running injuries Archives - Physio Room

227. Finding Your Perfect Stride | Dr. Vikash Sharma

Andrew Fix — Tue, 02 Jun 2026 12:00:15 +0000

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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226. Fast Comes Last: Getting Back to Running the Right Way | Dr. Drew Short

Andrew Fix — Tue, 26 May 2026 12:00:01 +0000

Most runners are one bad training week away from an injury they never saw coming, and the way they think about shoes, strength, and recovery is probably making that worse.

Dr. Drew Short specializes in working with runners at PhysioRoom, and his approach to running injury recovery starts somewhere most people wouldn’t expect: months back in an athlete’s training log. The culprit behind most injuries isn’t a single bad run. It’s accumulated load, under-fueling, or a strength gap that quietly grew until something gave out. When the mechanical picture looks clean, Drew digs deeper, sometimes all the way to blood work and nutritional consults. Multiple tendon issues flaring up in different parts of the body at once? That’s a systemic story, not a mechanical one.

The calf conversation is worth sitting with. Runners stretch it religiously and almost never strengthen it the way running actually demands. The soleus does significant work during each stride, but only when the knee is bent, which is almost never how people train it. A calf that always feels tight is probably asking for load, not length.

On the trail running vs. road running question, the differences go deeper than terrain. Strength demands, stability requirements, and pacing strategy all shift in ways that catch road runners off guard when they head onto the trails. And carbon-plated shoes? Both Drew and Dr. Ficks agree they have a place, but earning them matters more than buying them.

Quotes

“The downside to under-fueling is you’re going to hit a brick wall. The downside to over-fueling is maybe a rumbly stomach…I’d rather be on that end of the spectrum.” (14:58 | Dr. Drew Short)
“You might meet the rep scheme on a calf raise, but whenever you start making it more ballistic and you start using the tendon more, it doesn’t like that. The rate of fire is just a lot slower on that side.” (25:50 | Dr. Drew Short)
“Stiffer tendons or more robust tendons — that’s just free energy. If you’re able to use that elasticity like a rubber band whenever you hit the ground, that’s less that the muscles are having to push off.” (33:19 | Dr. Drew Short)
“If your calf always feels like it needs to be stretched, honestly, your tendon probably needs some load. You probably do need to be doing some heavy slow resistance through that tendon. Otherwise, you just keep stretching it all day every day.” (34:32 | Dr. Drew Short)
“If I’m doing a long effort and I can still breathe just through my nose, I know I’m gonna be fine at hour three, hour four.” (48:26 | Dr. Drew Short)

Connect with Dr. Drew Short:
https://www.instagram.com/thenamesdrew/

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Walk to Run Strong: Build a Better Foundation

Taylor Aglio — Wed, 09 Jul 2025 02:31:05 +0000

Walk to Run Strong: Build a Better Foundation

Navigating the journey of returning to run after an injury can feel like guesswork and frustration without professional guidance. That’s why embracing a Walk to Run Strong approach is essential—focusing on rebuilding strength, control, and confidence step by step. Here are some tips to keep in mind as you’re navigating this transition:

When should you initiate a walk to run program?

When it comes to returning to run after an injury, a clinician should be running you through strength, mobility, and movement pattern assessments. This takes out the guesswork of whether or not your key muscle groups and bones are ready for the loads of running, and gives you confidence in taking those first steps.

Along with strength and mobility assessments, a non-negotiable is: you have to walk before you can run. Before starting a walk to run, I’m looking for clients to be able to walk 45 minutes at a 3.2-3.5mph pace on rolling terrain.

Why the emphasis on walking?

One of the most common mistakes I see during this time frame (with both casual and competitive runners) is neglecting the walking aspect of a walk to run program. Rather than thinking about walk time as rest time, think of walk time as loading time. A lot more load is happening to your bones and tissues during walking than you may think.

For example, studies have shown that walking puts the SAME loads on the achilles tendon as:

standing 1 leg heel raises
high step ups
a forward jump
eccentric heel raises (the typical “2 up, 1 down” exercise)

The same study showed that walking puts even MORE load on the achilles tendon than:

body weight squats
lunges
seated heel raises with 150% of your body weight

This makes walking a very important component of methodically adding more load to your body!

What about hills and speedwork?

Runners are antsy to get back to running and running fast. In Colorado, specifically, a lot of runners are dying to get back on the trails. As tempting as it is to jump back into these activities – these should actually come at the end of your walk to run program. Both hill work and speed work fall under the umbrella of “intensity” and should only be worked back into once endurance, frequency, and overall volume have met certain thresholds.

How do I use all of this extra time?

While you’re going through this process, you’ll likely be spending overall less time training than you would if you were healthy. Because of that, it is a great time to be working on other aspects of your mental and physical well-being.

