Podcast With Jay Dicharry: Running Injuries, Running Shoe Selection and More

Jay Dicharry is a physiotherapist at Rebound Physical Therapy in Bend, Oregon.He is a certified coach through both the United States Track and Field Association and the United States Cycling Federation, and a certified Golf Fitness Instructor through the Titleist Performance Institute.Jay built his international reputation as an expert in biomechanical analysis as Director of the SPEED Clinic at the University of Virginia.Jay is also the author of "Anatomy for Runners", and writes on his website.In this interview, Jay and I discuss:

Jay's book "Anatomy for Runners".
The biggest "problem areas" for runners with regards to injuries.
Some of the most common running myths including stretching and cadence.
The current state of barefoot / minimalist running.
Where the running shoe industry headed.
Appropriate shoes for children.
Training tips for marathon runners.

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Full Transcription

Mark: Hey, everyone. Welcome to another Healthynomics podcast. I'm very excited for today's guest is Jay Dicharry. Jay is a physiotherapist at Rebound Physical Therapy in Bend, Oregon. He's a certified coach to both the United States Track and Field Association and United States Cycling Federation and a certified golf fitness instructor to the Titleist Performance Institute. Jay's built his international reputation as an expert in biomechanical analysis as a Director of the Speed Clinic at the University of Virginia. Jay's also the author of the "Anatomy of Runners" and writes columns for numerous other magazines. Welcome Jay.Jay: Thanks, Mark. Thanks for having me.Mark: No problem. Excited to talk to you and dive a bit deeper into some of the work you're doing. I guess first off, I gave a bit of a background on you and who you are, what you're up to but maybe, perhaps, you could provide a bit more detailed version.Jay: For sure. I was trying to set the stage a little bit. I guess my whole reason for choosing my career path was totally selfish. I got really tired of getting hurt and not knowing why and getting vague answers. I don't like getting vague answers and I'm trying to find out better answers and so eventually I decided on going to physical therapy school and learned a lot.I wanted to figure out how the body worked and what it did and I got out of school and practiced for awhile. Was able to help a number of people but realized I was still very frustrated because I wasn't getting the answers that I wanted to get. Wound up in a position running a biomechanics lab at University of Virginia for a number of years and it's a really interesting experience because I got to blend the aspect of clinical care where you look at clinical things and blend that with sports science in biomedical engineering world where you actually do measure things and get to see how clinical aspects really make a difference and impact biomechanics.Mark: Is your work now, is your work in the past primarily with athletes, or did you work with the general public as well?Jay: I worked with everyone, so I actually wind up seeing more of the athletic side but I work everybody from people who've got an Olympic medal around their neck to moms with four kids who just want to be able to run 30 minutes three or four times a week for stress relief. What I do really isn't any different and people think that they're not worthy of higher tech evaluation. I see just the same problems in elites as I do in recreational folks.Mark: So your book, "Anatomy for Runners," I've read it and really enjoyed it. Helped me tap into my inner exercise science geek a bit which is always good. Unlocking your athletic potential for health, speed and injury prevention, so what was your goal with this book? What made you decide to write it?Jay: It comes down to one simple thing. I think people have a right to know what exercise does to their body. I think in the first third of the book I try and make a bunch of simple analogies to how your body is affected by training. I think that as a society, and even for coaches and clinicians, we have a really good understanding of what happens if you say, "I'm going to go out and do zone three miles today, or zone four miles." Anybody can tell you, like, "Okay. Your heart [inaudible 03:43] it's going to be in this range," and we sort of get that.I make the analogy it's kind of like training your engine. That's pretty well understood but engines have to be supported by chassis and I think if people don't have a good understanding about how their body adapts to exercise. Your bones heal at a different rate than your tendons do. Your tendons are affected differently than your cartilage and so people always say, "Listen to your body when you're exercising," and it's wonderful advice, but you have to know what you're listening for. One of the goals I have is to try and give people information so they would know how to plug in with their feeling of their body with what's really happening to the tissues.Mark: That was my favorite part of the book, the background, the beginning and then diving in a bit to the self diagnosis which I found myself testing my ankle mobility and hamstring flexibility