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In episode 380 of The Physical Performance Show, host Brad Beer and Pogo Physio physiotherapist Tim Studley conclude their three-part expert series on bone stress injuries by focusing on what happens after diagnosis. From imaging and prognosis to rehabilitation, return to running, and long-term prevention, this episode provides a practical roadmap for athletes, coaches, and clinicians managing these complex injuries.
Brad explains why identifying the underlying causes of a bone stress injury is just as important as healing the bone itself. The discussion covers deloading, progressive reloading, strength and conditioning, bone-building exercise, and the simple but powerful strategies that can dramatically reduce the risk of recurrence.
Show Sponsor:PILLAR Performance is leading a new frontier in sports nutrition through micronutrition innovation. Their new Collagen Repair formula, developed in collaboration with Gelita Laboratories, is designed to support tendon and ligament health while promoting collagen synthesis to help athletes stay healthy and perform at their best.
For 15% off your first order, visit pillarperformance.shop (or thefeed.com for North American listeners) and use the discount code PHYSICALPERFORMANCE (one word, capitals) at checkout.
In this episode, you'll hear Why MRI remains the gold standard for diagnosing bone stress injuries and guiding treatment When a clinical diagnosis may be sufficient—and why imaging usually provides better certainty and prognosis The three-step rehabilitation framework: identify risk factors, deload appropriately, then progressively reload Why treating the underlying cause is essential to preventing repeat bone stress injuries How rehabilitation differs depending on injury severity and high-risk versus low-risk bone sites Practical principles for returning to running, including restoring volume before introducing intensity Why the opposite limb also requires strength and bone loading during rehabilitation The role of strength training, plyometrics and osteogenic exercise in rebuilding bone capacity Why bone responds best to short, novel loading sessions rather than long continuous exercise The concept that "bone cells get bored easily" and how to optimise bone adaptation Why multidirectional movement remains important long after returning to sport The impact of childhood sport participation and bone geometry on lifelong injury risk Brad's personal journey with osteoporosis and what it taught him about endurance athlete health Three practical strategies every endurance athlete can implement to reduce bone stress injury risk Why recovery—not just training—is where adaptation actually occurs Quotes / takeaways"Treat the cause—not just the injury."
"Restore volume before you restore intensity."
"Bone cells get bored easily."
"It's not the training you adapt to—it's the recovery from the training."
"Eat more than you think you need."
Partners / links mentionedShow Sponsor: PILLAR Performance — 15% off your first order using code PHYSICALPERFORMANCE at checkout.
North America: thefeed.com
Timeline00:00 – Introduction, sponsor and final episode of the Bone Stress Injury mini-series
02:27 – Clinical testing for femoral neck bone stress injuries
03:26 – Clinical diagnosis versus MRI: when imaging is essential
05:14 – Why MRI improves prognosis and return-to-sport planning
07:03 – The three-step rehabilitation framework: risk factors, deload, reload
08:58 – Deloading strategies for high-risk bone stress injuries
09:50 – Progressive tissue loading and returning to running
10:46 – Why training volume should return before intensity
11:45 – Reloading the unaffected limb during rehabilitation
12:44 – Strength training, muscle function and long-term bone health
14:30 – Why bone cells "get bored" and how osteogenic exercise works
15:56 – Novel loading strategies, multidirectional movement and chaos hopping
17:23 – Childhood sport participation and building stronger bones
19:14 – Brad's personal experience with osteoporosis as an endurance athlete
21:40 – Three practical strategies to reduce bone stress injury risk
24:29 – Skeletal deload weeks and cross-training alternatives
25:27 – Recovery as the key driver of adaptation
26:26 – Final advice for athletes and clinicians
27:49 – Brad's top performance tip: "Eat more than you think you need"
28:18 – Listener challenge: fuel immediately before and after every training session this week
28:56 – Episode close and conclusion of the Bone Stress Injury mini-series
THE TEAM:Join The Physical Performance Show LEARNINGS membership through weekly podcasts here:
https://www.patreon.com/TPPShowOur goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Your Host:
🏃 Brad Beer – Instagram & X @Bradbeer and YouTube @PogophysioAuThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperformanceshow
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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.
Show Sponsor:PILLAR Performance is leading a new frontier in sports nutrition through micronutrition innovation. Their new Collagen Repair formula, developed in collaboration with Gelita Laboratories, is designed to support tendon and ligament health while promoting collagen synthesis to help athletes stay healthy and perform at their best.
For 15% off your first order, visit pillarperformance.shop (or thefeed.com for North American listeners) and use the discount code PHYSICALPERFORMANCE (one word, capitals) at checkout.
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 sites and why blood supply matters Practical assessment strategies including observation, palpation and functional loading tests When hop testing is appropriate—and when it should be avoided Clinical pearls for distinguishing bone stress injuries from other common running injuries Quotes / takeaways"Training loads the skeleton—but biology determines whether the skeleton can cope."
"Eat more than you think you need."
"The biggest driver of bone stress injuries is often invisible."
"Above the knee, think fuelling. Below the knee, think biomechanics."
"Treat the cause—not just the bone."
Partners / links mentionedShow Sponsor: PILLAR Performance — 15% off your first order using code PHYSICALPERFORMANCE at checkout.
