The Physical Performance Show

Brad Beer (POGO Physio)

The Physical Performance Show exists to inspire people to achieve their physical best performance through candid interviews with the world's best and most inspiring physical performers. The show's host Physiotherapist, Best selling Author, and accomplished athlete Brad Beer delves into how top physical performers achieve success and the highs and lows of the journey in getting there.

  1. 2h ago

    Ep 384: Tibial Bone Injury Q&A - All Your Questions Answered

    In episode 384 of The Physical Performance Show, Brad Beer and fellow physiotherapist Tim Studley tackle a wide-ranging Q&A on tibial bone stress injuries. Following the recent bone stress injury mini-series and two-part tibial bone stress injury masterclass, Brad and Tim answer listener questions covering chronic tibial stress responses, recurring shin pain, rehabilitation, plyometrics, strength training, anti-inflammatory medications, and how to reduce the risk of future bone stress injuries. The episode explores some of the practical clinical questions that arise when athletes are trying to understand persistent shin pain and return to running. Brad and Tim unpack the difference between tibial bone stress injuries and medial tibial stress syndrome (MTSS), explain how workload and tissue tolerance interact, discuss when to introduce single-leg strength and plyometrics, and highlight why a thorough assessment of both biomechanical and biological risk factors is essential for athletes with recurring bone stress injuries. Show Sponsor: PILLAR Performance is leading a new frontier in the sports nutrition industry through micronutrition innovation. Their Performance Health range is designed to support the crucial hours outside of training and racing, helping athletes return to the start line in peak condition. One of their newest releases is Collagen Repair, developed in collaboration with Gelita Laboratories and featuring the clinically trialled collagen peptide TENDOFORT. For 15% off your first purchase, head to pillarperformance.shop or, for North American listeners, thefeed.com and use the code PHYSICALPERFORMANCE at checkout. 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.   Partners / links mentioned: Show sponsor: PILLAR Performance — 15% off your first purchase using code PHYSICALPERFORMANCE at checkout. PILLAR Performance: pillarperformance.shop North American listeners: thefeed.com Pogo Physio Telehealth Consultations: pogophysio.com.au     In this episode, you'll hear: Chronic tibial bone stress injuries: whether an experienced ultramarathon runner can adapt to a persistent Grade 2 stress response and continue running without progressing to a stress fracture Recovery strategies: what sauna, nutrition and strength training may—and may not—contribute to recovery from tibial bone stress injuries Nutrition and bone health: the importance of adequate calorie and micronutrient availability, and why recurrent bone stress injuries may warrant review with a sports dietitian Calcium supplementation: what is known about calcium availability and why there isn't a clear tibia-specific dose linked directly to bone stress injury recovery Recurring shin pain: why an athlete can continue experiencing medial shin pain despite controlled mileage and well-rounded strength training The three-part clinical framework: biomechanics, workload, and tissue capacity as key areas to investigate when shin pain keeps returning MTSS versus bone stress injury: why persistent posterior-medial shin pain may represent medial tibial stress syndrome rather than a bone stress injury Individual differences: why some runners seem more susceptible to shin pain and why comparing your injury history with other runners can be misleading Plyometrics and single-leg strength: when to introduce spring-based loading, hopping and jumping during tibial bone stress injury rehabilitation Rehabilitation progression: why single-leg strength work can begin relatively early while plyometrics are generally introduced later Training the opposite leg: why the unaffected limb should continue to be trained during rehabilitation Return to running with persistent shin pain: how MRI findings, symptom location and clinical presentation can help distinguish MTSS from tibial bone stress injury Strength training progression: moving from higher-repetition, lower-load work capacity training towards heavier strength and eventually rate-of-force and plyometric training Anti-inflammatory medications: what regular use of ibuprofen and diclofenac may mean for bone and skeletal health, and why they are unlikely to be the sole cause of a running-related bone stress injury Posterior tibial stress reactions: how running workload can exceed bone tolerance and how factors