you time, but rushing can Objective metrics with force plates: sub-maximal and maximal isometric testing, testing in dorsiflexion, rate of force development, reactive strength index, and pulsing to fatigue Footwear: Brad and Brady's "don't overcomplicate it, but be aware" approach, covering shoe drop, stiffness, rocker soles and stack height What imaging can and can't tell us,
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 episode 386 of The Physical Performance Show, host Tim Studley sits down with fellow Pogo Physio physiotherapist Lewis Craig to explore the world of surf life saving and Ironman racing — a sport many listeners may be unfamiliar with, but one that shares a huge amount in common with traditional triathlon and endurance sport. Tim and Lewis unpack what a typical training week looks like for a semi-professional surf ironman/ironwoman athlete, the most common injuries seen across swimming, ski paddling, board paddling and soft sand running, the disproportionate impact running-based injuries can have on an athlete's ability to race, and why energy availability, sleep and recovery are just as critical in this sport as they are in any other high-volume endurance discipline. 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: An introduction to surf life saving and Ironman racing: swimming, ski paddling, board paddling and soft sand running combined into one demanding sport The semi-professional nature of the sport, and how prize money from series like the Shaw and Partners Ironman Series and World Ocean Series has helped athletes A snapshot of a typical training day and week: double training sessions, four swim sessions, two to three ski paddling and board sessions, two gym sessions, two standalone runs, and Irons sessions combining all disciplines Typical weekly training hours for competitive athletes — estimated in the range of 15 to 20+ hours per week Similarities to other endurance sports: shared challenges around shoulder health, running-related injuries, and managing training load, intensity and recovery Whether discipline-dominant athletes (runners, swimmers, paddlers) experience different injury patterns, and the possible link between strong runners and higher bone stress injury risk via REDs What first drew Lewis to working with surf life saving and Ironman athletes, including his early experience working alongside elite athletes at Pogo Physio Common injuries in the sport: shoulder tendinopathies (supraspinatus, subscapularis), low back pain, Achilles tendinopathy, calf strains, ankle sprains, toe injuries, knee pain, bone stress injuries, and trauma-related injuries from craft or contact Why shoulder health is a season-long priority, while injuries that prevent running (calf strains, ankle sprains, bone stress injuries) carry the biggest time cost due to their impact on race ability Estimated prevalence of athletes competing while managing a shoulder or low back niggle, and how this may fluctuate across the competitive calendar An overview of the surf life saving racing calendar: trials, the Coolangatta Gold, and a condensed back-to-back race season with minimal true off-season Why the Coolangatta Gold's extra soft sand running volume increases physical demand and potential injury risk Common misconceptions about the physical demands of the sport, including underestimation of the aerobic and neuromuscular demands of soft sand running The energy cost and muscle activation differences of soft sand running compared to running on grass or road (roughly 1.4–1.6x ener
In episode 384 of The Physical Performance Show, Brad Beer and fellow physiotherapist Tim Studley tackle a wide-ranging Q&A on tibial bone stress injuries. Following the recent bone stress injury mini-series and two-part tibial bone stress injury masterclass, Brad and Tim answer listener questions covering chronic tibial stress responses, recurring shin pain, rehabilitation, plyometrics, strength training, anti-inflammatory medications, and how to reduce the risk of future bone stress injuries. The episode explores some of the practical clinical questions that arise when athletes are trying to understand persistent shin pain and return to running. Brad and Tim unpack the difference between tibial bone stress injuries and medial tibial stress syndrome (MTSS), explain how workload and tissue tolerance interact, discuss when to introduce single-leg strength and plyometrics, and highlight why a thorough assessment of both biomechanical and biological risk factors is essential for athletes with recurring bone stress injuries. Show Sponsor: 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. 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.
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.