Runningmate PT and Performance Coaching

All BSIs are training errors 🤥

Stress fractures (March fractures) were first described by Ernst Adolf Breithaupt, a Prussian physician in the early 1800s, who found that as soldiers marched, marched, and marched, they could develop bone pain that eventually led to structural failure.

From the earliest days of stress fractures, they were problems with training load.

The “too much, too soon” model.

Even today, we often assume these injuries are solely mechanical problems, with the temptation here that a simple change in training philosophy will prevent the next problem.

“I need more time on the AlterG or Boost.”
“Did you know Parker Valby used the Arc trainer?”
“I’m definitely gonna take a skeletal rest week, moving forward.”

Before you blame a BSI on training, check that their training cup isn’t full of holes.

Rarely do I find that a patient’s BSI is solely driven by silly training decisions.

Often, they are problems of

🩺Health
🥗Nutrition
😩Stress

Masquerading as training problems.

Look at their training log, but then zoom out to the whole person.

Clearing BSI to run 🏃‍♀️ 🦴

Returning a BSI to running shouldn’t feel like a guessing game.
�Following a foot BSI, runners need to be able to handle the following before we can run.

▪️Single-leg weight-bearing
▪️Large ranges of motion at the foot
▪️High bending forces
▪️Impact
�Regardless of injury specifics, I want all of my foot BSI patients to pass the following tests before starting a return-to-run testing.��1️⃣Pain-free palpation of the affected location�2️⃣Pain-free passive toe flexion/extension�3️⃣Single-leg stance x 30” in a wobble-free manner�4️⃣Lateral step down x 10 in a wobble-free manner�5️⃣Static pogos x 30�6️⃣Medial/lateral pogos x 20 in each direction�7️⃣Anterior/posterior pogos x 20 in each direction�8️⃣Single-leg hopping 3 x 30�
If a runner passes these tests ☝️ without pain, I’m confident we can start running.