North America: thefeed.com
Timeline00:00 – Introduction, sponsor and recap of the Bone Stress Injury mini-series
02:27 – Why biological risk factors deserve greater attention than ever before
03:51 – Early sport specialisation and athletic history as risk factors
04:50 – Medical conditions, medications and bone health
05:45 – Sleep, stress and the biological contributors to bone stress injuries
07:08 – Understanding low energy availability (RED-S)
08:32 – Practical screening questions for under-fuelling
09:02 – Female athlete indicators: menstrual health and amenorrhoea
10:29 – Male athlete indicators: libido and morning erectile function
11:51 – Blood tests, iron studies, vitamin D and hormone profiles
13:18 – Why even small daily energy deficits accumulate over time
14:16 – Working with sports dietitians and estimating energy requirements
15:40 – Brad's number one recommendation: "Eat more than you think you need"
16:08 – Common sites of bone stress injuries throughout the body
18:00 – Using injury location to distinguish biomechanics from under-fuelling
18:48 – High-risk versus low-risk bone stress injury locations
21:12 – The most commonly missed bone stress injuries in runners
22:37 – Clinical examination: observation, palpation and localisation of symptoms
24:19 – Differentiating shin splints from bone stress injuries through palpation
25:14 – Functional loading tests and when hop testing is appropriate
26:31 – Hop testing, femoral neck injuries and clinical safety considerations
27:24 – Differential diagnosis and key assessment principles
28:25 – Episode wrap-up and preview of Part 3
THE TEAM:Join The Physical Performance Show LEARNINGS membership through weekly podcasts here:
https://www.patreon.com/TPPShowOur goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Your Host:
🏃 Brad Beer – Instagram & X @Bradbeer and YouTube @PogophysioAuThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperformanceshow
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Saknas det avsnitt?
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In episode 378 of The Physical Performance Show, host Brad Beer is joined by Pogo physiotherapist Tim Studley for the first instalment of a three-part expert series exploring bone stress injuries. Drawing on decades of clinical experience and the latest research, Brad unpacks the mechanisms behind one of the most common and misunderstood injuries affecting endurance athletes.
This episode explains how bone stress injuries develop, why they occur, and why they're often missed until they become more serious. Brad and Tim discuss the relationship between training load, bone physiology, symptom progression, and risk factors, while providing practical insights for athletes, coaches, and clinicians seeking to identify problems before they become stress fractures.
Show Sponsor:PILLAR Performance is leading a new frontier in sports nutrition through micronutrition innovation. Their new Collagen Repair formula, developed in collaboration with Gelita Laboratories, is designed to support tendon and ligament health while promoting collagen synthesis to help athletes stay healthy and perform at their best.
For 15% off your first order, visit pillarperformance.shop (or thefeed.com for North American listeners) and use the discount code PHYSICALPERFORMANCE (one word, capitals) at checkout.
In this episode, you'll hear Why bone stress injuries exist on a continuum—from healthy bone through stress reactions to true stress fractures The biology of bone remodelling: osteoclasts, osteoblasts, microcracks, and why recovery is essential Why running intensity has a far greater impact on bone stress injury risk than training volume alone How a 10% increase in running pace can dramatically reduce the bone's fatigue threshold Why many athletes mistakenly blame the "last run" rather than the workload accumulated four weeks earlier The importance of deload weeks and allowing the skeleton time to repair accumulated microdamage Understanding the Fredericson grading system and what distinguishes stress reactions from stress fractures Why shin splints (medial tibial stress syndrome) are not the same as a bone stress injury How pain location and symptom behaviour provide more valuable diagnostic information than pain intensity Why serious bone stress injuries can sometimes hurt less than relatively minor periosteal injuries The progression of symptoms from post-run discomfort to persistent and night pain How clinicians assess training history, workload, Strava data, intensity distribution, terrain, and footwear The major biomechanical and biological risk factors that contribute to bone stress injuries Previous bone stress injuries as one of the strongest predictors of future injury The emerging discussion around performance footwear ("super shoes") and potential changes in bone loading Why muscle strength and tissue capacity remain important contributors to skeletal resilience Quotes / takeaways"A bone stress injury is simply stress of a bone."
"It's not usually the kilometres that catch people out—it's the intensity."
"Don't judge the severity of a bone injury by how painful it is."
"Symptoms often appear around four weeks after the training error—not the day after."
"If it's really obvious, it's probably important."
Show SponsorPILLAR Performance creates evidence-based sports micronutrition products designed to support recovery, sleep, health, and performance for athletes and active people.
For all your PILLAR products visit https://PillarPerformance.shop, or for our North American listeners, head to https://TheFeed.com.
🔥 For 15% off your first purchase enter PHYSICALPERFORMANCE at the checkout.
Timeline00:00 – Introduction, sponsor and overview of the new three-part Bone Stress Injury series
02:27 – Brad introduces expert editions and welcomes Tim Studley
03:54 – What is a bone stress injury?
04:23 – Bone loading explained: intensity versus training volume
06:50 – Bone physiology: microcracks, osteoclasts and osteoblasts
08:44 – Why recovery weeks are critical for skeletal health
09:14 – Bone remodelling timelines and why symptoms are delayed
11:40 – Bone stress injuries versus stress fractures
13:05 – The Fredericson grading system explained
14:26 – Shin splints (MTSS) versus bone stress injuries
15:21 – Why pain severity doesn't reflect injury severity
17:42 – The importance of symptom behaviour over pain intensity
19:08 – The progression of bone stress injury symptoms
20:30 – Taking a running history: training load, Strava and identifying workload errors
22:22 – Why today's symptoms often reflect training from four weeks earlier
23:20 – Biomechanical versus biological risk factors
24:17 – Previous bone stress injuries as a major predictor of recurrence
24:47 – Performance footwear ("super shoes") and emerging research
26:03 – Terrain, footwear changes and other biomechanical considerations
26:57 – Muscle capacity, tissue resilience and assessing the athlete
THE TEAM:Join the 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.
