Latest / The Endurance Athlete Journey / Why Endurance Athletes Get Stress Fractures: Training Load, Underfueling and Bone Health

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Why Endurance Athletes Get Stress Fractures: Training Load, Underfueling and Bone Health · The Endurance Athlete Journey

• 0:10
  SPEAKER_02: Welcome everyone to the Endurance Athlete Journey Podcast.
• 0:12
  SPEAKER_02: I'm your host, Coach Justin.
• 0:13
  SPEAKER_02: I'm here with Coach Katie.
• 0:14
  SPEAKER_02: And today's episode is episode 118.
• 0:17
  SPEAKER_02: And we're going to be talking about bone health.
• 0:20
  SPEAKER_02: Um, the reason that we kind of came up with this topic was because I've had a couple conversations with a particular athlete, and I I I actually know several athletes right now that are going through stress fractures.
• 0:33
  SPEAKER_02: And uh so it it really sparked an interest in me.
• 0:37
  SPEAKER_02: It's like, okay, well, what causes this?
• 0:40
  SPEAKER_02: You know, you can't just jump off and just say, oh, you must have a bad training plan or whatnot.
• 0:45
  SPEAKER_02: I think it's far more nuanced than that.
• 0:47
  SPEAKER_02: And this doesn't just impact runners.
• 0:51
  SPEAKER_02: I mean, uh, I know a particular athlete right now who is a high-performing elite athlete.
• 0:57
  SPEAKER_02: He's now sidelined for the rest of the year with multiple stress fractures.
• 1:01
  SPEAKER_02: And so this isn't just a running phenomenon, even though triathlon includes running in it.
• 1:07
  SPEAKER_02: So I wanted to uh bring Katie and see what if there's a nutrition side to it, is there a training side to it, and really kind of get this conversation going so that we understand why progressive overload is so important not only to adaptation, but it is crucial for durability and sustainability, uh, especially when it comes to these particular types of injuries.
• 1:36
  SPEAKER_02: So let's get the ball rolling.
• 1:38
  SPEAKER_02: Uh so Katie, uh, this is actually uh this is the Labor Day holiday, and uh so we're we're coming to you and working through the holidays.
• 1:47
  SPEAKER_02: So here it is.
• 1:48
  SPEAKER_02: We're coming with an episode.
• 1:50
  SPEAKER_00: So Well, you have some races and stuff coming up, so we're trying to be prepared.
• 1:55
  SPEAKER_02: Yeah, we're we're trying to get uh get ahead of the ahead of the ball a little bit.
• 1:58
  SPEAKER_02: Uh we've got some out-of-town time.
• 2:00
  SPEAKER_02: So Katie, what did you do today for uh for the holiday?
• 2:04
  SPEAKER_00: Um we went to uh um what did we do?
• 2:07
  SPEAKER_00: I'm tired.
• 2:07
  SPEAKER_00: I'm I'm tired.
• 2:08
  SPEAKER_00: I'm sorry I caught you off guard there.
• 2:10
  SPEAKER_00: No, it's okay.
• 2:11
  SPEAKER_00: We went to a parade.
• 2:12
  SPEAKER_00: I was like, what was it called?
• 2:13
  SPEAKER_00: No, yeah, like a Labor Day parade, and it was really long.
• 2:17
  SPEAKER_00: So it was like started at nine and it was still going at like 10 30.
• 2:21
  SPEAKER_00: And I'm like, okay, how many like things I know it would I and I had to leave and come get my groceries that were being delivered, so it it was and then I was trying to get out of there, and there was like all these people.
• 2:31
  SPEAKER_00: It was fun.
• 2:32
  SPEAKER_00: It it was it's something my son wanted to do, so I because he wanted all the candy that they throw.
• 2:37
  SPEAKER_00: So it's not something I would probably generally go do by myself.
• 2:42
  SPEAKER_00: In fact, I I only got like a couple mile run in before then, which is fine because I had a really, really big day yesterday, so I kind of needed a recovery day.
• 2:51
  SPEAKER_00: Um, but it uh it was yeah, it was fine.
• 2:54
  SPEAKER_00: And then we just kind of been hanging out getting stuff done today.
• 2:58
  SPEAKER_00: So how about you?
• 2:59
  SPEAKER_02: That's a slow that's a slow moving parade for like a couple hours.
• 3:03
  SPEAKER_00: No, there's so many things, and there was like a bunch of dance team like dance teams, and I'm like, how many dance teams could there possibly be?