including bone geometry, bone quality, biomechanics and psychology may influence risk Preventing recurrence: why runners with a previous bone stress injury have a significantly elevated future risk and need to identify and manage their individual risk factors The role of the gym: why strength and conditioning can help restore muscle capacity, support bone health and prepare the tibia for the demands of running Hop testing: why a pain-free hop test is useful when assessing tibial bone stress injuries, while recognising that other diagnoses can also produce pain with hopping The 10 cm palpation rule: why longer areas of shin tenderness are more consistent with medial tibial stress syndrome than focal bone stress injury Clinical assessment: why practitioners need to consider gait, palpation, loading tests, biomechanics, workload, tissue capacity and differential diagnoses rather than relying on pain intensity alone. Quotes / takeaways: "Bone stress is not something that the body adapts to." "Most people are paying a tax, I always say, to play the game they want to play." "There's no recipes." "It's never just one thing." "You need running workload and that workload exceeds, in simple terms, bone's tolerance." "Once a runner's had a bone stress injury, they have much heightened risk, six to seven fold for the rest of their running life."   Time Stamps: 00:00 – Episode introduction and breakthrough experience 00:23 – Episode 384 introduction: Q&A on tibial bone stress injuries 00:53 – Sponsor: PILLAR Performance and Performance Health 01:20 – Collagen Repair: formulation, TENDOFORT and collagen health 01:49 – 15% PILLAR Performance discount with code PHYSICALPERFORMANCE 02:18 – Episode begins: listener Q&A following the bone stress injury series 03:24 – How the listener questions were gathered and why these themes matter 03:53 – Chris' question: chronic Grade 2 tibial bone stress injury in an experienced ultramarathon runner 04:23 – Can the body adapt to bone stress and allow an athlete to run through it? 05:49 – Why symptomatic bone stress requires an appropriate deload 06:16 – Sauna, nutrition and other recovery techniques 07:11 – Micronutrients, calories and optimal skeletal health 08:07 – Strength training and progressive restoration of tibial capacity 08:33 – Calcium intake and the importance of sports dietitian review for recurrent injuries 09:57 – Zane's question: recurring medial shin pain despite controlled mileage and strength training 10:52 – Why some runners continue to struggle despite avoiding obvious training spikes 11:51 – The three key areas: biomechanics, workload and tissue capacity 12:19 – MTSS versus tibial bone stress injury 12:46 – Biomechanical strategies and the example of professional triathlete Josh 13:39 – Strength and conditioning relative to the demands of professional triathlon 14:07 – Why recurring shin pain may require a more individualised assessment 15:03 – Why comparing yourself with runners who appear injury-free can be misleading 15:33 – "Paying a tax" to participate in the sport you love 16:02 – Isaac Fishlock's question: when to introduce plyometrics and single-leg strength 16:28 – Plyometrics as a late-stage rehabilitation tool 16:57 – Why bones need spring loading and high rates of loading 17:26 – Introducing single-leg strength early and training the unaffected leg 17:55 – Why the opposite leg may also be at increased risk after deloading 18:18 – Are there strength or pain benchmarks before introducing plyometrics? 18:45 – Why rehabilitation progression needs to be individualised 19:15 – Rhonda Gainsford's question: persistent medial shin pain with a negative MRI 19:45 – Why persistent symptoms can point towards MTSS rather than bone stress injury 20:13 – What an MRI showing no bone stress response can tell you 20:42 – Focal versus longer-length tenderness along the shin 21:10 – Can the runner return to running? 21:41 – The Coil Crew's question: heavy reps versus endurance work for calf raises 22:10 – Starting with higher-repetition, lower-load work capacity 22:41 – Progressing towards heavier strength work 23:09 – The three-pronged calf framework: endurance, maximum strength and spring 23:39 – Clinical benchmarks for calf endurance and reactive strength 24:09 – Ryan Williams' question: can regular ibuprofen or diclofenac cause a stress response? 24:37 – Anti-inflammatories, collagen synthesis and potential effects on skeletal health 25:03 – Why anti-inflammatories are unlikely to independently cause a running-related bone stress injury 26:01 – How a posterior tibial stress reaction develops 26:31 – Running workload versus bone tolerance 27:00 – Bone geometry, bone quality, adolescent sport and other risk factors 27:29 – Why bone stress injuries are multifactorial 27:57 – Reducin