Your Host:
🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAuThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperforamceshowPlease direct any questions, comments, and feedback to the above social media handles.
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In episode 377 of The Physical Performance Show, Sports Physiotherapist Nick Kane joins host Brad Beer to unpack the rehabilitation of hamstring strain injuries.
Nick is the founder and director of SportsMap, one of Australia's leading professional development platforms for sports medicine clinicians. Drawing on more than a decade working in elite sport, including ten years with the Essendon Football Club in the AFL and five years as lead physiotherapist, Nick shares practical, evidence-informed insights into managing one of sport's most common and frustrating injuries.
This episode explores the common mistakes athletes and practitioners make during rehabilitation, the critical role of high-speed running exposure, how to assess injury severity, key risk factors for recurrence, and the practical steps required for a successful return to sport. Nick also discusses eccentric strength training, fascicle length, T-junction injuries, and the characteristics that separate great clinicians from average ones.
Whether you're an athlete, coach, physiotherapist, or sports medicine practitioner, this episode delivers practical takeaways you can immediately apply.
Show Sponsor
PILLAR Performance creates evidence-based sports micronutrition products designed to support recovery, sleep, health, and performance for athletes and active people.
For all your PILLAR products visit https://PillarPerformance.shop, or for North American listeners, head to https://TheFeed.com.
For 15% off your first purchase enter PHYSICALPERFORMANCE at the checkout.
How To Check:
LinkedIn - Nick Kane
SportsMap – https://sportsmap.com.auListen in as we delve into the following:
• The three most common mistakes in hamstring rehabilitation
• Why maximum speed exposure is essential for successful recovery
• The dangers of over-prescribing and under-prescribing sprint work
• Understanding hamstring injury pathology and injury mechanisms
• Key clinical assessment findings for hamstring strain injuries
• Risk factors including eccentric strength, fascicle length, and running mechanics
• The "push and pull of strain" concept
• Practical strength benchmarks for rehabilitation progressions
• The role of Nordic hamstring exercises and eccentric loading
• Monitoring recovery using objective clinical markers
• Criteria-based return-to-play decision making
• Preventing recurrence following return to sport
• Why regular exposure to high-speed running matters
• Understanding T-junction hamstring injuries
• What differentiates great clinicians from average practitioners
• The value of curiosity, continual learning, and athlete-centred communicationQuotes
"Preparing to sprint is preparing to play." — Nick Kane
"The highest strain you can apply to the hamstring is sprinting." — Nick Kane
"Consistency is key." — Nick Kane
"If you stop training eccentrically for two weeks, those fascicles shorten." — Nick Kane
"The person who stays curious and continues learning is the one who keeps improving." — Nick Kane
Timeline
00:00 – Introduction and sponsor messages
01:20 – Introduction to Nick Kane and SportsMap
04:08 – The three biggest mistakes in hamstring rehabilitation
05:35 – Over-prescribing and under-prescribing high-speed running
09:16 – Why sprint exposure is critical for recovery
10:34 – Understanding hamstring injury pathology
13:54 – Key risk factors for hamstring strain injuries
16:12 – The push and pull of strain concept
18:29 – Eccentric strength and fascicle length
20:22 – Practical strength assessment benchmarks
23:13 – Essential clinical assessment tools
27:20 – Using objective markers to guide return-to-play timelines
29:21 – Sponsor messages
31:14 – Return-to-play criteria and rehabilitation progressions
34:41 – Preventing hamstring injury recurrence
37:29 – Understanding T-junction hamstring injuries
41:41 – What separates great clinicians from average clinicians
44:25 – Nick Kane's one piece of performance advice
45:53 – The weekly physical challenge: 10 minutes of stillness
46:51 – Where to find Nick Kane and SportsMap
48:27 – Episode wrap-up and upcoming showsYour Host
Join the 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.
Your Host:
🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAuThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperforamceshowPlease direct any questions, comments, and feedback to the above social media handles.
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Brad shares what's happened over the last two years, why there has been infrequency in episode production adn what teh plan is from ehre. Listen into this brief update as he explains what shape the podcast will take and what content you can expect.
We want to say a special thank you to you, our loyal listeners. Without youthere wouldn't be this podcast, we deeply apprecaite you.
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In episode 376 of The Physical Performance Show, professional triathlete Ellie Salthouse joins Hugh Darnell and Brad Beer for a deeply honest conversation about resilience, pressure, and longevity in elite endurance sport. Recorded following knee surgery and a strong return to racing, this episode unpacks what it truly takes to rebuild confidence, performance, and belief when the path back to the start line is anything but straightforward.
Ellie reflects on her Wollongong T100 performance, the physical and mental demands of injury rehabilitation, and the systems that now support her consistency at the pointy end of the sport. From working with specialist coaches and reshaping her mental game, to mastering race-day execution, fueling, recovery, and decision-making under pressure, Ellie shares the frameworks that continue to sustain her elite career.