• 3:11
  SPEAKER_00: Seven of them or something.
• 3:12
  SPEAKER_00: I'm like, I don't know.
• 3:14
  SPEAKER_00: I just felt like it was a little bit redundant.
• 3:17
  SPEAKER_00: Um, it was okay, it was okay.
• 3:19
  SPEAKER_00: I mean, they had some cool things.
• 3:20
  SPEAKER_00: They had I really liked the Clyde.
• 3:21
  SPEAKER_00: They had a bunch of Clydesdale horses and a couple perchron horses and some old cars and things, but I would have liked to see more of that than some of the other stuff.
• 3:31
  SPEAKER_00: But what do you do?
• 3:32
  SPEAKER_00: It's okay.
• 3:32
  SPEAKER_00: How about you?
• 3:33
  SPEAKER_00: Anything exciting for Jesus?
• 3:35
  SPEAKER_02: Yeah, uh today was a uh Labor Day social for the Richmond Tri-Club, who I'm a sponsor, I'm one of the sponsors for the club, and so we had uh a swim bike social.
• 3:49
  SPEAKER_02: So we typically have like three of these a year, so it's like a Memorial Day, a Labor Day, and then uh uh Fourth of July is the other one.
• 3:57
  SPEAKER_02: Where we all get together uh at a at a local park and uh we do like a 1,500 meter swim in the river, and then we get out of the river and then we head out on the bike for you know a 20-mile ride or something like that.
• 4:10
  SPEAKER_02: That and uh then we sit around and we uh talk about triathlon stuff as as what triathletes usually do.
• 4:17
  SPEAKER_02: It's usually like what kind of races everybody's doing and stories from races.
• 4:21
  SPEAKER_02: So uh but yeah, and food, you know, it was it was nice.
• 4:24
  SPEAKER_02: We had some breakfast food that was that was there.
• 4:27
  SPEAKER_02: Um I was I was kind of like one of the volunteers on the bike to make sure that people made the the correct turn.
• 4:34
  SPEAKER_02: So I led the group out, but then found myself at the back end of the group.
• 4:40
  SPEAKER_02: Uh so then by the time I got to the picnic, a lot of the good food was already eaten.
• 4:45
  SPEAKER_02: Oh no.
• 4:46
  SPEAKER_02: And so I was just like, oh man, it was a total bummer.
• 4:50
  SPEAKER_02: But I did get something out of it.
• 4:52
  SPEAKER_02: But uh I it's just it's just fun.
• 4:54
  SPEAKER_02: It it's kind of outside of my comfort zone, and it's something that I'm forcing myself to do more of as I'm a sponsor of the of the club, trying to not just increase exposure for Taboo Russ or racing, but to make me, you know, personally more engaging, more of an extrovert kind of thing.
• 5:10
  SPEAKER_02: But these types of events, not just the ex like the the training side of it, but like the emotional side of it is just exhausting.
• 5:18
  SPEAKER_02: So I'm really kind of dragging right now because it yeah, it's hard to be quote unquote on, you know.
• 5:23
  SPEAKER_02: I I try really hard, uh, but I'm getting better at it.
• 5:27
  SPEAKER_02: So but uh but yeah, this is this is a busy week.
• 5:30
  SPEAKER_02: I've got like a coach track session this week, and then a new member social on Thursday, and then we leave Friday for for the race, and I'm doing a double race, so I'm racing Saturday and Sunday.
• 5:41
  SPEAKER_02: So this is this is a wild and crazy week uh for me.
• 5:45
  SPEAKER_02: So hopefully I can keep it all together.
• 5:48
  SPEAKER_00: You can keep it, yeah.
• 5:50
  SPEAKER_00: It's always busy.
• 5:51
  SPEAKER_00: I don't know.
• 5:52
  SPEAKER_00: I don't I'm trying to manage my time better.
• 5:58
  SPEAKER_02: So it it always kind of kind of goes that way.
• 6:02
  SPEAKER_02: But uh so let's let's jump into this.
• 6:04
  SPEAKER_02: So like I said, this is episode 118.
• 6:06
  SPEAKER_02: So let's let's talk a little bit about the anatomy and physiologic physiology of of the bone, just so that we have a basic understanding of of the structure.
• 6:16
  SPEAKER_00: Yeah, I just I think it's helpful to review.