Here are some areas I tend to recommend on how to use the time:

Look into other hobbies, or maybe pick back up some old hobbies that you’ve let fall to the wayside because of your busy training schedule.
Dial in your nutrition. With a full week of work and training, putting mental energy into nutrition can just seem beyond your capacity. This is a great time to work on dialing in your nutrition and getting meal prep ideas in place, so that once you are back to full training – that’s one less thing you have to spend mental energy on.
Work on breathwork and posture. Runners form often looks great for the first few minutes of running. Add in a little fatigue, and they soon start to slouch and gasp for air. The time spent working on walking is a great time to focus on your upright running posture and diaphragmatic breathwork.

Last tips:

Spend more time sitting than standing during the day…

In the same way that walking puts more load on the achilles tendon than you may think, even just standing puts more load on your bones than you may expect. Eight hours of cumulative standing time per day can equal the same load on bone as running a marathon. So during this process, load your tissues with the walk to run program, then let them recover by taking a load off during the day.

Even if the run feels easy, finish the process…

I’ll admit, a walk to run progression is not exciting. It’s not exciting on purpose, because it is a very calculated step by step progression in loading. Your cardio will come back much faster than your bone and tendon strength (even in Colorado). Chances are, you will get to the point later in the programming that the run feels easy and you want to skip stages. Because the tendons and bones take longer to adapt, don’t rush past, trust the process, and most importantly FINISH the process so that your body is fully prepared and you don’t have to backslide and take more time from training.

I hope that these tips have been helpful, and if you need guidance in these areas, don’t hesitate to come see our team to help you through the process!

Written by Dr. Drew Short – PT, DPT, CMFA | Physio Room

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151. Built to Run | Dr. Matt Silver

Andrew Fix — Tue, 17 Dec 2024 12:24:09 +0000

Running is a high-intensity sport—more than just putting one foot in front of the other, it’s about understanding mechanics, building strength, and managing stress on the body. In this episode, Dr. Andrew Fix is joined by Dr. Matt Silver, physical therapist and author of “Built to Run,” to discuss the common injuries runners face and the unique challenges of the sport. Pointing out running as a high-intensity activity—essentially a series of single-leg hops—they explore how this repetitive motion places significant stress on the body, often leading to injuries like runner’s knee, IT band syndrome, shin splints, and Achilles tendinopathy.

Dr. Silver shares his journey of overcoming running injuries and how it inspired his work at Alpha Project Phyzio & Performance, helping runners achieve longevity in their sport. He points out the important role of strength training in injury prevention, and debunks the myth that stretching alone can resolve running-related pain. Instead, he explains how strengthening muscles and tendons enhances their spring-like qualities, enabling better recoil and support during runs.

Join Dr. Fix and Dr. Silver’s discussion to gain insights that’ll indeed help you optimize your performance as a runner and stay injury-free.

Quotes

“Once we understand that running is essentially a single-leg hop repeated over and over, it’s clear that it’s a jumping exercise—a high-intensity exercise. I can’t think of any other sport that involves as much single-leg jumping as running does.” (07:59 | Dr. Matt Silver)
“We have to ensure we build strength and think of the muscles and Achilles as muscles and rubber bands. The Achilles acts like a spring—there needs to be a certain level of tension there. So, when we hit the end range, it can contract out of it, making us run more efficiently. If your tendons are loose, you’re going to have to work a lot harder to run.” (17:37 | Dr. Matt Silver)
“Strength training is important—you’ll gain a lot of adaptation just from that alone. But something else that I think would really help runners is jump training. If we know running is essentially jumping, then we need to incorporate jump training into our routine. It’s not only great for becoming a more efficient runner and training your tendons to contract and relax the way we want them to, but it’s also fantastic for your bone health.” (20:24 | Dr. Matt Silver)
“Before we even talk about how your foot’s hitting the ground, we need to address your running form. Shoe wear does play a role in this—if you’re wearing a shoe with a massively built-up heel, you’re probably going to heel strike more aggressively. But if you’re overstriding, that’s what we need to fix first before even discussing how your foot is hitting the ground.” (37:23 | Dr. Matt Silver)

Links

Connect with Dr. Matt Silver:

https://www.alphaprojectphyzio.com/built-to-run-book

https://www.instagram.com/alphaprojectphyzio/

https://www.amazon.com/s?k=running+rewired&hvadid=241596968295&hvdev=c&hvlocphy=9028754&hvnetw=g&hvqmt=e&hvrand=4347788781906826674&hvtargid=kwd-377142194578&hydadcr=22534_10353871&tag=googhydr-20&ref=pd_sl_4ngqsthky4_e

https://www.youtube.com/watch?v=PeVgsbB_TW4

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