In this episode of The Physical Performance Show, host Brad Beer sits down with Pogo Physio’s Tim Studley for Part 2 of their two-part mini-series on shin pain and tibial bone stress injuries. Having covered diagnosis and differentiation between MTSS and tibial bone stress injuries in Part 1, this episode shifts focus to management — mechanics, return-to-run programming, strength and conditioning, footwear, and terrain considerations for runners recovering from (or trying to prevent) tibial bone stress injury.
Show Sponsor:
Pillar Performance continues to lead the way in sports nutrition through micro-nutrition innovation, now expanding into the Performance Health range. One of their newest releases, Collagen Repair, was developed with Gelita Laboratories (Germany) using a clinically trialled collagen peptide (Tendofort) to support tendon and ligament health in conditions like hamstring tendinopathy, Achilles tendonitis, shin splints, and patellofemoral pain.
Head to pillarperformance.shop (or thefeed.com for North American listeners) and use code PHYSICALPERFORMANCE for 15% off your first purchase.
Pogo Physio also offers online Telehealth Consultations for endurance athletes managing bone, tendon, or joint issues — book online at pogophysio.com.au.
Listen in as we delve into the following:
Quotes
“Muscle loads bone.” — Brad Beer
“That runner doesn’t need to be strong. They need to be uber strong.” — Brad Beer, quoting tendon researcher Ebonie Rio
“A 10% increase in pace reduces the fatigue threshold of a bone by 50%.” — Brad Beer
Timeline
00:00 – Introduction & sponsor: Pillar Performance
02:26 – Running mechanics and tibial bone stress injury risk
03:18 – Cadence, overstriding, and heel-strike patterns
05:43 – Foot pressure distribution and medial tibial bending
07:39 – Case study: footwear, orthotics, and cadence cueing
08:37 – Overview of bone stress injury management complexity
09:35 – Anterior tibial cortex injuries: high risk, slow healing, surgery
11:30 – Shift from time-based to symptom-led management
14:49 – Balancing speed of return with recurrence risk
15:48 – Five evidence-based return-to-run criteria (Sheeran & Reid, 2024)
18:11 – Why intensity is a greater risk factor than volume
20:35 – Strength and conditioning: matching capacity to running demands
22:29 – Three-phase strength progression: pre-, during-, and post-weight bearing
24:52 – Clinical strength benchmarks for return to running
26:16 – Return-to-run walking milestones and symptom monitoring
27:16 – Pain tolerance guidelines: the “any pain, stop” rule for bone
27:45 – Footwear considerations: heel wedges, rocker-bottom shoes, carbon plates
28:42 – Surface and terrain considerations
29:40 – Treadmill running and distal loading effects
30:39 – What’s next: Q&A episode and future bone stress injury series
33:01 – Episode close & sponsor mentions
THE TEAM:
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 at pogophysio.com.au.
Your Hosts:
🏃 Brad Beer – Instagram & X @Bradbeer and YouTube @PogophysioAu
🏃♂️➡️ Timothy Studley – Instagram @timothy_physio
The Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperformanceshow
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.
