
The Beyond Pain Podcast
Struggling with pain? Does it affect your workouts, golf game, plans for your next half marathon? Join The Joe's, two physical therapists, as they discuss navigating and overcoming pain so you can move beyond it and get back to the activities you love most. Whether you're recovering from an injury, dealing with chronic pain, or want to reduce the likelihood of injury tune into The Beyond Pain podcast for pain education, mobility, self-care tips, and stories of those who have been in your shoes before and their journey beyond pain.
The Beyond Pain Podcast
Episode 64: Don’t Burn Out Before the Finish Line: Planning Races Around Pain and Performance
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Summary
In this episode, Joe Gambino and Joe LaVacca discuss various training strategies for clients preparing for races, the concept of peaking in performance, and the importance of managing client expectations.
They emphasize the significance of consistency in training and the need for readiness checks to prevent injuries and ensure optimal performance.
Takeaways
- Training strategies vary based on client goals.
- Peaking is crucial for optimal performance during races.
- Managing training volume is essential as race day approaches.
- The 10% rule helps prevent injuries during training.
- Consistency is key to achieving fitness goals.
- Client expectations should be aligned with their training history.
- Readiness checks can help gauge performance and recovery.
- Communication with clients about their training is vital.
- Adjusting training based on individual responses is necessary.
- Listening to the body is crucial for injury prevention.
Joe Gambino (00:43)
Welcome back into the podcast. am your host and I'm here with the host on Instagram at the Gambino dbt myself and for the co-leader at strength and motion underscore PC. You find this podcast on Instagram beyond pain podcast and on YouTube cups of Joe score P T you're back Joe.
Joe LaVacca (00:52)
Thanks.
Welcome back, man. You're officially back from vacation. I am looking forward to vacations ahead. yeah, man, we're almost halfway done with summer by the time this one rolls out. So it's flying, dude.
Joe Gambino (01:12)
I am.
Yes, yes. See here, you know, I don't feel as stressed about July or August because warm weather will stick around mostly through November and even into December. So we got a really long run away here in North Carolina than I did when I was in New York, obviously. So another clock is definitely ticking for you.
Joe LaVacca (01:46)
Exactly.
Does the Gambino Clan have any other trips coming up?
Joe Gambino (01:52)
We are talking about New York at some point, it keeps getting pushed back. I am the godfather to the Chirreles kids. They're young kids, so they're supposed to be in baptism. That's what was gonna bring it back to New York originally. I don't know when that's gonna happen now, but we are thinking about like a Labor Day-ish maybe, depending on things play out when come into New York. So that's probably the other trip for us this year.
Joe LaVacca (02:16)
Okay, alright.
All right, well, you maybe I'll have to bring my gear into the city. can do like a in-person pod. Maybe we line up some.
Joe Gambino (02:22)
⁓ in person
pod, lift, maybe just lift and pod at the same time. There we go. Yeah.
Joe LaVacca (02:30)
⁓ there we go. I've actually seen that a couple of times now and it seems to go really well. know, chatting
in between your sets and you just crush something and then we start chatting again. And yeah, I like that. The guests we would bring on if we were going to bring a guest would have to obviously be a lot weaker than us. ⁓ So we couldn't be like, you know, out lifted on our own podcast. So we'd have to be very strategic in who we select.
Joe Gambino (02:50)
Yes. Yeah.
Fair enough. Fair enough. I'll think about that. Okay. man. ⁓ I hear you have question for me today. So why don't we dive into it.
Joe LaVacca (03:05)
Thanks
Yes, I do.
So I have a few clients ⁓
this week and next week and probably towards the end of August who have been planning for returns to or competition of like a major race. So I have one client going for an Ironman. He's done them before. He's been very successful. I have another client returning to and what is her?
distance. I don't think it's a half. think the Olympic distance with the Ironman is the shorter one because there's a sprint, there's an Olympic, and then there's the half and full. So I think she's going to try to go for her first either sprint Ironman or Olympic Ironman. And then I have one or two people ⁓ looking forward to returning to some pretty long bike rides or, you know, like these 10K, 20K events. Now all of them
Joe Gambino (03:45)
Mm-hmm.
Mm.
Joe LaVacca (04:10)
obviously have been training with me for a while. We know them from previous injuries. So my question to you is, what would you do with these clients as they got closer and closer to their big race events? Is there a certain strategy or system of thinking that you use? And yeah, I'll just kind of let you take the floor there. You could run with it wherever you like.
Joe Gambino (04:37)
Yeah, so I think it depends on goal, you know, I mean, obviously, like an Ironman or an Old Dress, there's a race and especially if they're to say, you know, okay, I'd to run the race well in this time, right? There's a lot of who look at it differently than like the, this person, who just wants to be to do like a 20 mile bike. I don't know if they're doing like a race, they're trying to like, be in a race or it just like one of those like 20 mile bike tour through.
you know, New York or whatever area, right? So I was looking at those very, differently. If it was somebody who is just doing a bike tour or just going to do like a run on their own. And that's what they're trying to do is really not going to change how I'm programming, know, just kind of fit in. that we just going to find a little bit or you're not going to push that hard to deal with them that week and they can go enjoy their bike ride.
whatnot, a larger change. way, I probably have some rides right to build them up and make sure that they have been in while, have you tried five, you ten, can we try 15 and see how that stuff goes as a building up. For somebody doing a race,
Then things are going to change. I find out from them when they're trying to peak as far as they're like, I always want to know when their training starts to pick up. they're usually 12, six a week, whatever time of the week they're choosing to really pick up their volume and practice the race. And during that period of time, volume has to significantly drop from a strength training perspective. So sessions will be shorter.
Joe LaVacca (06:02)
you
Joe Gambino (06:21)
They'll be made lifts and to help open up mobility to keep them feeling good and that's really it, right? It's just a matter of keeping them moving well and feeling good in between their training because obviously at that point the inputs from a workout or fitness or goal perspective has to be specific to a contract. If someone wants to go out and be that guy, man, they're like, hey man, I want to crush this and I want to, you know,
hit my best time ever, right? Like you need to let them have that time to create those, those adaptations. And that's not the time to also create adaptations. You don't want to take advantage the gym, but you need to manage and modify it. And training at the point, like how we keep feeling good? How can we keep your mood pattern well, as you're doing this more sports training. And that's really how I look at it overall. It's like a high level overview.
Joe LaVacca (07:12)
Yeah, I think what you said there resonated with me. For a lot of people, peaking, right? That was a word we've heard thrown around. How would you explain peaking to clients or maybe to some healthcare providers who are listening just so they get an understanding of like, you know, organization?
Joe Gambino (07:28)
Yeah.
Yeah. So peaking is kind of you're going through this particular training over whatever period of time. So that at the time of the race or the event that you're doing, you are hitting your your peak of. Your performance at that point, right? So this way, when you hit the race, you've done all this training that has led up to a certain point.
where you're going to be running your fastest time. You're going to have your best endurance. And then anything after that, right? There's going to be kind of like a drop off because you've peaked, you've hit, you you've, you've kind of crushed your nervous system to a perspective and then you'll have some recovery as you're in between events. Same thing. If it was like power lifting or Olympic lifting, you go through this training cycle. And by the time you hit your event, you are going to be, that's when you like, you're testing your one RMs, right? Like you're trying to peak and hit that higher level performance.
And then you kind of reset, you do some more general prep work and kind of cool off and then you just kind of cycles, right? It's like until the next event, so to speak. So that's how I would kind of describe how peaking in a sense.
