Miriam Salloum, MPT, COMT, OCS - Build Better Tendons   Have you ever had an issue with your achilles, hamstring, patella, or IT band? As a runner, you probably just answered, “Yes.” Miriam Salloum, aka The Runner’s Mechanic, shares her tendon injury expertise in this episode, including what causes tendon issues in the legs and feet, how to treat these issues, and most importantly, how you can keep running while gradually getting pain free.    Miriam is a physical therapist who  specializes in working with runners at her aptly named business, The Runner’s Mechanic, in Asheville, North Carolina. She hails from Gulfport, Mississippi, earned a BS in Biology at the University of North Carolina at Chapel Hill, followed by a Masters of Physical Therapy at East Carolina University, and then a post-graduate internship at the Mayo Clinic’s prestigious biomechanics  and motion analysis lab in Rochester, Minnesota.    Miriam has practiced orthopedic and sports physical therapy for the past 20 years, helping runners in Western North Carolina and elsewhere with foot and ankle rehabilitation, foot orthoses fabrications, taping techniques, spine and lumbopelvic neuromuscular reeducation, spinal manipulation, and the biomechanical analysis of running gait.   Miriam also uses dry needling techniques used for rehabbing the neuromuscular system. In 2015, she studied these techniques under Sue Falsone, head of Athletic and Sport Performance training for the US Soccer’s Men’s National team, as well as effective treatment of chronic tendon disorders in high level athletes and runners. In 2016, she was the physical therapist for the Olympic Training Site under the Center for Excellence for Sports Science in Johnson City, where she worked with Olympic athletes in bobsled and track and field.   Miriam received her certification of orthopedic manual therapy (COMT) for spine and peripheral joint disorders through Maitland-Australian Physiotherapy and is an orthopedic certified specialist (OCS) through the American Physical Therapy Association. She has been a national presenter for North American Seminars for the past 4 years, educating health professionals in the latest treatments of running related injuries. She models her approach to runners’ rehabilitation after the Speed Clinic & Center for Endurance Sports at UVA and Spaulding National Running Center at Harvard, which has allowed her to utilize the most effective techniques for real time gait re-training.       Questions Miriam is asked: 2:15 You are the Runner's Mechanic.  What does that mean and how did you come up with the name?   3:45 You provide a wide range of physical therapy services for runners, but today, I would like to talk about just a few specific topics that runners face and what we can do to prevent and treat them.  One of the most common issues that comes up with runners is injury to our tendons, most often the Achilles and the hamstrings, but all the other tendons in the legs and feet as well.  Can you talk a little bit about what’s going on with this?   6:45 Let’s talk specifically about the achilles first. Is this so common, who is at risk for this, and what do we do about it?    8:30 What do we do to prevent our tendons becoming like brittle elastic bands, or at least push it down the road, specifically with Achilles because I think I hear Achilles injuries most often, and so what would you say you would do if you felt that niggle after, let’s say, a speed workout?   9:56 Can you talk about why hills are a problem for the Achilles?   11:09 Moving up to the hamstring, let’s talk about that. Who’s at risk for that? Is it the same population, or are there any differences you see between people who have hamstring injuries versus Achilles injuries?   12:13 Let’s start talking about treatment. We hear about for the Achilles, some people say do the eccentric drop, some people say the calf raises, some say do one but not the other, so what should we be doing for rehab for that?   16: