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| Picture from Bikatadventures.com |
Sunday, June 28, 2026
Can Cross Training On A Bike Translate To Better Running Performance?
Sunday, June 21, 2026
Carbon Plated Shoes And Stress Fractures
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| Picture from Prodirectsport |
No running study has studied whether carbon plated shoes (known as advanced footwear technology or AFT) changes running biomechanics associated with bone stress injuries (BSI), or shin splints. The researchers goals were to measure running biomechanics while running in an AFT shoe.
23 runners (11 women, 12 men) with an average age of 25.4 ± 2.7 years were recruited for the study. They ran randomly in 3 different types of running shoes, neutral, lightweight (responsive foam) and AFT at 3 self selected running speeds. A run at their 'training effort', a tempo run and at 5 km race pace.
Biomechanical variables associated with BSI such as cadence, vertical ground reaction forces, ankle and rearfoot eversion forces were measured during each run and shoe condition.
Results show that with neutral running shoes, ankle plantarflexion moment was higher compared to lightweight foam and AFT. There was less rearfoot eversion movement in the neutral shoe compared to lightweight foam and AFT.
Cadence was lower while running in AFT shoes compared to neutral or lightweight foam shoes. This is relevant since a longer running stride has been linked (in earlier studies) to BSI in the lower limbs.
Rearfoot eversion velocity (the speed at which your foot rolls down and inwards), or pronation was higher in the lightweight foam shoe compared with both neutral and AFT shoes. There was no significant difference in this between the neutral and AFT shoe.
The authors concluded that there were increases in several biomechanical variables associated with BSI while running in AFT shoes. Although these changes were small, they tend to accumulate and can contribute to increased forces on bones in the lower limbs.
The authors suggest that rotating running shoes and gradually using AFT to adapt to the differences may help reduce potential injury risk while optimizing running performance.
Reference
Bruneau MM, Gaudette LW, Sirls E et al (2026). Biomechanics Associated Withe Bone Stress Injuries While Using Advanced Footwear Technology In Elite Distance Runners. PM & R. 18(2): S143-150. DOI: 10.1002/pmrj.70153
Sunday, June 14, 2026
Repeat The Same Training?
Sunday, June 7, 2026
Can You Trust AI With Nutritional And Athletic Performance Advice?
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| Picture from Sixminutemile.com |
Faulkner said she coded to build the AI technology that can learn from data, spot patterns and make decisions. These are skills that we usually associate with human intelligence.
AI is already in our everyday lives. We get Google Maps directing our commute, Spotify suggesting songs on your playlist and hit ChatGPT with any question we might have.
Many people use AI for everyday health, exercise and medical queries. Are these AI driven chatbots reliable and accurate? Our patients already use AI to self diagnose their pain and injuries. Some studies show chatbots are largely accurate, while others reported frequent errors and even a risk for transmitting inaccurate information.
The following research investigated 5 popular AI driven chatbots to evaluate their responses to everyday health and medical queries across 5 categories: cancer, vacines, stem cells, nutrition and athletic performance. Both open ended and closed ended questions were used.
Gemini, Meta AI, DeepSeek, ChatGPT and Grok were the 5 chatbots used. They were each presented with 50 prompts across the 5 topics mentioned above. The researchers used an adversarial framework to strain models towards misinformation or contraindicated advice.
An adversarial framework refers to a system, process or analytical model structured around opposition, competition or conflict. This is a cybersecurity approach used to test the vulnerabilities of AI systems.
Responses were then independently rated by 2 domain experts as non-problematic, somewhat problematic or highly problematic. Citations were assessed for authenticity and completeness while readability evaluated using the Flesch Reading Ease score (100 point scale with higher scores being easier to read).
Results showed that nearly half of ALL responses (49.6 percent) were problematic, 30 percent somewhat and 19.6 percent highly problematic. Nutrition and athletic performance topics had the weakest performance and Grok generated significantly more highly problematic responses than expected.Reference quality was poor across all chatbots. The median completeness score was 40 percent. No chatbot came up with a fully accurate reference list. Misleading, unreliable or fabricated citations were common. So please be careful if you use them.
All the 5 chatbots produced responses that were rated "difficult" on the Flesch Reading Ease scale, equivalent to university-level reading. Chatbots answered consistently with confidence regardless of accuracy, while rarely declined to respond (2 refusals to answer across 250 total responses).
The researchers concluded that continued deployment of AI chatbots without public education and regulatory oversight risk amplifying health misinformation. Especially in the field of nutrition and athletic performance. They also suggested that public education, professional training and regulatory oversight to ensure that generative AI support rather than replace professionals.
My suggestion when searching for health information is to treat these AI chatbots with a good amount of skepticisim and to verify information with qualified professionals or peer-reviewed sources. There will be some benefit seeking ideas and initial information from a chatbot, but beyond that you will need a real human expert.
Reference
Tikker NB, Marcon AR, Zenone M et al (2026). Generative Artifical Intelligence-Driven Chatbots And Medical Misinformation: An Accuracy, Referencing And Readability Audit. BMJ Open. 16(4): e112695. DOI: 10.1136/bmjopen-2025-112695.