Joe LaVacca (08:29)
Yeah, I like the other thing you said too, almost like the goals, right? So keeping the end in mind. And if I have a client that I've been training and they give me enough heads up, because sometimes they just genuinely forget and they're like, hey, I forgot. I have an Ironman this weekend. And I'm like, Ooh, no, probably not a good thing that you did your EMOM, AMRAP workout like the day before. ⁓ But assuming they give us enough leeway programming out or starting backwards, I've always found this helpful.
Joe Gambino (08:46)
Ha ha ha ha ha.
Mm-hmm.
Joe LaVacca (08:59)
You know,
like I know like that week, whatever programming you're on, whether it's deadlifting or squatting or benching, you know, maybe the week before, maybe two weeks before, depending on the person and their schedule, I'm going to try to keep that intensity up, right? So I want them to still sort of lift a little bit heavy, but maybe I switched into more mid range movements. So maybe it's more box squats instead of full rep squats so they can kind of stay fresh to your point. You know, maybe it's some like good morning pulls from the rack.
Joe Gambino (09:19)
Hmm.
Joe LaVacca (09:28)
you know, just so again, so they're keep priming their nervous system for these outputs, but it's not taxing them from a really heavy recovery standpoint. And the other thing I found kind of helpful is instead of torching them with some, you know, finishers that are going to leave them huffing and puffing, they're already getting a lot of that during the week. So these isometrics, I find that people typically, you know, like a lot more towards the end of their sessions, definitely the mobility work. So I've gotten there with people too. so that's
kind of helpful to hear. Is there ever a time or when you're working with a client where they say something like, Hey, I want to do this Ironman or I want to do this, you know, this bike race. it's beginning of September. And I'll share a story with my ⁓ client has been working super hard pushing it. She's doing so, so, so awesome. And she wants to do this 70 mile race by, you know, like September or so. So
Joe Gambino (10:09)
you
Joe LaVacca (10:27)
working backwards from where she's at now, she's at about 25 miles. So it would be about a nine mile, you know, distance jump per week to even kind of get her remotely in the ballpark for like a 70 mile race. So, yeah, it didn't seem too aggressive for me. You know, maybe we're just outside those like little 10 % jumps, but in your mind, when you're trying to squeeze something in for a client, do you have a rule like a
Joe Gambino (10:36)
Mm-hmm.
Joe LaVacca (10:52)
Hey, I don't want to jump their volume more than 10 % a week. I don't want to do it more than 20%. Is there a little like Joe Gambino system of approach or thought process? Or again, is it really probably pretty contextual at that point?
Joe Gambino (11:04)
Yeah, it's pretty contextual. think it's based on the person's symptoms. I mean, if they're 25 miles and there's not really pain when they're running and you're guys are working on other things, then you don't really at the 10 % rule probably doesn't really fully apply. Right. Like 10 % rule in rehab, right. Is to make sure that you're not flaring up and doing too much too fast. So this way you can figure out when you hit that point of like, this is your tissue tolerance and now we can train that level. Right.
Joe LaVacca (11:11)
you
you
Joe Gambino (11:33)
If this person is 25 miles and doing pretty well, maybe, I mean, sure, maybe a nine mile, like jump every single week for two months could give them some pain. this is what the conversation to have with these people is here's the risk reward.
Joe LaVacca (11:50)
Bye.
Joe Gambino (11:50)
Cycle
here, right? Like you really want to do this and that's perfectly fine. But you probably should expect that if we're pushing the needle here to get you to this race, that something might pop up. And as long as you're OK with that and we're going to kind of go through it and really our goal for PT right now is we're going to put you in like we're going to manage symptoms. How can we manage them to bring them down a lot to continue to go to your race if this is something really important to you? There are always going to be risks in the future. So if you feel right now with where you are that doing this race is important.
And you want to go do it and fine by me. Let's, do what we can. As long as things aren't really hitting the fan, you're, you're paying getting so bad where you're not even going to be able to do the race anyway. Then, you know, obviously then you have that conversation. And maybe the expectations for this person is, know, this year, maybe it's like, you just want to get through this one, right? Where you're not going to be aiming from a performance perspective. Like even if you're not running 50 miles in your training, right? Like you get yourself as prepared as possible. Maybe you run most of it and walk some, but at least you get it done. And then next year, when trust comes around.
