Ready to Run

What we talked about: 3:10- Outlining the episode 3:40- What is iron and why it is importance for endurance athletes 4:35- Different types of iron deficiency 7:50- Diagnosis of iron deficiency 11:05- Altitude training and optimization of iron 11:55- Who is screened for iron deficiency 12:40- Goal ferritin levels for athletes 13:45- Getting more iron in your diet 14:55- When and how to take iron supplementation 17:25- IV supplementation 18:50- Summary of episode Sponsors: 2Before Use the code "Lindsey" for 30% off of 20 packs plus free shipping Sidekick Tool Go to sidekicktool.com/rtr and use the code "readytorun" for a 15% discount

What we talked about: 4:00- Introduction to calcaneal bone stress injuries 4:25- What is the calcaneus? 4:55- Where these injuries typically occur within the heel 5:55- Risk factors 7:15- Presentation 10:30- Progression of the injury 11:15- Treatment 13:40- Summary Sponsors: 2Before Use the code "Lindsey" for 30% off of 20 packs plus free shipping Sidekick Tool Go to sidekicktool.com/rtr and use the code "readytorun" for a 15% discount

What we talked about: 4:00- Terminology of groin pain 6:10- How to start treatment with groin pain 9:20- Utilizing ultrasound 15:20- Finding the source of pain to provide an effective treatment strategy 18:00- Running protocol with these injuries 21:55- Rehabilitation exercises 25:45- Return to run expectations 29:00- Sports hernia protocol Sponsors: 2Before Use the code "Lindsey" for 30% off of 20 packs plus free shipping Sidekick Tool Go to sidekicktool.com/rtr and use the code "readytorun" for a 15% discount

What we talked about: 3:40- Quick introduction to stress injuries 6:05- Bone stress injuries of the femoral neck 7:35- How these injuries present with these injuries 11:00- Recovery and return to run program 18:20- Bone stress injuries of the lesser trochanter 20:40- Injuries of the femoral shaft 23:20- Takeaways from the episode Sponsors: 2Before Use the code "Lindsey" for 30% off of 20 packs plus free shipping Sidekick Tool Go to sidekicktool.com/rtr and use the code "readytorun" for a 15% discount

What we talked about: 3:00- What is the sacrum 3:45- Characteristics of a bone stress injury 6:20- Defining a sacral stress fracture 6:45- Signs and symptoms 8:25- Imaging 9:35- Treatment 11:55- Different layers of bone 13:30- DEXA scans 15:30- Rehabilitation Sponsors: 2Before Use the code "Lindsey" for 30% off of 20 packs plus free shipping Sidekick Tool Go to sidekicktool.com/rtr and use the code "readytorun" for a 15% discount

On this week’s episode of the Ready to Run Podcast, we have the pleasure of meeting with Lindsey Plass to discuss femoroacetabular impingement (otherwise known as FAI) and hip labrum tears in runners. Lindsey is a Chicago-based physical therapist, performance coach, author, and international speaker. Lindsey is a former college soccer player turned 10-time marathoner and triathlete. She completed an orthopedic physical therapy residency and manual therapy fellowship making her a board certified Orthopedic Clinical Specialist and Fellow of the American Academy of Orthopedic Manual therapists.  It was her own lived experience, nearly 10 years ago, with hip pain related to FAI and a labral tear that sparked her interest in helping others with hip issues getting back to doing the things they love.  She is a clinician and coach and owner of Plass Physical Therapy and Performance. She is currently faculty in the University of Chicago Medicine Orthopedic Physical Therapy Residency and University of Chicago Manual Physical Therapy Fellowship. In 2021, Lindsey was invited to be a part of the international Young Athlete’s Hip Research Collaboration led by Dr. Henrik (Paul) Dijkstra who is the Director of Medical Education at Aspetar. Lindsey was also invited as an expert clinician panel member of the 2022 Oxford University Young Adult Hip Consensus meeting, where she represented physical therapists internationally.  We are excited to share her wealth of knowledge and expertise in how to recognize and manage these injuries with the best current evidence. Let’s get ready to run with Lindsey Plass! Show notes: 5:10- What is FAI and its associated pathologies? 7:50- Prevalence of FAI  9:15- When does cam/pincer morphology develop? 12:15- Signs and symptoms of FAI/hip labrum tear 19:15- Key components of the physical exam and diagnostic work-up 28:45- Interpretation of MRI findings 33:00- Common functional impairments in patients with symptomatic FAI 39:10- Understanding non-surgical and surgical treatment options and managing expectations  44:10- Effect of athlete level of sport and decision-making process for surgical and non-surgical treatment of FAI References: Freke MD, Kemp J, Svege I, Risberg MA, Sem-ciw A, Crossley KM. Physical impairments in symptomatic femoroacetabular impingement: a systematic review of the evidence. Br J Sports Med. 2016;50:1180. Kemp JL, Coburn SL, Jones DM, Crossley KM. The Physiotherapy for Femoroacetabular Impingement Rehabilitation STudy (physioFIRST): A Pilot Randomized Controlled Trial. J Orthop Sports Phys Ther. 2018 Apr;48(4):307-315. Mansell NS, Rhon DI, Meyer J, Slevin JM, Marchant BG. Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up. Am J Sports Med. 2018 May;46(6):1306-1314. Thorborg K, Reiman MP, Weir A, Kemp JL, Serner A, Mosler AB, HÖlmich P. Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management. J Orthop Sports Phys Ther. 2018 Apr;48(4):239-249.  Social media links: Website: https://plassptperformance.com/ Instagram: @plassptperformance

