E22: Read the Runner, Not the Pattern with JP Gloria.

Jimmy: Welcome to the Physio Insights podcast presented by Runeasi. I'll be your host, doctor Jimmy Picard. I'm a physical therapist, running coach, and team member here at Runeasi. On this show, we have real conversations with leading experts digging into how we recover from injuries, train smarter, and use data to better guide care. Whether you're a clinician, coach, or an athlete, we're here to explore what really matters in rehab and performance.

Let's dive in.

Jimmy: Alright. JP, welcome to the podcast. Pleasure to have you here.

JP: Yeah. Thank you for having me.

Jimmy: I've been following your work. You got a really fun Instagram where you dig into all things gait analysis. You've also been using Runeasi for quite some time and I think you're I do believe you have probably done the most assessments using Runeasi all time. So congratulations there.

JP: I have no idea if I'm the one who's used it most, but yeah, I've put down a lot of I don't I think they only do the count for the clients now. But I remember the last time I checked like, what is it, half a year ago, it was at like, I don't know, 2,000, 3,000 sessions or something like that.

Jimmy: Yeah. I think that's like, that's individual runners too. Yeah. So you've done a lot of gait assessments. But before we dig into that, for the listeners who are not familiar with you, could you introduce yourself a little bit?

JP: I'm a doctor of physical therapy. So I specialize in working with injured runners, injured runners that are trying to get back into training. I also consult and work with some of the on the performance end of things. So working with some of the, whether it's amateur, but even some of the professional runners, particularly in like the long distance space, like marathons or ultra running. I'll do some consulting there to get a lens on how to get people to that next level or how to preemptively, let's say, you know, this is a tricky word, but reduce risk of injury or be really mindful of how to approach training given the context of that runner.

Jimmy: Awesome. Do you coach as well?

JP: Yeah. I have my technically, I also have my, you know, USATF running coach certification, which is kind of funny because I think I remember doing that course remotely. And I remember when they were going through that class, one of the coaches was like, hey, like, this is a really good, like, page to show, like, running mechanics. And then he, pulled up my page. I was like, oh, that's crazy.

Jimmy: I love it. Well, so that's a good segue. So tell me your Instagram page is filled with lots of videos of runners from elites to I think some of your clients. And kind of it looks like the main thing you're trying to get across is there's a lot of uniqueness or individuality when it comes to gait mechanics. And so when it comes to things like gait assessment, when we're working with whether it's a patient or performance clients, are there things that you see people doing wrong, clinicians or coaches doing wrong when it comes to gait assessments?

JP: I think the thing that I think goes wrong is the idea of trying to fix things. I think my motto, and you'll see this across whether it's clients or even on social media, it's and when I think about running analysis, I think about it more like thinking, you you've the priority is to understand the runner, not try to fix the runner. Part of the reason I post so much on, like, different runners, whether it's amateur or whether it's elite or whether it's, like, world class runners, is just to show that there are different types of running styles out there. And one's not necessarily wrong versus the other because I feel like there's a preconceived notion of like a cookie cutter, you know, how you should run. And of course, there's guidelines.

Right? But I think the biggest issue with clinicians is trying to force someone to run a specific way without understanding the context of the runner. Because more often than not, I found that people will try to change the running without that context, and usually, it only magnifies the issue even more so.

Jimmy: I've seen some of the posts where you have two runners side by side and similar gate mechanics. One's actually with pain, can't run. The other is competing like 100 miles or something. Yeah. So talk a little bit about that.

So this idea like we're not going to fix, we're trying to seek understanding by looking at them run. What are we trying to understand?

JP: I mean, was an interesting case. I mean, all the stuff that I post are usually an underlying message behind it. It's actually, I don't really I'll get back to it more, but I don't really I really post to kind of have a gallery of things I could actually show clients. So there's usually a little message behind those. So the reason I post posted that one, that one was an interesting person I still currently work with.

Can't quite get rid of him. Initially, again, everyone's different, right? I'd say there are times when, you know, changing someone's running mechanics can get someone from having pain each step they run to being able to at least for a short distance. But I also know that that's not the end all be all. The interesting thing about this one, it was we really didn't go too much about running technique.

I think we attempted and it was just it doesn't go very well. Like, you know, he ends up getting stiff. It just wasn't the best way to work with him. But the things that really mattered for him was really addressing the foundational thing. So we really spent less we only took footage of him in the beginning and at the very end, like one year later, just because they're like, hey.

Like, let's look at the footage. I am unsure. I was like, I'm unsure if there's any differences, but it'd be interesting to get that footage regardless. Because, again, that beginning footage was him barely little context on him. I think he has had pain before working with him.

I think he had pain for like two years in that left hip. And then he was diagnosed. And then obviously one year later, it's like, what's wrong? Let me get like, some imaging. And ended up coming out with just a hip labrum tear.

And then I think he already came across my page initially because he told me, he was like, yeah, saw you like one year prior to first meeting him. But he's like, maybe I could like sort this out myself. But he's been stuck at being able to run one to two miles because of that hip pain. So what's interesting about him is we spent less time on, you know, throughout the time, we really didn't spend that much time on the running technique. We spent more time on, you know, improving the quality of his hip with daily stuff.

Like, you know, initially, had pain with, like, pain with sitting, pain with sitting on benches, couldn't really cycle because, you know, getting into those deep hip flexion ranges were particularly bothersome. And, you know, sleeping on his side would be a little bit painful as well, especially if that side's on the top side. You know, if you're let's say you're laying on your right side and the left side's on top. But, you know, I obviously kept him running, but I had to minimize his mileage. I was like, instead of prioritizing we still ran, but instead of prioritizing the running, really focused on on the other stuff, really just getting that hip to be comfortable with all these daily life activities.