Joe LaVacca (12:37)
Right.
Joe Gambino (12:50)
you're aiming for the higher level performance if that's the goal, or like you want to get your mile time down or do this under a certain time. So again, it depends on the person's goals and what they want. if in that case, I say, hey, listen, listen, let's get you there. ⁓ You may need to take your expectations because this probably isn't going to be like your best performing run that you've ever had because you only have two months to get prepared. Your knee is not in a good, mean, two months is really not that bad of a time to prepare for a race.
Joe LaVacca (13:17)
Yeah. Yeah.
Joe Gambino (13:17)
⁓ But if
they haven't done that in a while and you're worried about flare ups and stuff like that, then there has to be some room to kind of back off on and stuff like that to make sure that she can get to that race without pissing off whatever body part it is by the time she gets there.
Joe LaVacca (13:31)
Yeah. And that's what's interesting about all these like little rules with progression of training, you know, with, with weight training, you know, I'm typically guiding people on like, Hey, let's try to go up like 2 % a week, maybe max 5 % on some of your, your weights and reps or sets for running. We've heard like this 10 % rule for a really, really long time. And actually, I don't know if you saw it, but last week, there was a study that came out, I think about 5,000 runners and what the biggest advice or what
Joe Gambino (13:34)
.
Joe LaVacca (14:00)
One of the biggest advice pieces ⁓ from that article seemed to be was to not have runners jump more than 10 % of their longest run over the last 30 days when it comes to their training. So in each individual training cycle, you look back 30 days, hey, what was your highest run? All right, cool, we don't wanna jump more than 10 % of that in any given training session. So I thought that was kind of interesting. But then with my client now, the one that I mentioned, is that the same for biking?
You know, is that, is that 10 % rules same for biking? mean, you know, sometimes you could be again, coasting through some of your straights, maybe get some downhill and you're not pedaling, you're not working, the bikes doing a lot of that work for you. So I think that's where the expectation factor really comes in that you pointed out that look, according to the math here, this is what we would have to do to kind of jump you up week to week at a
Joe Gambino (14:38)
Mm.
Joe LaVacca (14:56)
even remotely safe clip. However, this is if a perfect cycle of events happens, right? Like you're sleeping regularly, you don't feel over trained, you are eating the right amount of food, nothing happened with your kids, you didn't miss a workout session, the list goes on and on. So I think the shorter the timeframe, setting expectations is so important. But then we're also really hedging our bets that, for these next eight weeks or
however many weeks, things have to go perfectly. And then maybe if they're not, well then maybe we gotta think about maybe pulling out of this race or what's the next one? And to share one other story, I have another client who is sort of looking forward to that Ironman, that shorter distance one, hasn't been as consistent with training. So now my concern with a message I get today is, hey Joe, I'm gonna go real heavy into my tri training now.
Joe Gambino (15:34)
Mm-hmm.
Joe LaVacca (15:54)
I got to fit it all in. I'm going to be starting to do two a days and she hasn't really been consistent. So I messaged her today. We haven't, I haven't heard back from her is that, is this, is this the best path forward for you? Is this the safest path forward for you? You know, what's the next race? What, what else can we look forward to? Because I know how hard she's worked to get out of pain. I know how much she's juggling with, you know, her life and her family and her work. So I expect all those things to stay the same and then to throw in suddenly two day a week.
two times a day workouts just to get you to a point. I don't know if that's going to be the best fit for her. So hopefully we can kind of collaborate on that, come up with a plan, maybe, maybe think about pushing this race out a little bit. You know, obviously you and I can't make a decision for anyone, but all we can sort of do is say, reflecting back on your last eight, 10, 12 weeks of training, I don't have enough data to confidently say, Hey, yeah, two, two a days are going to be perfect for you. Cause I remember.