In this episode, we meet with Dan King who is a US masters runner from Boulder, CO. Dan is an accomplished runner and currently holds the world record in the 60-64 age group in the mile with a time of 4:49:08 set in 2020. He discusses how he overcame a years long history of recurring plantar fasciitis and calf strains which led to his unique training regimen focusing on high volume cross training and Easy Interval Method running. His training methods and plant-based lifestyle have led to his success and longevity in running as a world class masters athlete, and he shares some great advice for the person who has the goal of being a lifelong runner. Let’s get ready to run with masters runner and cross training king – Dan King! What we talked about: 3:25- Setting the world record for the mile for the 60-64 age group 8:15- Managing injuries 12:35- Strength training 16:45- Nutrition as a masters athlete 21:10- His current training methods 26:55- The easy interval method 30:55- The long run 37:10- Racing shorter distances versus the marathon 42:50- Nutrition 56:00- Advice he would give his younger self Show notes: The China Study Connect with the Ready to Run Podcast: Ready to Run Podcast on Instagram Ready to Run Website Follow SandyBoy Productions: Sandyboy Productions on Twitter Sandyboy Productions on Instagram SandyBoy Productions Shows: Why is Everyone Yelling? I'll Have Another Podcast The Illuminate Podcast The Herban Farmacy Podcast Sponsors: Previnex Use the code "ReadytoRun" for 15% off your first order

While most runners return to sport following an acute ankle sprain without complications, not all ankle sprains are simple. In this episode, we'll discuss an example case to demonstrate several important considerations for someone with chronic ankle instability. This includes a discussion on the most common causes of persistent ankle pain including cartilage injuries, peroneal tendinopathy, posterior tibialis tendinopathy, and recurring sprains. We'll break down some of the alterations in movement patterns seen after ankle sprain, physical exam pearls, and rehabilitation plan. If you've ever had an ankle injury that has taken a long time to heal then you'll want to check out this episode and explore the main reasons why runners can end up with ankle instability and what you can do to break the cycle of injury.Show notes: 3:30 - What is chronic ankle instability? 4:00- Key findings from 2016 consensus statement on lateral ankle sprains 6:40- Common causes of persisting ankle pain 11:10- Why is it important to manage ankle sprains early on?  25:50- Pathomechanical impairments following an ankle sprain 30:30- Alterations in joint forces and movement patterns  31:50- Effect of loss of range of motion 38:00- Too much supination on landing 42:00- Assessment and physical exam pearls 45:00- Rehab programming  References: Cho JH, et al. Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1022-8.Delahunt E, et al. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br J Sports Med. 2018 Oct;52(20):1304-1310. Hertel J, Corbett RO. An Updated Model of Chronic Ankle Instability. J Athl Train. 2019 Jun;54(6):572-588. Palmieri RM, et al. Arthrogenic muscle response to a simulated ankle joint effusion. Br J Sports Med. 2004 Feb;38(1):26-30. Roemer FW, et al. Ligamentous Injuries and the Risk of Associated Tissue Damage in Acute Ankle Sprains in Athletes: A Cross-sectional MRI Study. Am J Sports Med. 2014 Jul;42(7):1549-57.  Saltzman CL, Salamon ML, Blanchard GM, Huff T, Hayes A, Buckwalter JA, Amendola A. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005;25:44-6.  Sponsors: Previnex Use the code "ReadytoRun" for 15% off your first order

