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Wanted: Physiotherapist Associate 

We are looking for the right physiotherapist to join our growing team.

Hours: 10-20 hours/week or more if desired.  Flexible in terms of days and times. 

We are hoping to find an evidence-based therapist with strong work ethic, who works well independently, is motivated, possesses good people skills, and has a keen interest in the science of injury management with a focus on active care.  Acupuncture is an asset. 

We are also hoping to find somebody who values patient care above all else, and is easy to get along with and contributes to our positive work environment.  We want a great teammate! 

Learn more about our clinic and club we are associated with: www.drdelanghe.com www.health-performance.ca

Included:

  • Jane practice software
  • Full time reception during regular office hours
  • Access to office after hours 
  • Your own treatment room 
  • Access to gym space for 1-on-1 sessions 
  • TENs and acupuncture needles 
  • Payment: Percentage split with ceiling 

Send Resumes to: info@drdelanghe.com

Dear Patients,

It’s time for an update.  As many of you already know, our staff is contributing to Canada’s dwindling population growth!

We’re excited to let you know that Dr. Sean and his wife are expecting their first child in early August, while physio Sayaka and her husband are expecting their first in September.

That being said, we want to make sure you all are taken care of during this busy time. 

What this means for office hours:
(1) Dr. Sean along with reception will take the first week of August off with reduced hours in August.  

  • If the baby comes as expected, no changes will be made.  
  • If the baby comes at a different time your appointment will have to be moved accordingly- we apologize for any inconvenience this may cause! 
  • During the time Dr. Sean is off, physio and RMT will still be available at the clinic if you are in pain and cannot wait.
  • We will also have an emergency chiro available- details TBA. 

(2) Physio Sayaka will be taking about a year off closer to September.

  • We have high standards! If the right person comes along to cover her mat leave, we will bring them on board.
  • Otherwise, full time hours with Dr. Sean, RMT and occasional hours with physio Kayla will be available to keep you in one piece in the meantime. 


As always, you can book online, call (519) 885-4930 or reply to this e-mail if you you need to reach us. 


Yours in good health,


Dr. Sean Delanghe 

waterloo physio sayaka tiessen


By: Waterloo Physiotherapist Sayaka Tiessen

No, I’m not talking about this season’s hottest Balenciagas, and I’m not even going to get into the carbon plated shoe thing. (Side note: a lot of interesting studies about their efficiency have come out, as have some important discussions about equity in sport.)

We are going to just have a straight talk about your running shoes – what to look for when buying, how to screen for lemons, and injury considerations. Get ready to nerd out!

What to look for when buying

  1. What is the purpose of the shoe you are looking for?
    • A trail shoe for grip and stability? A plush road runner for pounding the pavement? A racing flat or track spike to break the speed of sound? Know what you are looking for to help narrow your search.
    • Stability shoe or neutral? Or dare I say, minimal? This is a complicated question and one where I would look at your previous shoe history and maybe stay within it, unless a change is recommended by your health professional. For example, I know people with pancake flat feet who were put into a stability shoe and it caused more problems for them, so having flat feet DOES NOT mean you need a “motion control” shoe. If you have orthotics, you should go with a neutral shoe 100% of the time so that it can function the way it should. Perhaps get your feet checked out by your health provider if you are in doubt.
  2. Shop when your feet are the largest, and bring anything you typically would have on your feet when you run
    • Your feet tend to get a smidge larger as the day goes on, so plan your trip to your local running shop for the afternoon or later in the day if you can.
    • BYOS – bring your own socks, specifically the types of socks you would wear while running. This will give you a much more accurate feel for the shoe and fit. If you wear orthotics, an ankle brace, or special heel lift in your runners, bring them!
  3. Brand loyalty is ok to a point, but keep an open mind (unless you are sponsored, which I am not).
    • Most companies will tweak their models with each new iteration – new foam! a different upper! a whole new last! There is no guarantee that a shoe will be the same from year to year, meaning it might not provide the same type of ride.
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4. COMFORT IS KING- No matter how much you try to convince yourself, the shoe will not become more comfortable over time. Don’t ignore hot spots, rubbing, and sliding. These will become your nemesis. See how your foot sits on the insert. This is a fun trick I learned from listening to Chris Johnson, a PT legend in the running field. Just take the insert out and place your foot on it. What do you see? If your foot oozes way beyond the borders of the insert, it might be too narrow. In this photo, you can see that my foot is a bit wide relative to the insert, meaning my toes are going to scrunched together once in the confines of the shoe. I have wide feet and finding a shoe that fits is a tough quest, but some brands do fit wider than others (Altra, New Balance to name two).

