The Physical Performance Show

In episode 378 of The Physical Performance Show, host Brad Beer is joined by Pogo physiotherapist Tim Studley for the first instalment of a three-part expert series exploring bone stress injuries. Drawing on decades of clinical experience and the latest research, Brad unpacks the mechanisms behind one of the most common and misunderstood injuries affecting endurance athletes. This episode explains how bone stress injuries develop, why they occur, and why they're often missed until they become more serious. Brad and Tim discuss the relationship between training load, bone physiology, symptom progression, and risk factors, while providing practical insights for athletes, coaches, and clinicians seeking to identify problems before they become stress fractures. Show Sponsor: PILLAR Performance is leading a new frontier in sports nutrition through micronutrition innovation. Their new Collagen Repair formula, developed in collaboration with Gelita Laboratories, is designed to support tendon and ligament health while promoting collagen synthesis to help athletes stay healthy and perform at their best. For 15% off your first order, visit pillarperformance.shop (or thefeed.com for North American listeners) and use the discount code PHYSICALPERFORMANCE (one word, capitals) at checkout. In this episode, you'll hear Why bone stress injuries exist on a continuum—from healthy bone through stress reactions to true stress fractures The biology of bone remodelling: osteoclasts, osteoblasts, microcracks, and why recovery is essential Why running intensity has a far greater impact on bone stress injury risk than training volume alone How a 10% increase in running pace can dramatically reduce the bone's fatigue threshold Why many athletes mistakenly blame the "last run" rather than the workload accumulated four weeks earlier The importance of deload weeks and allowing the skeleton time to repair accumulated microdamage Understanding the Fredericson grading system and what distinguishes stress reactions from stress fractures Why shin splints (medial tibial stress syndrome) are not the same as a bone stress injury How pain location and symptom behaviour provide more valuable diagnostic information than pain intensity Why serious bone stress injuries can sometimes hurt less than relatively minor periosteal injuries The progression of symptoms from post-run discomfort to persistent and night pain How clinicians assess training history, workload, Strava data, intensity distribution, terrain, and footwear The major biomechanical and biological risk factors that contribute to bone stress injuries Previous bone stress injuries as one of the strongest predictors of future injury The emerging discussion around performance footwear ("super shoes") and potential changes in bone loading Why muscle strength and tissue capacity remain important contributors to skeletal resilience Quotes / takeaways "A bone stress injury is simply stress of a bone." "It's not usually the kilometres that catch people out—it's the intensity." "Don't judge the severity of a bone injury by how painful it is." "Symptoms often appear around four weeks after the training error—not the day after." "If it's really obvious, it's probably important." Show Sponsor PILLAR Performance creates evidence-based sports micronutrition products designed to support recovery, sleep, health, and performance for athletes and active people. For all your PILLAR products visit https://PillarPerformance.shop, or for our North American listeners, head to https://TheFeed.com. 🔥 For 15% off your first purchase enter PHYSICALPERFORMANCE at the checkout. Timeline 00:00 – Introduction, sponsor and overview of the new three-part Bone Stress Injury series 02:27 – Brad introduces expert editions and welcomes Tim Studley 03:54 – What is a bone stress injury? 04:23 – Bone loading explained: intensity versus training volume 06:50 – Bone physiology: microcracks, osteoclasts and osteoblasts 08:44 – Why recovery weeks are critical for skeletal health 09:14 – Bone remodelling timelines and why symptoms are delayed 11:40 – Bone stress injuries versus stress fractures 13:05 – The Fredericson grading system explained 14:26 – Shin splints (MTSS) versus bone stress injuries 15:21 – Why pain severity doesn't reflect injury severity 17:42 – The importance of symptom behaviour over pain intensity 19:08 – The progression of bone stress injury symptoms 20:30 – Taking a running history: training load, Strava and identifying workload errors 22:22 – Why today's symptoms often reflect training from four weeks earlier 23:20 – Biomechanical versus biological risk factors 24:17 – Previous bone stress injuries as a major predictor of recurrence 24:47 – Performance footwear ("super shoes") and emerging research 26:03 – Terrain, footwear changes and other biomechanical considerations 26:57 – Muscle capacity, tissue resilience and assessing the athlete THE TEAM: Join the The Physical Performance Show LEARNINGS membership through weekly podcasts here: https://www.patreon.com/TPPShow Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Your Host: 🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAu The Physical Performance Show can be found at: Facebook: facebook.com/thephysicalperformanceshowpodcast X: @tppshow1 Instagram: @physicalperforamceshow Please direct any questions, comments, and feedback to the above social media handles.

Brad shares what's happened over the last two years, why there has been infrequency in episode production adn what teh plan is from ehre. Listen into this brief update as he explains what shape the podcast will take and what content you can expect. We want to say a special thank you to you, our loyal listeners. Without youthere wouldn't be this podcast, we deeply apprecaite you.

