When the question every injured runner is afraid to ask, "Do I have to stop?", finally gets a straight answer, it turns out the real story has less to do with the pain itself and more to do with everything the runner wasn't tracking.

Dr. Andrew Fix sits down with Dr. Vikash Sharma, DPT, founder of Perfect Stride Physical Therapy in New York, to talk through managing running injuries, avoiding stress fractures, and building a smart return to running after time off.

Stress fractures get missed more often than they should, and the clue is usually hiding in a two-minute conversation about nutrition and training load. Has your mileage gone up? Has your food intake kept pace? For a lot of runners, the answer to that second question is no.

For soft tissue injuries, Sharma's approach is less about stopping and more about finding a sustainable baseline, trimming the run, filling the rest with cross-training, and using that window to build the strength and mobility that likely broke down first.

The conversation also covers training load management, deload weeks, why most runners' strength work stopped producing results long ago, and what a real return-to-run progression actually looks like.

Find Dr. Vikash Sharma at @vikashsharma_dpt on Instagram or at perfectstridept.com. His clinical education platform for coaches and clinicians is at runningforlifeeducation.

Quotes

• "Runners run. That's what they want to do, and they'll keep running until the wheels fall off." (09:48 | Dr. Vikash Sharma)
• "If two months ago you were running X amount of mileage and now you're up 75% from that, but your nutrition hasn't really changed at all, and now you're starting to get signs and symptoms that make me think you have a bone stress injury, a hundred percent we're shutting it down." (10:39| Dr. Vikash Sharma)
• "Just like training their musculoskeletal system, just like training their nervous system and their brain — we got to train your gut as well." (22:13 | Dr. Vikash Sharma)
• "Your low days need to be low so that your high days can truly be high days." (32:53 | Dr. Vikash Sharma)
• "There's always a story behind this human. There is a human in front of you. Just get back to that human element and dig — a lot of your questions will get answered the more they're talking to you." (54:23 | Dr. Vikash Sharma)

Connect with Dr. Vikash Sharma:

Perfect Stride Physical Therapy

Follow Perfect Stride Physical Therapy on Instagram

SideKick Tool

Movemate: Award-Winning Active Standing Board

15% off Promo Code: DRA15

RAD Roller

Revogreen

HYDRAGUN

Athletic Brewing

20% off: ANDREWF20

Connect with Physio Room:

Visit the Physio Room Website

Follow Physio Room on Instagram

Follow Physio Room on Facebook

Andrew’s Personal Instagram

Andrew’s Personal Facebook

Podcast production and show notes provided by HiveCast.fm

Most runners are one bad training week away from an injury they never saw coming, and the way they think about shoes, strength, and recovery is probably making that worse.

Dr. Drew Short specializes in working with runners at PhysioRoom, and his approach to running injury recovery starts somewhere most people wouldn't expect: months back in an athlete's training log. The culprit behind most injuries isn't a single bad run. It's accumulated load, under-fueling, or a strength gap that quietly grew until something gave out. When the mechanical picture looks clean, Drew digs deeper, sometimes all the way to blood work and nutritional consults. Multiple tendon issues flaring up in different parts of the body at once? That's a systemic story, not a mechanical one.

The calf conversation is worth sitting with. Runners stretch it religiously and almost never strengthen it the way running actually demands. The soleus does significant work during each stride, but only when the knee is bent, which is almost never how people train it. A calf that always feels tight is probably asking for load, not length.

On the trail running vs. road running question, the differences go deeper than terrain. Strength demands, stability requirements, and pacing strategy all shift in ways that catch road runners off guard when they head onto the trails. And carbon-plated shoes? Both Drew and Dr. Ficks agree they have a place, but earning them matters more than buying them.