Joe Gambino (16:38)
Yep.
Joe LaVacca (16:52)
summer camp with football and even doing summer camps leading up to our sleep and wake camp, we started doing two a days. I I was completely toast and I was doing a ton of conditioning to even get to that point. So two days for me at 16 were almost impossible. And I can't even imagine as a working mom, kids, supporting all the things that you have to do in life and not being as consistent what that could do to you.
Joe Gambino (17:18)
Mm.
Joe LaVacca (17:22)
Hopefully we'll be able to come up with some ideas for that. But have you had to have that conversation with anybody or recently?
Joe Gambino (17:32)
Yes, I actually asked recently I work with the runner who runs a bunch of he's an ultra runner and He had a little like hamstring It's really no bruising swelling. It's just a little sore. It's getting better day by day. Yeah, it is already Sunday's like, you know, I'm even worth it not gonna run it I was like and then I told him to do a test run
yesterday I haven't yet or not I was like I do test run see how it feels if you get him better every day and if you want to do the reason that's okay he's like no do it so that was an easy conversation I'm to have it he was fine he's but I have whenever I have conversation someone they have if they already have it booked
Joe LaVacca (18:01)
Right.
Joe Gambino (18:21)
I say, these are the two outcomes here. Here's a risk reward. If you want to do it like, oh, do it, but you need to understand that there are going be some hiccups on the way and that there are some pain, and we just need to make sure that we're managing here. As long as they're okay with that, then I mean, it's fine, right? As long as they're not doing more harm than good at that point, right? And the pain is not picking up and getting to a place where they can't do what they want to do. And I think that's the big thing.
I know you all turn up, but that's really where I'm at. ⁓
Joe LaVacca (18:52)
Cool. Yeah, no, I mean, I completely agree. Yeah, no, I completely agree. I mean, obviously our number one job or the way I explain my number one job to people is to be a guide, but
to be a guide that best serves you to stay safe. And, you know, we've talked about it numerous times on the podcast. We see it all the time. The thing that's going to get you to your goals is consistency. So if we blow up and now we can't run or we can't train for two weeks, three weeks, four weeks.
Joe Gambino (19:18)
and
Joe LaVacca (19:22)
you name it, that's going to be the quickest way out of consistency. That's going to be the quickest way out of reestablishing your lifestyle and behaviors that you've been working towards. And then we're sort of like back maybe stuck in that rut or back kind of feeling hopeless or back kind of then now dealing with provider after provider who wants to do what to us with braces and boots. And as we talked about last week or two weeks ago, you know, then who's going to start to say, well, hey, you know, running it just isn't for you. You know, you're not the body type or
your knee has too much arthritis in it or your this has too much degeneration in it and really you just never gave yourself enough time you know to be successful or to even have the opportunity to actually fail so I think that that's definitely a valuable piece and I appreciate you sharing your thoughts with us buddy.
Joe Gambino (20:12)
I will share this because I was actually curious about it and we'll have to take a look at the GERNASAL because it's a customer from JGBT with no background looking at the data here. But I was actually curious where the 10 % rule came from. Do you know, Joe? Or is this a mystery for you as well?
Joe LaVacca (20:28)
I believe, mean,
story I built up into my head was the acute chronic workload ratio studies. ⁓ And I want to say they were from like Tim Gabbitt and his group back in the day that suggested that whole kind of like 10 % jump day to day, week to week sort of thing. But please educate me Mr. Gambito.
Joe Gambino (20:48)
Yeah, so
according to this, she originally came in a, out of the running community in 1976, we'll call it woman's running. Yeah. And so was pretty much just, she's a doctor and really after seeing that, she's breakdown, they went and added some more suits. So she came up with the 10 % jump in mileage over time. And really it seems like from this that the research is not super.
Joe LaVacca (20:58)
Love it.
