The Physical Performance Show: Professor Stuart Warden (PT, PhD, FACSM, FASBMR) ‘Preventing Bone Stress Injuries in Runners’

Posted August 6, 2021

In Podcast (The Physical Performance Show)

The Physical Performance Show host Brad Beer shares a conversation with Professor Stuart Warden (PT, PhD, FACSM, FASBMR) ‘Preventing Bone Stress Injuries in Runners’ in this Expert Edition.

Professor Stuart Warden is an avid runner. Academically and professionally Dr Stuart Warden serves as a Professor of Physical Therapy and the Associate Dean for Research within the Indiana University School of Health & Human Sciences. Professor Warden embarked on a Post Doctorate at the Australian Institute of Sport and Indiana University Department of Orthopaedic Surgery, following graduation from the University of Melbourne with a Physiotherapy degree in 2001.

Professor Warden’s research interests focus on the form and function of the musculoskeletal system, in-particular the lifelong contribution of physical activity to skeletal health. Professor Stu has contributed to over 170 peer reviewed publications and currently serves as an Associate Editor for The Journal of Orthopaedic & Sports Physical Therapy and also as an Editorial Board Member for Bone, Journal of Bone and Mineral Research and the Journal of Science and Medicine in Sport.

Professor Stuart Warden alongside colleagues Brent Edwards and Dr Rich Willy released a landmark commentary by way of a scientific paper titled “Preventing Bone Stress Injuries in Runners with Optimal Workload”.

In this episode we dive deep into the contents of the recently published paper:

What the author’s mean by optimal bone workload
Optimal workload to induce skeletal adaptation
The fact that not all athletes have good skeletons
Why it is that distance running does not build good bones
How we can use periodisation to help build more bone
The effects of early specialisation with sport and the contribution this may have on bone stress injury risk
Why it is that optimising bone structure is critical and how it only develops before puberty
How we can positively increase the robustness of our skeleton through bone centric exercises
How we can try and minimise training errors to avoid the onset of a bone stress injury
And much more

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Listen in as we delve into the following:

Bone Stress Injury
The role of porosity in bone stress injuries
The role that running intensity/speed and bone load magnitudes plays on the risk of bone stress injury
The relationships between bone stress injury risk and the number of loading cycles & bone load magnitudes
Misconceptions around running and bone health
How to augment bone health through bine centric exercises
Periodising workload in order to reduce BSI risk
Tips on running mechanics
Top learning to perform at your physical best
Physical Challenge of the Week

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Quotes

“If you can reduce your magnitude in loading just a little bit, you get a much larger decrease of bone stress injury risk.”
“Try to find the balance between intensity and distance.”
“Running itself is not really a great bone building activity.”
“The best time to build bone is before puberty.”
“The thing that loads bone the most is not hitting the ground but muscle contractions.”

“Taking one day off is not going to allow much recovery than having 5 consecutive days for recovery.”
“People who play ball sports before they enter military training have a much lower risk of bone stress injury than those who never played ball sports.”
“Increase your cadence especially if you have multiple stress injury” – Tip on Running Mechanics

Top 3 Tips
– Document your workload
– Look at nutrition, sleep, menstrual cycles and other factors
– Increase your distance before you increase your intensity

“Join and train with a group.” – Top Learning Tip
“You need to do 20 countermovement jumps at least this week.” – Physical Challenge

Resources

Publication: Preventing Bone Stress Injuries in Runners with Optimal Workload

To follow Stuart Warden

Bio: Stuart J. Warden, PhD
Twitter: @StuartJWarden
LinkedIn: Stuart Warden
ResearchGate: Stuart J Warden

Timeline

00:00 Start
07:43 Bone Stress Injury
09:55 Role of porosity and how it happens
15:30 Magnitude of Bone loads
18:00 Approach on Bone stress injury
20:51 What is Intensity
24:08 Misconceptions on Running and Bone Health
30:55 Risk Factors of Bone Stress Injury
34:00 How to augment bone health
36:20 Frequency to help the skeleton adapt
37:49 How high bone loads get
45:17 Suggestions on De-loading period (Skeletal reset period)
58:00 Tips on Running Mechanics
1:01:24 Top 3 Tips to avoid stress injuries for runners
1:04:35 Top Learning to perform at your physical best
1:06:20 Physical Challenge
1:07:57 Finish

People Mentioned

Dr Rich Willy – Running Researcher & Physical Therapist at University of Montana (Assoc Prof.), Episode 74 and 132 of The Physical Performance Show
Prof Belinda Beck – Bone Health Expert – Episode 82 of The Physical Performance Show
Dr Stephen Seiler – Acclaimed Sports Scientist: COVID training & marathon considerations, Episodes 172, 219 and 226 of The Physical Performance Show
Dr Christian Barton – Patellofemoral ‘knee-cap’ pain, Episode 112 of The Physical Performance Show

Resources

Preventing Bone Stress Injuries in Runners with Optimal Workload (Warden, Edwards, & Willy, Current Osteoporosis Reports, 2021)

For questions and comments about this Episode

Send to the Show Host @Brad_Beer (Twitter) or @brad_beer (Instagram)

athletes, bone injury, Bone Stress, physical, PHYSICAL THERAPY, Running, sport, stress fracture, training