Quotes

• "The downside to under-fueling is you're going to hit a brick wall. The downside to over-fueling is maybe a rumbly stomach…I'd rather be on that end of the spectrum." (14:58 | Dr. Drew Short)
• "You might meet the rep scheme on a calf raise, but whenever you start making it more ballistic and you start using the tendon more, it doesn't like that. The rate of fire is just a lot slower on that side." (25:50 | Dr. Drew Short)
• "Stiffer tendons or more robust tendons — that's just free energy. If you're able to use that elasticity like a rubber band whenever you hit the ground, that's less that the muscles are having to push off." (33:19 | Dr. Drew Short)
• "If your calf always feels like it needs to be stretched, honestly, your tendon probably needs some load. You probably do need to be doing some heavy slow resistance through that tendon. Otherwise, you just keep stretching it all day every day." (34:32 | Dr. Drew Short)
• "If I'm doing a long effort and I can still breathe just through my nose, I know I'm gonna be fine at hour three, hour four." (48:26 | Dr. Drew Short)

Connect with Dr. Drew Short: https://www.instagram.com/thenamesdrew/

SideKick Tool

Movemate: Award-Winning Active Standing Board

15% off Promo Code: DRA15

RAD Roller

Revogreen

HYDRAGUN

Athletic Brewing

20% off: ANDREWF20

Connect with Physio Room:

Visit the Physio Room Website

Follow Physio Room on Instagram

Follow Physio Room on Facebook

Andrew’s Personal Instagram

Andrew’s Personal Facebook

Podcast production and show notes provided by HiveCast.fm

Sleep isn't a luxury you negotiate with; it's the biological foundation every other health habit is built on, and most people are getting far less of it than they think.

Dr. Andrew Fix revisits one of the show's most foundational episodes for Better Sleep Month, and the timing feels personal. A new baby at home has a way of clarifying just how much everything falls apart when sleep does. Drawing from Matthew Walker's landmark book Why We Sleep, this episode makes a compelling case that sleep deprivation isn't just fatigue. It's a direct line to cancer, cardiovascular disease, dementia, weight gain, and a compromised immune system.

Here's a question worth sitting with: if you went to bed at 10 and woke up at 6, did you actually get eight hours of sleep? Probably not. Time in bed and time asleep are not the same thing, and that gap is where most people are quietly losing ground.

Dr. Fix gets practical without being prescriptive. A consistent sleep schedule, a cooler and darker room, cutting caffeine earlier than feels necessary, and keeping alcohol away from bedtime are the kinds of shifts that build real resilience over time. He also draws a connection that often gets overlooked in fitness culture: sleep is where recovery actually happens, and poor sleep throws off the hormones that regulate hunger, making weight management an uphill battle no matter how clean your diet is or how early you get to the gym.

What would change about your daily habits if you treated sleep as seriously as your workouts or your nutrition? That's the real question this episode leaves you with.

Quotes

• “I think it's a shock to nobody that sleep is the most important thing in our lives. If we don't get enough of it, pretty much every major function of our body is going to suffer.” (02:37 | Dr. Andrew Fix)
• "The amount of time that you spend in bed that you think you are asleep does not equal or correlate to the amount of time that you actually sleep." ( 06:27 | Dr. Andrew Fix)
• “I do have a change in my sleep quality when I cut that caffeine out earlier. So, avoiding caffeine and nicotine, in theory, will help with your sleep quality.” (13:52 | Dr. Andrew Fix)
• “You want your brain to be planning to go to bed when you get in bed. You want your body's cycle to be just so in tune with, ‘Oh, this is where I come when I want to go to sleep.’” (20:19 | Dr. Andrew Fix)
• “All of the professional athletes that we watch on television and whatnot, I can tell you that they are putting a much higher emphasis on sleep than we do in our normal lives.” (31:59 | Dr. Andrew Fix)

Links

https://www.sleepdiplomat.com/

SideKick Tool

Movemate: Award-Winning Active Standing Board

15% off Promo Code: DRA15

RAD Roller

Revogreen

HYDRAGUN

Athletic Brewing

20% off: ANDREWF20

Connect with Physio Room:

Visit the Physio Room Website

Follow Physio Room on Instagram

Follow Physio Room on Facebook

Andrew’s Personal Instagram

Andrew’s Personal Facebook

Podcast production and show notes provided by HiveCast.fm