• 6:18
  SPEAKER_00: I mean, obviously people can look at this up, but I think it's helpful to remember.
• 6:23
  SPEAKER_00: So there are different kinds of bones that are they're just shaped differently.
• 6:27
  SPEAKER_00: You kind of have like your long bones, which may be like the limb bones in your limbs, like the femur, um, would be an example.
• 6:36
  SPEAKER_00: Uh you have kind of your lumpy short bones, which would be like the bones that you might have in like wrists or ankles.
• 6:43
  SPEAKER_00: They're just kind of lumpy, you know, smaller, lumpier bones, or maybe not necessarily small, but um, and then you kind of have these irregular bones like your vertebrae, which have, you know, they have different shapes to them.
• 6:54
  SPEAKER_00: They're a little bit irregular, I suppose.
• 6:57
  SPEAKER_00: Um, so those are just different kinds of bones that we have.
• 7:00
  SPEAKER_00: Um, you know, all sorts of obviously bones in our body and the different shapes.
• 7:05
  SPEAKER_00: Um, the two different um types of bone would be cortical bone, which is like the compact.
• 7:12
  SPEAKER_00: So you kind of think of this like the outside of our bones have more cortical bones, and then the inside of the bone is more of this spongy material called trabecular bone, and that's just so in all of the different kinds of bones, there's the cortical and the trabecular, just the the amount of each is a little bit different depending on the type of bone.
• 7:33
  SPEAKER_00: Um, but that's just that's just kind of so if you were to cut the bone open, you might even be able to see those different layers in there a little bit.
• 7:40
  SPEAKER_00: Um bones are like awesome because they're the way that they're structured is in such a way it just the amount of load that our bones can actually handle is pretty amazing if you kind of think about it, the structure of the bone and how much we can actually load onto the bone.
• 7:58
  SPEAKER_00: So I think it's important to really have a very strong respect and and awe of how amazing it is, um, how they're formed and how amazing they are.
• 8:09
  SPEAKER_00: They're just resistant to like loading both, you know, loading from the top sort of down and also like twisting, loading, you know, twisting movements that we do and that sort of loading.
• 8:19
  SPEAKER_00: So it's able to sort of that bending and then the gravity forces, our bones are able to handle both types of loading, which is great.
• 8:26
  SPEAKER_00: I mean, to a point, obviously, we can break bones and that does happen, but the the amount we can put onto the bone is is quite amazing, I think.
• 8:35
  SPEAKER_00: Um, and then within the bone, in terms of f formation of bones, we have uh the osteocyte, which is like the bone cell, but we have two different types of um cells or different different um they're how the bone is formed and how it's broken down.
• 8:51
  SPEAKER_00: So like this is kind of it's hard to remember this because you you think it's the opposite, but the osteoblast is actually what forms the bone.
• 9:00
  SPEAKER_00: I always that always confuses me because I'm thinking blast, and I'm thinking it's gonna blast the bone, but it's actually the blast, osteoblast is the forming bone forming um part of the bone, and then the osteoclasts come in and they break bones down.
• 9:15
  SPEAKER_00: So there's these two um opposing things are both really important.
• 9:19
  SPEAKER_00: I think sometimes we think bone is just kind of a stagnant, stagnant tissue, but there's constantly our bodies are constantly kind of going in and remodeling and and taking and breaking bone down and getting calcium out of bone but reforming it.
• 9:33
  SPEAKER_00: It's not like the bones are just sort of a stagnant tissue, it's a constant kind of flux that's happening.
• 9:40
  SPEAKER_00: And so it's really important to remember that uh about bone too, as we're talking about different nutrients and things like that, because there's this constant remodeling and um both the osteoblast and osteoclasts are kind of constantly working in that way.
• 9:55
  SPEAKER_00: Bone is a reservoir for calcium, so sometimes we do break bone down in order to, if we need more calcium for other things, that's why, you know, we'll talk a little bit about nutrients and why calcium is so important later.
• 10:06
  SPEAKER_00: Um, try to think of other things that mention.
• 10:09
  SPEAKER_00: I think that's a big overview, really quick, like three-minute overview of bones.
• 10:14
  SPEAKER_00: So I, you know, if you're like really fascinated by this, there's so much information you can find on the internet about how bones are made and all of these different things.
• 10:24
  SPEAKER_00: But I think just a little overview is important.
• 10:27
  SPEAKER_00: Um, the one thing I do want to mention here is that bone health is really determined a lot based off genetics.