Show Sponsor: The Rehab Mechanics offers Simple Tools and Real Results. Easy fixes for your feet with a massive impact.
For 20% off all The Rehab Mechanics products. Go to www.therehabmechanics.com.au
Enter discount code TPPS20 at checkout. In this episode, you'll hearWollongong T100 debrief: executing the plan, racing at home, and handling the "always want the podium" competitor mindset
Race-week routines: keeping things consistent, arriving a week early, and why Ellie doesn't taper heavily
The injury story: severe knee pain pre-70.3 Worlds, major swelling post-race, scan results, and surgery timing (Feb)
Rehab timeline & milestones: back on bike + pool at ~10 days, building trainer time, returning to road riding, quad activation challenges, strength work, and a ~6-month return to start line
The mental toll of injury: identity, motivation, sponsor pressure vs internal pressure, and staying process-driven with "small controllables"
Return-to-racing lessons: Vancouver as the first race back, managing expectations, and surprising run performance with minimal prep
Mental performance breakthrough: building a "toolbox" with a sports psych, handling pressure, thoughts, and race-week spirals
Tools that work: "a thought is just a thought," bus analogy, and the "monsters in the boat" approach to sitting with emotions
Coaching structure shift: moving from one coach (8 years with Siri) to specialists (swim/cycle/run/strength) + managing training load
Training with data: the steep learning curve of power/metrics and why it took ~12 months to truly click
Partner + coach dynamic: boundaries between "boyfriend Zach" and "coach Zach," and why switching off matters
Race-day execution: whiteboard cues, focusing on controllables, and adapting plans on the fly
Fueling evolution: from "a few gels and Gatorade" to calculated carbs/sodium/fluid + planned recovery
Recovery essentials: movement-based recovery, boots, protein targets, sauna/ice baths, sleep, magnesium, and tracking what actually works
Filtering the '1%ers': ease of use, time cost, measurability, and avoiding noise
What's next: 70.3 World Champs (Marbella) then camp in the Canary Islands and T100 World Champs (Qatar, Dec 13)
Ellie's advice: stay disciplined, stay hungry, trust your instincts
Listener challenge: 20 x 3 min tempo / 3 min endurance on the bike (yes… brutal)
Quotes / takeaways"A feeling is just a feeling. A thought is just a thought."
"If it's a chore or doesn't integrate into your life, it's probably not the right 1%er."
"Who's willing to suffer the most — that's the name of the game."
Partners / links mentionedShow sponsor: The Rehab Mechanics — 20% off with code TPPS20 at checkout (therehabmechanics.com.au)
Follow Ellie: @elliesalthouse (Instagram)
Timeline00:00 – Introduction & sponsor: The Rehab Mechanics + TPPS20 discount
01:13 – Hugh introduces featured performer: Ellie "Salty" Salthouse + Wollongong T100 context
02:43 – Ellie joins: quick bio + why this conversation has been a long time coming
03:42 – Wollongong T100 debrief: home-race energy, execution, 4th place
05:04 – Race-week process: keeping routine consistent + days leading into race
06:21 – "Pressure in the athlete hotel": being around competitors all week
07:43 – Knee injury origin: severe pain pre-70.3 Worlds, race week adjustments
09:03 – Post-Worlds swelling + scan findings: missing cartilage + floating fragments
10:17 – Surgery timing (early Feb) + season disruption + finding positives
11:43 – "Blessing in disguise": freshness late season + only 5 races so far
12:37 – Rehab milestones: back on bike & in pool ~10 days post-op
13:59 – Quad shutdown challenge: stim/BFR + "it finally clicked"
14:28 – Return-to-racing timeline: ~6 months off the start line
14:57 – Mental toll of injury: motivation, identity, checklist of controllables
16:20 – Sponsor pressure vs internal pressure: clauses, but mostly self-driven
17:14 – First race back: Vancouver expectations + rebuilding run fitness
19:02 – Surprise outcome: 11th place + faster-than-expected run execution
19:31 – The "low expectations / low pressure" effect when returning
20:48 – Key win: testing the knee under race stress (sand, mounts/dismounts)
21:48 – Perspective from Jan Frodeno: same surgery took him a year
22:44 – Mental performance shift: why big races used to unravel
24:07 – Working with a sports psych: building a toolbox for pressure + thoughts
25:28 – Why mental coaching should be "the 4th discipline"
26:54 – Advice for athletes who didn't gel with a sports psych before
27:47 – Readiness + openness: why it clicked this time
29:54 – Practical tools: "thoughts on a bus" + "monsters in the boat" analogy
33:26 – Coaching evolution: leaving Siri after 8 years + hard "breakup" conversation
36:10 – Why specialists: swim/cycle/run/strength + being great at all three
39:42 – Adjustment year: results dipped before training began correlating again
40:08 – Learning to train with data: cadence/speed → full power metrics
42:32 – When it clicked: 12 months to understand, 18 months to see new numbers
43:30 – Negatives of multi-coach model: communication + squad consistency when travelling
44:47 – Partner + coach dynamic: boundaries, downtime, and early arguments
47:35 – Race-day execution: Zach's whiteboard cues, focus, and adapting plans
50:16 – Discipline vs instincts: sticking to plan without getting dragged into racing emotions
52:14 – The "ability to suffer": born with it + learned deeper over time
55:33 – Hard sessions nerves: nothing to lose vs race-day stakes
57:23 – Fueling shift: from "whatever felt right" to calculated carbs/sodium/fluid
59:47 – Recovery pillars: movement, boots, protein targets, sauna/ice baths
01:01:33 – Sleep & performance: 8+ hours, magnesium, investing in a great bed
01:03:21 – Filtering "1%ers": track it, keep it easy, avoid time-wasting noise
01:07:27 – What's next: 70.3 Worlds (Marbella) + Canary Islands camp + T100 Worlds (Qatar)
01:08:20 – Ellie's advice: stay disciplined, stay hungry, trust your instincts
01:08:49 – Listener challenge: 20 x 3 min tempo / 3 min endurance on the bike
01:10:14 – Episode close, credits, and sponsor reminderTHE TEAM:
Join the 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.