And then from there, we were able to progress. We eventually progressed into training. And I think that foundation was really good because that solidified the base to train off of Because then eventually he ended up doing his first 50 k into eventually doing his first, he ended up running another trail race for like, I think 62 miles. And we're dialing a lot of stuff, whether it was a lot a lot had to do with like the capacity of the body. So really incorporating specific strength training work and all that type of stuff.

You know, one year later when we when we first consulted each other, just interesting where he it literally was one year later where he ran his first 100 mile race. And, you know, now he's gonna run. Is he done? No. He wants to run another 100 mile race in,

Jimmy: June. Nice.

JP: And I think that's the thing. The point of this one is a lot of people try to sell, and you'll see it online, they try to sell, if you fix this one thing with your running technique, all your problems will go away. Mhmm. But the point of that post that I made was it doesn't have to be. You don't necessarily have to change your running technique to be able to get to where you want to be.

Jimmy: Yeah. Why do you think that's such a common misconception in this space?

JP: I think it's like, you know, the idea of quick fixes, right? That's rampant, especially in physical therapy. It's like, oh, if I do like dry needling or if I do these, like, if I just get this manual therapy or this manipulation done, like, you know, it'll address my issues. But from a running perspective, it's like, man, you know, the issue, the reason for my issues is because I heel strike. And it gets sold on, I don't know, it's just a shiny thing.

The reason you're having pain is because you heel strike. I'm like, okay. Well, it's not you know, maybe that helps offset certain areas to help someone continue running. You know, I have this thing where, you know, there's people who have, let's say, knee pain, but they don't really have knee pain when they run barefoot or run with barefoot shoes, let's say. But then I argue it's like, well, it's not that the other shoes are the issue.

It's just that you have, like, you need to really work on your knees, I guess. So

Jimmy: So when if we go back to this idea of, like, understand not fix. Mhmm. When you say, we don't want to fit or we don't need to fix, I should say. You're saying we don't need to we can watch a runner run to get an idea of how they're loading their body, what tissues may or may not be taking more load. But not to say, not to do it with the idea of like, we need to change it, but just to understand.

JP: Right. Like, again, his context was he found the most benefit from really addressing the capacity the the body itself, not necessarily technique. But then we just talked about the beginning of the session. Well, I'm pulling what is it? Probably 3,000 to 4,000 run assessments, you know, probably in a year.

So again, I still think it's important, but it's for a very different reason. And a good example of this is particularly when I do a run assessment, let's say for knee pain, you know, what's interesting is people already tend to look at for the adaptations already. So I kind of show this case because this case happens time and time again is the, you know, the idea of, let's say, a runner and I have to have a post on this too on an ultra running or ultra runner that has, like, knee pain on, let's say, the right knee, I believe. When you look at him run, he would have an asymmetrical foot strike pattern. I mean, it's confusing for most, but as a clinician, you'll see it quite a bit, right, when you work with runners is, well, on one side, he was heel striking on his left side.

On his right side, he was forefoot striking. Now understanding, you know, for some of the viewers who might not understand, like, context about the strike patterns in terms of force distribution, When you heel strike, that tends to put loading more into the knee area. And then when you do more of a forefoot strike, that tends to shift the forces a little bit more distally into the foot and ankle area. So given that context, you know, okay. This person's dealing with knee pain.

It's probably the left leg because on the left or it's probably the left leg because he's putting a lot more force in the knee in that context. However, when I this happens a lot where it's actually the opposite leg. I found out a lot where the side that's forefoot striking is the area that has knee pain. And the reason they're forefoot striking on that right side is a compensation because they can't handle the loading on that knee. And when we think about it like that, it's more about understanding the runner.

What do we need to address? If I try to, like, let's say, try to fix anything. Let's say, try to oh, well, maybe let's make it more symmetrical. Right? Let's may maybe have him heel strike on both sides.

No. That might make his knee worse. I think I also talked about how complex this gets with, the school year study. But theoretically, it would make the pain worse. And then if you decide to forefoot strike on both sides, that probably wouldn't make a difference at all.

Jimmy: So it's this idea of maybe it's it's a red herring. We would see it maybe coming out of school. We're taught to try to fix this kind of thing. But in this case, this is the runner's learned behavior to unload the cranky joint.

JP: That's what I'm saying. It's all it's all about, you know, with run analysis, it's all about understanding the runner. And and I will never try to change someone's mechanics until I understand the context behind that runner.

Jimmy: Yeah. When you say that, can we dig into that for a little bit? Like, what are the specific things with the individual runner context wise that you're looking to understand?

JP: You know, I'll do the run assessment. But a lot of times before I do the run assessment, actually, pretty much all the time, unless I'm doing screens for fun, is I always go through performance and mobility testing. Taking them through a series of or a battery of tests, such as testing things. I'll actually use the Runeasi. I'll actually usually test the jumping into single leg hopping pretty much before I do the run because I really want to understand what's going on with this person.

Jimmy: And so for the listeners who aren't aware, so like that's basically, you're assessing double egg hopping 10 times, single egg hopping left and right 10 times each. And what are you looking for when you when you do that?

JP: Well, I'll look for the response to it if there's discomfort. Right? I'll also look at, you know, what the symmetry is between both sides specifically with that single leg hopping.

Jimmy: Yeah.

