Luke Nelson - Sports & Exercise Chiropractor

Luke Nelson - Sports & Exercise Chiropractor 🔹Fellow Sports & Exercise Chiropractor (AICE 2019)
🔸President Sports Chiro Australia
🔹Director Health & High Performance
❤️️Family, Running & Sports Chiro

16/04/2026

Achilles paratenon irritation: what is it & how do you fix it? 🤕
Not all Achilles pain is tendinopathy.

Sometimes it’s the paratenon, the sheath surrounding the tendon, that helps reduce friction and protect it. When this gets irritated, it behaves very differently.

Telltale signs 👇
🔑 Diffuse pain along the tendon (not a single pinpoint spot)�🔑 Worse with slow movements (e.g. calf raises)�🔑 Often better with quicker movements like hopping�🔑 Crepitus- a squeaky/crunchy feeling or sound�🔑 Visible puffiness or swelling around the tendon

So what actually helps? 👇
🎯 Short-term: topical anti-inflammatory + hirudoid (only if advised by a health professional)�🎯 Load smart: isometrics or faster, elastic work often feel better than slow heavy calf raises�🎯 Why? Less tendon “sliding” within the sheath = less irritation

Big clinical pearl from Ebonie Rio & Jill Cook 🙏

👋 Runners & clinicians, save this for later, and share it with someone dealing with stubborn Achilles pain

09/04/2026

Got told your heel spur is the problem?

Not so fast.

Heel spurs are incredibly common —
and plenty of people have them with zero pain.

They’re part of the picture…
but rarely the whole story.

👉 Focus on load
👉 Build capacity
👉 Don’t panic

🎧 Full episode of The Rehab Runway out now
https://www.healthhp.com.au/the-rehab-runway/episode-9-plantar-heel-pain

You stopped running…�but your heel pain didn’t improve?That’s not uncommon.Because plantar heel pain isn’t just about ru...
07/04/2026

You stopped running…�but your heel pain didn’t improve?

That’s not uncommon.

Because plantar heel pain isn’t just about running load�👉 it’s about TOTAL daily load

Standing. Walking. Time on your feet.

If those aren’t adjusted, you may not actually be reducing load at all�you’re just changing how it’s applied.
And the plantar fascia still has to deal with it.

The research shows:�📌 It’s a load-driven condition (Martin 2023)�📌 Time on feet and occupational standing matter (Riddle 2003; Beeson 2014)�📌 Managing load is key to recovery

Start here:�👣 Track your daily steps�🕒 Be aware of time on feet�🔄 Break up long periods of standing�📈 Progress load gradually

Your foot doesn’t care where the load comes from�only how much it has to tolerate.

🎧 Full episode of The Rehab Runway out now
https://www.healthhp.com.au/the-rehab-runway/episode-9-plantar-heel-pain

02/04/2026

Most plantar heel pain rehab starts too easy.

If they can walk…
they’re already producing more force than most “foot exercises.”

That doesn’t mean those exercises are useless.
But it does mean they’re often not where you should start.

👉 Build load.
👉 Progress properly.
👉 Match the demands of running.

🎧 Full episode of The Rehab Runway out now
Link https://www.healthhp.com.au/the-rehab-runway/episode-9-plantar-heel-pain

HEEL SPUR = YOUR PAIN? 🤔Not quite.Heel spurs show up in: 👉 85% of painful heels 👉 71% of pain-free heelsSo just because ...
31/03/2026

HEEL SPUR = YOUR PAIN? 🤔
Not quite.

Heel spurs show up in:
👉 85% of painful heels
👉 71% of pain-free heels

So just because it’s on your scan…
doesn’t mean it’s the problem.

Most heel pain is about:
✔ load
✔ tissue capacity
✔ how you’re training
Not the bone.

This is exactly what we unpack in the latest episode of The Rehab Runway 🎧 with John Osborne

👉 Episode 9: Plantar Heel Pain Explained: Load, Foot Strength and the Truth About Heel Spurs with John Osborne

We break down:
• What plantar heel pain actually is
• Why foot strength is often misunderstood
• The truth about heel spurs
Stop chasing the spur.
Start managing the load.