Sunday, May 31, 2026
New Way Of Grading ACL Tears
Remember the Cross Bracing Protocol (CBP)? These are patients who are managed conservatively without surgery, they are put in a brace to allow ACL healing to occur.The injured knee is kept at 90 degrees of knee flexion to reduce the gap between the ruptured ACL remnants. Research shows that 90 percent people regain continuity of the fibers after 3 months of treatment in the CBP.
Yes, the torn ACL can heal when both ruptured ends attached to each other while the knee is in a bent position. However, more severe ruptures are the least likely to achieve optimal healing.
Not all ACL's that heal (or regain continuity of fibers) in studies had a normal appearance on MRI. 50 percent of subjects in the KANON trial had a normal appearance ACL, the other 50 percent had a thinner/ elongated continuous ligament (Filbay et al, 2023).
56 percent of those with a continuous ligament 3 months post CBP treatment had a thick ligament with normal course. The other 44 percent had a thinned/ elongated continuous ligament.
In this currrent study, subjects with a thick ACL with normal course at 3 months had better 12 month outcomes when it came to knee function, quality of life and return to sport.
In addition, the following characteristics may affect the likelihood of achieving an optimal healing outcome. Patients with partial avulsion of ACL tissue from the femoral attachment are more likely to have a suboptimal healing or even no healing compared to those with the femoral origin intact (pictured above).
Displacement of the ACL ligament outside the intercondylar notch is also associated with suboptimal healing when managed with CBP. This may be due to a significant disruption to the synovial sheath that encapsulates the ACL. Disruption of this sheath negatively impacts healing potential.
If the distance of the gap between the 2 ends of the ruptured ACL is too wide (assessed by measuring the largest distance between the torn ends of the ACL), optimal healing is less likely to occur. Among the first 80 people in this study, 7 out of 40 (18 percent) patients achieved a thick/ taut ligament healing had a gap of ≥7mm on MRI.19 out of 32 (59 percent) had a thinned/ elongated ligament while 7 out of 8 (88%) had no ACL healing at 3 months.
When one or both ends of the ACL stumps appear rounded or retracted, also know as ACL involution, it is usually the early stages of a 'non-heal' and may correspond to poor or no healing. This is observed commonly in patients who present for MRI more than 3 weeks post ACL tear.
Besides the above, meniscal injuries, another ligament injury, articular cartilage damage, osteoarthritic features, bone bruising and joint swelling may also affect the likelihood of achieving optimal healing.
The authors concluded that with further research they may be able to assist people in making an informed treatment decision of the likelihood of individuals achieving optimal healing with nonsurgical management.
Reference
Filbay S, Dowsett M, van Haeringen M et al (2025). A New Way Of Grading Severity Of ACL Rupture On Acute MRI To Consider Potential For Noin- Surgical Healing With Cross Bracing Protocol: ACL Acvute Rupture Characteristics For Healing (ACL-ARCH) MRI Criteria. J Sci Med Sp. 29: 145-148. https://www.jsams.org/article/S1440-2440(25)00411-6/fulltext
Sunday, May 24, 2026
Is Your Evening Workout Costing You Sleep?
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| Picture from Sitnsleep.com |
A second session often takes place between 10-11 am. This is usually reserved for track interval sessions. Typically they do 2-3 key interval sessions a week with most of the runs really easy so they can recover. When asked why they do the second run before lunch, the reply is so that they have more time to recover before the next day's sessions.
Sometimes they even do a lighter recovery run between 4 to 5 pm to add to their weekly mileage.
So I was not surprised when I read that the timing of our workouts can affect our sleep (Akhtar and Eleftheriou, 2026). To avoid confounding factors, sleep and activity data from the same day through a model with fixed effects and terms for activity time, activity-sleep gap and the interaction between these terms.
Data collected from users sleep looked at how sleep was affected by when they decide to exercise. The focus was on cardiovascular exercises, specifically walking, running (outdoor and treadmill), cycling (outdoor and stationary) and hiking. They studied over 100,000+ workout sessions and found that the later you train, the worse you recovered (pictured above).When you exercise later in the day, your sleep heart rate is higher, your heart rate variabilty (HRV) is lower and you get fewer REM sleep events. You may sleep quicker with later workouts, but it is not better sleep. It is falling asleep faster while recovering less.
The benefits plateau around the 10 hour mark. The sweet spot is a 11 to 14 hour gap between your workout and bedtime. If you can exercise earlier in the day, you can capture most of the benefits. Perhaps that's the reason the Kenyan runners do their second run at 9 am.
What about those people who can only exercise at 8pm onwards or later? Should you worry about this? My take is no. Majority of people should NOT worry. I think it is more important to exercise where it fits in your life.
Don't worry too much about HRV scores or perfect recovery. You are only working out at 8 pm or later because that's the only time when family and work gives you an opportunity to. Many people do not have the luxury to choose the time to exercise and exercising at any time is better than no exercise.
Our bodies are remarkably adaptable too. I am sure if you exercise at 8 pm or later long enough your body will get better sleep. Not perfect sleep but the detriment is less.
Showing up and exercising is way more important than perfect conditions. Consistency beats optimization every time. That is what will compound.
Reference
Akhtar F and Eleftheriou K (2026, May 24). Your Evening Workout Is Costing You Sleep. Terra API. Https://trryterra.co/research/best-time-toworkout--for-sleep#the-honest-takeaway
Sunday, May 17, 2026
Warming Up Body And Mind
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| Picture from Healthywomen.org |