• 10:34
  SPEAKER_00: Some people just kind of say, like, hey, I'm like strong boned, or you know, you have people that are maybe less prone to bone injuries than others, and that may be somewhat genetic.
• 10:43
  SPEAKER_00: If there's a a strong family history of like osteoporosis, for instance, it's probably really genetic and something you really want to be thinking about yourself and how do you make sure that your bones are are strong as you age, as you're young, as you age.
• 10:58
  SPEAKER_00: Um, and we generally can determine bone mineral density or bone density by you getting a DEXA scan is kind of the gold standard for that.
• 11:08
  SPEAKER_00: Uh and so that's kind of something you if you haven't had a honestly, I'm just gonna put this out there for anyone.
• 11:14
  SPEAKER_00: I mean, especially if you have a stress fracture or if you're prone to stress fractures or you currently have one, I highly, highly recommend going ahead and getting a bone mineral density scan or DEXA scan, because if you're already sort of osteopenic or you're sort of um starting to lose bone mineral density, that is something you want to know now.
• 11:35
  SPEAKER_00: You don't want to wait until like you're um unable to like move or you have something very much more severe, like a true osteoporosis happening.
• 11:44
  SPEAKER_00: You want to have that, you want to know that now.
• 11:46
  SPEAKER_00: So if somebody does have a stress fracture, they seem to be prone to that.
• 11:50
  SPEAKER_00: I think if they have never had a DEXA scan, I highly recommend it.
• 11:53
  SPEAKER_00: In fact, like I think I've had one done in my teens or 20s, but I'm actually thinking um, I might be getting one soon just to double check where my bones are now in terms of bone mineral density, just as a precautionary measure.
• 12:06
  SPEAKER_00: And I'm actually surprised that most physicians don't do that more often for people.
• 12:11
  SPEAKER_00: Like, wouldn't it be like I almost think it'd be good to know every five years, maybe starting one in your 20s, one in your 30s, and then from 40 on every five years.
• 12:19
  SPEAKER_00: That I mean, that's not that's just based off my personal suggestion.
• 12:23
  SPEAKER_00: I don't think that's based off of any evidence, but I'm just saying, like having those done periodically so that you can see where your bones are, because um, yeah, you're one thing important about bones is that in our 20s is kind of when we stop building new bone.
• 12:38
  SPEAKER_00: We we both stop getting taller, so we stop building bone, you know, growth in that way.
• 12:44
  SPEAKER_00: But the bone mineral density is kind of at its peak in our 20s or like teens into 20s.
• 12:50
  SPEAKER_00: And so it's really our 30s and beyond that we start to risk losing bone mineral density.
• 12:56
  SPEAKER_00: And it's really hard at this point as we get older to actually get den like build density in our bones.
• 13:03
  SPEAKER_00: And so honestly, like if it's too late, I mean, some of us obviously are in our 30s and 40s, and this people listening are probably older, but what happened in your 20s is really important.
• 13:14
  SPEAKER_00: And if you didn't do enough to build strong bones, there may you may be sort of at your peak of where you can be, and there may not be a lot you can do to really build those bones.
• 13:24
  SPEAKER_00: Like you'll never have bones like you would have in your 20s, if that makes sense once you're older.
• 13:28
  SPEAKER_00: So those are like really critical years.
• 13:30
  SPEAKER_00: And if anyone's listening has kids, like I'm not gonna go into children and and bone density, but wow, what a critical time making sure your kids are doing all that they can to build bone density as they're in their teens and um you know, children into teens and into early adulthood.
• 13:46
  SPEAKER_00: That's just a P PSA, making sure your kids are so they don't have stress fractures and things like that, hopefully, as they if they're active.
• 13:53
  SPEAKER_00: But that's just an overview really quickly of bone density and kind of how we would maybe measure it.
• 14:00
  SPEAKER_00: I'm not gonna go into T scores, Z scores in terms of like if you get the DEXA scan, there's different things that measure bone density.
• 14:07
  SPEAKER_00: I'm not gonna go down that r right now.
• 14:09
  SPEAKER_00: Um I think that's just something you would want to talk with your physician about if you get that done.
• 14:15
  SPEAKER_00: And it's saying like this is your Z score, T score is just measuring bone density, and it's based off of kind of an age match control, I believe.
• 14:23
  SPEAKER_00: And so to talk with your doctor about what that means would be my suggestion.