This week, our guest is Rochelle Basil. Rochelle is a local elite long-distance runner, coach, and dog mom. She is originally from New Zealand but now lives just outside of Boulder, Colorado. Her career highlights include competing in the World Cross Country Championships and running a 2:39 marathon in London. In this episode, she shares her personal story of the ups and downs of her career following a peroneal tendon injury and multiple bone stress injuries which changed the trajectory of her career for multiple years. Getting back to good health and getting to the starting line of a marathon was a goal that she didn't think was possible for a long time. With patience, consistency, trust in the process, and support from those around her, she was finally able to reach her goal of getting to the start line of a marathon and crossing that finish line. In this episode, you'll hear about how she ran shoeless for the last 6 miles! Rochelle's journey is one that is defined by refinding the fun in running. This is a story that we know many runners go through and we wanted to open this conversation to share the message that getting back to good health is possible! So if you are someone who is looking to break the cycle of injury, we hope that this episode inspires you as much as Rochelle has inspired us! Let's get ready to run with Rochelle Basil. What we talked about: 4:05- Introduction to Rochelle 7:15- Rochelle’s running and coaching career 11:45- Her injury history 22:20- Your body’s ability to recover from energy deficiency 29:15- The impact of diet culture 32:00- Peroneal tendon injury 39:45- Finding joy in her comeback 43:50- Racing CIM and how she ended up finishing without shoes on 58:00- Changing the narrative of her career Show notes: Follow Rochelle on Instagram Connect with the Ready to Run Podcast: Ready to Run Podcast on Instagram Ready to Run Website Follow SandyBoy Productions: Sandyboy Productions on Twitter Sandyboy Productions on Instagram SandyBoy Productions Shows: Why is Everyone Yelling? I'll Have Another Podcast The Illuminate Podcast The Herban Farmacy Podcast Sponsors: Previnex Use the code "ReadytoRun" for 15% off your first order

What we talked about: 1:50- Defining Haglund’s syndrome 4:40- Prevalence of Haglund’s syndrome 8:00- How these patients present 14:50- Diagnosis 18:40- Prognosis 25:20- Rehab from this injury and return to running program 40:10- Alternative treatments if there is not full recovery with physical therapy 54:20- Evolution of the treatment of Haglund's syndrome Sponsors: Previnex Use the code "ReadytoRun" for 15% off your first order

Dr. David Hryvniak is a physical medicine and rehabilitation sports medicine physician based out of Charlottesville, Virginia at the University of Virginia. He is an expert in several areas of sports medicine including sports ultrasound, running medicine, and Orthobiologics. In this episode, he shares his expertise on platelet rich plasma (PRP). PRP is a tool used by many sports medicine physicians. The goal of today's episode is to discuss the state of the science and to discuss some of the myths and facts, common clinical applications, and ways we can optimize our outcomes for patients with use of ultrasounds to guide our injections, and formulating a post PRP rehabilitation strategy. This is an exciting topic that generates a lot of attention in our sports medicine practice and we are excited to have a leading expert in this arena share his knowledge on PRP! So let's get ready to run with Dr. David Hryvniak. What we talked about: 4:10- Introduction to Dr. David Hryvniak  12:25- What PRP is and how it works 17:45- Common applications of PRP for runners 20:35- Timing in the rehab process to utilize PRP 24:05- Patients that have the most success with PRP 29:15- PRP procedure 38:20- Return to run protocol after PRP 43:55- Tendons that have the highest success rate 50:05- Increase in proximal hamstring tendinopathy 53:00- Ultrasound guided PRP 55:15- Summary of PRP for clinicians and patients 59:20- The Running Medicine conference Sponsors: Previnex Use the code "ReadytoRun" for 15% off your first order Guest info: Dr. David Hryvniak: https://uvahealth.com/provider/David-Hryvniak-1316238934  UVA Runner's clinic: https://www.uvarunnersclinic.com/  Instagram: @uvarundoc PRP references:  -Malanga G, Ibrahim V. Scientific evidence of platelet-rich plasma for orthopedic conditions: basic science to clinical research and applications. Regenerative Treatments in Sports Medicine and Orthopedics. 2018. Chapter 7. 89-117. -Mautner K, Malanga G, Colberg R. Optimization of ingredients, procedures, and rehabilitation for platelet-rich plasma injections for chronic tendinopathy. Pain Manag. 2011. 1(6):523-532. -Dai WL, Zhou AG, Zhang H, Zhang J. Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 2017 33(3): 659-670.

