The Run Smarter Podcast

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For years, chronic tendinopathy has been treated as a tendon problem — load it, strengthen it, remodel it. But what if, for some runners, the tendon itself isn’t the main driver of pain anymore?
In this episode, Brodie breaks down a new 2026 systematic review that may reshape how we think about stubborn, long-standing tendon pain. The paper explores whether nerve ingrowth and abnormal blood vessels around tendons — not degeneration of the tendon tissue itself — may be the real pain source in chronic cases.
We unpack the emerging research, explain each intervention in plain language, and discuss who this may (and may not) apply to — especially runners stuck in repeated rehab cycles despite “doing everything right.”
This is early, evolving science. But it’s a fascinating glimpse into where chronic tendon treatment may be heading next.
What You’ll Learn in This Episode
Why some chronic tendon pain may be neuropathic (nerve-driven) rather than structural
How abnormal blood vessels and nerves grow into painful tendons over time
Why traditional loading programs sometimes stop working in very chronic cases
What “neural modification” treatments aim to do — and why they’re gaining interest
The six intervention categories reviewed in the paper (explained simply)
How strong (or limited) the current evidence actually is
Where this research fits alongside exercise-based rehab, not against it
Interventions Reviewed (Plain-English Overview)
1. High-Volume Injections (HVIGI / HVDI)
Large volumes of fluid are injected around the tendon (not into it) under ultrasound guidance to mechanically disrupt abnormal blood vessels and pain-sensitive nerves.
Key takeaway:
Consistent short- to medium-term pain and function improvements, especially in people who had failed exercise-based rehab.
2. Sclerosing Polidocanol Injections
A chemical agent is injected directly into abnormal blood vessels to deliberately close them down, cutting off blood supply to pain-producing nerves.
Key takeaway:
Moderate to strong pain reductions in very chronic cases, with outcomes comparable to surgery in some studies.
3. Radiofrequency Microtenotomy
A minimally invasive procedure using controlled heat to disrupt nerve ingrowth and abnormal vessels at the tendon–paratenon interface.
Key takeaway:
Very strong results in a small cohort, but higher risk and limited evidence so far.
4. Minimally Invasive Paratenon Release
Scar-like adhesions between the tendon and surrounding tissue are mechanically released to restore tendon movement and reduce nerve irritation.
Key takeaway:
Large pain reductions and high rates of pain-free outcomes in non-insertional Achilles tendinopathy.
5. Electrocoagulation Therapy
Electrical energy is used to seal off abnormal blood vessels surrounding the tendon under ultrasound guidance.
Key takeaway:
Promising early results, but evidence limited to one small study.
6. Surgical Interventions (Open & Endoscopic)
Surgery physically separates the tendon from irritated surrounding tissue and removes abnormal vessels and nerves.
Key takeaway:
Effective for some, but invasive, with longer recovery and higher risk.

The Big Picture Takeaway
Across very different procedures, outcomes were surprisingly similar.

That points to a common mechanism:
 👉 Modifying the neural (nerve-driven) pain environment around the tendon, rather than “fixing” tendon structure itself.
This doesn’t replace exercise-based rehab — but it may explain why a subset of runners with long-standing, highly sensitive tendinopathy stop responding to load alone.
This research is best viewed as a future direction, not a replacement for good rehab principles.

