When the question every injured runner is afraid to ask, “Do I have to stop?”,  finally gets a straight answer, it turns out the real story has less to do with the pain itself and more to do with everything the runner wasn’t tracking.

Dr. Andrew Fix sits down with Dr. Vikash Sharma, DPT, founder of Perfect Stride Physical Therapy in New York, to talk through managing running injuries, avoiding stress fractures, and building a smart return to running after time off.

Stress fractures get missed more often than they should, and the clue is usually hiding in a two-minute conversation about nutrition and training load. Has your mileage gone up? Has your food intake kept pace? For a lot of runners, the answer to that second question is no.

For soft tissue injuries, Sharma’s approach is less about stopping and more about finding a sustainable baseline, trimming the run, filling the rest with cross-training, and using that window to build the strength and mobility that likely broke down first.

The conversation also covers training load management, deload weeks, why most runners’ strength work stopped producing results long ago, and what a real return-to-run progression actually looks like.

Find Dr. Vikash Sharma at @vikashsharma_dpt on Instagram or at perfectstridept.com. His clinical education platform for coaches and clinicians is at runningforlifeeducation.

Quotes

• “Runners run. That’s what they want to do, and they’ll keep running until the wheels fall off.” (09:48 | Dr. Vikash Sharma)
• “If two months ago you were running X amount of mileage and now you’re up 75% from that, but your nutrition hasn’t really changed at all, and now you’re starting to get signs and symptoms that make me think you have a bone stress injury, a hundred percent we’re shutting it down.” (10:39| Dr. Vikash Sharma)
• “Just like training their musculoskeletal system, just like training their nervous system and their brain — we got to train your gut as well.” (22:13 | Dr. Vikash Sharma)
• “Your low days need to be low so that your high days can truly be high days.” (32:53 | Dr. Vikash Sharma)
• “There’s always a story behind this human. There is a human in front of you. Just get back to that human element and dig — a lot of your questions will get answered the more they’re talking to you.” (54:23 | Dr. Vikash Sharma)

Connect with Dr. Vikash Sharma:

Perfect Stride Physical Therapy

Follow Perfect Stride Physical Therapy on Instagram

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Key Takeaways

• Use the first half of a marathon as a warm up, race slower than your goal race pace

• Runners can use strength training to restore damaged body tissue and build a more robust body

• All 3 macronutrients are important for runners, but protein is actually the most important

“People talk about hitting a wall. To me the wall just means that you ran dumb. You’ve been too fast and you have nothing left,” explains Tristan Mitchell, owner, manager, and coach at Lions Den SMP. Tristan has completed 24 marathons and has learned a lot about training for running since his first attempt at age 20. Today, he joins host Dr. Andrew Fix to discuss strategies for smarter marathon training.

Running for extended periods of time is very rough on the body because it is incredibly repetitive. In order to master the marathon without harming your body, it is important to train strategically. This means not only learning how to pace yourself properly throughout the race depending on its length, but also knowing how to fuel your body efficiently beforehand. People are quick to think of carbohydrates for runners, but protein is even more important as a building block for your body to function at its best. Additionally, adding in strength training can help restore the body tissues that have been damaged by the repetitive motions of running.

If you start off a marathon running your hardest, you will likely hit a wall pretty quickly. That’s why it is imperative to pace yourself and purposefully run slower than your race pace goal for the first half of the marathon before kicking it into high gear for the second half. Be sure to fuel up on lots of protein beforehand and consider adding strength training to your regimen to help your body become more robust.

Quotes

• “Learning how to negative split races was huge, and ever since then it’s something I’ve really worked at in the marathon and prided myself on. (20:20-20:29 | Tristan)

• “The way I always like to think about it is having these things that I can draw upon to elicit an adrenaline response, something that just fires me up. And I save these things for the second half of a marathon.” (21:51-22:05 | Tristan)

• “If you go out too hard, you simply burn up too much of your stored carbohydrates.” (33:00-33:06 | Tristan)

• “People talk about hitting a wall. To me the wall just means that you ran dumb. You’ve been too fast and you have nothing left.” (33:11-33:19 | Tristan)

• “When it comes to running, strength training builds a more robust body. It builds a body that can tolerate the demands of running training more effectively.” (49:25-49:38 | Tristan)

• “All three of the macronutrients are highly important aspects of a runner’s diet, protein, fat and carbohydrates. But I think that we must get runners to think through the lens of protein first, because it is the building block.” (1:05:41-1:05:59 | Tristan)

Links

Connect with Tristan Mitchell:

Website | ​​https://www.lionsdensmp.com/

Instagram | https://www.instagram.com/lionsdensmp/?hl=en

Facebook | https://www.facebook.com/LionsDenSMP

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Andrew’s Personal Instagram | https://www.instagram.com/dr.andrewfix/

Andrew’s Personal Facebook | https://www.facebook.com/andrew.fix.9/

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The post 65. Mastering the Marathon: Strategies for Smarter Training | Tristan Mitchell appeared first on Physio Room.