Luke Nelson - Sports & Exercise Chiropractor

Luke Nelson - Sports & Exercise Chiropractor 🔹Fellow Sports & Exercise Chiropractor (AICE 2019)
🔸President Sports Chiro Australia
🔹Director Health & High Performance
❤️️Family, Running & Sports Chiro

My knee symptoms started the day after a weekend of running drills and stair climbing at a symposium.So naturally, that’...
08/06/2026

My knee symptoms started the day after a weekend of running drills and stair climbing at a symposium.

So naturally, that’s what I initially blamed.

But after going back through the training data, I don’t think it was quite that simple.

More likely:�the drills were the straw that broke the camel’s back.

Because before that, there had already been:
- months of marathon training
- races
- workouts
- travel
- 6 speaking engagements in 2 months
- long days on my feet
- disrupted recovery
- accumulated fatigue

Interestingly, there actually wasn’t one massive spike immediately before the injury.

There WAS a noticeable jump in training load earlier in the block, and given we know symptoms from load spikes can sometimes be delayed by 4–6 weeks, that period may still have been relevant.

That’s something I think a lot of runners miss:�injuries are often delayed.

Sometimes the painful session is just the final stressor added onto an already fatigued system.

Looking back, I probably would’ve:
- respected recovery a little more
- created more separation between stressors
- been more cautious adding novel drills into fatigued periods
- given myself a little more margin around busy work/travel weeks

Hard training wasn’t necessarily the issue.

Accumulated stress without enough recovery probably was.

05/06/2026

Pushing hard in training AND cross-training at the same time? You might be cooking your calf🔥

Aponeurotic calf injuries don't always announce themselves loudly. They build. Session on session, the cumulative fatigue stacks up, until one day the athlete pulls up with what looks like a sudden injury that was actually weeks in the making.

Brady Green nails it here: it's not always one big moment. It's the gradual onset of failure after loading the calf hard, repeatedly, without enough recovery between.

If you manage runners or are a runner, this one's worth understanding before you end up on the sideline wondering what went wrong.

🎙️ Full episode with Brady on The Rehab Runway:
https://www.healthhp.com.au/the-rehab-runway/calf-strains-explained

Most runners think long runs are simply about aerobic conditioning 🏃‍♂️But emerging research suggests they may also impr...
04/06/2026

Most runners think long runs are simply about aerobic conditioning 🏃‍♂️

But emerging research suggests they may also improve durability:
your ability to resist physiological deterioration during prolonged exercise 📉➡️📈

In a recent study, runners regularly performing long runs showed:
✅ better preservation of running economy
✅ less neuromuscular fatigue
✅ smaller physiological deterioration over time

And importantly, these runners were matched for performance 👀

Meaning durability may not just be about how fit you are…
but how you train 🎯

Because the marathon isn’t just about how good you are fresh.

It’s about how much of that physiology you can HOLD onto late in the race 🧠⚡

That’s exactly what we explored with Michele Zanini on the latest episode of The Rehab Runway 🎙️

Save this post for your next marathon build 💾

https://www.healthhp.com.au/the-rehab-runway/ep-13-running-durability-explained-michele-zanini

🚨 A recent 2026 study found more than half of female trail runners screened “at risk” for eating disorders and low energ...
02/06/2026

🚨 A recent 2026 study found more than half of female trail runners screened “at risk” for eating disorders and low energy availability.

That’s a striking number.
But the study also raised some really interesting clinical questions 👇

The findings supports RED-S involves more than simply “not eating enough,” with associations seen between:
🧠 mood
😴 recovery
⚡ chronic stress
🏃‍♀️ long-term training exposure
📉 libido changes

At the same time, it’s important not to overinterpret the results: This study used screening questionnaires, not diagnostic testing, and did not directly measure energy availability, hormones, or bone health.

Still, I think the broader message is important:
Many endurance runners struggling with fatigue, recurrent injuries, poor recovery, mood changes, or hormonal symptoms may not fit the stereotypical “underweight athlete” picture.

As clinicians and coaches, we need to broaden the conversation beyond mileage and training load.

📚 Reference
Hill C, Vigne C, Basset P, Scheer V, Baud D. Screening for eating disorders and low energy availability in female trail runners: A cross-sectional study. PLoS One. 2026;21(5):e0348896.

29/05/2026

🏃‍♂️ Can strength training improve running durability?
A recent study by Zanini and colleagues investigated exactly that.

Well-trained runners completed a 10-week strength training program consisting of:
🦘 Plyometrics
🏋️ Heavy lower body strength work
🦵 Soleus-focused calf isometrics

The program progressed from simple pogo jumps and hop-and-stick drills towards more advanced plyometric exercises while gradually increasing strength training loads.

📈 The result?
The strength training group improved:
✅ Running economy durability
✅ High-intensity running performance under fatigue
✅ Maximal strength

Importantly, the study doesn't prove these are the only exercises that work.

But it does provide a useful framework:
• Build force capacity
• Develop elastic qualities
• Don't neglect the calves

Durability is becoming an increasingly important concept in distance running. It's not just about how fast you can run when fresh, but how well you can maintain performance as fatigue accumulates.

🎙️ We recently discussed running durability in depth with Michele Zanini on The Rehab Runway podcast.

👇 Do you currently include any of these exercises in your training?

📚 Reference
Zanini M, Jan-Carrillo N, Balsalobre-Fernández C, et al. (2025). Strength Training Improves Running Economy Durability and Fatigued High-Intensity Performance in Well-Trained Male Runners: A Randomized Controlled Trial. Medicine & Science in Sports & Exercise. 57(2):237-248.