JP: For example, to put this a little bit together in more of a case, I did a recent one probably a week ago where I was working with this runner, and when I was taking them through single leg hopping, for her, she could hop pretty well on the right leg, you know, no discomfort with that. And then on the left side, we start you know, it was a lot. She had a little bit of discomfort in that left ankle. And then when we look at the measurements, which is kinda cool, you know, you could get the quantitative aspects of it is it wasn't able to generate as much force on that left side versus the right. You know, the RSI or reactive strength index was not as good.

Or to keep it really simple, they weren't able to jump as high on that side. But then okay. So I have an understanding that, okay, this person has limited ability to tolerate impact through that left leg. And that makes sense because I went through her history as well. You know, we chatted about it earlier on, and she did sustain, like, an old fracture probably two years ago in that calcaneus, in the anterior lateral aspect or oh, sorry.

Let's just say in the heel bone. In the heel bone, there was a previous fracture in that area. So so that kinda makes sense. Okay. Well, impact seems to be really affected.

Well, how does this affect this person's running pattern? And the way that she ran is she had a pretty high you know, for an easy run. Again, this is the idea of under using things as a guide, but we're taking her for an easy effort. Her cadence was really high. You know, it was probably closer to, you know, for an easy pace.

You know, this depends on the person, but we're going at roughly like twelve to twelve to thirteen minutes per twelve minutes per mile, which would be easy for her. And then she was already at, like, a 190 steps per minute, which I would argue is pretty darn high. And then her flight ratio is basically almost, very low.

Jimmy: And so flight ratio for the listeners, essentially how bouncy of a runner they are similar to, like, vertical oscillation.

JP: Right. Minimal bounce. And if you think about that, like, well, how does that how does that happen? It's almost like, yeah. How does that happen?

Well, she can't really, based off what we went went through, she can't really take that much impact through that left leg. So she's learned to adapt to running in a manner where there is minimal impact through that.

Jimmy: It's almost like power walking.

JP: It's almost like power walking, which sounds great where you think you're minimized, you know, minimized balance that, you know, some people will think, oh, man, that must be really efficient. Well, actually, to a certain degree, that's just straight up very taxing. You know, it's a lot of muscular effort. So she fatigues very quickly at her, you know, at what's supposed to be an easy effort. It's probably there's a probably a lot more metabolic cost to that as it fatigues are very fast.

So yeah. So she's basically adapted her running, form in a manner where now she's minimized all bounds because of that left leg.

Jimmy: Yeah.

JP: Now if I were to try to fix it, right, let's try to normalize it a little bit. Let's get the flight ratio maybe a little higher. Let's incorporate a little bit more springiness in the step. What would probably happen I didn't do it at that moment because I was actually more concerned about other things. Is if I probably tried to improve the springiness, and I I probably would have bothered her left leg more.

Because, actually, she could do the single leg hopping. The single leg hopping was painful, but the running itself was was not because she actually minimized that bounce. If I tried to add a little bit more springiness to it, that would probably upset her left leg.

Jimmy: Interesting. Yeah. So what what did you end up doing with this runner?

JP: With this one, you know, navigating runners is it looks like humans that run. Right? It's a little bit of a dance. Right? Because obviously when I see runners, they'll typically see me specifically to be able to continue running.

I think for the and this is a relatively new console, but or new person I'm working with. But during the first day, had to did a little bit of, negotiating, if you may. Yeah. I was like, you know, instead of running two to three miles, let's let's start with, a run walk. And I know you're gonna hate me for it, but I want you to start with one minute of walk, you know, 10 repeats of, let's say, one minute of easy running with three minutes of walking.

Because she was very initially, was very set on continuing running. So however, I think after our conversation, what was interesting, and that's kind of the whole point of why it matters to understand, you know, of approaching it this way, and I guess we could talk about that next, is based off our conversation and based off the assessment initially, I think she thought about what we went over and realized, you know, well, maybe I don't need to prioritize running at the moment. Yes, I want to run, but I want to prioritize feeling better. So actually, she didn't run. She focused on what I recommended initially, which is, you know, I'll stick to walking initially and address those things.

Because you noticed there's other things that happen with this. Again, running injuries are incredibly complex. You know, there's certain compensations that happen after two years of sustaining a fracture, right, in terms of things around the hip, knee, and all that type of stuff. So actually, stuck to walking. We're sticking to walking.

We're really addressing some of the deficits that she has first. Also, we're gonna you know, we're also in the context of possibly getting into imaging again as well. Even though it was two years ago, it'd be very again, she's really pushed this leg. So that might be something to revisit.

Jimmy: Yeah. So it sounds like, there's a lot of messiness around this.

JP: Of course.

Jimmy: And the one size fits all approach of see a heel strike fix it or pick your favorite like abnormal gait pattern and fix it doesn't really work. And we can kind of piggyback from here onto that post you did with JF's paper. JF has been on the podcast too. We talked a lot. I don't remember.

I don't think we talked about this paper, but yeah, tell the listeners about that that paper.

JP: For context, like, I chose this paper because it's just it's fun to look at at a very common thing. But actually, this happens in a lot of research papers. Is, you know, people will say, oh, yeah, like, based off the research, this seems to be the most beneficial for whatever. But if you actually look into the paper, right? And then almost sometimes this is treated as, Oh, this must be good for everybody.

Like everybody should do whatever treatment was planned. But if you actually look into any of the papers, you'll realize there's always mixed responses. And that's the context leading into this paper, which is, it was looking at the idea of patellofemoral pain and seeing if you basically, know, keep this simple, it's like, you know, what are the effects of using utilizing cues in terms of patellofemoral pain, essentially? And what's interesting is, yes, I think the predominant thing was, you know, forefoot striking and increasing cadence seemed to helpful in terms of reducing pain in the knee. However, and while, yes, it helped most of them, you'll also notice something I can't remember the exact numbers, but then you'll find like maybe 10 of them or maybe seven to eight of them, let's say 16 of them responded well to that, just to keep this simple.