• 14:27
  SPEAKER_00: Um, so we're not gonna do that deep of a dive into that.
• 14:30
  SPEAKER_00: We're just gonna talk more about like athletes and stress fractures and what that means for bones and what we can what risk factors there are for stress fractures, what we can maybe do to help prevent them, or to if we have a stress fracture, heal from that.
• 14:43
  SPEAKER_00: But that's really where we're gonna go today, right?
• 14:45
  SPEAKER_00: Is that the plan?
• 14:47
  SPEAKER_00: Sounds good.
• 14:48
  SPEAKER_00: So I just wanted to I feel like that was just helpful to kind of review that bone piece and bone density piece.
• 14:54
  SPEAKER_00: Um, I don't know, where do you what are you thinking like in terms of stress like stress fractures?
• 15:01
  SPEAKER_00: Do you when you have an athlete that has one or talking with someone that has a stress fracture, are there any things you're asking them or how are you kind of exploring that with them in terms of um like getting to figure out what's going on?
• 15:15
  SPEAKER_02: Yeah, the interactions that I've had with athletes when it when it comes to this particular type of injury is the first thing that I ask is okay, what was your training volume like?
• 15:25
  SPEAKER_02: You know, uh how quickly did you ramp things up?
• 15:27
  SPEAKER_02: Were you when you were conservative?
• 15:29
  SPEAKER_02: Did you do kind of like you know, I did I followed the 10% rule and had recovery stuff in there.
• 15:34
  SPEAKER_02: So first I I take a look at training volume, both in terms of increases in duration or mileage, however it is that that you measure that, and intensity.
• 15:45
  SPEAKER_02: Uh those those are the two things that I that I first look at.
• 15:48
  SPEAKER_02: If we really don't see anything that stands out and it's like, oh, that was really irresponsible, then my next approach is usually um, well, what is your recovery process like?
• 16:01
  SPEAKER_02: You know, what kind of how's your quality of sleep?
• 16:03
  SPEAKER_02: You know, what sort of things are you doing when you're not training?
• 16:07
  SPEAKER_02: You know, and then the third thing that I look at is the nutrition side of it.
• 16:11
  SPEAKER_02: It's like, okay, have you had any blood works that have that have been done?
• 16:16
  SPEAKER_02: Are you nutrient deficient and anything that that would explain why the remodeling process isn't taking place like it should?
• 16:25
  SPEAKER_02: You know, I I think of it in terms of you know, what's the rate of destruction versus the rate of you know repair?
• 16:32
  SPEAKER_02: And when those two get offset uh and you can't recover, then it makes sense on how it can go into you know a stress episode, and then you know, eventually if you don't heed those warnings, then it can go into like an actual stress fracture.
• 16:49
  SPEAKER_02: Um so that that's usually my approach is you know, training, recovery, nutrition.
• 16:55
  SPEAKER_02: Would would you use a similar approach if if somebody came to you?
• 16:58
  SPEAKER_02: I'm just curious because your your focus is tends to be you know on the nutrition side.
• 17:04
  SPEAKER_02: So I'm curious if you if you look at the nutrition side first and then flow down from that and you go into training or to the training volume.
• 17:12
  SPEAKER_00: I mean, I think what's your method?
• 17:14
  SPEAKER_00: I might ask like the basic things like you're saying.
• 17:16
  SPEAKER_00: I mean, I think I would ask about training first just to make sure that that isn't what it was.
• 17:22
  SPEAKER_00: Like sometimes that can be an obvious thing.
• 17:24
  SPEAKER_00: Someone's like, hey, I went from 20 to 40 miles a week, like doubled their mileage or whatever, something like that, you know.
• 17:30
  SPEAKER_00: And it's like, oh, well, that may be part of the problem.
• 17:34
  SPEAKER_00: Um I do think a lot of times, even so, even when someone is maybe it's obvious it's it's something related to training, I still explore nutrition because um, I guess when it comes to healing from a stress fracture, that becomes just as vital, you know.
• 17:52
  SPEAKER_00: So it's it's something I always explore with a stress fracture no matter what, but in terms of what causes it, I do, I do ask about the training surface, like anything different.
• 18:04
  SPEAKER_00: You know, is there something different you're doing?
• 18:06
  SPEAKER_00: Anything you've added in?
• 18:07
  SPEAKER_00: Has somebody decided they heard on a podcast they need to do like plyometrics or they're found something crazy that they're they're we're told to do.