Your Hosts:
🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAu
💪 Huw Darnell - Exercise Physiologist & Performance Coach : YouTube: @huwdarnell & Instagram @huwdarnellThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperforamceshowPlease direct any questions, comments, and feedback to the above social media handles.
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In episode 375 of The Physical Performance Show, Coach Lino Holler and Exercise Physiologist Alex Butchies—founders of The Breath Room—join hosts Hugh Darnell and Brad Beer to unpack the science, the soul, and the surprising simplicity behind breathwork.
Known for blending physiological precision with deep nervous-system awareness, Lino and Alex explain how breath training can radically influence performance, recovery, emotional regulation, and everyday resilience. They share the models they've built for athletes, clinicians and everyday performers—equipping listeners to understand when to activate, when to regulate, when to release, and how to stay composed under pressure.
This episode explores breathwork as a foundational human movement—right alongside gait—and highlights how poor breathing mechanics echo into every body system. From apnea training to flow-state access, from nervous-system overload to psychological clarity, Hugh, Lino, and Alex guide listeners through practical tools and principles that can reshape life, training, and mental wellbeing.
Show Sponsor: The Rehab Mechanics offers Simple Tools and Real Results. Easy fixes for your feet with a massive impact.
For 20% off all The Rehab Mechanics products. Go to www.therehabmechanics.com.au
Enter discount code TPPS20 at checkout. On instagram checkout: Lino @coachhola
AB @butschies TBR @thebreatheroomglobal Consulting @ab_physiology To get the TBR Master Your Breath: Personal Development course head to https://cleanhealth.edu.au/product/online-courses/master-your-breath/ To get the Level 1 TBR Certified Breathwork Coaching course head to https://cleanhealth.edu.au/product/online-courses/the-breathe-room-level-1/ To get 20% of either course use promo code 'AB20' at checkout Listen in as we delve into the following:Lino & Alex's backgrounds and the origin story of The Breath Room
Why breathwork is both universal and wildly misunderstood
The "science and soul" model: activate, regulate, release
How breath patterns influence physiology, psychology, posture, and performance
Understanding flow state and how breath helps athletes access it
What inefficient breathing looks and sounds like—and why it matters
Nasal breathing, LSD breathing, and the dangers of skipping the basics
Apnea training, CO₂ tolerance & performance crossover
Assessing breathing in athletes: practical tests and markers
Nervous system burnout, emotional load & modern stress physiology
Training resilience: why athletes must learn to perform under pressure
How to help clients (and yourself) find the "middle zone"
Why 5 minutes of daily breathwork is the minimum effective dose
Two practical breathwork protocols listeners can start today
Quotes"If you can master your breath, you can master your life." — Lino Holler
"Seek balance, not perfection. A well-balanced nervous system can go fast, slow, and always find its way back to centre." — Alex Butchies
"Most people breathe all day, but not efficiently. Awareness is the gateway."
"When your breath is compromised, your body will sacrifice everything else to get it back."
"Breathwork is the universal tool to shift your state—faster than anything else."
Timeline00:00 – Introduction & sponsor: The Rehab Mechanics
01:15 – Hugh & Brad introduce the Breath Room founders
01:40 – The "science and soul" of breathwork
02:31 – Why breathwork is misunderstood and undervalued
03:26 – Alex's journey: connecting physiology, sport & nervous-system regulation
05:19 – Clinical insights from veterans, trauma, anxiety & PTSD
06:42 – Lino's story: sickness, burnout & finding regulation
09:41 – Breathwork, performance and the nervous system
11:03 – Breathwork for flow state: accessing presence under pressure
12:32 – Jiu-jitsu, endurance sports & composure under stress
14:39 – Everyday breathwork: LSD breathing, nasal breathing & awareness
17:02 – "Don't sit like a croissant or breathe like a French bulldog"
18:30 – Nasal breathing red flags & the mouth-taping debate
19:56 – Using breath to control transitions & race composure
21:15 – The Breath Room model: activate, regulate, release
23:40 – How the system works in training & everyday life
28:33 – Assessing breathing: tests, observations, retention walks
31:27 – CO₂ tolerance, awareness, and common pitfalls
36:31 – Life stress, emotional load & the body keeping score
38:48 – Mental performance: head noise, pressure, and elite sport
42:01 – Self-consciousness, overthinking & performance breakdown
47:12 – Training resilience: don't flee stress—learn to stay in it
48:35 – Robust versus fragile nervous systems
50:20 – Why endurance athletes must train breath
51:15 – Apnea training, head noise & physiological adaptation
53:06 – The psychology of pressure: young athletes & emotional load
56:13 – Balance, HRV & the "pendulum" model
58:05 – Minimum effective dose: 5 minutes/day
59:01 – The "brakes" metaphor: learning to shift state
01:00:29 – Two breathwork protocols listeners can apply today
01:06:11 – Final messages from Lino & Alex
01:09:12 – Listener challenge: 7-7-7 breathing & nasal-only warm-ups
01:11:02 – Breath Room Global: building a system for all people
01:17:17 – Guided 15-breath practice to close the episode
01:21:40 – Episode close & credits
THE TEAM:
Join the 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.
