Episode Details

Welcome back to Interdisciplinary Case: Miles, where real runner stories meet clinical expertise. In Episode 8, Dr. Sara Raiser (MD), sports dietitian Kelsey Pontius, and physical therapist Dr. Kate Mihevc Edwards (PT) team up to break down a complex case: a mid-30s female roadrunner and backpacker navigating persistent butt pain, posterior leg symptoms, and unexpected GI challenges. This episode uncovers why seemingly simple running injuries often have not-so-simple causes and why a whole-body, interdisciplinary lens matters.

In this case study, we explore:

• Buttock and posterior thigh pain, what “sciatica” really means, why it’s often misdiagnosed, and how nerves, joints, tendons, and biomechanics interact
• The nervous system connection how an injury high up (like the hip or butt) can contribute to issues farther down the chain, including the Achilles
• The hidden role of nutrition & gut health, IBS, GI testing, microbiome insights, nutrient absorption, and how underfueling impacts nerve healing and recovery
• Breathing, stress & recovery why parasympathetic activation, rest, and mindful eating support both performance and injury resolution
• Clinical decision-making differential diagnoses, red flags, when imaging is needed, and how PT, nutrition, and sports medicine intersect
• Real-life biomechanics like hiking with a backpack, running form, posture, core engagement, nerve mobility, and how everyday habits amplify or relieve symptoms

This episode takes a comprehensive look at the messy, interconnected reality of running injuries where gut function influences glute activation, posture affects nerve mobility, and stress and recovery can make or break healing. Whether you’re a runner, clinician, or coach, you’ll walk away with: A clearer understanding of butt and posterior leg pain Practical insights on GI issues, fueling, and stress management A roadmap for thinking holistically about athlete health.

00:00 – Podcast Intro & Hosts
Overview of Interdisciplinary Case Miles and introduction of the three clinicians. 
01:35 – Case Overview: Mid-30s Female Road Runner
Runner background, hiking/backpacking at altitude, work-from-home lifestyle, inconsistent meals. 03:40 – Initial Presentation: Butt & Posterior Thigh Pain
Why the PT flagged nutrition as a possible barrier to healing.
05:30 – GI Symptoms & IBS-C / IBS-D Explained
Connection between alternating constipation/diarrhea, discomfort after meals, and training disruption. 07:40 – Why Gut Health Matters for Injury Recovery
Micronutrient absorption, inflammation, and nerve healing considerations.
09:40 – Nutrition Interventions: Eating Enough & Consistently
Hydration, missed meals, work-from-home challenges, and fueling basics.
12:00 – Gut Testing & Microbiome Findings
Trail runner risks, lab testing, microbiome imbalance, and implications for healing.
14:20 – Polyphenols, Probiotics & Fiber Strategy
Green tea, targeted probiotics, fibers, and supporting beneficial bacteria.
16:20 – Chewing, Digestion & Parasympathetic State
Why slowing down eating and breathing matters for gut regulation.
18:10 – Exercise Load vs Recovery (The “90-Minute Rest Day”)
Why constant training prevents healing and nervous system recovery.
19:50 – Medical Perspective: Diagnosing Butt Pain
Hip vs spine vs nerve vs tendon; complexity of posterior chain pain in runners.
22:20 – Red Flags & Imaging Decisions
When imaging, injections, and stepwise diagnostics are appropriate.
24:45 – What “Sciatica” Really Means
Why true sciatica is uncommon and often misdiagnosed.
26:30 – Sciatic Nerve Anatomy & Referred Pain
Lumbar roots, piriformis myths, nerve pathways, and distal injury risk.
29:45 – Nerve Loading: Hiking, Backpacks & Downhill Stress
How posture, stride length, and load affect nerve irritation.<