Then maybe 10 of them had no response to it. So actually didn't make a difference whether or not they increased their cadence or moved to more of a forefoot strike. And then there is like another section of like maybe six people, let's say, that it increased their pain. And that leads to the messiness of all this because even when we look into the research, you know, I think Jay Deshery says this quite well, is, you know, you're treating the human in front of you. You're not, it's, you're not just treating the general population because that's what research looks at really.

It's looking at a set population of people. And while that's really helpful to kind of guide our process, we have to understand that the person in front of this might respond a little differently to what's being given.

Jimmy: Yeah. Can we back up a second? Because your approach is nuanced, like we said, messiness, there's a lot of individual response here. When you graduated from PT school and you started working with patients, did you always approach rehab with this kind of mindset?

JP: No. Yeah. You know, I think that's and I think this is good. Actually, this is a good conversation. You know, when I came out of PG school, I would argue that did I know you feel like, you know, quite a bit of runners, but then you look back and you're like, well, how much time did I spend really looking at running?

And I think it was like, maybe like one class. And I mean like

Jimmy: You mean like one class, like one day.

JP: Like one day of looking into running. But that's probably that's what got me into it in the first place. Right? It's like, you know, you get curious. Well, it's like, you know, the initial standard.

Well, if eighty percent of runners get injured, like, shouldn't we look more into this per se?

Jimmy: So what spurred your interest in working with runners?

JP: I think a lot of that dates back to when I was a kid, I guess. Probably you go through like tough times as a teenager, you know. However, I would say one of the best coaches I've had, his name's coach Fisher. He was the track and field coach. For a little bit of context, I I this was my sophomore year in actually.

Yeah, I was a sophomore in high school, and I was going through a really rough patch. I actually never really done track and field. You know, I'd play soccer, basketball, baseball, all those. However, I also didn't didn't really feel like I belonged anywhere, really. However, I think, you know, with coach Fisher, I remember he went to one of the basketball practices once, and he's like, hey.

You know, just like, hey. You should you're really fast. You should join the track and field team. And, you know, I've never had that happen before, but I felt like, wow. Like, this person's actually, like, very interested in, like, nurturing me and helping me, like, grow.

So I think a lot of it starts with that aspect. But to save a little bit of time on that, I think I didn't really have much self confidence. My self esteem was low. And I mean, that happens quite a bit with some teenagers. But I think through running, realized, There were things like, as you train, you realize, Oh man, I could get better.

At first, I couldn't run a five minute mile. Now I can. It's the idea of that growth mindset and the idea that you can get better. So I think it's interesting that we talk about that because it really wasn't about the I know I mentioned the time, but it really wasn't about the time, but it was kind of about the mindset that revolves around running. And then when you go into, like, working with runners, when someone can't run, it's almost like you remove when a runner can't run, it's almost like you're removing, like, a part of their identity.

Right? It affects someone more a lot, you know, yes, physically, but also mentally as well. And I think that's in combination with I love a good underdog story. And you know, plenty of the people that you'll see sometimes, I mean, maybe it's not as prevalent now, but before it was like, you know, some of the, you know, a runner will go to a runner, to a doctor and they'll say, Hey, you know, I have pain with this when I run. And then they're just like, oh, stop running or, you know, you'll never be able to run again.

And I think that, like, sparks a fire to like, you know what? Let's prove them wrong.

Jimmy: Yeah. Nice. Well, that's a great story about coach Fischer calling you out and inviting you to join the team. Sounds like set you on a a trajectory that brought you here helping other runners. It's always nice to hear when coaches have that impact on somebody.

Jimmy: I'd like to take a moment to thank our sponsor Runeasi. Runeasi is a running and jumping analysis tool that helps provide objective data on things like impact loading, dynamic stability, and symmetry. I've been using it in the clinic for the past three years and I love how easy it is to add to my evaluations. Not only that, but it backs up my clinical reasoning and helps me with my decision making process when I'm doing exercise prescription. So if you're a physical therapist or running coach, book a demo.

If you're lucky, it will be with me.

Jimmy: All right. So yeah, you get out of school, maybe you're not as nuanced as you are now. You started learning more. How did you then become who you are today with tons of followers sharing all the good word about gait analysis? How did that yeah.

What happened?

JP: Initially, I made I I started with YouTube, actually. And the reason I made a YouTube was for like a scholarship for physical therapy. You know, lived in New Jersey. Actually, I'm in California now, but initially I lived in New Jersey like seven to eight years ago. But there was a scholarship for like the opioid crisis.

I was like, You know what? I was kind of interested in videos. I mean, I would love to learn how to make videos. However, I was like, You know what? Maybe this is it.

I'll try to make a video. At least I tried to make it. And that was actually my first video on You had to like put it on like YouTube so they could like find the video, I guess. So that was actually the first So everything started on YouTube. So I posted that initially.

People were really interested in that. And then I went through like, I've been always heavily interested in biomechanics. I mean, there's going to be a lot to unpack. Questions you're asking are incredibly layered. In terms of like, I've been always interested in biomechanics It's something that I've done was I used to animate.

That was actually probably my first job. At, fourteen, fifteen, was, like, animated characters for a game. I get paid really poorly for it, but, I can actually create human characters from, like well, the graphic designer would actually send me the character, and I would actually take that character and create joints and all that, you know, split it up into different immovable joints and stuff and make it move, like walk and run and all that type of stuff

Jimmy: Nice.

JP: From scratch, which is really difficult. You know, I think when I initially took that on, I was like, oh, yeah, that's not a problem because, you know, when we walk, we don't have to think about it. When you try to piece it together from scratch, you realize just how complex it is.

Jimmy: So the and this was all before PT school, before you had any Oh, this

JP: is normal before PT

Jimmy: Yeah. So you had to do like a deep dive in walking and running and I guess movement mechanics. Yeah. Biomechanics and training.

JP: I was just interested in that stuff. There is no reason to get into that. I was just like, let's figure it out. Yeah.

Jimmy: Yeah. So I feel like when most people have that kind of starting point of biomechanics as the background, their approach ends up a little bit different than yours though. Where they stick to the biomechanics lane. They stick to like a mechanical model where it's, this is how we should move versus what you're saying. Yeah.

So where's the where the nuance come from? I guess that's what I'm trying to get at.

JP: I mean, because that's what happens particularly after PT school for plenty of students too. It's heavily like, man, if I just do this one thing, this will fix everything. Or even the biomechanics, oh, you're moving wrong. If you just fix this, you should move that way. And certainly I had a, you know, and I'm not going to say I was different initially.

I would say like, I definitely put much more stock into biomechanics initially. And that's part of the reason that got me into, you know, on YouTube, I would like find like, you know, like very top level runners and I would just like animate each aspect of the frame. I'd look at each frame and each frame is like, it could be like, if it's 30 FPS, 30 frames per second, that means I'd look at just to look at track two seconds of like someone's running. I'd have to look at 60 frames and like draw that out by hand. Anyway, yeah, I initially put a lot of stock onto it, but I think you start to I think that's the idea of trying to I think there was a lot of mentors that actually helped, I would say, this initially.

Yeah, there's the experience, sure, of starting to work with runners and realizing some things don't quite add up with the bioinforming ego and just being like, you know, maybe it isn't all about the biomechanics. But I would say, like, one of the big mentors initially that was helpful for understanding this was Chris Johnson. As I remember going to his course initially, and obviously it was clinical running essentials. I think that's what it's called. I might be wrong.

Jimmy: Or, or the tendons, weights and whistles one.

JP: That's the one I think. I went to, I did that one, but that was like after that.

Jimmy: After. Okay.

JP: Yeah. Usually the first, I think that his first more OG course was, was that one. Okay. And what's injured, what stuck out to me with that one? Yeah, sure.

We went into, you know, the biomechanics. We went into understanding how to work with, you know, certain types of injuries and what you can do for it, what types of exercises to incorporate and all that kind of stuff. But I found that the most interesting thing that struck me with that course is, and I don't know if it's structured this way still. Obviously, I haven't taken it for a while. Maybe I should take it again.

But the first thing that we went over was interviewing. So like understanding the human, right? So we went over communication first though for everything. You know, as much as it talked about running, it started with understanding the human and communicating with the human in front of you. And I think that struck a chord with me of, you know, I think that actually helped me start to think in a little bit of a different way of like, maybe it isn't all about the biomechanics or maybe I'm putting too much stock into biomechanics and all this stuff.

And maybe I should spend more time understanding the person in front of me and the context around that person and how they navigate adversity and all that type of stuff. Because it all matters. A lot of this comes to even decision making. So if we use Because at the same time, I feel like running is a little bit of a proxy. But I think working through running really gives you a lens into human being.

And I think being able to get into that next step is where you really make meaningful change with that person. Sure, with running, but I feel like that spreads into a lot of other parts of life as well, which makes it even more fulfilling.

Jimmy: Yeah. So how do you go about communicating all this to the patient?

JP: One step at a time.

Jimmy: Do you ever get pushback? Like, that they want you to change their gait or that you're thinking too much about all this other stuff and they just want you like paying attention to the running form?

JP: I mean, where I start with someone, it's kind of like, you know, we could think about it this like exercise, right? You know, when we think about incorporating a specific exercise, we don't choose the hardest exercise initially, right? You meet them where they're at. And that's exactly what I do in any situation, whether it's communicating or when I'm doing assessment or when I'm doing a consultation, it doesn't really matter. It's meeting that person where it's at.

That's why the first thing is I always ask is like, you know, if we're going to make this, okay, we have like, I don't know, an hour, hour and a half, let's say, you know, I'm talking to a runner. It's like, okay, what are two questions that you want answered that would make this session meaningful? Because it's based and usually it's like, that's a good it was a that's a good question. I never thought about that before. But it's based off of that where I could start to understand.

And I do this with everyone. Based off that, based off the answers to that, and it doesn't there's no right or wrong answer, but based on how they answer that, I could figure out where to start.

Jimmy: Yeah. And you you're learning what's important to them.

JP: Because even before change can happen, right? It's you also need to develop that trust. And someone can know a lot you know, this happens a lot. Someone can understand or have a lot of knowledge on a particular topic. But if you don't feel understood, that person is like, yeah, sure.

They know a lot, but they don't really know my situation.

Jimmy: They don't know me. Yeah. Right. Yeah. Do you think just the act it so sounds like you're talking about communicating and making the patient feel accepted.

Do you think doing, actually performing a gait assessment can have a similar impact on that?

JP: I've said this before, but I think of running as a form of body language. Right? And you know, the way someone runs when they're tired, the way, you know, it will look different. It gives me clues on the person. And there's a lot of clues hidden specifically through the run.