Your Hosts:
🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAu
💪 Huw Darnell - Exercise Physiologist & Performance Coach : YouTube: @huwdarnell & Instagram @huwdarnellThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperforamceshowPlease direct any questions, comments, and feedback to the above social media handles.
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Running technique coach Paul Mackinnon (The Balanced Runner) unpacks why most runners "force outcomes" (cadence, foot strike, knee drive) instead of changing the inputs that actually reshape movement. Paul explains his top-down approach—starting at the arms and torso to influence what happens below—so athletes can reduce ground contact time, improve rhythm, and shift along the continuum from rehab to performance.
Across an engaging conversation in episode 374 of The Physical Performance Show, with hosts Brad Beer and Huw Darnell, Paul challenges the idea that "technique doesn't matter," arguing that how you move determines how you load. He distinguishes economy from efficiency, shows why arm swing and thoracic control set the timing for the legs, and shares practical cues to build self-awareness, symmetry, and lift—without derailing training volume. Clinicians and athletes alike will gain a clearer roadmap for translating S&C work to the road, coaching more effectively, and making durable technique change.
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The Rehab Mechanics offers Simple Tools and Real Results. Easy fixes for your feet with a massive impact.
For 20% off all The Rehab Mechanics products. Go to www.therehabmechanics.com.au
Enter discount code TPPS20 at checkout.TIMELINE:
00:00 Forcing outcomes: the #1 running mistake
03:19 Inputs over outcomes; changing the whole system without losing training
04:32 Knee drive, ground time, and why top-down coaching works
07:28 Midline crossover: finding the true driver of the pattern
09:35 Physics → biomechanics → the individual: three coaching silos
11:11 Do mechanics matter? Why the debate misses the point
14:11 Lessons from swimming: skill, workload, and injury risk
16:27 Breaking-2 insight: efficiency beating raw physiology
18:09 Economy vs efficiency; cost per step explained
21:07 Two paths to change: full-pattern reset vs detailed top-down
23:05 New-way/old-way contrasts to build self-awareness
26:06 Feel, timing, rhythm: enlarging the athlete's "sweet spot"
32:29 What good running looks like: rhythm, symmetry, flight
36:37 Coaching language, listening, and athlete buy-in
43:22 Mental health: running as a lifeline
44:43 Humerus–femur coupling: why arms and thighs must sync
49:17 Simple buy-in: reduce ground time & ground reaction force
50:18 Paul's top three: Awareness • Symmetry • Lift
52:50 Why S&C often doesn't transfer—and how to fix it
59:35 One piece of advice: self-awareness—know where you are now
1:00:27 Listener Challenge: film your running, build your baseline
LISTEN IN AS WE DELVE INTO THE FOLLOWING:
The #1 mistake runners make: forcing outcomes vs changing inputs Why technique, capacity, and rehab are independent—but interlinked—puzzle pieces The injury ↔ performance continuum and coaching before athletes break Top-down mechanics: how arms/torso shape leg action and knee drive Midline "tight-rope" running: finding the driver (ribcage, arms, rotation) Physics → biomechanics → individual: the three silos that govern change "You can't outrun physics": mechanics as applied physics, not opinion Efficiency vs economy: cost per step, flight time, ground contact time Why research lags coaching—and what to change (and not change) first Translating S&C and plyos to running: when good gym work fails to show up Coaching language, storytelling, and athlete-led awareness (new vs old way) Rhythm vs being rhythmic: symmetry, timing, and longer flight Mental health, identity, and why running is a lifeline for many athletes Three practical cues: Awareness • Symmetry • Get off the ground The week's challenge: Film your running and build an honest baselineQUOTES:
"You can't outrun physics."
"How you move determines how you load."
"Stop forcing outcomes—change the inputs."
"Awareness, symmetry, get off the ground. Every step costs—know what you're paying for."
PEOPLE MENTIONED:
Ellie Salthouse – Triathlete
Enda King – Hip & groin specialist (Aspetar)
Rich Willy – Running biomechanics researcher
Alec McKenzie, Stephen Doohig – Swimming biomechanics researchers
Jenny Alcorn – Triathlon coach (historical reference)
THE TEAM:
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Your Hosts:
🏃 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAu
💪 Huw Darnell - Exercise Physiologist & Performance Coach : YouTube: @huwdarnell & Instagram @huwdarnellThe Physical Performance Show can be found at:
Facebook: facebook.com/thephysicalperformanceshowpodcast
X: @tppshow1
Instagram: @physicalperforamceshowPlease direct any questions, comments, and feedback to the above social media handles.
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In episode 373 of The Physical Performance Show, sports medicine expert Dr Jay Hertel shares an in-depth exploration of chronic ankle instability in athletes. Drawing on his extensive clinical and research experience, Dr Hertel discusses the prevalence, consequences, and complex rehabilitation of ankle sprains. The conversation covers the patho-mechanical, sensory-perceptual, and motor-behavioral impacts of repeated ankle injuries, including early onset osteoarthritis, proprioceptive deficits, and the psychological hurdles faced by patients—such as loss of confidence and fear of re-injury.