in the living room a couple of nights ago and my wife's like, "What are you doing?" No. I really like that and I thought, I have an exercise science background so obviously I understand it all but I thought just the way you wrote it. It's great tools for anyone to have. How can I testify I have the right amount of flexibility in my hamstrings for running because often people think, "If I don't have 90 degrees, well, that's not enough to run [inaudible 05:08] from what I've read in your book having seven degrees is good enough for running.Jay: Plenty. You just need enough. One of the things people always talk about is, "You have to be flexible to run." It's like, "You just need enough. You don't need more." More has not been shown to do anything beneficial for us. Just try and tell people that the things that you need, it's like the runner, people always talk about form and form is very important in running but it's important to understand what you as a runner have to bring to the table.Mark: Exactly. Anyone who reads your book, I would encourage them not to skip over the beginning chapters because I think a lot of people, it's easy to skip towards the exercises and the pretty pictures and start looking at them, but the background is essential. Give yourself the tools to know your body and know what's happening when you go for a run or something is bothering you or your cadence off, etc. On to running injuries. I know you see probably tons of different injuries. What are some of the big problem areas you see on a day to day basis both with high level running athletes and your regular weekend warriors?Jay: Yeah, for sure. I think the top ones I see are the technical term is patellar femoral pain syndrome if you really get a pain in the front of the knee.Mark: Runner's knee?Jay: Yes. Runner's knee can be five or six different thing. Runner's knee can be femoral patellar problems, it can also be fat pad impingement. It's also called jumper's knee sometimes, that's more of the fat pad problem, but I see, definitely, a lot of interior knee pain. I see a lot of shin splint problems. I see lots of Achilles issues, lots of low back pain, IT band syndrome, the whole gamut.Mark: One thing, a lot of people, runners, me included, read a lot of blogs and stuff and you see a lot of the articles in newspapers and you go, "Oh, it's all in the hips." Obviously the hips are very important for many things but there's a lot of different aspects to look at, I'm sure, when your diagnosing running injuries, from the feet to the hips to posture, etc. Can you expand on that a bit?Jay: It's a great point. It's funny. When someone comes to me for an evaluation often they'll say, "I have a [site] of pain here," and they'll tell me some location. The first thing I do is not look there. Sure, you have symptoms and we want to fix that. I don't want people to have symptoms. I want them to feel better but that's not my job is to fix symptoms. If you want to fix symptoms all you have to do is basically rest and stop doing what you're doing and the area will calm down and get better, but if you want to fix the problem, you have to look at how the body's moving. The song you learned when you were a kid, "Hip bone connected to the knee bone." It's all true and you have to look at what the body's doing comprehensively. I try and find the point at which things are breaking down and fix that problem.Your body's pretty well laid out and made up and you can make sure it's moving correctly for the way each individual's supposed to move. It can tolerate a great amount of stress and strain through training but when you have some problems or flaws, you've broken certain areas of your body then the load shifts to other areas and those areas break down. They're overwhelmed. They were never designed to have the amount of load that they end up receiving, so it's important to think about, again, you're training a body. You don't just train a knee or train an ankle, you have to think about your whole body.Mark: What about for people, especially me and I'm sure a lot of other people, I sit at a desk a lot of the day. What are some of the problems you see with people like me?Jay: A ton. It's funny. I actually have a National Geographic cover I keep in my lab and I keep it with me and sometimes [inaudible 09:20] posture I just take out the National Geographic picture and people are like, "Wow. They look really straight. Their neck's nice and long and they're standing correctly." I'm like, "Yes. Does this look like you?" They're like, "No. It doesn't at all." In societies where people have to be active they figure out, "If I have to carry rice and flour and water, etc. on my body, it hurts if [inaudible 09:42] poor positions."Those muscles that you have as kids, crawling for infants is a great way to simulate core activation to get your shoulders to work correctly. It's a wonderful thing and so as we age we tend to settle into more of a seated position and we lose that good skilled movement and we really have a hard time because certain muscles get tight, hip flexors get tight and pull our back into lots of arches or extensions which creates problems with all the muscles in the whole lower body.Our shoulders tend to get rounded