How to screen for lemons

Sometimes life gives you lemons, and that’s ok if you know how to screen for them to avoid being saddled with a pair of defective shoes. You might get some odd looks if you try these in the store, so bring the shoes home, and in a reasonable, non-Hulk manner, put them through their paces.

The video posted below is a sequence of tests developed by physiotherapist Bruce Wilk. Some of my favorites are:

  1. The Break Test: This is to see if the shoe breaks at the level of the toes and not in a weird place like the mid foot. It shouldn’t be overly stiff either. This does not apply to minimalist shoes as they will fold up like a piece of origami.
  2. The Twist Test: Mostly looking for symmetry here
  3. The Rock Test: This is to see if the shoe is sitting evenly on the surface. Press straight down and apply a bit of a rock left and right. Does one shoe start tilting a lot?

WATCH MORE HERE.

What if I’m injured?

There are some footwear considerations when it comes to dealing with injury. I will mostly be talking about drop, which is the height difference between the heel and the toes. Most shoes will describe the drop in mm. Below are a few considerations about heel-toe drop and how it might play into injuries. These are generalizations, so take it with a grain of salt!

Zero Drop (aka a flat bottom, not necessarily no cushioning. Remember, we are talking about the difference in height between the heel and toes)

  • Places more stress on feet, ankles, and the Achilles, so if you have any issues in these areas, it might be best to avoid this type of shoe.
  • Good if you are dealing with knee issues, or have a stiff first toe because the shoe won’t bias you into slight extension.
  • If you are new to zero drop shoes, it is important to gradually introduce them into the shoe rotation because you will probably get tight calves when you start using them.

Regular Runner with a Drop (the vast majority of shoes)

  • Places more stress at the knee, so if you have cranky knees, consider avoiding this type of shoe.
  • Good if you are dealing with an Achilles injury, or plantar fascia pain because it will put your posterior chain on some slack.

Cushioning or Barefoot/Minimal?

  • Cushioning is best if you are: recovering from an injury (notably any bone stress injury, plantar foot pain), have osteopenia or osteoporosis, are new to running, or are planning on doing the vast majority of your runs on pavement*.
  • Barefoot is something you can work towards if that is what you are interested in. I know people that love the tactile sensation that going more minimal gives them. *you can run in barefoot/minimalist shoes on pavement, but you must give your body time to adapt to the stress.

THE TAKEAWAY?

The most recent studies suggest the best shoe for you if the shoe that FITS, meaning you won’t subconsciously change your gait to avoid that nasty blister on your toe. I know you love that hot new colourway from (insert whatever brand here), but if it has a weird break pattern, or it feels uncomfortable in the shop, it is highly unlikely to EVER be comfortable. Take it from me – I have made that mistake a few times in my career.

Give this post a share with anyone you know who is eyeing up a new pair of kicks. Live in the Kitchener-Waterloo area, dealing with a running injury and want to get a plan in place? Book your appointment here.

Here is an updated, simplified version of our protocols as of July 2023.
 
  • Masks are no longer mandatory.  
    • Practitioners will either wear a mask or mirror what patients are doing.
    • All staff will wear a mask upon request.
    • Please wear a mask if you suspect you have been in close contact with a sick person. 
  • Do not enter if you have tested positive for COVID-19
  • If you are actively sick with COVID-19 or otherwise, please reach out to re-schedule. 

As always, we have virtual appointments available if needed.

Thank you!

Nowadays, most runners use some sort of social media as a part of their running lives.  Whether that be posting your runs on Strava, updates on Facebook, or post-run selfies on Instagram, the number of runners who do their thing with an absolute zero online presence seems to be dwindling (but they are out there)!

Over the last few years, I’ve been encountering discussions more and more frequently with the athletes I coach, so I figure now would be a good time to discuss this topic: Is posting on social media about your running a good, bad or neutral thing?

Before I get into some of the research, I would like to preface this article but saying that I don’t have a good answer, as I normally would, with clear science (like how many grams of carbs you should take for optimal performance). The reality is, the use of social media is highly individualized and requires real self-awareness and self-reflection to decide how it works for and against you and your unique situation.

CLICK HERE to read the rest on the Run Waterloo blog. 

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marathon

By Rachel Hannah, RD, DIP. Sports Nutrition IOC

There are a lot of myths around carb loading. That confusion mixed with pre-race nerves, and you’ve got a recipe for a tummy disaster. But carb loading is actually pretty straightforward. There are a few key numbers and rules to follow so that you’ll have all the energy you need to start your quest for that big marathon breakthrough.

What is this “carb loading” I keep hearing about?

First, let’s start with removing the shroud of mystery around the carb load. What the heck is it, and why do marathon runners do it?

