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.
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.
“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.”
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.
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
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Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
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Telehealth rehabilitation can be effective for people needing help to get back to their physical best who are geographically not able to attend appointments in person at POGO Physio (Mermaid Waters, Gold Coast).
Our team of physiotherapists routinely conduct telehealth consultations for patients who live:
There are several elements of an in person consultation that cannot be actioned when receiving a telehealth consultation. However in most instances this does not represent a barrier to an effective consultation being delivered.
Manual therapy (hands-on) treatment can also not be conducted remotely. If a patient will benefit or requires manual therapy it can be sought in the patient’s local area with guidance (if required) from a local provider.
Exercises are demonstrated and prescribed via our exercise prescription software and app TrackActive. Trackactive has viewable videos and photos, as well as detailed commentary on how to complete the exercises with accuracy at home or the gym. See below for an example series of exercises:
COLLAGEN REPAIR
Now, you've all heard me talk about Pillar Performance. They have truly led a new frontier in the sports nutrition industry through their micronutrition innovation — and as someone who has spent their career working with endurance athletes managing injury, this one really caught my attention.
You may have also recently seen Pillar launch some new product lines under the banner of Performance Health. Like all Pillar products, this expansion is designed to maximize those crucial hours outside of training and racing, helping you return to the start line in peak condition.
One of their newest releases is Collagen Repair. This has been specifically developed to address some of the most common tendon and ligament overuse injuries among endurance athletes — conditions like hamstring tendinopathy, Achilles tendinitis, shin splints, and patellofemoral pain. As a physio, these are honestly the injuries I see walk through the door most often.
This product was brought to market in collaboration with Gelita Laboratories from Germany, and features a clinically trialled collagen peptide called Tendoforte, designed to strengthen and promote collagen synthesis.
Did you know that after the age of 30, you lose 1% of your body's collagen every year? That's significant — especially if you're pounding out kilometres week after week.
All you need is one scoop — it's flavorless and pairs perfectly with your morning coffee.
So check it out. Visit PillarPerformance.shop, or for North American listeners, head to TheFeed.com and use the code PHYSICALPERFORMANCE for 15% off your first purchase.
TRIPLE MAGNESIUM
On The Physical Performance Show, we talk a lot about training load, but sleep and recovery are where the real adaptation happens — and that's something I've become genuinely obsessed with optimising.
Pillar's Triple Magnesium has become a non-negotiable part of my evening routine. Informed by leading Heart Rate Variability researcher Dr Dan Plews, I take it 30 minutes before bed every night to help my body spend as much time as possible in REM and deep sleep.
Pillar uses a high dose of Glycinate Magnesium, which activates the parasympathetic nervous system — essentially telling your body it's time to switch off, recover, and rebuild. My WHOOP data each morning tells the story: higher HRV, longer deep sleep cycles, and I genuinely wake up feeling more restored.
For anyone listening who is serious about performance — whether you're training for your first marathon or your tenth Ironman — sleep quality is the multiplier on everything else you do. This is the product that's moved the needle most for me personally.
Head to PillarPerformance.shop and use code PHYSICALPERFORMANCE for 15% off your first purchase.