forward, which basically increases strain on our neck, increases strain on our upper shoulders and people wonder why they have neck problems from sitting at a computer all day long. Your head's like a big bowling ball. If you stick that bowling ball over your body where it should be, all the muscles can work a little bit to support it. You stick that head out in front of you, you strain at a computer all day long, those muscles in your neck are basically working all day long to keep your bowling ball from falling off. They get tired.Mark: Exactly. Now what about specific to runners for people that are sitting lots. Obviously hip flexors are in a flex position, or shortened position, much of the day. Is there anything else? You mentioned hamstrings as well, lower back.Jay: All the research points to the idea where people who sit, again, kind of slumped positions they tend to have the tightness in the muscles. Those changes of position when your spine rolls into an arch and your pelvis has to tip forward, so it's important to think about this is most runners who sit all day long have a common postural issue. Their cereal bowl, as I call it, the pelvis, tends to spill forward and the back starts to arch to compensate backwards. So that's the way they sit, that's the way they walk, that's the way they stand. They perceive it as normal and the problem is they carry the exact posture right into their running and that postural alignment causes a few big problems. One is it causes you to inhibit your ability to activate your glutes and your hamstrings and the muscles inside of your shin and your foot.It's like saying, "If I just snap my fingers and say I can make you 100 percent strength in every single one of your muscles instantly," and you just adopt poor position, you just basically shifted your ability to activate those muscles, so it's a big issue. The second thing is that postural alignment is really inefficient for running because it forces you to contact too far in front of your body, which is bad for economy. Correcting your posture when you're running is really critical and something I definitely want people to pay attention to but before we can talk about running we have to talk about correct posture when you're sitting and standing and walking because those are pretty easy tasks and so if we can think about correcting our posture when we're not running it gives us a goal to shoot for and something to find when we're running because we know what our target is.Mark: Exactly. You mentioned contacting the ground too far in front of you body. How do you know if you're actually doing that? Is there certain things that, perhaps your quads will work a bit more, you'll fatigue in a certain area a bit more when that's happening?Jay: Yes, definitely. When you contact too far in front of you, you definitely over work your quads. If you just look at all the fancy measurements I like in my lab, any time you contact in front of you, you force your quads to work over time. The quads are a very large muscle and they have an okay leverage ability to exert force but your glutes are a very large muscle and have a much, much better leverage or position to basically apply some torque to the body. It's really effective to try and move that contact point back underneath you as you're running.Mark: I can see, you could probably get away with it, maybe a 10K runner but I'm training for a marathon right now so I'm assuming the more I'm using my glutes, the better because you get a kilometer 30, I'm in Canada here, your quads, they won't be able to take it, but if you're using those glutes you're going to save those quads and your glutes are more able to handle that load throughout that distance.Jay: Exactly. It's all about economy and efficiency. Your quads, they require more, they're going to fatigue quicker and they just can't generate as much force. Your glute, while it's a mover, it does tend to move your hip. It's a part of its job. It's the most effective mover you've got for hip control. It's also a posterior stabilizer and it helps keep your body, again, in line, so it has a double effect function there and again, it's like both sides of the equation here. You have to have strong glutes to plug into running and you have to basically tap into it when you're running as well. It's a form issue as well as a body issue.Mark: How long does it take for someone who is say not activating their glutes very efficiently to getting them to fire their glutes to a point where they're improving their running stride? Are we talking weeks or months?Jay: It depends. The people who flat out don't have hip extension, if they just can't get their hip [inaudible 14:48] with, those folks, they literally don't have the movement, so it takes time to get things to open up. It takes about two and a half to three months before you see changes in flexibility through stretching, so those folks, it takes a little while to get things to really transfer over but the folks who have the range but just can't activate it, I start on day one with what I call basic phase one exercises. Those are all about teaching people to better control the mobility they already have and then if we are opening up the hip, stretching is not