{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Ep 382: Tibial Bone Stress Masterclass Part 2 (Fixing Shin Pain & Tibia Injuries)","description":" Physical Performance Show \u2013 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 \u2014 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 \u2014 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." \u2014 Brad Beer "That runner doesn't need to be strong. They need to be uber strong." \u2014 Brad Beer, quoting tendon researcher Ebonie Rio "A 10% increase in pace reduces the fatigue threshold of a bone by 50%." \u2014 Brad Beer Timeline 00:00 \u2013 Introduction & sponsor: Pillar Performance 02:26 \u2013 Running mechanics and tibial bone stress injury risk 03:18 \u2013 Cadence, overstriding, and heel-strike patterns 05:43 \u2013 Foot pressure distribution and medial tibial bending 07:39 \u2013 Case study: footwear, orthotics, and cadence cueing 08:37 \u2013 Overview of bone stress injury management complexity 09:35 \u2013 Anterior tibial cortex injuries: high risk, slow healing, surgery 11:30 \u2013 Shift from time-based to symptom-led management 14:49 \u2013 Balancing speed of return with recurrence risk 15:48 \u2013 Five evidence-based return-to-run criteria (Sheeran & Reid, 2024) 18:11 \u2013 Why intensity is a greater risk factor than volume 20:35 \u2013 Strength and conditioning: matching capacity to running demands 22:29 \u2013 Three-phase strength progression: pre-, during-, and post-weight bearing 24:52 \u2013 Clinical strength benchmarks for return to running 26:16 \u2013 Return-to-run walking milestones and symptom monitoring 27:16 \u2013 Pain tolerance guidelines: the "any pain, stop" rule for bone 27:45 \u2013 Footwear considerations: heel wedges, rocker-bottom shoes, carbon plates 28:42 \u2013 Surface and terrain considerations 29:40 \u2013 Treadmill running and distal loading effects 30:39 \u2013 What's next: Q&A episode and future bone stress injury series 33:01 \u2013 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: \ud83c\udfc3 Brad Beer - Instagram & X @Bradbeer and YouTube @PogophysioAu \ud83c\udfc3\u200d\u2642\ufe0f\u200d\u27a1\ufe0f Timothy Studley - Instagram @timothy_physio The Physical Performance Show can be found at: Facebook: facebook.com\/thephysicalperformanceshowpodcast X: @tppshow1 Instagram: @physicalperformanceshow ","author_name":"The Physical Performance Show","author_url":"https:\/\/physicalperformanceshow.com\/","html":"