• 18:16
  SPEAKER_00: Um like, you know, I'm thinking things I've heard that I'm like, oh, that would be helpful, but you know, runners, we just tend to take it too far.
• 18:23
  SPEAKER_00: Somebody decided they're gonna skip, you know, a mile every day because they heard skipping is good, you know, something totally just the the the forces are just totally different, but now they're taking it to an extreme, you know, stuff like that.
• 18:35
  SPEAKER_00: Whatever they're telling me that there's something that I'm like, oh, that could have maybe been it.
• 18:40
  SPEAKER_00: And then um, okay, then I might ask, how are you eating?
• 18:43
  SPEAKER_00: Even if there's training, if it seems like that might be the answer, I still go into the nutrition.
• 18:49
  SPEAKER_00: Um, because I do think sometimes it can be multifactorial, and sometimes it is a factor of both training and nutrition.
• 18:57
  SPEAKER_00: And I do think that endurance athletes are just very prone to uh underfueling in general, and it's a major factor, I think, for stress fractures, but I may be a little bit biased because I'm you know that's just what I do, so I'm thinking about it more than maybe coaches might, in terms of like it.
• 19:15
  SPEAKER_00: I think when it's coaches and you do all the coaching, you're thinking training more.
• 19:20
  SPEAKER_00: But I'm thinking it from both sides, but I do think of more nutrition, and so it's always something I'm talking with people about or making sure that I'm asking about.
• 19:29
  SPEAKER_00: Um, but it's hard sometimes because sometimes it's hard to get to the bottom of it a little bit.
• 19:35
  SPEAKER_00: You know, there's maybe no obvious answer, and I think sometimes then it could be maybe more than one factor, or maybe there is a genetic, you know.
• 19:42
  SPEAKER_00: Sometimes if it's like, wow, this is really weird, this person's, you know, they haven't done anything crazy with their training, their nutrition seems to be okay, you know, maybe, or I'm doing a deep dive and I'm like, yeah, they're fueling vine.
• 19:55
  SPEAKER_00: You know, sometimes it can be genetic, so there are obviously things that maybe put people at risk that are outside of their control.
• 20:02
  SPEAKER_00: Um, but yeah, I'm usually trying, it's like playing a detective, right?
• 20:05
  SPEAKER_00: You're just trying to figure out what's going on, why, why did this happen to someone, and how are then how are we gonna get them well and and heal, and then how are we gonna prevent it from happening again?
• 20:18
  SPEAKER_00: And um, yeah, that's kind of the way I go about it.
• 20:21
  SPEAKER_02: There's something that just kind of like popped into my mind a little bit, and so I'm curious on your thoughts on it.
• 20:27
  SPEAKER_02: Um for individuals who have lost weight quickly, we're talking whether they're on like GLP1s or they're on they've had some kind of like weight loss surgery, or for whatever the circumstances may be, they have lost a significant amount of weight in a short amount of time.
• 20:47
  SPEAKER_02: Do they become more susceptible or does their risk profile change if they have maintained a training schedule during that weight loss?
• 21:01
  SPEAKER_02: Um, I mean, you know, I'm a little bit biased because, you know, I'm a bariatric patient, so I'm kind of curious on you know, on how the body responds to not just the weight loss, but the hormonal changes that take place with rapid weight loss because estrogen is stored in fat cells.
• 21:19
  SPEAKER_02: And we know that as women enter into perimenopause and menopause, that they become more susceptible to stress fractures as a result of the reduction in estrogen.
• 21:31
  SPEAKER_02: So if somebody goes through a rapid weight loss, they're losing effectively they're losing estrogen, whether they be male or female.
• 21:39
  SPEAKER_02: So I'm curious now if rapid weight loss changes that risk profile.
• 21:45
  SPEAKER_00: It depends.
• 21:45
  SPEAKER_00: Like r usually rapid weight loss, they're in some sort of uh low energy availability, especially if they're still training and they're losing more than one or two pounds a week, like put puts you at really high risk of low energy availability and for For males, that could lead to a drop in testosterone.
• 22:04
  SPEAKER_00: For females, that could lead to just um your body to just naturally stop producing as much estrogen, your cycle stops, you know.
• 22:12
  SPEAKER_00: So if you're not heeding those risk factors, especially unfortunately for men, there is no warning sign.