Simply put, to carb load is to put a bigger emphasis on getting in an increased ratio of carbohydrates in a couple of crucial days leading up to a big distance race of over about two hours, like a half-marathon for most, and certainly a marathon. The reason for doing this is to make sure your body is full stocked with something called glycogen, which is the energy used by your muscles to fire during your run.

Glycogen is your storage form of carbohydrates and the body can only store up to a certain amount, making fuelling throughout a Marathon distance race very important. Ever heard of the infamous “wall” runners hit when the marathon gets really tough? That wall goes up typically when your body is depleted of glycogen. It’s why races put Gatorade on the course, and its why runners stuff their faces with pancakes the day before the race.

Pancakes… sounds like fun! But how do you get carb loading just right?

Make a Plan

When working with athletes of all ability levels or going into my own marathons, the first thing I do is make a carb loading plan. It’s not necessarily a menu of exactly what to eat, but more of an outline of when to start the load, examples of great food options, and specific numbers that are easy to calculate so that its clear just how many carbs are needed each day before the big race.

Here’s what it looks like:

You should start your carb load 36-48 hours before race morning. So, if the marathon is on a Sunday, begin focusing on carb-rich foods on Friday at breakfast. You’ll hear about athletes going on a “carb depletion” diet for the week leading up to the marathon, starving themselves of glycogen so that, supposedly, their body will horde the sugars thrown at it during the carb load. There are conflicting studies on this strategy, and the science is leading towards saying it produces a negative outcome in most situations, so just eat normally for the period leading up to the carb load.

Keep your calorie intake relatively normal

A common myth is that you should stuff your face during the carb load. This may cause some serious tummy issues and water retention, so instead, just focus on getting the percentage of carbs within each meal and snack to overwhelm the ratio to protein and fat. Fat intake should be kept low (<20% of calories) during the carb load, but you should focus on getting a consistent amount of protein at every meal and snack like you normally would.

Because you’ve reduced you the amount of exercise during the taper, if you maintain your peak season diet, you should be coming in pretty well stocked up on calories.

Focus on the Math

Here’s the magical formula to follow during the carb load:

8-12 g/kg of your body weight of carbs per 24 hours.

So, if you weigh 65 kg (or just over 140 lb.) you should be consuming about the middle range of that formula, meaning 650 g of carbs in a day. A small banana has 14 g of carbs, so you’ll have your work cut out for you to get them all in without starting to hate certain go-to snacks. You’re going to have to find simple ways to make sure you get that amount all in.

Eat what you love

Stick with things you enjoy eating, and I mean really enjoy. Carb loading is the opposite of what you typically would eat to stay healthy. I also need to add carbs that I wouldn’t normally add during the load. This may sound ridiculous, but I will even bring packets of jam or honey with me, and smear them on things like crackers and bread if I feel I’m not hitting my goal carb number for the day.

Use a fitness tracker

Keeping track of all those carbs can be daunting. I recommend either doing the math in advance and making a meal plan for that 48 hours (think of it as fun; you get to eat waffles and maple syrup for dinner!) or use a basic calorie counting app. I rely pretty heavily on MyFitnessPal, a free and fairly detailed nutrition tracking app you can get on your phone that will do the math for you.

Beware of fibre

Crushing carbs can be fun, but you have to be mindful of those with loads of fibre. You’ll want to focus on simple carbs for this crucial 36-48-hour period. You don’t want to pack your guts with fibre before heading to the start line, for obvious reasons.

On the eve of the race, switch to liquid carbs, like fruit juices or sports drink, in order to keep your stomach in check while continuing to get those glycogen stores stocked. Choosing the sports drink you will use during your race is a good idea the night before.
Spread Your Snacking Out

Aim to eat about five or six times per day, spread out, particularly if you have pre-race nerves and your digestion is slowed down. Focus on eating every three-four hours, but feel free to snack a bit in between and take in fluid.

See the carb load as the final fun workout

Just like training, view the carb load as a sort of food workout. Stick to your numbers, stay focused and see it as the final building block in order to have a big breakthrough in your goal race.

Rachel Hannah is a Pan Am Games medallist in the marathon and a registered dietitian.  Learn more about her HERE or book online HERE. 

 

 

4 months later, and here we are!  With many of the fall races now officially cancelled, this article is even more relevant than when I originally started to think about this the topic of how much one should train in a time of uncertainty.  Of course there is the chance that something will happen race wise, whether it be in the form of a small group or virtual race.  In the meantime, knowing how much training you should do to maintain fitness is a key question.

