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

 In Podcast (The Physical Performance Show)

Stuart Warden

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 

To listen to Episode 281:


Click the icon to listen to the interview on iTunes or listen using the Soundcloud player below

Don’t forget to SUBSCRIBE at the links to ensure you get performance insights from our future upcoming exciting guests.

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 

Show Sponsor: Precision Hydration

If you’ve ever struggled with hydration issues like cramp during long, hot sessions, it’s worth checking out If you can’t get to a test centre, then you can take their free online Sweat Test to get a personalized hydration strategy to test in training. As a listener of the show you can get 15% off your first order of Precision Hydration electrolytes and the new Precision Fuel range by using the code TPPS at the checkout at

Patreon Membership

Our aim is to help further your physical performance LEARNINGS through ongoing FREE access to our tri-annually held Livestream events with key performance speakers.
These Livestream events in 2020 have proven to popular across the globe & it’s our pleasure to say THANK YOU for your support of the Show through FREE access vs the usual $49 access fee for the Livestreams and post event recordings.
We have been endeavouring to support the endurance sports community of athletes, coaches, and practitioners since Show launch in 2016 through a weekly outputted Show. As a way of continuing to improve on quality and assisting our audience after 240 Episodes we are appreciative of any patrons that wish to support the Show going forwards through a low monthly contribution.

Keep pursuing your Physical Best Performance.
Become a patron of The Physical Performance Show today: Get access to exclusive content and experiences on the world’s largest membership platform for artists and creators.


“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


Publication: Preventing Bone Stress Injuries in Runners with Optimal Workload

To follow Stuart Warden


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


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)

The Physical Performance Show

Recommended Posts
  • Graeme Hadlow

    Overflowing with brilliant advice and tips, one of the best speakers
    Great show

Leave a Comment

Ashar KhanSimon Gerrans