In episode 380 of The Physical Performance Show, host Brad Beer and Pogo Physio physiotherapist Tim Studley conclude their three-part expert series on bone stress injuries by focusing on what happens after diagnosis. From imaging and prognosis to rehabilitation, return to running, and long-term prevention, this episode provides a practical roadmap for athletes, coaches, and clinicians managing these complex injuries.
Brad explains why identifying the underlying causes of a bone stress injury is just as important as healing the bone itself. The discussion covers deloading, progressive reloading, strength and conditioning, bone-building exercise, and the simple but powerful strategies that can dramatically reduce the risk of recurrence.
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"Treat the cause—not just the injury."
"Restore volume before you restore intensity."
"Bone cells get bored easily."
"It's not the training you adapt to—it's the recovery from the training."
"Eat more than you think you need."
Show Sponsor: PILLAR Performance — 15% off your first order using code PHYSICALPERFORMANCE at checkout.
North America: thefeed.com
00:00 – Introduction, sponsor and final episode of the Bone Stress Injury mini-series
02:27 – Clinical testing for femoral neck bone stress injuries
03:26 – Clinical diagnosis versus MRI: when imaging is essential
05:14 – Why MRI improves prognosis and return-to-sport planning
07:03 – The three-step rehabilitation framework: risk factors, deload, reload
08:58 – Deloading strategies for high-risk bone stress injuries
09:50 – Progressive tissue loading and returning to running
10:46 – Why training volume should return before intensity
11:45 – Reloading the unaffected limb during rehabilitation
12:44 – Strength training, muscle function and long-term bone health
14:30 – Why bone cells "get bored" and how osteogenic exercise works
15:56 – Novel loading strategies, multidirectional movement and chaos hopping
17:23 – Childhood sport participation and building stronger bones
19:14 – Brad's personal experience with osteoporosis as an endurance athlete
21:40 – Three practical strategies to reduce bone stress injury risk
24:29 – Skeletal deload weeks and cross-training alternatives
25:27 – Recovery as the key driver of adaptation
26:26 – Final advice for athletes and clinicians
27:49 – Brad's top performance tip: "Eat more than you think you need"
28:18 – Listener challenge: fuel immediately before and after every training session this week
28:56 – Episode close and conclusion of the Bone Stress Injury mini-series
Join 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 @PogophysioAu
The Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperformanceshow
In episode 379 of The Physical Performance Show, host Brad Beer and Pogo Physio physiotherapist Tim Studley continue their three-part expert series on bone stress injuries by shifting the focus from training errors to the biological factors that determine whether an athlete's skeleton can tolerate training demands.
This episode explores the critical role of energy availability, bone health, recovery, and risk stratification in both preventing and diagnosing bone stress injuries. Brad shares practical screening strategies developed over two decades of clinical practice, explaining why identifying the underlying cause—not just treating the injury—is essential for long-term athletic performance and injury prevention.
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.
"Training loads the skeleton—but biology determines whether the skeleton can cope."
"Eat more than you think you need."
"The biggest driver of bone stress injuries is often invisible."
"Above the knee, think fuelling. Below the knee, think biomechanics."
"Treat the cause—not just the bone."
Show Sponsor: PILLAR Performance — 15% off your first order using code PHYSICALPERFORMANCE at checkout.
North America: thefeed.com
00:00 – Introduction, sponsor and recap of the Bone Stress Injury mini-series
02:27 – Why biological risk factors deserve greater attention than ever before
03:51 – Early sport specialisation and athletic history as risk factors
04:50 – Medical conditions, medications and bone health
05:45 – Sleep, stress and the biological contributors to bone stress injuries
07:08 – Understanding low energy availability (RED-S)
08:32 – Practical screening questions for under-fuelling
09:02 – Female athlete indicators: menstrual health and amenorrhoea
10:29 – Male athlete indicators: libido and morning erectile function
11:51 – Blood tests, iron studies, vitamin D and hormone profiles
13:18 – Why even small daily energy deficits accumulate over time
14:16 – Working with sports dietitians and estimating energy requirements
15:40 – Brad's number one recommendation: "Eat more than you think you need"
16:08 – Common sites of bone stress injuries throughout the body
18:00 – Using injury location to distinguish biomechanics from under-fuelling
18:48 – High-risk versus low-risk bone stress injury locations
21:12 – The most commonly missed bone stress injuries in runners
22:37 – Clinical examination: observation, palpation and localisation of symptoms
24:19 – Differentiating shin splints from bone stress injuries through palpation
25:14 – Functional loading tests and when hop testing is appropriate
26:31 – Hop testing, femoral neck injuries and clinical safety considerations
27:24 – Differential diagnosis and key assessment principles
28:25 – Episode wrap-up and preview of Part 3
Join 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 @PogophysioAu
The Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperformanceshow
In episode 377 of The Physical Performance Show, Sports Physiotherapist Nick Kane joins host Brad Beer to unpack the rehabilitation of hamstring strain injuries.
