167. Bones, them strong bones: How to use bone loading programs. Physio Edge Running repairs podcast with Tom Goom

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Nov 29, 2024

Tom Goom, a Running Physio and expert in treating running injuries, shares valuable insights on bone loading programs crucial for recovery from bone stress injuries. He details how these targeted strategies differ from traditional strength training to enhance bone density and strength. Goom emphasizes the importance of individualized exercise plans, the right timing for introducing impact training, and techniques for ensuring proper patient technique. His practical guidelines aim to support athletes in returning to their sport safely and effectively.

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INSIGHT

Bone Adaptation Saturation

Bone adapts to impact but saturates quickly (40-80 loading cycles).
Longer durations don't mean stronger bones, making endurance athletes vulnerable to injuries.

ADVICE

Patient Selection for Bone Loading

Apply bone loading programs after bone stress injuries (e.g., medial tibial stress syndrome, stress fractures) when patients are non-irritable.
Ensure patients can walk pain-free for 30 minutes and are 6-8 weeks post-stress fracture.

ADVICE

Bone Loading Program Frequency and Tendinopathy Caution

Implement bone loading programs with short, frequent sessions (1-2 minutes, twice daily) with adequate rest (4-8 hours) between sessions.
Use caution with patients experiencing tendinopathy, especially Achilles tendinopathy, and consider reducing frequency or duration initially.

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Bone strength and density are vital in your running and sporting patients who can experience bone stress injuries (BSI’s), and also as patients get older and more vulnerable to falls and fractures.

How can you improve bone strength in patients following a bone stress injury such as Medial Tibial Stress Syndrome or stress fractures, or in other patients that you’d like to improve bone density or strength?

Traditional approaches to strength and conditioning may not always address the needs of your patients recovering from bone stress injuries. That’s where bone loading programs come in—a targeted strategy to help prepare bones for impact, improve power, and support a return to sport.

In this episode, Tom Goom (Running Physio) dives into the research and how to use a bone loading program to stimulate bone adaptation.

In this podcast, you’ll discover:

The theory and evidence behind bone loading programs and how bones respond to impact.
How to identify the right stage of injury recovery for introducing impact training.
Practical guidelines for implementing short, progressive bone loading exercises.
Techniques for progressing exercises based on patient goals and symptoms.
Strategies to improve bone strength in patients experiencing other musculoskeletal issues such as Achilles tendinopathy.
Real-world applications and demonstrations of bone loading programs.

Tom also shares insights on identifying readiness for impact exercises, managing patient expectations, and adjusting programs for individual needs. You’ll leave this episode equipped with actionable strategies to help patients safely and effectively return to sport while supporting their bone health.

If you’re a clinician or physiotherapist looking for practical solutions to manage bone stress injuries or improve bone density, this podcast is packed with valuable information you can apply in your practice right away.

🔗 Free Webinar Alert! Don't miss out on our free webinars for therapists on shin pain and Achilles tendinopathy in runners. Check the link in the description for more information.

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Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs.

Get free access to the "Tricky tendons" infographic series

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Article associated with this episode:

Turner CH, Robling AG. Mechanisms by which exercise improves bone strength. Journal of bone and mineral metabolism. 2005 Jan;23:16-22.

Links associated with this episode:

Chapters:

04:37 - Turner and Robling (2005) running longer doesn't make bones stronger
10:46 - Bone loading progressions
15:58 - Analysis of the evidence
17:05 - Whether loading technique matters
15:03 - Summary