In today's episode of The Ready to Run Podcast, we are joined by professional runner, Joe Klecker. Joe competed at the University of Colorado in Boulder, Colorado where he was a 9-time All-American and is currently the school record holder in the 5000m. He turned pro in 2020 with the On Athletics Club in Boulder and became an Olympian in 2020 in the 10,000m.  Joe is originally from Minneapolis and both of his parents were professional marathoners and US National record holders in the ultramarathon. He won his first national championship in 2020 where he edged out Grant Fisher in the 10,000m. He went on to finish 9th at the World Championships in Eugene, Oregon later that year. In this episode, we discuss some highlights from last season and some factors that have led to his success and his ability to overcome past injuries including a foot injury that happened prior to some of his breakout performances last year. Joe also shares some of his goals for the upcoming season and beyond. Hearing his take on how to maintain Achilles strength provided a unique perspective in our conversation and ties in nicely to a previous recording where Kurt and I discussed Achilles tendon exercise strategies. This episode was recorded just before his 2023 season opener at the BU Invitational where he achieved his goal of breaking the 13-minute barrier in the 5k by going 12:54 which is now the third-fastest indoor 5k for American men!  What we talked about: 3:40- Introduction to Joe Klecker and how training has been going 6:40- 2022 highlights 11:55- Preparing for racing the best in the world 16:20- Racing strategy 19:05- Other factors in training 23:20- Achilles injuries 37:40 - Imaging of his Achilles 47:20- Takeaways from his first two years running professionally Sponsors: Previnex Use the code "ReadytoRun" for 15% off your first order

Our goal in this week's Down Week episode of the Ready to Run Podcast is to sort through the literature on Achilles tendinopathy and provide practical rehabilitation strategies for the athlete with acute reactive tendinopathy and chronic recurring degenerative tendinopathy. We'll also highlight some of the key articles on Achilles tendinopathy rehabilitation as well as a few other considerations including the role of the forefoot and load management strategies for the runner returning from Achilles injury. What we talked about: 1:15- Outlining achilles tendon injuries 3:05- Initial examinations of a patient with achilles pain 7:05- Load management 15:45- Rehab strategies 32:50- Restoring stability 35:00- Mobility, stability, and strength 37:30- Degenerative changes in the tendon References: Alfredson H, Pietilä T, Jonsson P, Lorentzon R. Heavy-Load Eccentric Calf Muscle Training For the Treatment of Chronic Achilles Tendinosis. The American Journal of Sports Medicine. 1998;26(3):360-366. doi:10.1177/03635465980260030301 Beyer R, Kongsgaard M, Hougs Kjær B, Øhlenschlæger T, Kjær M, Magnusson SP. Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial. Am J Sports Med. 2015 Jul;43(7):1704-11. Ganderton, Charlotte, et al. "Achilles tendinopathy: Understanding the key concepts to improve clinical management." Australasian Musculoskeletal Medicine 19.2 (2015): 12-18. Rio E, Kidgell D, Moseley GL, Gaida J, Docking S, Purdam C, Cook J. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. Br J Sports Med. 2016 Feb;50(4):209-15.

