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.

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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 sit