Dr Hertel explains the evolution of clinical models for assessing and treating chronic ankle instability, emphasising individualised care that considers not just the structural and neuromuscular factors, but also personal and environmental influences on recovery. The episode includes practical wisdom and a holistic approach and leaves athletes, clinicians, and listeners with a greater appreciation for the complexity of ankle injuries and a roadmap for improving outcomes both physically and mentally.
Show Sponsor:
The Rehab Mechanics offers Simple Tools and Real Results. Easy fixes for your feet with a massive impact.
For 20% off all The Rehab Mechanics products. Go to www.therehabmechanics.com.au
Enter discount code TPPS20 at checkout.
--POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
Huw Darnell — Exercise Physiologist & Performance Coach
Helping athletes move from pain and injury to peak performance. Learn more at huwdarnell.com.au and follow on Instagram @huwdarnell.
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In episode 372 of the Physical Performance Show, Brad Beer and Huw Darnell host a live event featuring dual Olympic triathlon medallist Hayden Wilde. Hayden shares his athletic journey, from his early days in multi-sport and the influence of family and personal adversity, through his path to Olympic success. He details the highs and lows of elite sport, including the physical and mental challenges of coming back from a significant injury sustained in a cycling accident, with unique insights into his rehabilitation, mindset, and the role of his multi-disciplinary support team. Hayden discusses his training philosophies, coaching changes, and the importance of maintaining humility amid professional success. The episode explores balancing ambition with self-care, adapting to setbacks, and the power of community in sport.
Show Sponsor: The Rehab Mechanics offers Simple Tools and Real Results. Easy fixes for your feet with a massive impact.
For 20% off all The Rehab Mechanics products. Go to www.therehabmechanics.com.au
Enter discount code TPPS20 at checkout.
--POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
Huw Darnell — Exercise Physiologist & Performance Coach
Helping athletes move from pain and injury to peak performance. Learn more at huwdarnell.com.au and follow on Instagram @huwdarnell.
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Please direct any questions, comments, and feedback to the above social media handles.
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In episode 371 of the Physical Performance Show, Charlie Clements, a first contact physiotherapist and specialist in musculoskeletal care based in the UK shares his expertise on the topic of sciatica, particularly as it affects athletes, discussing the prevalence, causes, and different types of leg pain associated with the condition.
Charlie explains the role of disc injuries, inflammation, and nerve root irritation, and provides practical advice on when imaging and interventions like nerve root blocks may be appropriate. Charlie emphasises the importance of patience, staying active through alternative forms of exercise, and seeking qualified healthcare support when needed.
This episode also offers guidance for clinicians on managing sciatica and highlights the value of reassurance and a holistic approach to care.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
Huw Darnell — Exercise Physiologist & Performance Coach
Helping athletes move from pain and injury to peak performance. Learn more at huwdarnell.com.au and follow on Instagram @huwdarnell.
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In episode 370 of The Physical Performance Show, Dr. Jen Hamer—researcher, consultant, and former elite athlete—delivers a powerful exploration of physique considerations, body image, and the risks of low energy availability in sport. Drawing from her own journey as a high-performing endurance runner who battled an eating disorder, Dr. Hamer shares both personal and professional insights into the complex interplay between athletic culture, health, and performance.
This episode delves into Dr. Hamer's PhD research on supporting coaches to manage the risks of relative energy deficiency in sport (RED-S) among developing athletes. She discusses the challenges of shifting deeply ingrained beliefs and behaviours in sports environments, the impact of coach and practitioner language on athlete well-being, and the importance of systemic education that goes beyond awareness to drive real change. You will hear practical examples from Dr. Hamer's work with national sports organizations, including Swimming Australia and Triathlon Australia, and learn actionable strategies for coaches, parents, and practitioners.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
Huw Darnell — Exercise Physiologist & Performance Coach
Helping athletes move from pain and injury to peak performance. Learn more at huwdarnell.com.au and follow on Instagram @huwdarnell.
The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1)
Please direct any questions, comments, and feedback to the above social media handles.
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In episode 369 of The Physical Performance Show, sports physiotherapist Victor Popov shares insights from his four-decade career working with elite athletes across Olympic Games, Tour de France cycling, AFL premiership teams, and international swimming. He recounts his journey from early days in Sydney's top sports medicine clinics to supporting champions like Robbie McEwen, Susie O'Neill, and Shane Watson, emphasising the value of multidisciplinary collaboration and continuous learning.
This episode delves into the critical role of the nervous system in athletic performance, with Victor Popov explaining how heart rate variability, sleep, nutrition, and even ice baths can be used to assess and optimise recovery and resilience. He introduces his Neural Engagement Therapy and Training (NET) program, designed to help clinicians and athletes better understand and improve nervous system function. Victor Popov also offers practical advice for both aspiring professionals and athletes, highlighting the importance of self-belief, teamwork, and the ability to train consistently without injury.
Show Sponsor:
Special High Performance Seminar Event with Victor Popov on 30th August - register here.POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
Huw Darnell — Exercise Physiologist & Performance Coach
Helping athletes move from pain and injury to peak performance. Learn more at huwdarnell.com.au and follow on Instagram @huwdarnell.
The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1)
Please direct any questions, comments, and feedback to the above social media handles.