In this episode we welcome back renowned tendinopathy expert, Professor Peter Malliaras, for a 2025 Tendinopathy Rehabilitation Update. As a leading physiotherapist, researcher, and director at Monash University's Musculoskeletal Research Unit, Peter shares the latest advancements in managing and rehabilitating tendon injuries. Peter continues to provide cutting-edge insights into evidence-based treatments for persistent tendon symptoms. Whether you're an athlete dealing with tendinopathy or a practitioner looking to refine your approach, this episode is packed with valuable takeaways to help you stay at the forefront of tendon rehabilitation. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.

Alec Mackenzie is a PhD scholar with Griffith University, the Queensland Academy of Sport, and Swimming Australia. Alec dives into the prevention of shoulder injuries in swimmers, sharing insights from his ground-breaking research. His recent systematic review, "Identifying Evidence-Practice Gaps for Shoulder Injury Risk Factors in Competitive Swimmers," has made waves in the sports medicine world by bridging literature and expert opinion to better manage swimmer's shoulder. In this episode Alec unpacks the top three statistically significant factors contributing to shoulder pain in swimmers, offering invaluable advice for athletes, coaches, and triathletes. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.

David Butler has been a pivotal Physiotherapist figure in the field of pain management since the mid-1980s, with a career spanning clinical practice, research, and education. As the director of the Neuro Orthopedic Institute (NOI), David leads numerous biopsychosocially-based seminars worldwide, educating both practitioners and patients about pain. In this episode, David delves into the intricacies of pain, discussing its mechanisms, significance, and impact on our health and well-being. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.

Dane Baker works with elite athletes and active people helping to resolve low energy availability and Red-S or relative energy deficiency in sport. He studied Nutrition at the University of Otago graduating in 2003 and now works at the University as a Professional Fellow and Lecturer. Dane consults out of the AXIS Sports Medicine Clinic and when he's not there, he's educating New Zealand's elite coaches as the Lead Nutrition provider for High Performance Sport New Zealand. After nearly 20 years in sports nutrition, Dane's developed a depth of experience and expertise that comes through in everything that he does. In this episode Dane shares information around how an athlete can get themselves out of a state of low energy availability, it's the how, what and why of overcoming low energy availability or relative energy deficiency in sport. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about telehealth consultations and book online. Join the The Physical Performance Show LEARNINGS membership through weekly podcasts | Patreon If you enjoyed this episode of The Physical Performance Show please hit SUBSCRIBE for to ensure you are one of the first to future episodes. Jump over to The Physical Performance Show for more details. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.

In early 2022 Sam finished a very credible 8th place at the Ironman World Championships held in St. George. By year's end, Sam came out and did what many thought was almost impossible, he took it to the Norwegian train of Kristian Blummenfelt current Olympic Triathlon Champion and Gustav Iden, both dominant Norwegian triathletes in the long course space, Sam picked up a silver medal at the Kona 2022 Ironman World Triathlon championships, and along the way obliterated the bike course record. It was a stunning performance, one that I rate as one of the greatest I've seen in my 30 years in endurance sport. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about telehealth consultations and book online. Join the The Physical Performance Show LEARNINGS membership through weekly podcasts | Patreon If you enjoyed this episode of The Physical Performance Show please hit SUBSCRIBE for to ensure you are one of the first to future episodes. Jump over to The Physical Performance Show for more details. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.

Harry Garside, Olympic Bronze Lightweight Boxing Medallist's career achievements are impressive: • 2020 Tokyo Olympic Games bronze medalist in the lightweight division • 2018 Commonwealth Games champion • 2018 Commonwealth Games lightweight champion • 7 x Australian National Boxing Champion This episode is an uplifting, inspiring and informative conversation. Harry outlines some top tips to see you perform at your physical best, he lays down a physical challenge and outlines some career highs lows and learnings. In recent times, Harry undertook some rigorous physical challenges including taking part in endurance events such as a 70.3 Triathlon. Show Sponsor: If you are looking for a gift this Christmas, do check out Polar's Gift Guide which will help take get you or a loved ones' health, fitness and training to it's best. As we very well know, everyone is different, but we all get the same 24 hours to make the most of each day. We know it can be so tough to squeeze in that training session or get the optimal amount of sleep into our busy schedule. But it does not have to be this way! Polar are very excited to announce a solution, launching their new fitness and wellness watch the Polar Ignite 3! If you or a loved one feel that you haven't been able to be at your best … then it's time to start living a life more in tune with our body's natural rhythm! If you're keen to find out how you can get the most out of each day, simply check out Polar's latest fitness and wellness watch at Polar.com Join the The Physical Performance Show LEARNINGS membership through weekly podcasts | Patreon If you enjoyed this episode of The Physical Performance Show please hit SUBSCRIBE for to ensure you are one of the first to future episodes. Jump over to The Physical Performance Show for more details. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.