No training at all 

With my last article, I looked at just how much fitness we can lose if we completely stop.  You can read the full thing HERE.  In summary, I discussed how:

  • You would likely lose 5-10% of your VO2max in a couple weeks
  • It would take a very long time to lose your running economy
  • The longer it takes the develop an adaption, the harder it is to lose it

How much is enough?

There are many reasons to be optimistic and to believe that non-optimal training will leave you not that far removed from your best performance.  But just how much is enough?

CLICK HERE to read the rest on the Run Waterloo Magazine 

To start things off, I just want to say I hope everybody is staying healthy and happy during this COVID-19 situation!

One of the biggest issues we have been tackling with athletes at H+P is just how hard should we be training right now. With no clear races in the foreseeable future, and the risk of burnout and injury going up when you are training at your FULL capacity over long periods of time, it definitely makes sense to decrease your training load for the time being. However, at what point are you decreasing things TOO much?

Where do you fit? 

Race-Training Ready 

All of the decisions about how to change your training comes down to a person’s individual circumstances and goals. For instance, somebody who is thinking about PB’ing a marathon the second we have finalized race dates will probably want to stay fit enough at a strategically decreased volume so that they are only a few weeks removed from a 12-16week marathon build.

Race Ready

On the other hand, somebody who tends to be exceptionally injury resistant and just enjoys high-level training might choose to keep training at a high level regardless.

Recovery Time 

Then, there might be the person who is prone to injury and burnout and may take this opportunity to detrain to a more significant degree, perhaps even including some major time off, saving their training weeks for when we have a definite set of races scheduled.

With whatever category or hybrid of categories above that you fall into, I am going to take a look at just how much you can expect to detrain at different levels of activity.  Before we get into the effects of training at a decreased volume, we must first look at how detraining actually happens when we do nothing. Understanding the basics of the physiology is not only super interesting (just me?), but it’ll help guide your decision making for how you manage your decreased volume and help you understand why you feel the way you do when you’re coming back!

 

CLICK HERE to read the rest on the Run Waterloo blog.

In light of the COVID-19 situation, we have some time until we know when our next A-race will be.  As a result, some athletes I work with have been analyzing their winter performances and workouts in an attempt to gauge their current fitness and make training plans moving forward.

As I have written about in the past, there are many things other than just your VO2max and running economy that impact what the clock shows on race day.  For instance, I’ve explored how heat slows you down, light shoes make you go faster, stretching slows you down, carbs make you run faster, courses with corners slow you down, how beat juice might speed you up… The list goes on!

With all of those factors, I think practicing a balanced, evidence-based implementation of their principles is important.  We want to have an educated idea of just how much each can slow you down, but also keep in mind the studies are limited in how accurately they apply to us.

With all this, let’s see what researchers show about how running in the cold impacts performance.  The interesting thing to me is that there just isn’t as much research out there as I thought!  Additionally, a key variable to consider is that a cold environment does not necessarily mean the individual is cold (actually often we can overheat by dressing too warmly).  On the other side of the coin, there seems to be more research on performing in the heat, and consistently we know that when it’s hot out, you’re actually going to be hot.  There are also other variables such as traction and weight of clothing that we have to take into consideration in real-world circumstances when running in the cold.   All that being said, let’s see what some of the studies out there show!

Click HERE to read the rest in the Run Waterloo magazine! 

Hello everybody! It’s been a while! With H+P and the clinic getting so busy, time has been lacking, but I’m hoping to carve out more space in 2020 to contribute regularly to my Training and Performance column.

For this article, I want to address a question that I have been getting from a few athletes in relation to the upcoming Re-Fridgee-8er: How much slower does running a loop course vs. a straight course make you?

Over the years, I’ve always tried to analyze athletes’ results in an evidence-based way, especially when it’s related to factors out of one’s control.

training and performance

Whether it be how much heat slows you down, or how heavy your shoes are, it’s good to be as precise as possible. This is crucial because for an athlete to improve by 5% (i.e. going from a 20 to a 19minute 5K), it requires a lot of training and dedication. As I’ve written about HERE, running in hot and humid weather can easily decrease performance by 5%. So if an athlete works hard to improve by 5%, races on a hot day, and runs the same time as they previously did on a cool day without an exact awareness of how much that heat impacted their performance, that can become a very demoralizing day when it should be seen as a positive sign of improvement.

How much do corners hurt?

Specifically, when it comes to corners, I’ve always safely assumed they are slower, but until now I have never actually looked into the exact impact they have. This is especially because I tend to lean toward recommending straight courses when my athletes are going for PBs, BQ’s etc.

There’s a lot of research out there on the topic, but here is the best summary I’ve come across, published in 2019.

….

READ THE REST IN THE RW MAGAZINE HERE

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