Improving durability probably isn’t about ONE magical workout 🏃‍♂️It’s likely the combination of:• adequate training vol...
28/05/2026

Improving durability probably isn’t about ONE magical workout 🏃‍♂️

It’s likely the combination of:
• adequate training volume
• regular long runs
• strength & plyometric training
• fueling
• pacing
• recovery

Recent research from Michele Zanini and colleagues suggests runners performing regular long runs show better preservation of running economy during prolonged exercise 📈

And supplementary strength + plyometric training improved:
✅ running economy durability
✅ fatigued high-intensity performance
✅ late-stage fatigue resistance

That’s important.

Because marathon performance isn’t just about your physiology fresh.

It’s about what happens after 90 minutes… 2 hours… or 35km ⚡

That’s exactly what we explored on the latest episode of The Rehab Runway 🎙️

Save this post for your next marathon build 💾

Running DurabilityWe’ve traditionally focused on 3 major physiological determinants of endurance performance 🏃‍♂️• VO₂ma...
26/05/2026

Running Durability
We’ve traditionally focused on 3 major physiological determinants of endurance performance 🏃‍♂️
• VO₂max
• Lactate threshold
• Running economy

But there’s increasing evidence that another factor matters massively in long-distance racing:
👉 Durability.

The ability to maintain physiology and performance as fatigue accumulates 📉

Because what matters at 30km isn’t always what you looked like at 0km.

Recent work from Michele Zanini & colleagues suggests prolonged running can progressively worsen:
• running economy
• VO₂max
• lactate threshold speed

And the athletes who resist those changes best may have a major performance advantage ⚡

This episode of The Rehab Runway dives deep into:
• what durability actually is
• how it’s measured
• what breaks down during prolonged running
• and importantly… how we can train it 🎙️

https://www.healthhp.com.au/the-rehab-runway/ep-13-running-durability-explained-michele-zanini

19/05/2026

🦘 How are your springs? Try this simple test!

👀 For those with a keen eye, what stands out in these examples?
A submaximal single-leg hop can be a quick and useful screen of plyometric function. Simply perform 10 hops on one leg and compare it to the other side.

🔍 What are we looking for?
😣 Any pain or discomfort?
📏 Similar hop height between sides
🤸 Balance and control throughout the task
🤫 Quiet landings — we shouldn’t hear a loud “thud”
⚡ Quick ground contact times
🦵 A slight bend through the knee — not too stiff and not too deep. Those with knee pain may often stiffen up here
🚫 No excessive compensation from the upper body or opposite leg to generate momentum

The findings from this test may either prompt further assessment or help guide progression into more demanding plyometric tasks, such as maximal hopping and jumping drills.

Give it a try & let us know how you go 👇

5 Things I Got Wrong About The Calves1️⃣ I was taught the soleus was a “postural muscle”�At uni, the soleus was often fr...
16/05/2026

5 Things I Got Wrong About The Calves

1️⃣ I was taught the soleus was a “postural muscle”�At uni, the soleus was often framed as a low-level endurance muscle that mainly kept us upright.
What I underestimated was just how important it is during running 🏃‍♂️
The soleus handles enormous loads during stance: more than any other muscle. It’s not just a background stabiliser. It’s a major performance muscle.

2️⃣ I underloaded weighted calf raises 🏋️�I used to think “heavy” calf raises meant holding a dumbbell.
Now it’s not uncommon for my runners to work toward very high loads on seated and standing calf raises.
Because if the tissue is expected to tolerate repeated high-force running loads, rehab probably needs to expose it to meaningful strength demands too.

3️⃣ I thought seated calf raises were only for soleus�I used to view seated calf raises as a “soleus exercise” and standing calf raises as a “gastroc exercise”.
Reality is more nuanced.
Yes, knee position changes the contribution, but the plantarflexor system still works together. Seated calf raises can still heavily load the entire calf complex.

4️⃣ I used to focus too much on pain ⚠️�Pain became less useful to me once I started looking more closely at:�• strength deficits�• endurance�• reactive capacity�• running tolerance�• training density
Symptoms often improve before true calf capacity returns.

5️⃣ I underestimated how much the calf influences the rest of the chain 🔗�The calf isn’t just an ankle muscle.
Reduced calf capacity can influence:�• Achilles loading�• plantar fascia loading�• knee mechanics�• hamstring demand�• running economy
The more I work with runners, the more I see the calf as a major system influencing overall running load tolerance.
The calves are far more important than I realised early in my career.

P.S. I’ve put a lot of these principles into my Calf Strain Rehab Framework for clinicians and runners.
https://www.healthhp.com.au/calf-strain-rehab-framework

We’ve been told running makes you stronger 🏃‍♂️But that depends on what you mean by “strong”Running is incredible for im...
14/05/2026

We’ve been told running makes you stronger 🏃‍♂️

But that depends on what you mean by “strong”

Running is incredible for improving:
• endurance 🔋
• movement economy ⚙️
• coordination 🧠
• elastic energy use 🦘
And running itself is still the primary driver of running performance.

But where the discussion becomes interesting is whether running alone fully develops all the supporting physical qualities underneath those adaptations.

Particularly:
• maximal force production 🏋️
• tendon stiffness
• reactive force capacity ⚡
• load tolerance

Because while those qualities may not directly determine performance in isolation, they may influence:
• efficiency under fatigue
• robustness to training load
• injury resilience 🩹
• and the “reserve” available during high-demand running

So the point isn’t: “running is insufficient”

It’s: “running may not maximise every physical quality that supports the task”

And clinically, that distinction matters.

Because if a runner has:
• calf strains
• Achilles pain
• bone stress injuries
And the only intervention is more running…You may just be reinforcing the same qualities they already have.

A better question is:
👉 What does this runner actually need more of?

🎙️Listen more on The Rehab Runway Episode 13
https://www.healthhp.com.au/the-rehab-runway/ep12-does-running-build-strength

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