  2. Jul 30

    Ep 383: Prof Franco Impellizzeri on Load Management, Data & the Truth About ACWR

    Physical Performance Show – Episode 383 Show Notes In episode 383 of The Physical Performance Show, host Brad Beer sits down with Professor Franco Impellizzeri, one of the most influential and outspoken voices in athlete load management research, for a wide-ranging conversation on why "load management" is an old concept dressed up in new data, why the acute to chronic workload ratio (ACWR) never held up to scrutiny, and why context — not more metrics — is what separates good decision-making from noise. 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.   Professor Franco Impellizzeri's work can be explored here: https://profiles.uts.edu.au/Franco.Impellizzeri And... https://scholar.google.com/citations?user=z35F1WAAAAAJ&hl=en   Listen in as we delve into the following: What "load management" actually means, and why it's a relabelling of concepts coaches have wrestled with since the 1930s–40s The double-edged sword of the data revolution: from heart rate monitors to today's GPS, wearables, and AI-driven analytics Commercial and career incentives behind pushing metrics — both from tech companies and researchers Confirmation bias and why interpreting data without a theoretical framework is "like reading tarot" The case against the acute to chronic workload ratio (ACWR): its lack of scientific support despite IOC endorsement A landmark runners' study showing the opposite relationship between ACWR and injury risk — and what that reveals about the field Why meta-analyses and systematic reviews in load research can be manipulated to "find whatever you like" The difference between using a metric personally versus promoting it as scientifically validated Why the most skilled clinicians tend to hold their conclusions with the least certainty A real-world case study: a soccer training drill "failure" that was actually a video-monitoring blind spot, not a bad drill The expanding role of data scientists in sport, and why interpretation — not collection — is the real skill gap Whether AI and machine learning can (or should) replace the sports scientist's judgement Individualised and personalised training approaches — and why even these are still built on group-level generalisations Distinguishing signal from noise, and why one "failed" intervention doesn't mean an athlete won't respond next time Practical advice for coaches and practitioners: accept uncertainty, treat training like a "trial of therapy," and reassess If he could track only one metric: heart rate (or perceived effort) over power The push for more honest scientific debate — including a proposed on-air "intellectual sparring" series with dissenting researchers   Quotes: "Understanding the quantity of training for athletes has been a hot topic since training methodology started... managing load is not new." — Professor Franco Impellizzeri "When you don't have a theoretical framework and an a priori idea strong and supported, it's like reading tarot, to be honest." — Professor Franco Impellizzeri "There's zero evidence that this metric can either help or can actually reflect some sort of mechanism." — Professor Franco Impellizzeri, on the acute to chronic workload ratio "Don't take yourself too seriously." — Professor Franco Impellizzeri   Timeline: 00:00 – Introduction: host's specialist physio training and the load management "viva" question 01:04 – What is load management? An old concept, relabelled 02:31 – From heart rate monitors to GPS: the rise of training data 06:14 – Commercial interests and the risk of becoming "slaves of data" 08:05 – Why load management matters: the drug-dosing analogy 09:24 – Load management as a decades-old coaching concern 10:23 – Confirmation bias and interpreting data "like reading tarot" 13:17 – Championing methodological rigor in sports science 16:33 – Meta-research, honesty, and acknowledging uncertainty 18:22 – Why the most skilled clinicians express the least certainty 19:18 – Origins of the critique of the acute to chronic workload ratio (ACWR) 20:09 – Takeaways for contemporary practitioners on load management models 21:34 – Why the ACWR lacked scientific and conceptual support 23:02 – Training load, time-at-risk, and reframing injury risk 24:24 – The contradictory runners' study and what it implies 26:43 – Cherry-picking and overfitting in load-injury meta-analyses 28:34 – Taking a stronger public stance on social media 30:34 – Science as a self-correcting process 31:31 – The discipline required to properly read and critique research 33:58 – Why data alone can't tell you what to do 34:24 – Case study: the soccer drill that "failed" — until the video told the real story 36:49 – The role (and limits) of data scientists in sport 38:46 – Could AI replace the sports scientist's job? 40:42 – Advice for coaches and practitioners: accept uncertainty 42:09 – Individualised approaches are still a form of generalisation 44:31 – Separating signal from noise — and why not to give up early 46:56 – If only one metric: heart rate over power 48:21 – One piece of advice: "don't take yourself too seriously" 48:51 – This week's physical challenge: swimming without pain 50:16 – What's next: meta-research projects and replication studies 51:43 – A proposal for public scientific debate, and Ian Shrier's work on consensus 56:32 – Why genuine debate is hard to find in science communication today 57:59 – Episode close 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 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

  3. Jul 24

    Ep 382: Tibial Bone Stress Masterclass Part 2 (Fixing Shin Pain & Tibia Injuries)