In today's episode of the Ready to Run Podcast, we will kick off our first episode of the new year with professional long-distance runner, Paige Stoner. Paige is originally from Pennsylvania and competed in the 5k and 3000m steeplechase at Syracuse University where she was an ACC Champion in both events. She started her professional running career with the Reebok Boston Track Club in Charlottesville, Virginia. She recently relocated to Flagstaff, Arizona. Paige transitioned to the marathon in 2020 where she debuted at the Marathon Project in a time of 2:28:43. This earned her the fastest marathon time for an American female under 25 years old. In just her third marathon, Paige earned her first career US Championship title and also set a new course record of 2:26:02 at CIM in December. Our discussion provides a lens into some of the things that have led to her success in transitioning to the marathon at an early stage in her career. We also discuss the adjustment to living and training at altitude during a marathon training block. Lastly, we recap her race at CIM and discuss her goals for 2023.  What we talked about: 5:05- Introduction to Paige Stoner 6:20- What her training looked like going into CIM 8:40- Adjusting to training at altitude 12:30- The decision to move to Flagstaff 15:40- Her running history 18:05- Debuting in the marathon at a young age 21:05- Her future in marathoning 22:15- Lessons that she learned at the Boston Marathon that helped her prepare for CIM 25:40- Strength training 27:25- Recapping her race day at CIM 30:45- Training at altitude 34:45- Goals for 2023 36:50- Advice to younger athletes Show notes: Paige on Instagram Sponsors: Green Growers Farm Elderberry Syrup Use the code “Sandyboy” for free shipping Previnex Use the code "ReadytoRun" for 15% off your first order

In today's episode of the Ready to Run podcast we'll meet with professional long distance runner, Bria Wetsch. Bria lives in Colorado and has been passionate about competitive running since she was 11 years old. Following a successful high school career, Bria went on to compete at a collegiate level at the University of Oregon. After college, she began her career as a pro runner in Mammoth Lakes, CA where she met her - now husband and coach - Aaron Lange. We'll discuss her journey from Haglund's surgery in 2017 to Olympic trials qualifying time just 13 months later. Bria ultimately finished 27th at the 2020 Olympic marathon trials in Atlanta. More recently, Bria ran a marathon PR of 2:28:35 to finish in 4th place at the California International Marathon earlier this month. We'll recap her incredible performance as well as some of the mental health challenges she overcame during her build up. For Bria, CIM was about more than a marathon PR. She shares a very open conversation on her struggles with depression, anxiety, and panic attacks at the beginning of her marathon training cycle. She also discusses how the trajectory to finding groundedness was not linear. We hope this episode encourages everyone in the running community to better understand the influence of mental health in sports so that we can support those in need and help others achieve their goals. Let's get ready to run with professional long distance runner Bria Wetsch!  What we talked about:  4:15- Introduction to Bria  5:25- How Bria is feeling coming off of her race at CIM  9:50- Her racing mentality  14:15- Her mentality during her race at CIM  15:10- Her buildup to CIM  20:25- Her Achilles injury she sustained post-college and her Haglund's surgery  26:10- Bria's husband and coach, Aaron  28:55- Return to running post Haglund's surgery  29:45- Moving to Boulder  31:05- What has kept her in the sport through all of the injuries  38:05- What she is looking forward to in the coming years  41:20- Her battle with her mental health this summer and how she treated that  Show notes:  Bria on Instagram  Sponsors:  Green Growers Farm Elderberry Syrup  Use the code “Sandyboy” for free shipping  Previnex  Use the code "ReadytoRun" for 15% off your first order

What we talked about:  1:10- Case presentation of anterior knee pain  2:50- Terminology surrounding anterior knee pain  4:20- The various myths surrounding anterior knee pain  9:55- Primary reasons patients develop these symptoms  11:30- Imaging to order with this injury and how to interpret it  16:20- Where swelling occurs  17:40- Ability to run through this injury  21:05- Passive interventions  26:35- Active rehab programs  37:35- Knees over toes  42:00- Treating someone with anterior knee pain that is still training at a high level  45:15- Topical and oral anti-inflammatory