Joe Gambino (21:18)
So again, it's a guide but the 12 % is I can be that know, it's is 10 can be too much for somebody to write so there's always a little room for There's gonna be room to let them go and it all comes down even the practical takeaways is actually pretty good tracking soreness and pain for you know within the first 40 hours of when it happens That's probably the bigger sign than anything because if you do all these jumps on the sun orness in your pain
Joe LaVacca (21:26)
Correct. ⁓
Joe Gambino (21:46)
taking up and it keeps lingering and sticking around and things are feeling worse and that's a pretty clear sign that you're overtraining that tissue and if none of that stuff is happening or there's some little bit of soreness and after a couple days of rest you're back to baseline, you go do more runs, you can kind of keep going up then it's probably going to be fine, you're probably not going to really run into much issues. I really think it comes, you know, for me a lot of it just comes back listening to the body, the pain guidelines that we talked about a thousand times in this podcast.
Joe LaVacca (22:11)
Yeah.
Joe Gambino (22:14)
And I think when we use all of these things in tandem, where you kind of get a quick picture of when we need to back off a little bit, when you can push a little bit harder, when you can continue on your journey and all those little things.
Joe LaVacca (22:25)
Yeah, I think the little extra nuance there I would add with the pain piece is just how are you feeling during your training? You know, if you start sleeping like shit, if you start feeling like shit, if you know that you're irritable, if you know that you're lashing out at your kids or your spouse or you're calling out sick from work, you know, you don't have to have pain to have your body kind of let you know that it's not in a good place.
So whether that's days off, whether that's working with a coach for programming, whether that's getting your nutrition dialed in, you name it. But I think on top of those little pain rules that we push a lot, my general sort of rule of thumb is just to ask people a generic question, how are you feeling? Do you feel any different than you normally do over the last two, three, four months? And if you do, then maybe it's.
that early warning sign, maybe it's even a precursor to pain because we do know now even with some of these other studies coming out with pain and tendonitis and these systemic changes with arthritis, mean, blood panels of people who are sick, depressed, overly anxious, match a lot of the blood panels and draws that we take from people with tendinosis, tendinopathies, arthritis, things like that. it is, I think, kind of pushing a little bit more into this whole systemic effect with people and I that's definitely something that we...
want to keep a lookout for.
You're muted.
Joe Gambino (24:06)
I a crying baby back there. Yeah. So I really like what you were mentioning about like having this, was almost like your readiness check instance. Um, because that goes on top of everything else, right? It's how you're feeling and energy levels and all that stuff. And those are all good indicators on even just overturning in general. I we took injury out of equation. These are the things that we're going to be tracking to make sure that, you know, if we are going back to trying to peak, right? Like you need to track these things because all of sudden, if you start to see and you're getting closer to a race,
Joe LaVacca (24:13)
Yeah.
Joe Gambino (24:34)
And all of a sudden your times are going down and you're feeling groggier and you're feeling heavy and you're feeling irritable, right? Those are signs that you're you've actually probably overdid and you've already peaked and now you're getting into that phase of overtraining, right? So you're going to back off and kind of try to come back up. So that's some of the scale of being able to kind of peak and stuff like that. So it's the same type of quality here. So even if we remove injury from the perspective, we're looking at performance only.
Joe LaVacca (24:38)
Yeah.
Joe Gambino (25:02)
It's the same stuff that we talk about here, right? It's just at a different level. So we're making sure that we're paying attention to all that stuff. All these little pieces give us clues to where you are on the journey and if you're gonna get hit those goals or not, or, you know, and how we can start to modify and move around them.
Joe LaVacca (25:20)
Absolutely. All right. I think ⁓ that's what I wanted to ask you today. That's all I got to say for the moment. Mr. Gambino, anything else that you'd like to add? All right. Well, Joe, love you. Good to have you back. Listeners, we love you. Thank you for joining us again on the Beyond Paid podcast. And don't forget to tune in next week for another exciting episode.
Joe Gambino (25:29)
Take us home.