    Physical Performance Show – Episode 382 Show Notes 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: Biomechanical vs. biological risk factors, and why running intensity matters more than mileage for bone Cadence, overstriding, and how a heel-strike pattern increases tibial loading Foot pressure distribution, lateralised loading, and how footwear/orthotics can help A case study: how cadence cueing, orthotics, heel raises, and calf strengthening resolved recurrent tibial bone stress injury Managing anterior tibial cortex injuries: why they're high-risk, slow to heal, and often need surgery Moving from time-based to symptom-led (optimal load) management for posterior-medial tibial bone stress injuries The five evidence-based criteria for returning to running after a tibial bone stress injury Why a 10% increase in pace can cut a bone's fatigue threshold by 50% Structuring intensity and volume in a return-to-run program to avoid a "double whammy" of risk Strength and conditioning phases: contralateral leg work, weight-bearing progressions, and pre-running plyometrics Clinical strength benchmarks for calf raises, leg press, hamstring curls, and hip abduction Footwear considerations: heel wedges, rocker-bottom shoes, and the debate around carbon plates Surface and terrain: why stiffer surfaces and flat terrain are preferred during return-to-run Treadmill running and its effect on distal loading What's next: an upcoming Q&A episode, and future instalments covering the femur, sacrum, tarsal bones, and calcaneus 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

    Ep 382: Tibial Bone Stress Masterclass Part 2 (Fixing Shin Pain & Tibia Injuries)

  4. Jul 17

    Ep 381: Tibial Bone Stress Masterclass Part 1 (Shin Pain, Shin Splints or Stress Fracture?)

    In episode 381 of The Physical Performance Show, host Brad Beer — sports and exercise physiotherapist — sits down with Pogo physiotherapist Tim Studley for the first instalment of a two-part mini-series on shin pain and tibial bone stress injuries, following on from their earlier three-part bone stress injury series. This episode is essential listening for runners, coaches, and clinicians alike, unpacking how to tell the difference between medial tibial stress syndrome (MTSS/shin splints) and a true tibial bone stress injury — two conditions that can feel identical but require completely different management. Brad and Tim walk through the physiology of bone loading, the palpation tests that separate a "safe to keep running" diagnosis from one requiring an MRI, and the loading tests used to stress-test the tibia safely in clinic. 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 https://pogophysio.com.au. Listen in as we delve into the following: The prevalence of tibial bone stress injuries and why the shin is the most common bone stress site in runners Why bone stress injuries occur: workload errors, loading frequency vs. magnitude, and individualised risk factors The continuum from "happy bone" to stress reaction to frank stress fracture Why pain magnitude doesn't reliably predict injury severity The heterogeneity of bone innervation and why the periosteum is key to understanding pain Differentiating MTSS from tibial bone stress injury — and why the management is entirely different The 10cm palpation rule: a clinical prediction rule for when to suspect bone vs. soft tissue Why the anterior (front) shin is a higher-risk, non-union-prone injury site The loading-test ladder: double leg calf raise → single leg calf raise → single leg hop → side-to-side hop → forward hop The role of muscle-bone synergy: how calf strength and girth influence tibial bone stress risk Recovery timelines by injury grade, and why MRI matters for prognosis and athlete buy-in A real case study: a triathlete's navicular injury, deconditioning, and return to tibial bone stress injuries Quotes "You can go from hero to zero really quickly with bone."  "Higher levels of pain don't necessarily mean a worse injury."  "Muscle loads bone."  Timeline 00:00 – Introduction & sponsor: Pillar Performance 02:15 – Introduction to Tim and Brad's conversation 02:27 – Prevalence of tibial bone stress injuries 03:56 – Why bone stress injuries occur: workload and biomechanics 05:22 – Symptom patterns: bone stress injury vs. other shin pain 07:42 – Heterogeneity of bone innervation and pain variability 10:10 – Why pain severity doesn't predict injury severity 11:07 – MTSS vs. bone stress injury: two schools of thought 12:06 – Brad's clinical experience and personal injury history 13:59 – Cardinal signs and symptom progression in MTSS 15:23 – The three-legged stool: history, physical exam, imaging 16:19 – The 10cm palpation rule explained 19:43 – Applying the rule in practice 20:42 – Anterior shin pain: a higher-risk presentation 21:39 – Loading tests: from calf raises to forward hopping 24:07 – Individualising the loading-test progression 26:03 – Does the 10cm rule apply anteriorly? 26:55 – History as the biggest predictor of reinjury 27:53 – MRI, prognosis, and grading via the Fredericksons scale 29:15 – Reading hesitancy and movement quality in loading tests 31:10 – Why bone stress injuries aren't purely about vertical impact 33:03 – Calf girth and bone stress risk correlation 34:56 – Case study: a triathlete's navicular injury and recovery 35:58 – 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

    Ep 381: Tibial Bone Stress Masterclass Part 1 (Shin Pain, Shin Splints or Stress Fracture?)