In our last episode, Olympic marathoner Jake Riley and registered dietician and professional runner Maddie Alm shared a lens into the personal journey and athlete’s perspective on Relative Energy Deficiency in Sport (RED-S). Today, we’ll expand on the topic of RED-S with Sports Medicine Physician - Dr. Aubrey Armento and Registered Dietician - Amanda McCarthy of Children’s Hospital Colorado. They will share their expertise and provide insight into screening, diagnosis, treatment, and recovery considerations for return to sport. Dr. Aubrey Armento is a pediatric sports medicine physician at Children’s Hospital Colorado and Assistant Professor in the Department of Orthopedics at the University of Colorado. She is the founder and medical director of The Running Athlete Clinic (TRAC) at Children’s Hospital Colorado and is passionate about caring for runners, in addition to care of the female athlete, the athlete triad, and RED-S. Amanda McCarthy is the Sports Nutrition Program Coordinator and Certified Specialist in Sports Dietetics at Children’s Hospital Colorado Sports Medicine Center. Amanda enjoys working with the young, competitive athlete to help them understand nutrition's role in their wellness and performance. Let’s get ready to run with sports medicine experts - Aubrey Armento and Amanda McCarthy! What we talked about: 4:20- Introduction to Dr. Aubrey Armento and Amanda McCarthy 9:55- Defining RED-S 12:50- Health and performance consequences from RED-S 16:40- Micronutrients and macronutrients 20:00- Considerations for lab work while training at altitude 22:50- Assessing an athlete's diet 25:10- Screening for iron deficiencies  27:40- Considerations for iron supplementation 34:25- Labs and tests for RED-S 37:50- Calculating an athlete’s energy availability 40:15- Treatment plans for athletes with RED-S 45:35- Assessing younger athletes for RED-S 54:10- DEXA scans 1:02:20- Treatments for low bone density 1:11:45- Return to sport considerations 1:17:15- Wrap-up message about RED-S Sponsors: Green Growers Farm Elderberry Syrup Use the code “Sandyboy” for free shipping Previnex Use the code "ReadytoRun" for 15% off your first order

In today's episode, we have a discussion on relative energy deficient in sport, otherwise known as RED-S with Jake Riley and Maddie Alm.  Maddie is a Registered Dietitian and the founder of Fueling Forward Sports Nutrition. Maddie has Masters in Nutritional Science from San Diego State. She completed her training and a registered dietitian at Lipscomb University in Nashville, Tennessee. She also competed at the University of Colorado in Boulder and currently runs professionally for Team Boss.  Jake is an American professional long distance runner and 2020 Olympic marathoner. He currently lives and trains in Boulder, Colorado and is coached by 3-time Olympic marathoner, Lee Troop. Jake grew up in Washington and was an 8-time All-American at Stanford. He previously ran with the Hanson's Distance Project. Jake had one of the most memorable performances and comeback stories at the 2020 Olympic Marathon Trials in Atlanta where he grabbed an American flag with about 400m to go and ran to a sprint finish where he finished 2nd. In June 2022, Jake shared his story about being diagnosed with RED-S in Runner's World. His story helped to open the door to discussing RED-S in the context of male athletes. The term RED-S evolved from what was previously described as the female athlete triad. In 2014, the IOC published a description of RED-S to include a broader definition of the health and performance consequences as well as both inclusion of both male and female athletes.  Identifying an athlete with RED-S is not always straight forward. By sharing an athlete and expert perspective, we hope that this episode can provide a unique lens into the challenges, both physical and mental, that go into diagnosing and managing RED-S. We also get an update on where Jake is at several months after sharing his diagnosis as well as Maddie's advice on how athletes can make positive changes that can be long lasting.  What we talked about: 3:55- Introduction to Maddie 4:25- Introduction to Jake 7:25- RED-S and low energy availability 9:55- Early signs and symptoms of RED-S 12:35- Jake’s diagnosis with RED-S and working with Maddie 20:50- What prompted him to seek help 26:30- Warning signs and symptoms to pay attention to as an athlete 32:35- Questions to ask male athletes to diagnose RED-S 34:10- Treatment approach 41:50- Timeline of recovery 45:20- Differentiating between being tired in training and symptoms of RED-S 51:30- Jake’s recovery from achilles surgery and where he is at in training 1:01:15- Fueling during the marathon 1:05:35- Take home messages about RED-S for athletes and clinicians Show notes: Jake on Instagram Maddie on Instagram Fueling Forward