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In episode 368 of The Physical Performance Show, the podcast enters a new era as accredited exercise physiologist Huw Darnell joins as co-host alongside Brad Beer. With over a decade of experience in the endurance sports industry, Huw brings a fresh perspective to the show, sharing his journey from a sport-obsessed youth through injury setbacks to becoming a leading strength and conditioning coach for runners and triathletes.
This episode explores Huw's personal and professional evolution, including the pivotal injuries that shaped his approach to athlete rehabilitation and performance. Huw and Brad discuss the importance of psychological support for injured athletes, the barriers endurance athletes face in adopting strength and conditioning, and practical strategies for integrating effective training into busy schedules.
Listeners are introduced to a new show format, Uncovering Injuries, which will feature deep dives into common endurance sports injuries from both physiotherapy and exercise physiology perspectives. The episode is rich with actionable advice, including Huw's "four pillars of performance"—movement, recovery, mindset, and nutrition—and a weekly physical challenge encouraging barefoot training to build foot strength.
Learn more at huwdarnell.com.au
Follow Huw on Instagram: @huwdarnell
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
Huw Darnell — Exercise Physiologist & Performance Coach
Helping athletes move from pain and injury to peak performance. Learn more at huwdarnell.com.au and follow on Instagram @huwdarnell.
The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1)
Please direct any questions, comments, and feedback to the above social media handles.
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In episode 367 of The Physical Performance Show, sports physiotherapist Sue Mayes shares her expertise in foot and ankle injury management. With over 30 years of experience leading physiotherapy at the Australian Ballet and now a senior lecturer at La Trobe University, Sue provides groundbreaking insights into injury prevention and rehabilitation.
Sue discusses her innovative research on ballet dancers and athletes, highlighting the importance of calf strength, strategic exercise implementation, and challenging traditional approaches to stretching. She reveals how implementing targeted calf raises reduced injury rates in professional dancers, and explains why prolonged stretching can be counterproductive.
This episode offers a masterclass in foot and ankle assessment. Her practical advice spans from managing bone stress injuries to developing comprehensive rehabilitation strategies that support athletes' long-term performance and recovery.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
Follow @Brad_Beer Instagram & Twitter
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In this episode, Olympic triathlete Hayden Wilde shares a powerful 2025 update. Just days after running a blistering 27:38 10K in Tokyo — one of the fastest ever by a triathlete — Hayden was involved in a high-speed cycling crash that left him with a fractured scapula, five broken ribs, and a punctured lung. Hayden shares the emotional and physical rollercoaster of his injury, including emergency support from his sponsors, a medical evacuation, and career-saving surgery in Belgium. Now deep in rehab, he opens up about the mindset, team effort, and small wins guiding his return to racing. This is a must-listen for anyone interested in elite performance, resilience, and the real journey behind recovery at the highest level. Show Sponsor: POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services. Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.
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In this episode we welcome back renowned tendinopathy expert, Professor Peter Malliaras, for a 2025 Tendinopathy Rehabilitation Update.
As a leading physiotherapist, researcher, and director at Monash University's Musculoskeletal Research Unit, Peter shares the latest advancements in managing and rehabilitating tendon injuries.
Peter continues to provide cutting-edge insights into evidence-based treatments for persistent tendon symptoms. Whether you're an athlete dealing with tendinopathy or a practitioner looking to refine your approach, this episode is packed with valuable takeaways to help you stay at the forefront of tendon rehabilitation.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
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In this episode we're syndicating a conversation originally recorded for the Physio Network podcast with Dr Rich Willy and host Sarah Yule.
We delve into the art and science of injury prevention and recovery for runners. With a focus on mastering running injuries, this conversation is packed with actionable insights tailored for endurance athletes. Dr Rich Willy, Associate Professor at the University of Montana and Director of the Montana Running Lab shares his expertise on managing persistent running injuries, the critical role of education and load management in treatment, and the impact of footwear—including clinical insights on "super shoes." We also explore the challenges of Relative Energy Deficiency in Sport (RED-S) and effective strategies for managing bone stress injuries in runners.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
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Alec Mackenzie is a PhD scholar with Griffith University, the Queensland Academy of Sport, and Swimming Australia. Alec dives into the prevention of shoulder injuries in swimmers, sharing insights from his ground-breaking research. His recent systematic review, "Identifying Evidence-Practice Gaps for Shoulder Injury Risk Factors in Competitive Swimmers," has made waves in the sports medicine world by bridging literature and expert opinion to better manage swimmer's shoulder.
In this episode Alec unpacks the top three statistically significant factors contributing to shoulder pain in swimmers, offering invaluable advice for athletes, coaches, and triathletes.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
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Dr Kieran Richardson is a specialist musculoskeletal physiotherapist who advocates for physiotherapy rehabilitation to address ACL injuries. He completed the rigorous two-year specialist training program conferred by the Australian College of Physiotherapists in 2016. With a research-based, individualised approach, Kieran aims to achieve significant long-term outcomes. He has a keen interest in non-surgical ACL management, running national workshops and lectures on the subject. As the Director of Global Specialist Physio, Kieran shares his expertise online.
In this episode, we delve into the conservative management of ACL injuries, the what, why, and how of non-surgical ACL injury management.
Show Sponsor:POGO Physio Telehealth Consultations believe that everyone deserves access to complete and remarkable physiotherapy services.
Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online.
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- Visa fler