  5. Jul 10

    Ep 380: Bone Stress Injuries: Recovery, Rehabilitation & Return to Running (Part 3)

    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. 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 MRI remains the gold standard for diagnosing bone stress injuries and guiding treatment When a clinical diagnosis may be sufficient—and why imaging usually provides better certainty and prognosis The three-step rehabilitation framework: identify risk factors, deload appropriately, then progressively reload Why treating the underlying cause is essential to preventing repeat bone stress injuries How rehabilitation differs depending on injury severity and high-risk versus low-risk bone sites Practical principles for returning to running, including restoring volume before introducing intensity Why the opposite limb also requires strength and bone loading during rehabilitation The role of strength training, plyometrics and osteogenic exercise in rebuilding bone capacity Why bone responds best to short, novel loading sessions rather than long continuous exercise The concept that "bone cells get bored easily" and how to optimise bone adaptation Why multidirectional movement remains important long after returning to sport The impact of childhood sport participation and bone geometry on lifelong injury risk Brad's personal journey with osteoporosis and what it taught him about endurance athlete health Three practical strategies every endurance athlete can implement to reduce bone stress injury risk Why recovery—not just training—is where adaptation actually occurs Quotes / takeaways "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." Partners / links mentioned Show Sponsor: PILLAR Performance — 15% off your first order using code PHYSICALPERFORMANCE at checkout. North America: thefeed.com Timeline 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 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. 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

    Ep 380: Bone Stress Injuries: Recovery, Rehabilitation & Return to Running (Part 3)

  6. Jul 3

    Ep 379: Bone Stress Injuries: Risk Factors, Diagnosis & Prevention (Part 2)

    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. 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 biological factors may contribute more to bone stress injuries than training load alone The long-term consequences of early sport specialisation and why multi-sport participation builds a stronger skeleton Medical conditions and medications that can compromise bone health and increase injury risk Why low energy availability (RED-S) is one of the biggest contributors to bone stress injuries Practical screening questions clinicians should ask to identify athletes who may be under-fuelling The relationship between training volume, mood, gastrointestinal symptoms, sleep, life stress and bone health Female-specific indicators including menstrual irregularities and amenorrhoea Male-specific indicators including reduced libido and changes in morning erectile function Why blood tests, iron status, vitamin D and hormone profiles provide valuable clues to athlete health The importance of working with sports dietitians to optimise energy availability and performance Common locations of bone stress injuries throughout the lower limb and pelvis How injury location can provide clues to whether biomechanics or under-fuelling is the primary driver Understanding high-risk versus low-risk bone stress injury sites and why blood supply matters Practical assessment strategies including observation, palpation and functional loading tests When hop testing is appropriate—and when it should be avoided Clinical pearls for distinguishing bone stress injuries from other common running injuries Quotes / takeaways "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." Partners / links mentioned Show Sponsor: PILLAR Performance — 15% off your first order using code PHYSICALPERFORMANCE at checkout. North America: thefeed.com Timeline 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 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. 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

    Ep 379: Bone Stress Injuries: Risk Factors, Diagnosis & Prevention (Part 2)

  7. Jun 25

    Ep 378: Bone Stress Injuries: Causes, Symptoms & Early Warning Signs (Part 1)

    *]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id= "request-WEB:6a57fa5e-c460-45da-be9f-861e67a1cd4e-2" data-turn-id-container= "request-WEB:6a57fa5e-c460-45da-be9f-861e67a1cd4e-2" data-testid= "conversation-turn-4" data-turn="assistant"> 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. *]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-(--sticky-padding-top)" dir="auto" data-turn-id="081498ac-bc39-4ab2-a81c-691cffa69424" data-turn-id-container="081498ac-bc39-4ab2-a81c-691cffa69424" data-testid="conversation-turn-5" data-turn="user">

    Ep 378: Bone Stress Injuries: Causes, Symptoms & Early Warning Signs (Part 1)

  8. Jun 17

    Ep 377: The Complete Guide to Hamstring Strain Rehabilitation with Nick Kane

    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.

    Ep 377: The Complete Guide to Hamstring Strain Rehabilitation with Nick Kane
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Hosts & Guests

4.9
out of 5
71 Ratings

About

The Physical Performance Show exists to inspire people to achieve their physical best performance through candid interviews with the world's best and most inspiring physical performers. The show's host Physiotherapist, Best selling Author, and accomplished athlete Brad Beer delves into how top physical performers achieve success and the highs and lows of the journey in getting there.

Information

  • Creator
    Brad Beer (POGO Physio)
  • Years Active
    2016 - 2026
  • Episodes
    385
  • Rating
    Clean
  • Copyright
    © Copyright POGO Physio Pty Ltd & Evolution Strength & Rehabilitation Pty Ltd
  • Show Website
    The Physical Performance Show

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