It's like a compound dynamic movement going on. And there's a lot happening all at once. That's actually why the Runeasi is quite helpful. Because I'd say, you know, trying to look at someone's running with just like without slow motion and just like doing like a visual analysis, it's not quite enough. There's so much information inside that person's running.

Jimmy: Tell me more about that. Is it, like helping you with buy in because you can show them the data? Like yeah. Tell me more.

JP: I think they're sure there's buy in with the data. I'm sure that happens. But I think it's helpful with buy in with the data, but also I think it's like, okay, well, this person is, you know, is looking at my running, right? They are paying attention to what I need and my needs. Think it's really just pretty that simple.

It's like because, you know, when I start you know, in the context for me, it's like if I see someone, usually it is a runner. Usually, they want me to do a run assessment because that's what I'm known for, I guess. They want me to see, you know, what is wrong with my running. How do you even I said, even if running it out, you know, changing someone's running isn't the priority, it's still something you should all pretty much always look at. Barring certain times when I'm like, okay, there's, like, very possible bone stress injury or some type of fracture going on.

Maybe you shouldn't look at your running yet. But most of the time, again, it helps with that full picture.

Jimmy: Yeah.

JP: And I think that's important to think. I'm not just when I make these posts specifically about showing, Hey, this person's run didn't have to change to be able to run 100 miles pain free. But I think it's the idea of it's seeing things holistically and, you know, looking at someone's running, the way someone runs is still very much very important. Cause in a way, I still think of running as a skill as well. It's kind of like, I think I've described this before, which is, and there's like two levels to this.

It's like, okay, someone has an ankle sprain on their right side and they're a fresh ankle sprain and they're walking and you notice a limp, right? They're putting less pressure on that right leg and they're putting more weight on that left the left leg. Let's say they have sprain on the right and they're offloading that right side. So now they're limping and they're putting more pressure on the left leg. If I try to change that running pattern immediately and it's like, oh, yeah, you know, put more weight on your right leg.

Let's make it more symmetrical. It'll probably hurt hurt you know, hurt them even more so. However, at the same time, sometimes there's certain habits that are sustained because yeah, sure. That strategy was effective maybe like for the first, I don't know, one week of having an ankle sprain. But the thing is now we're two years later and you don't really have pain there and you still have this little lip like pattern going on.

So again, that's kind of the second level to it is like, yes, I don't necessarily change it right away, but there are times when it's like, well, is it worth changing it? But I don't answer that question until I get all the context first, which is understanding the person in front of you, which does include looking at the running. Because running in a way, you see how well they tolerate loading, right? You see how well they tolerate loading through the legs. You see how, you know, how they tolerate impact forces, how they generate force.

There's a lot you could see in there. I mean, I have some interesting footage on some runners, which it's it's almost interesting to reverse engineer some of this stuff. Like, remember I had someone who sustained recently. I mean, he had like a left hip left. Think he had a femoral shaft fracture, like, I think last year.

And then, you know, he got the plate removed in January. And then I I think his mother wanted me to look at his running because something you know, even though it's not painful, something's he's not he's running a little, interestingly. Well, looking at him, I did the single leg hopping with him, and he can't even hop on that left leg.

Jimmy: Woah.

JP: I mean, it's not painful. It's just really. But then when I look at him run, it's so fascinating. Is when he runs, you'll notice, okay. And that that that's the idea.

The running really tells you a lot about the person. He has propulsion on his right leg, but on his left, he never actually gets off the ground, really. And that makes sense. If you can't hop on that leg there, can't pulse off of that left, can't do any propulsion off of the left leg. Well, when he runs, you when he it's it's the same thing.

He he can come off the ground. He has vertical oscillation on the right side when he comes off that leg, but nothing on the left.

Jimmy: So when you use like a tool like Runeasi and you have that data, you can present this to the client actually show them in the numbers. Yeah. So what I'm guessing is like flight time was like nothing on that side. Maybe ground contact time was asymmetrical.

JP: Right.

Jimmy: Yeah. And then I'm just curious, this particular runner, how did he respond when you showed him this stuff?

JP: He you know, the thing is it was interesting in a way. It's like, I didn't really quite know know that before. Actually his mother, because this person was a little bit, you know, he's younger, but the mother was definitely more like, I never really I knew he was running funny because you get this intuitive sense that something's quite not right. But to be able to break it down was really helpful because it's like, okay, now I know. Because we're able to break it down, now we know what we need to work on.

Jimmy: Yeah. And so like going back all the way to the beginning of this conversation, it's helping you understand how he's using his body, not to fix the gate, but to look at the, like, sounds like in this case, the underlying capacities, deficits, and then address those deficits.

JP: Right.

Jimmy: Is that kind of like this, If you had to break it down, like in the simplest terms of like why and how you use gait assessment, would it be something like that?

JP: Yeah, it's just an assessment, right? I mean, you could think about it like, you know, when some, like, why do we look at someone's squat or deadlift or stuff like that? It gives you clues on, sure, there might be a technical aspect, but it gives you a little bit of clues on the person's mobility, but also areas that they might not tolerate forces as, or it'll show areas that they might not tolerate as much force.

Jimmy: To push back a little bit though, I think like our profession is notoriously does these assessments to fix things, not necessarily to understand or to fix to look for flaws. Right. That's something different that you're kind of pushing and I like it because I agree. Like my bias is more in line with you is to say it's, there's a lot of variety in the way that we move, especially when you start looking at skills like running.