• 22:19
  SPEAKER_00: There can be like things you would have to pay attention to, but for women, it's usually loss of menstrual cycle.
• 22:25
  SPEAKER_00: But if you're on like a hormonal birth replacement birth control thing, you wouldn't notice it happening because you have that, you know, birth control piece there with the natur with the um artificial uh estrogen that's kind of being supplied from that.
• 22:39
  SPEAKER_00: Um, but you can still be at risk for low energy deficiency and actually still at risk for stress fractures as well.
• 22:46
  SPEAKER_00: So I think in that case, yes, I feel like somebody who's losing weight rapidly and they're still training, like they're in some sort of even if they're not increasing their training, they're just maintaining some load of training, I think they would be at increased risk of stress fractures.
• 23:01
  SPEAKER_00: And I would be worried for those individuals long term, depending on the length of time that they spent, like in reduced energy, maybe.
• 23:10
  SPEAKER_00: Um, it just really depends on also if they're all protein, if they've lost muscle mass as well.
• 23:18
  SPEAKER_00: Like a lot of times with muscle mass loss can bone loss, not not because you're losing muscle, but because they kind of go hand in hand.
• 23:27
  SPEAKER_00: You know, you lose muscle, you're probably losing some bone mineral density.
• 23:30
  SPEAKER_00: But I think when we're that losing weight that quickly and it's such a restricted amount of energy intake, the chances you're actually meeting your needs, unless you're super good about supplementing everything and making sure you're getting all of those nutrients, all of those critical nutrients for bone density might be missing, you know, or at least some of them.
• 23:52
  SPEAKER_00: Um, so you would if you're like, hey, I I really need to lose weight, I'm gonna do a GLP one or I'm going to do um bariatric surgery, but I want to continue training maybe after the surgery, but I want to continue training, I think it's then extremely critical that you A, try not to restrict energy so as m as much as you can control it, so the point where you're losing like you know, more than five pounds a week, that's probably excessive.
• 24:18
  SPEAKER_00: I know that's hard in a bariatric surgery because you're losing a lot.
• 24:21
  SPEAKER_00: But usually people who have those surgeries aren't also training right away, you know.
• 24:26
  SPEAKER_00: So, but like a GLP one or something like that, I think the biggest problem would be people just aren't paying attention to what they're eating enough to be able to make sure they're getting adequate nutrients.
• 24:37
  SPEAKER_00: So I think it it does that situation would be definitely a a huge risk factor for someone.
• 24:44
  SPEAKER_02: Um if you're if you're on something like a GLP one and you've you're trying to maintain your training load, then that just tells me that that supplementation is is going to be even more important.
• 24:57
  SPEAKER_02: It's the it's really going to be the only way that you can ensure that you're getting the nutrients that you need in order to facilitate the resources.
• 25:06
  SPEAKER_00: But yeah, you'd have to be probably supplementing some.
• 25:09
  SPEAKER_00: And yeah, you're just gonna have to think about it a bit, you know, and really plan it out and make sure that the majority of your calories are nutrient dense.
• 25:17
  SPEAKER_00: You don't really have a lot of uh wiggle room to have cheat things.
• 25:22
  SPEAKER_00: You know what I mean?
• 25:23
  SPEAKER_00: Like you if you're only getting in twelve, you know, a certain amount of calories, the majority of those calories really need to be nutrient dense.
• 25:30
  SPEAKER_00: And most people aren't doing that.
• 25:32
  SPEAKER_00: They're they're like, oh, like I can eat whatever I want because I'm eating less of it.
• 25:37
  SPEAKER_00: Um, but they're eating things like donuts and chips and things like that that are have low nutrient quality, and then that they're running into this problem because their calories don't have they have less calories, but those calories aren't nutrient dense enough.
• 25:53
  SPEAKER_00: So they would probably benefit from supplementing, but also having to pay a lot more attention to nutrient density.
• 26:00
  SPEAKER_00: Because I think most athletes, when we're eating enough and we're fueling enough, you know, so we're just eating junk all the time.
• 26:05
  SPEAKER_00: Most of the time we're eating enough healthy foods, enough calcium, enough things with iron to be able to meet our nutrient needs.
• 26:12
  SPEAKER_00: Like we probably don't need to supplement because we're probably eating enough calories in general to get all of those things we need.
• 26:19
  SPEAKER_00: But when we start to restrict energy, that's where it becomes a bigger problem, you know.