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Chronic plantar fasciitis can quietly strip away your confidence, your identity as a runner, and eventually your belief that running is even possible again.
In today’s episode, Jon shares his seven-year battle with stubborn plantar fasciitis—and how he went from barely being able to walk in the morning to completing trail marathons at age 59.
This is not a story about a magic treatment or a quick fix. It’s about patience, progressive strength, smarter recovery, and changing the way you think about pain. If you’ve tried everything and feel like you’re running out of options, this conversation will resonate deeply.
What We Cover in This Episode
Jon’s long road with plantar fasciitis
How his symptoms started, disappeared, then returned worse than ever
Why years of rest, stretching, and passive treatments didn’t solve the problem
What “first-step pain” taught him about whether he was improving or regressing
Why many plantar fasciitis treatments fail
Over-stretching and aggressive rehab that actually delayed healing
Why ticking “strength training” off the list too early is a common mistake
The difference between doing exercises and loading tissue correctly
The turning point
The mindset shift that stopped the injury from controlling his life
How slow, progressive calf strengthening rebuilt tissue capacity
Why learning not to catastrophize flare-ups changed everything
Strength training that actually worked
The calf exercises that gave the biggest return on investment
How he progressed from double-leg to single-leg loading safely
Rep ranges, frequency, and why patience mattered more than intensity
Recovery beyond rehab
How improving sleep quality accelerated his progress
Nutrition changes that supported training and recovery
Why recovery became non-negotiable as he got older
Where Jon is now
Running pain-free most days after years of struggle
Completing half marathons, mountain runs, and a self-supported trail marathon
How he’s approaching goals differently to stay healthy long-term

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Matt is a repeat guest from the Doctors of running and a running shoe fanatic!
Our discussion on today's episode starts with shoe expiry dates. Matt gives his opinion on when it is time to buy new running shoes and what variables play a role in running shoe wear and tear.
Next, we explore the different features of a shoe that you need to consider when buying a new pair. Matt discusses comfort, flexibility, stability, upper, drop, weight and many other features.
Matt also shares his recommendations on shoe brands for beginner runners, performance-minded runners and his take on maximalist versus minimalist.
Follow Matt's work by visiting the doctors of running website, youtube,  podcast and insta.

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In this month’s Latest Running Research episode, Brodie breaks down three high-impact studies that every runner should know about—covering sleep quality and injury risk, what actually gets injured during marathon running, and how strength training can improve running economy. If your goals are to run faster, stay injury-free, and train smarter in 2025, this episode delivers clear, evidence-based insights without the fluff.
We start with a standout prospective study tracking runners over six months, showing that poor sleep quality—not sleep quantity—significantly increases injury risk. Each one-point drop in perceived sleep quality increased injury risk by 36%, while rising fatigue and muscle soreness emerged as early warning signs in the 1–2 weeks before injury. The takeaway is clear: sleep quality, recovery monitoring, and subjective signals like soreness and fatigue deserve far more attention than most runners give them.
Next, we zoom out and examine a comprehensive review of marathon-related injuries, separating race-day injuries from training injuries and identifying the most commonly affected areas (thigh, knee, calf, foot, and ankle). The paper highlights both modifiable risk factors (training load, recovery, alcohol use, footwear transitions) and non-modifiable risks (age, sex, prior injury), offering valuable context for runners preparing for longer events or returning from injury.
Finally, the episode explores new research on strength training and running economy, focusing on how combining heavy resistance work with plyometrics (“complex training”) can meaningfully improve efficiency. The findings reinforce that strength training isn’t just for injury prevention—it directly improves how much energy you burn at a given pace, making it a powerful performance tool when programmed correctly.

Learn more about Brodie's Research Database & AI Assistant 📄🔍
For MORE Run Smarter Resources 🏃‍♂️📚
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- The Run Smarter Book 📖
- Access to Research Papers 📄🔍
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In this reflective end-of-year episode, Brodie pulls back the curtain on his own training highs, mistakes, injuries, and breakthroughs to help you make 2026 your smartest running year yet. Drawing from a full year of HYROX preparation, calf and hamstring setbacks, strength gains, sleep struggles, and race-day lessons, he breaks down what actually worked, what didn’t, and—most importantly—why. 
This isn’t just about racing faster; it’s about learning how to adapt, manage load, avoid repeating injury cycles, and build resilience over the long term. Whether you’re training for a marathon, HYROX, or simply trying to stay consistent and injury-free, this episode will prompt honest self-reflection and give you practical ideas you can immediately apply to your own running journey