enough.We've done research and showed that just because you stretch someone, you do see increases in length, so you open up the joint, but if you look at, do they actually carry that over into their running technique, they don't. The idea is to make sure that just because you get range, you're strengthening into the new range you're getting each and every day.Mark: Perfect. Moving on here. I wanted to touch base just on some of the common running myths. There's probably tons out there. I feel like, often, reading newspapers and stuff people can get misled even more. What are some of the common myths that you see on a day to day basis?Jay: The whole barefoot running movement of the past few years has been great because it's gotten people to pay attention to things. Out of this the media's kind of run with the idea, 'You have to land your forefoot and you [inaudible 16:23] barefoot. Well, I don't think everyone has to run barefoot all the time. It's a great drill but it's not realistic for most folks.The whole idea about laying on your forefoot, you can land on your forefoot, or your midfoot, or your heel and run well. It's just one of many factors you look at, so it's really impossible for me to say, "You should land like X." For the vast majority of folks, if they land more on their midfoot, that's probably a little bit better but not always. Again, people change where they land their feet on terrain, uphill, downhill, speed increases we change things, so the way in which we run does change.I think that the research supports the idea and the way I [key] people is for a given speed, it's better to land as close to your body as you can for a given speed and if you land on your heel and midfoot or forefoot, that's just what you do. It's, again, one of many things we look at. That's just one big one.The second thing is cadence. People are talking about the idea that everybody must be at 180. I am kind of guilty of this. A long time ago I was one saying, "Yes. You should increase your cadence and be at 180." The reality is world records have been set between 178 and 214 RPM, so there's a wide range there and again, cadence is just one of those factors that changes. I think that trying to, a lot of novice runners do have a very low cadence. They're probably in the 160-ish range and for those folks, they do need to work on improving their turnover, for sure, as research shows that.Again, improving cadence also decreases the torque or the twisting force in the joints which is a good thing for injury prevention, but to say that everyone must run with a certain cadence is really over reaching that statement. I'd say that monitoring your cadence is effective and just seeing what you are typically, seeing what feels comfortable. If you're in that 172 to 190 range, or something, I really wouldn't worry about it and fixate it a whole lot.Mark: What about stretching because now the big thing is, I guess, less stretching, if not no stretching before running, perhaps maybe more dynamic warm up and then stretching after. Is that what you would say?Jay: [inaudible 18:48] clear up a few things here. One, you only stretch if you don't have enough range for the sport that you're doing. The demands of runners are much different than demands of gymnasts when we talk about mobility. If you are in a sport that needs tons of end range motion, like gymnastics or something along those lines, then yes, it's something you have to do everyday to keep things in range and keep them solid, but for runners, you just need enough. More range of motion's not really needed, so if the goal is to get folks more limber so they can get better range of motion to run, we always stretch after. When I say stretching, I'm talking about literally lengthening tissue.Interestingly enough, when we stretch we're literally ripping tissues open. Ripping tissues open after you work out is a good time to stretch. We never rip the body apart before a workout if our goal is to get a good workout. It's just like common sense, right? [inaudible 19:46] stretch before, quite honestly. When we talk about pre-run activities like dynamic warm-ups and dynamic stretching, I like the word dynamic warm-up a whole lot because the purpose is to prime your nerves and your muscles and wake them up for the run. It's not to actually lengthen your tissues, so you may call it dynamic stretching but you're not really stretching. Again, to stretch a muscle requires, the dosage we've seen out there is you need to do it four to six days a week of stretching for three minutes at a time per muscle.Mark: I was going to ask you that. Holding it for at least three minutes?Jay: Yes. Total. You're going to do a minute on and break, minute [inaudible 20:25] at a time, but a total dosage of three to five minutes done four to six days per week. That's very much it. That's a whole [80] degrees from that pre-warm-up bounding, 10, 15 second stretches. Those are great for basically waking up your nerves and telling your body, "Let's relax," on their muscular system from the tightness standpoint let's get it ready to move and no doubt, people say, "Wait a second. I feel tight." I do some dynamic warm-up and I feel more limber. Again, that's just waking up your nerves