JP: That is part of why I still initially when I was on YouTube, because that's where it all pretty much started. You know, I was posting these things and the question I was trying to figure out for myself was like, okay, what is the silver lining on? Like how do these, you know, how do these high class runners run? Like what is that silver lining? What is the common denominator?

But then like nowadays, I think the thing, the reason why I still post like a bunch of different like run analysis or run techniques of different runners is to show the variety. Because right now, to your point, and I actually just made a post on this very recently, is that and I think I put it in the caption, which is, you know, the misconception is that variety is seen as an error, right? When someone sees someone move a little differently, that's an error, that's a flaw that needs to be fixed. When in actuality, that's not necessarily true. Is it maybe something to clue in on to perhaps look more into?

Like, does this person move that way? Sure. But it doesn't necessarily mean it has to be fixed. So, yeah, I agree. It's like, oh, you don't move quite the way that I imagined you'd move.

Let's fix it. But first, maybe before you say, let's fix it, let's understand it, and then decide if it's worth fixing or

Jimmy: not. So to you, it sounds like the assessment, running assessment during your initial eval or that first consult with the client, you're seeking to understand and then communicating as a part of the story, right? It's not the whole thing. It's not this by itself. It's just a piece of the puzzle with all the other stuff you mentioned, their personal history, probably training loads.

Guess, yeah, piggyback on that. Where do you feel like training loads fit into the assessment here?

JP: I mean, that's what I'm training loads in what manner? Like actual run and train?

Jimmy: Yeah. Life loads, training loads, like everything that they're doing, I guess. I feel like it's something that we didn't necessarily I wasn't taught to sit down with an injured runner and like pull up their Strava and let's take a look at what you've been doing. However, I feel like maybe I would get more personally, I think I do get more out of that than sitting down and watching them run for sixty seconds on

JP: the treadmill. Absolutely. I mean, I spend most of more of the time really trying to understand that. That's actually what I first do. You know, that's that's my priority.

Typically, I'll do the run assessment. The run assessment part is almost close to the end. I would say I spend time after that trying to connect the dots with them. However, the first thing I always do is I do go through that first part. And for them, sometimes it's like, why the heck is he asking me these questions?

Seems like it has nothing to do with disruptive. You know, nothing to do with what I'm coming in for. But it actually does. Because for instance, when someone misses runs, right? It's like, oh man, I'm not able to run as much.

But it's not because of injury, they just can't run as much. What does that tell you about that person? When someone is missing runs, that means they're pretty, probably busy or certain things are getting away or probably they're just very stressed. What ironic about that though is, you know, they're stressed with more, let's say there's more work stresses, so they're not able to run as much. And because they're not able to run as much, they get even more stressed.

So yeah, I would say like it all matters. I think honestly, would argue that that's the most important thing. Understanding that person's ecosystem is really the most important thing. Because even with the running, it's decision making. Yeah, sure.

That's one session, you know, that's one session. We kind of see where your body's at at the moment. But a lot of times when we're working with runners, how do we get them from where they are now and where they want to be? And that requires and typically, like I said, for let's go back to that person that could barely run to now running a 100 miles that happened off of one training cycle? Absolutely not.

That happened over like months of building and building on top of each other, making the right decisions. Going through different decision making problems, like, it's like, oh, man. I feel know what happens? Oh, man. I'm feeling really good.

I think now I could really push the training. But then sometimes the run the Runeasi could actually be quite helpful in this because sometimes, you know, I've actually this happened recently. I'm getting someone ready for La Sierra. Another it's a 100 mile race, trail race here. And I remember was it when I was working with him two weeks later, he was like, man, I feel like I'm good to go.

I feel like I need to start pushing it. I know it's in July. Let's but I I feel really soft. But as we were looking at his running, I mean, there was the compensations were still very present, very messy. I mean, to keep that simple, it's a very messy running pattern with a lot of asymmetries and a lot of, like, limping.

Let's just put it that way, simple. And then I think that helped him realize, you know, maybe we do need to take our time because I think what's helpful with doing a run assessment is when we work with runners or when we help runners train, a lot of training is based off of the engine. It's based off the aerobic system, right? If you think about a lot of training, it's like, okay, I mean, we could talk about paces, but a lot of it's based off like heart rate zones and people will base it off of that. But if the limiting factor is not the engine, but rather the body part, maybe we should base the training off of the weakest link.

And I feel like doing a run assessment continually, right? I'm not doing it once. I'll be looking at the running throughout the time. Really gives a good lens onto the capacity of the body. Cause that's a majority of the people that I work with.

They're not necessarily limited by their aerobic engine. They're they're limited by, let's say, limited tolerance to loading through the ankle, knee, hip, Achilles tendon, whatever.

Jimmy: So what does that look like in practice? How do you do that?

JP: Let's see. Well, the London Marathon happened recently. That was crazy, right?

Jimmy: It was insane. Yeah.

JP: But I remember two years ago when I was prepping someone for the London marathon. Very interesting case. I'll spare the details for now because we won't have done, you know, all these cases, there's so much depth that we go into with it. But with this person, I remember she was getting ready for the London Marathon and her goal was just to be able to run it at this point. Because I I think I started working with her two, three months prior and she was having pain with, you know, running.

It was interesting. She was like, And then her goal was to Boston qualify, not for that race. She just wanted to run it at that point. Because, you know, you spend a lot of money and, you know, to to get into the you know, to investment to run those races. So she still wants to run it.

