Performance & Rehab

All things Physiotherapy, Biomechanics and Movement Related.


Excess Anterior Knee Translation (Knee Forward to Toes)

Excess Hip Internal Rotation

Excess Pelvic Drop


Hip Abductors and Hip Stability

Hip Adductors and Hip Stability

Hip Extensors and Back Pain

Hip Extensors and Hip Stability

Hip External Rotators and Hip Stability

The Ankle Joint and Ankle Stability

Gastrocsoleus and Achilles Health

The Iliotibial Band

Sciatic Nerve Tension and Lower Extremity Flexibility


Performance and Strength Leaks: Hip Drop


Propulsion: The Glutes, Hamstrings and Adductors (in progress)
Propulsion: The Ankle, Calf Muscles and Plantarflexors (in progress)
Plyometrics and Power (in progress)


  1. Hi Matt
    Do you know any runners that have arthritis? And are still training?

    1. I have treated plenty of runners with arthritis. Their training ability depends heavily on the type of arthritis, the severity and location. Cross training is always a great option. I have seen those with severe arthritis who are still training heavily (and feel little to no pain) and others with mild arthritis who have severe pain and quit running. It depends on the individual and what they are will to do. Strength, joint mobility, flexibility and intelligent training are the keys.

      So yes to both.

      -Dr. Matthew Klein, PT, DPT

  2. Hi Matt,
    I have flat arches, and I have heard there are ways to strengthen the arch so that they won't be "flat" anymore. IS there any validity to this?

    1. Hello.

      It completely depends on the reason as to why you have "flat" arches. You may have weak muscles that cannot hold up the medial longitudinal arch, you may have flattening of the arch to compensate for instability further up the leg or you may have congenitally flat feet. I cannot tell you over the internet which one will work for you as myself or another medical rehab professional would need to evaluate you.

      So could it help? Yes, but it depends on the cause.

      Hope that helps clear things up a bit.

      -Dr. Matthew Klein, PT, DPT

  3. Hi there. I just discovered your super informative review of the Hoka Clifton 4, which led me to lurk all over your site. :). Im a 39 yr old female, used to be an avid runner until 6 years ago, when I was diagnosed with Hallux Rigidus in my right big toe joint and told that I could no longer run or exercise. Fast forward to now: (because I'm a wuss and put if off until now) I'm 6weeks post op from the cheilectomy and I'm wanting to know if you have any advice or suggestions on PT exercises I can do to increase mobility and ease pain? I'm pushing the toe up and down, one
    minute each way, a couple of times a day. The problem is that my toe stays so sore, red. and swollen from just that one exercise (I Stopped the exercise for 5 days to see if that was cause) that it's difficult for me to walk. so naturally, I walk on the side of my foot as to avoid the pain. If I'm honest, that's been my "go to" for the last six years. I want to stop doing that! My range of motion has gone from about 1degree to 40-45 degrees (with me pushing it up). I feel like it should be at 90 just like my right toe! :-/ I'm ready to start easing back into running and exercising. Please help! Thank you!

    1. Hey Candace. As my disclaimer states, I cannot treat you over the internet because I cannot truly and accurately evaluate you. Thus I cannot truly suggest exercises because I do not know where you are in your rehab. I do not want to mess anything up or cause further injury. 90 degrees of great toe extension is excessive. You need about 60-70 for normal gait. For now I would look for a shoe with some toe spring to ease the pressure on your hallux. However you need to make sure the toe spring is in the sole and not in the foot bed. You do not want your toes held in extension as that will be more uncomfortable. They should be able to move. If you are not already, I would suggest seeing a physical therapist in your area who can give you a hands on assessment and treatment.

      -Dr. Matt Klein PT DPT

    2. It does sound like you are on the right track mobility wise, but you may find that strength may take longer. I would definitely work on keeping your calf muscles flexible and your hip muscles strong. You can see my posts on that. Too much calf muscle tightness will put a great deal of pressure on the Hallux. Weak hips will also contribute to additional pressure. I find those two areas contribute a great deal to Hallux Valgus. If you want to stop this from happening again (which the recurrence rate it very high if you do not change the reason why it happened in the first rate), those would be my exercise suggestions. But again I suggest seeing a physical therapist in your area who can truly figure out in person not only where to go from here, but how this started.

      -Dr. Matt Klein PT DPT

  4. Hi Matt,
    long time reader of your side. I really appreciate your putting together this compendium. For a couple years I've been suffering from little aches and pains in my left lower leg when I up intensity/duration of my runs too quickly. When I was diagnosed with a SFX in my left fibula, my physician sent me to have my lower body screened: The raster scan x-ray showed a "rudimentary hip dysplasia" (right Femur +13mm, resulting in 18mm of higher hip). Since it's only "rudimentary" and I'm already 39 his opinion was that raising the left leg would cause more problems than it solves. Instead, he told me to avoid concrete, especially flat roads, and run as much trail, and inclines as possible.
    Long story short, what exercises do you suggest to support my hip as much as possible "in the long run", so to speak. he said with my structure he highly recommends shoes with good cushion instead of minimal ones. But what about drop?
    I know you're professional enough to not give recommendations, let alone diagnosis over the internet but PT in my country is cvery "old school" and not really up-to-date, so your opinion is of high value to me.

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  6. Nice to be visiting your blog again, it has been months for me. Well this article that i’ve been waited for so long. I need this article to complete my assignment in the college, and it has same topic with your article. Thanks, great share.


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