and adjusting your body's perception of where you're tight and teaching you to move better. It's not actually making anything longer.Mark: Interesting. I want to go back to, actually, the minimalist to the barefoot running craze and looking from my standpoint. I run in [inaudible 21:20], I think it's probably got a fairly high heel lift. I do have a couple of other pairs of shoes with a lower heel drop which I've used and one pair in particular, a couple of years ago, when I went, not a long run for me, but definitely noticed my calf muscles were shattered for probably two days. I guess my question is why should one change to a more minimalist shoe if they don't have any problems with the shoe they're wearing now?Jay: That's a great question. I would say that if you're having zero problems there's absolutely zero conclusive data for me to look at and say you're going to either run faster or decrease your injury risk. [inaudible 22:06] shocking for people to hear, but that's the truth. Right now there is no conclusive data to show that groups of people that had less injuries or have been able to improve performance by switching shoe styles.Now, if we step away from that argument to say that's the overarching thing we have to focus on, we get into a little more detailed discussion. There's no research out there that shows that barefoot running is better. There's also no research out there that shows that traditional shoe construction, meaning elevated heels and [inaudible 22:39] control devices, really make a difference at all. Injury rates that we've seen from running, even when we correct for the fact that there's just more people running now have not gone down at all. We like to think that if all this technology really is going into footwear we'd like to see it making a difference, and it's just not.I think that points to a few things. One, it's not just about the shoes. It's also about people. It's a little bit different topic, but yes. I have seen in my research, in my working with runners, getting objective data on them every single day, I have seen situations, I've told people, "There's no need for you as an individual to switch." I've definitely seen many situations where I was like, look, based upon a number of things and seeing we would be better to have you in some different footwear. I've used footwear as a filter. It changes the interaction that your body has with the ground somewhat. It's not going to make you faster or slower but they do change the way we contact. They change how our muscles stabilize and activate, so shoe prescription right now as a state today, I view it very much as a one on one type evaluation where I look at individual aspects of people and based upon individual aspects I definitely make some pretty good recommendations for each person, but to say everyone should be in this shoe, we can't really say that right now.Mark: I would say I do like the feel of a more minimalist shoe. They're typically lighter and I do like the feel. They're a bit closer to the ground. You feel like you're in a sports car instead of a minivan. If that makes sense. I do like the feel and people should read your book to learn more, but if they want to try it, I know there's a few things they should do and [start] working on their mobility in both their foot and ankle, etc. They can read more about it in your book, but would you recommend, people are looking to experiment a bit, that they should try it? Keeping in mind that they'll need to ease into it and also look about the different mobilities about the foot and ankle, etc.Jay: I think any runner should. I view shoes like bikes. I have a commuter I ride on back and forth to work every single day and while I can take it in the trailer, I can take it on road rides, it's not the best choice, so I'm not going to take my high dollar mountain bike with full suspension around town because it will get stolen. It's all about picking the right tool for the job.I have a variety of different shoes and I run in different shoes depending on what my goals of the run are. If you told me our goal is to do speed work, I never am going to pick out my zero drop minimalistic shoes, ever. I run most of my miles in very minimal products but I can't run fast in them. For me, and for most folks, but for me, I need a little bit of a rocker and it's a little bit of a [inaudible 26:00] rollover toe spring in the shoe and you don't get that from being zero drop. I typically find shoes that are about four to six millimeters work really well for me to run fast in, so you have to use the right tool for the job.Mark: What about the shoe industry? Where do you think it's headed? Every shoe company now has got, it seems, a minimalist range. It kind of looks like they're heading back to designs which were the running shoes that came out in the late '70s, the early Nike Waffle shoes. What do you think's happening or what's going to happen in the shoe industry with regards to the technology?Jay: The shoe industry is in an interesting time right now. The shoe industry was in the super minimalist when it started, right? They were making minimalist shoes back there in the '70s and then things went a little bit more, a little bit more, and to be realistic, most of the running shoes, I think the numbers out there have shown 80 percent of the running shoes sold aren't really worn by runners. They're worn by people that play in their garden or walk the dog, or whatever, or wear to work and school.The companies figured out if they made shoes softer and more cushy they'd sell more shoes. They're a company. That's not to fault them, but over time, almost all the products out there for running sort of morphed into these big fluffy shoes and so while they're very comfortable for walking, they weren't the best thing for running. Now we saw Vibram Fivefingers come out and that shifted that pendulum way back to the side and they sold like hotcakes. I'll tell you my personal opinion is that one of the biggest things about Vibram Fivefingers was a fashion statement, just because they looked so different.Mark: I would agree. I've never tried them but you certainly notice them if someone's wearing them.Jay: It's interesting because right now in the shoe industry it's a really distinct time because the sales of Vibram Fivefingers are plummeting. Not many people are buying them and so you could say, "This minimalist stuff is just hokey," or you could say, "The Vibram Fivefingers made up like 65 percent of the minimalist shoe market and now that people aren't buying shoes that look that crazy, people are saying, 'The minimalist is dead.'" Minimalism is not really dead. That type of fashion has obviously fallen out of vogue but you're seeing things shift, I think, yes. Definitely not towards where they were, not towards the barefoot but shifting back towards the middle ground and I [inaudible 28:31] shoe industry and a bunch of projects and all the shoe manufacturers are trying to do the same thing. They're trying to find out where is that better middle ground.Mark: That sweet spot.Jay: Yeah. Is it about the drop? Is it about the softness? Is it about, what factors really do produce that sweet spot and how do you match that sweet spot to the runner, which I think is an even bigger story out there. Lots of shakeups. It's good. It's good for the industry.Mark: Yes. That's a good transition into children's shoes. I've got a 14 month-old boy and I love running shoes, so every time we go to the States where most shoes a lot cheaper than Canada, I want to load up on shoes for him, but I'd love to hear your opinions and thoughts on shoes for kids.Jay: It's interesting. When you have a kid, obviously either barefoot or in socks, whatever, and then they have those, I'm not plugging them but I call them Robeez, those leather soled flat nothings. Then it seems like they have that option out there for kids and once they hit that one and a half to two standpoint, most shoe companies that switch into these insanely stiff, rigid things which look like what mom and dad have but in reality are about as stiff as you putting on a concrete shoe. They just don't move. The kids are so light they can't bend that shoe and they're now in the toe boxes and a number of problems, so I'd say a few things.If you look at your kid's foot, you'll notice the largest part of their foot are their toes, not the ball of the foot. If you look at your foot, you'll notice the largest part of your foot is most likely, unless you were raised in an unshod society, likely going to be the ball of your foot, not your toes. We all practice this idea of Chinese foot binding and conventional shoes with tapered toe boxes look nice, I should say they look like what we expect, but they really provide a situation where over time we sort of crimp the forefoot. We narrow the structure and it's a big problem. The problem is when you run, 85 percent of your force under the foot is under your big toe and if you allow that big toe to splay out you get good contact and good support.In the book I have a picture of an x-ray of someone standing and they're standing up. You can see how widely splayed their foot is when they're in [inaudible 31:05] weight bearing and I have a picture of that same foot in a shoe and you can see that the shoe cannot splay. It's actually bound and constricted and narrowed and you just decrease your stability by being in a narrow toe box, so I'm a huge proponent of wide toe boxes for kids. Their foot needs to be able to splay. My goal is that both my kids' feet do not look like mine. We're never going to have a situation where they were born and raised in those narrowed shoes, [not] narrow toe boxes. That's one thing.The second thing is very little cushioning and very super simple. I have what I call the finger test. You should literally be able to take a kids' shoe and put one end of it in your index finger, or one end in your thumb and just basically pinch your fingers together and you should feel almost no resistance there. If there's any resistance, that shoe's way too stiff for your kids.Mark: I tried that last May with a pair of my son's shoes and you know what I thought looking at them? I thought, "They're pretty flexible," but they weren't and he's 14 months old so there's no way that his foot is able to get any flex out of that shoe, so it's a good point.Jay: It's interesting. I have an 18 month old right now. It's really funny. We were out of town and it was cold and