And then run-in CIM, so that's a California International Marathon, for a lossing qualifier. What's interesting is when I was taking her through this, as she was this was roughly six to seven weeks out from the race because I've already gotten baselines of her running. And I noticed that as we start, typically in the last eight weeks, you're trying to basically build, right? You're trying to build the intensity in whatever aspect. But I remember she was working on her peak because two weeks after that, anyway, she was building up and her running was pretty her baselines look good because that's what I kind of sometimes treat it as.

I treat it as like, okay, I expect some things to probably drop a little like symmetry, all that type of stuff, but I want to kind of maintain as we're getting into training at this point if injury isn't the issue anymore. But what was interesting is toward that sixth week, I noticed like a really big shift in her like running. Like the, you know, to keep this one simple, the symmetry was like really off. Usually it was pretty good and then all of a sudden it was consistently like lower. And so but the thing for her training was like, okay, she was supposed to go into her peak week was two weeks after that moment or supposed to be.

But how did we navigate her running from that? So for her, we noticed that the symmetry got decreased, you know, it decreased a lot more specifically at that moment, specifically with running faster. She was dealing with like a posterior tibialis tendon, tendinopathy, But it didn't really bother her too much with easy runs. So what did we end up doing? Well, I kind of, when I work with people, you know, yeah, I could be both a physical therapist and coach, but for this person she had a coach.

But then I also look at the coach's schedule and I'm like, Okay, well, based off what we see here, maybe what you do is you're supposed to peak at, I don't know, I think it was like 50 miles per week. Maybe you maintain the 50 miles per week, but we cut out some of that intensity work because that seems to be affecting this. And what's interesting is sometimes this goes hand in hand. She was like, You know, I was thinking that I have been feeling a little bit of achiness in area, but sometimes I think that's just like, I don't know if I should push through it, whatever. But intuitively, I agree with you.

I think that's a really good idea. And then you know, when I checked her three weeks later, as we were getting into more of a tune up thing, the symmetry already like improved and actually was feeling much better. So I think we were able to then, talking when we looked back, it's like, you know, if we didn't make those changes, she probably would have gotten injured prior to that race. But what ended up happening is, yeah, we took it a little easier, but what ended up happening, she ended up Boston qualifying at, at London. So she actually was able to, she did less than she anticipated to do preparing for the race, but she ended up doing way better than she thought she would ever do.

Jimmy: I love that. Yeah. And that

JP: And that's the idea that, you know, training is about training where your body's at, not where you want it to be.

Jimmy: Yeah. I love it. With the in that that case, how often were you assessing her gait?

JP: Sometimes I don't even sometimes I'll do, like, tune ups right before race. I don't even bother looking at it at that moment. It's just not worth it. It's just not worth it. But for her I mean, it it depends, you know, on the context of the person.

But when someone's in training, typically I'll see them every two to four weeks, probably barring especially if they're feeling pretty good and there's no volatility, I'd say it's more along, like, weeks time.

Jimmy: Yeah. And you're gonna

JP: for her, it was more every other week. I was still looking at her running. And I think the important context was I wasn't changing it. I was just I think we got it good enough

Jimmy: Yeah.

JP: For Jay. Because that's part of this too. It's not it's about navigating the injury, but also getting them ready for the race. You can't do nothing and then expect to run a marathon the way you want it to.

Jimmy: Yeah. So I like that use case where you're using it to, like you said, as another you're using running assessment as another metric to help guide training loads. So you saw something change. You had baseline data on that runner. You saw something change to something that didn't really look like it was heading where you wanted to.

So you helped her adjust and kept her running. Yeah, that's great. That's really cool. Let's start to wrap up here and say like, I want to circle back to your Instagram account and you Yeah. That resource there.

Because I do think it's a valuable resource. I pulled it up actually this morning for a runner. Was working, had a early appointment this morning and he's getting back to running after a stress fracture. And I pulled up one of your posts just to show him this like the flaws on the standard way of thinking about flaws is maybe we can challenge that a little bit. And it was really helpful for him.

So I think it's a great resource that you've put together. It sounds like selfishly like for you to have that point to your clients, but then for people like me and our listeners, hopefully, I would encourage them to check it out because it's really cool to just see the variability in running mechanics, especially when you can point at an elite runner and show, oh, look at this pronation. This runner's ankle is basically hitting the pavement with each foot strike. Was that the intention with the the Instagram?

JP: Well, it depends. I'd say it's like free flowing, but that's kind of where we're at right now with it. And it's interesting because that's how I think I get a lot of messages from clinicians that use it in that manner. They like to pull it up just to show their clients like, Hey, look at this person run, or How you're running really stiffly? Well, watch this person look at the It's okay to move side to side.

You could see that in that front view.

Jimmy: Think that case right there, it's like a really good tool to You've curated the content for us to help us reassure our patients that their running form is okay. Yeah. So keep doing I love it.

JP: Thank you.

Jimmy: JP, thank you so much for your time today. For the listeners who don't follow you, where can they find your work?

JP: I mean, I'm on YouTube, Instagram, I think TikTok, just kind of post all the same stuff. I'm most active on probably in terms of on I'm most active on Instagram. So you could find me. I don't know. If you pull up, like, JP Gloria, it'll probably pop up.

So, technically, I think my handle is JP Gloria. So j p g l o r I a dot d p t. I'll pop up for Instagram. If you search JP Space Gloria on YouTube, you'll find me there.

Jimmy: Cool. We'll put links to this in the show notes. Yeah. I would encourage everyone to check it out. Again, JP, thank you so much for your time.

Really appreciate you coming on there. Hope you have a great rest of your day.

JP: You too. Thank you for having me.

Jimmy: Of course.

Jimmy: That's it for today on the Physio Insights Podcast presented by Runeasi. Would you like to share

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