Nick is the founder and director of SportsMap, one of Australia's leading professional development platforms for sports medicine clinicians. Drawing on more than a decade working in elite sport, including ten years with the Essendon Football Club in the AFL and five years as lead physiotherapist, Nick shares practical, evidence-informed insights into managing one of sport's most common and frustrating injuries.
This episode explores the common mistakes athletes and practitioners make during rehabilitation, the critical role of high-speed running exposure, how to assess injury severity, key risk factors for recurrence, and the practical steps required for a successful return to sport. Nick also discusses eccentric strength training, fascicle length, T-junction injuries, and the characteristics that separate great clinicians from average ones.
Whether you're an athlete, coach, physiotherapist, or sports medicine practitioner, this episode delivers practical takeaways you can immediately apply.
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 North American listeners, head to https://TheFeed.com.
For 15% off your first purchase enter PHYSICALPERFORMANCE at the checkout.
How To Check:
LinkedIn - Nick Kane
SportsMap – https://sportsmap.com.au
Listen in as we delve into the following:
• The three most common mistakes in hamstring rehabilitation
• Why maximum speed exposure is essential for successful recovery
• The dangers of over-prescribing and under-prescribing sprint work
• Understanding hamstring injury pathology and injury mechanisms
• Key clinical assessment findings for hamstring strain injuries
• Risk factors including eccentric strength, fascicle length, and running mechanics
• The "push and pull of strain" concept
• Practical strength benchmarks for rehabilitation progressions
• The role of Nordic hamstring exercises and eccentric loading
• Monitoring recovery using objective clinical markers
• Criteria-based return-to-play decision making
• Preventing recurrence following return to sport
• Why regular exposure to high-speed running matters
• Understanding T-junction hamstring injuries
• What differentiates great clinicians from average practitioners
• The value of curiosity, continual learning, and athlete-centred communication
Quotes
"Preparing to sprint is preparing to play." — Nick Kane
"The highest strain you can apply to the hamstring is sprinting." — Nick Kane
"Consistency is key." — Nick Kane
"If you stop training eccentrically for two weeks, those fascicles shorten." — Nick Kane
"The person who stays curious and continues learning is the one who keeps improving." — Nick Kane
Timeline
00:00 – Introduction and sponsor messages
01:20 – Introduction to Nick Kane and SportsMap
04:08 – The three biggest mistakes in hamstring rehabilitation
05:35 – Over-prescribing and under-prescribing high-speed running
09:16 – Why sprint exposure is critical for recovery
10:34 – Understanding hamstring injury pathology
13:54 – Key risk factors for hamstring strain injuries
16:12 – The push and pull of strain concept
18:29 – Eccentric strength and fascicle length
20:22 – Practical strength assessment benchmarks
23:13 – Essential clinical assessment tools
27:20 – Using objective markers to guide return-to-play timelines
29:21 – Sponsor messages
31:14 – Return-to-play criteria and rehabilitation progressions
34:41 – Preventing hamstring injury recurrence
37:29 – Understanding T-junction hamstring injuries
41:41 – What separates great clinicians from average clinicians
44:25 – Nick Kane's one piece of performance advice
45:53 – The weekly physical challenge: 10 minutes of stillness
46:51 – Where to find Nick Kane and SportsMap
48:27 – Episode wrap-up and upcoming shows
Your Host
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.
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