he had a bunch of super flexible things that I like and one of my friends had a pair of [big] snow boots and I just stuck them on there real quick [inaudible 32:27] and they were more traditional stiff snow boots and I put them on him and I put him on the ground and he literally couldn't walk. He had no idea what to do [inaudible 32:47] so used to having his foot bend but here's this thing that didn't bend. He only weighs 18 pounds, or 20 pounds. He isn't heavy enough to actually bend the shoe and he literally was like, "What do I do now?"Mark: How do I walk?Jay: Yes.Mark: That's great. Actually the first time we put snow boots on our little guy, same thing. He'd never been in snow boots so we took him outside and his first few steps he looked like he was walking on poles basically. It was classic.One last thing. I'm training for a marathon right now so for all those others training for a marathon, is there a good plan of attack with regards to, I guess, weekly check-ins with a physio or any sort of healthcare practitioner or coach during the training plan, or do you go and if nothing's bothering you, just keep going? I know for my first marathon I had, pretty much a weekly, if not every ten days, appointment with my physio and it seemed to really help keep on top of things. I had some IT band syndrome creep up and was able to address that fairly quickly so wondering what your thoughts were there.Jay: Two things to point out. Number one, yes. If you were to make really good tomato sauce, put better ingredients in your sauce, right? The better ingredients for your body and it's really critical to make sure you stay on top of yourself and we say, "Listen to your body." It's important that you do get a baseline measure. I'm a big fan of [inaudible 34:23]. Check yourself on single leg balance. Check yourself on single leg squat. Do some of the tests that I outline in the book, but the whole idea is to get a starting point.As you're running and training with higher mileage, you want to make sure that you continue to be ready for that higher mileage. If you strengthen and have stability then the straining stresses on your body will be lower for the mileage that you're at. That's certainly very critical and certainly been very effective.One of the things I just want to point out with this simple advice for every runner doing long distance events, something I see just botched left and right, I think there's somewhere along the line that we had this idea that marathoners have to run 20, 21, 22 miles, even some cases some coaches have people run 24 miles before a marathon. It takes a long time to recover from runs that long and a lot of recreational novice folks try and model their training around elite training, and I'll just put something out there which is pretty interesting.Ryan Hall's longest run is about two hours [inaudible 35:27] race day. Granted, he's running 20 miles in two hours but think about how many times his foot's contacting the ground. Think about the stresses that are out there on his body over two hours and some folks may look at it and say, "I can't run as fast as he can so I now have to run four hours to get my 20 miles in." Whatever it may be.The idea is they're contacting the ground a third to half as much times over the course of the same distance and so you start thinking about the stress level that your body receives per mile and we start becoming mileage junkies we're getting a lot of breakdown on our body. I'm a huge fan of telling people, "Let's train for time. Let's not train for mileage," because it depends on terrain, right? I'm from New Orleans and New Orleans has, I think there's a bridge which has about 30 feet of elevation gain on it and that's it. It's easy to run 15 miles in New Orleans.I lived in Virginia for a number of years, which is very hilly even just in town. There was a five mile loop I did on the trail by my house and five miles, I hit about 1200 feet of elevation in just five miles. I had to run for time there because if I try to [inaudible 36:44] at the same mileage, I was exhausted, so I would say, be realistic about what you think long run is. Long run doesn't have to be three and four and five hours. Long run can be an hour and a half to two hours. That's one thing. Then make sure that your form isn't changing. If you notice that after a long run or the day after your long run your form is breaking down, you're putting too much stress on your body.Mark: Excellent advice there, Jay. Thanks for that. Being respectful of your time we'll end it here but let us know where we can find out more about you and keep up to date with what's happening. Of course, you've got the book, "Anatomy for Runners," which is available on Amazon and anywhere else?Jay: Correct. I have a little blog I host as well. It's called AnAthletesBody.com and I try to put some relevant stuff out in there whenever I can, so hope it helps.Mark: We'll make sure I put that into the post, the show notes there. Thanks again, Jay, and we will talk to you soon.Jay: Thanks so much. Have a great day.Mark: Take care.Jay: Bye.

Lastly, I thought I would post an interesting video with Jay where he talks about what runners must consider before running in a more minimalist shoe.