Nathan Carlson is a physical therapist, coach, and business owner based out of Kansas City. He specializes in the management of bone stress injuries, managing the high school and collegiate runner, and implementing resistance training with endurance athletes. Nathan teaches nationally and internationally on these topics. Nathan has two digital resources - A Guidebook to Running After a Stress Fracture and A Guidebook to Navigating High School Running. In this episode, we focus on how to approach bone stress injuries once we have established our diagnosis. We open our discussion with the physiology of bone healing and what the current research says about how long it actually takes for a bone to heal and how that may differ based on the location of the injury. We also discuss the factors that influence treatment, how to test when an athlete is ready to return to running, and how to progress training load for a successful recovery.  Bone stress injuries are one of the most complex and frustrating injuries for runners. After our discussion with Nathan, we hope that you will have a better understanding of the training, nutrition, and metabolic factors that need to be considered with diagnosing and treating these injuries. What we talked about: 3:05- The physiology of bone healing and the expectations to set for patients 17:40- Modalities for recovery 22:20- Focus for the return to run program 31:00- Being flexible with the protocol Show notes: Nathan's website Nathan on Instagram References: Gehman S, Ackerman KE, Caksa S, Rudolph SE, Hughes JM, Garrahan M, Tenforde AS, Bouxsein ML, Popp KL. Restrictive Eating and Prior Low-Energy Fractures Are Associated With History of Multiple Bone Stress Injuries. Int J Sport Nutr Exerc Metab. 2022 May 6;32(5):325-333. Popp KL, Ackerman KE, Rudolph SE, Johannesdottir F, Hughes JM, Tenforde AS, Bredella MA, Xu C, Unnikrishnan G, Reifman J, Bouxsein ML. Changes in Volumetric Bone Mineral Density Over 12 Months After a Tibial Bone Stress Injury Diagnosis: Implications for Return to Sports and Military Duty. Am J Sports Med. 2021 Jan;49(1):226-235. Rudolph SE, Caksa S, Gehman S, Garrahan M, Hughes JM, Tenforde AS, Ackerman KE, Bouxsein ML, Popp KL. Physical Activity, Menstrual History, and Bone Microarchitecture in Female Athletes with Multiple Bone Stress Injuries. Med Sci Sports Exerc. 2021 Oct 1;53(10):2182-2189. Warden SJ, Davis IS, Fredericson M. Management and prevention of bone stress injuries in long-distance runners. J Orthop Sports Phys Ther. 2014 Oct;44(10):749-65. Warden SJ, Edwards WB, Willy RW. Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning. J Orthop Sports Phys Ther. 2021 Jul;51(7):322-330.

Nathan Carlson is a physical therapist, coach, and business owner based out of Kansas City. He specializes in the management of bone stress injuries, managing the high school and collegiate runner, and implementing resistance training with endurance athletes. Nathan teaches nationally and internationally on these topics. Nathan has two digital resources - A Guidebook to Running After a Stress Fracture and A Guidebook to Navigating High School Running. In this episode, we have an in-depth conversation on bone stress injuries. Our conversation was packed with so much valuable information that we broke it down into two episodes. In part one, we discuss bone physiology, factors that contribute to bone stress injuries, clinical perils, and radiographic tools for diagnosis.  Bone stress injuries are one of the most complex and frustrating injuries for runners. After our discussion with Nathan, we hope that you will have a better understanding of the training, nutrition, and metabolic factors that need to be considered with diagnosing and treating these injuries.  What we talked about: 3:10- Introduction to Nathan 6:40- Weight lifting for high school athletes 8:25- Defining a bone stress injury 11:00- Differences between a stress reaction and stress fracture and what causes them 22:05- Obtaining a more in-depth background of an athlete to learn more about the injury 25:45- Diagnosis and prognosis of bone stress injuries 38:05- Testing and imaging for bone stress injuries Show notes: Nathan's website Nathan on Instagram References: Bergman AG, Fredericson M, Ho C, Matheson GO. Asymptomatic tibial stress reactions: MRI detection and clinical follow-up in distance runners. AJR Am J Roentgenol. 2004 Sep;183(3):635-8. Hoenig T, Ackerman KE, Beck BR, Bouxsein ML, Burr DB, Hollander K, Popp KL, Rolvien T, Tenforde AS, Warden SJ. Bone stress injuries. Nat Rev Dis Primers. 2022 Apr 28;8(1):26. Kaeding CC, Miller T. The comprehensive description of stress fractures: a new classification system. J Bone Joint Surg Am. 2013 Jul 3;95(13):1214-20. Wright AA, Hegedus EJ, Lenchik L, Kuhn KJ, Santiago L, Smoliga JM. Diagnostic Accuracy of Various Imaging Modalities for Suspected Lower Extremity Stress Fractures: A Systematic Review With Evidence-Based Recommendations for Clinical Practice. Am J Sports Med. 2016 Jan;44(1):255-63. RED-S CAT - https://bjsm.bmj.com/content/bjsports/49/7/421.full.pdf