Save this for later 📌
And send it to a runner who needs to hear this 👇

🔗 https://www.healthhp.com.au/the-rehab-runway/episode-9-plantar-heel-pain

20/03/2026

Honor to be involved in this event 😊

🧬 Hormones influence tendon health more than we often think.Tendons adapt to mechanical load, but they also respond to t...
12/03/2026

🧬 Hormones influence tendon health more than we often think.

Tendons adapt to mechanical load, but they also respond to the endocrine environment.

Hormones can influence:
• collagen synthesis
• tendon stiffness
• tissue repair
• adaptation to training

This may help explain why tendon problems sometimes occur alongside:
• menopause
• thyroid disorders
• corticosteroid exposure
• hormone therapy

Load matters.
But biology matters too.

📚 References on final slide.

🎧 More tendon nuance on the recent The Rehab Runway podcast with Peter Malliaras https://www.healthhp.com.au/the-rehab-runway/episode-6-achilles-tendinopathy-what-actually-matters

05/03/2026

Muscle cramps aren’t caused by dehydration 💧

And they’re probably not caused by electrolyte loss either 🧂
For years we’ve blamed salt.
Hot races 🔥 Heavy sweating 💦 Sodium loss.
It made sense.

But prospective Ironman and ultramarathon studies haven’t found consistent differences in hydration or sodium levels between crampers and non-crampers 📊

So if it’s not just salt… what is it?
Cramps look far more like a neuromuscular fatigue problem than a hydration problem 🧠⚡️
Which means the long-term solution isn’t chasing electrolytes. It’s building capacity 🏗️💪

🎧 Full episode: Muscle Cramps: It’s Not Just Salt
🔗 https://www.healthhp.com.au/the-rehab-runway/episode-7-muscle-cramps

Muscle cramps suck. 🦵⚡️But they’re probably not caused by what you think.For years we’ve blamed:💧 Dehydration🧂 Low sodiu...
04/03/2026

Muscle cramps suck. 🦵⚡️
But they’re probably not caused by what you think.

For years we’ve blamed:
💧 Dehydration
🧂 Low sodium
🍌 Not enough potassium

But prospective endurance studies show that cramps are more strongly linked to:
🏃‍♂️ Higher relative intensity
🔥 Accumulated fatigue
📈 Going out too hard
🧠 Neuromuscular control breakdown

Stretching works because it resets the reflex loop.

Pickle juice may help once a cramp starts…

But neither fixes poor preparation.

If you’re repeatedly cramping, it’s time to look at:
✅ Endurance capacity
✅ Strength training
✅ Race pacing
✅ Recovery
✅ Smart hydration (supportive, not magic)

Cramps aren’t random.

They’re usually a preparation problem.

🎙 I unpack all of this in the latest episode of The Rehab Runway:
🔗 https://www.healthhp.com.au/the-rehab-runway/episode-7-muscle-cramps

Let me know in the comments: when do you tend to cramp? Late race? Hills? Heat? 👇

Most runners think strength training should be added on top of running 🏃‍♂️But one landmark study replaced 32% of endura...
19/02/2026

Most runners think strength training should be added on top of running 🏃‍♂️

But one landmark study replaced 32% of endurance training with explosive strength training, and the runners got faster ⚡️

Not because they trained more.
Because they became more efficient.

Strength improves tendon stiffness, elastic energy return, and neuromuscular efficiency, all key drivers of running economy 🦵

This doesn’t mean replacing all your runs with strength.

But if you’re running 4 or more days per week, swapping one easy run for a well-structured strength session can improve performance and build durability 🏋️‍♂️

More running isn’t always the answer.
Better prepared tissues are 💪

There’s nuance here. Your training history, injury profile, race distance, and overall load all matter. Speak with your coach or health professional to determine what’s appropriate for you.

📚References
Mikkola, J. et al. (2007). Neuromuscular and cardiovascular adaptations during concurrent strength and endurance training in untrained men. International Journal of Sports Medicine, 28(7), 602–611
Mikkola, J. et al. (2011). Concurrent endurance and explosive type strength training improves neuromuscular and anaerobic characteristics in young distance runners. International Journal of Sports Medicine, 32(8), 597–605
Paavolainen L, Häkkinen K, Hämäläinen I, Nummela A, Rusko H. Explosive-strength training improves 5-km running time by improving running economy and muscle power. J Appl Physiol (1985). 1999 May;86(5):1527-33.

Address

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Melbourne, VIC
3129

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