• 26:24
  SPEAKER_02: So let's let's let's take this one step further then.
• 26:27
  SPEAKER_02: And now that we've introduced the the nutrient piece of it, where like, you know, so are you nutrient deficient in some way?
• 26:35
  SPEAKER_02: Let's talk about what those nutrients are so that we have something that to say, okay, what do I need to focus on then?
• 26:43
  SPEAKER_02: You know, in terms of making sure that I'm picking the right foods, what nutrients do I need to make sure are on my plate in order to ensure that I'm being as optimal as I can?
• 26:53
  SPEAKER_02: So can you go through some of those?
• 26:55
  SPEAKER_00: Yeah, let's let's do that.
• 26:56
  SPEAKER_00: I think I mean I mentioned calcium already, so let's start there because it's kind of like the big one.
• 27:01
  SPEAKER_00: Um, calcium is really important because it's like a big majority of our bone is kind of composed of um calcium.
• 27:10
  SPEAKER_00: And so we want to try to get in general, it's gonna be a little different depending on age range of where we are in our age, but a thousand to about twelve hundred milligrams a day, up to about fifteen hundred milligrams of calcium.
• 27:24
  SPEAKER_00: Calcium is one of those things where we want to not have too little and we don't want to, it's not one of those nutrients that we want to like overdo either, because there can be issues with like calcification of things.
• 27:34
  SPEAKER_00: You know, we just don't want to be like overdoing it.
• 27:37
  SPEAKER_00: We just want to kind of have enough the right amount each day.
• 27:41
  SPEAKER_00: Um, and it's absorbed in the gut, and so we'll talk about vitamin D in a minute, but vitamin D does help calcium absorption, so that's another very important nutrient.
• 27:50
  SPEAKER_00: Those two are like the top two, but there's other, like quite a few others as well.
• 27:54
  SPEAKER_00: Um, and honestly, like this is what really irks me about this like vilification of dairy products for some reason.
• 28:02
  SPEAKER_00: People love to like vilify food groups and you know, oh, dairy's not natural, like we shouldn't be consuming dairy because it's coming from a cow.
• 28:11
  SPEAKER_00: But the majority of people, especially in the United States, that's where the majority of our calcium is coming from.
• 28:17
  SPEAKER_00: It is, you know, a yogurt or a glass of milk has something like two or three hundred milligrams, maybe closer to three hundred milligrams of calcium in it.
• 28:25
  SPEAKER_00: So you could see how if you just have some cheese or some milk or yogurt or cottage cheese or something like that, a couple servings a day, you've already at least met half of that need.
• 28:35
  SPEAKER_00: And so that's gonna be our most abundant source.
• 28:39
  SPEAKER_00: So if you're not doing dairy, I think really you're you're gonna have to try to get those calcium fortified milks and things like that because you're just yes, there's calcium and things like tofu and certain like small amounts and nuts and small amounts and leafy greens, and oh, you know, you could do salmon and eat the bones, you know, there's like that type of thing has calcium.
• 29:00
  SPEAKER_00: I mean, there's our there's there's other like maybe things that have some, but I would say, you know, it's harder, you know.
• 29:07
  SPEAKER_00: So for our people who are vegan or um vegetarian, you know, usually you might be eating dairy, but vegan or just avoiding dairy because it bothers their stomach or something, I do think then you just have to be more aware of it.
• 29:20
  SPEAKER_00: And the the sad news here is that yes, I mean, you can like maybe do some supplementation.
• 29:27
  SPEAKER_00: We want to make sure that all of the calcium is not supplemented though, because there's actually like a whole something people should really think about is there's this um synergistic piece of uh what we eat with the foods we eat and how there are different nutrients in there that kind of help um have some synergy in terms of how they absorb, how they help things absorb or how they work in the body.
• 29:50
  SPEAKER_00: So sometimes just taking a calcium supplement, you know, maybe you would be it would behoove you to also take it with a vitamin D so that you can absorb it.
• 29:58
  SPEAKER_00: But we don't really want to take more than 500 milligrams at once because more than that we can't absorb.
• 30:04
  SPEAKER_00: So you do have to kind of think these things through if you're not taking in dairy, maybe taking some amount of supplementation, but also really trying to then find those foods that have calcium in it to eat so that you can get the most benefit.
• 30:17
  SPEAKER_00: Um, and you know, just kind of looking.
• 30:18
  SPEAKER_00: There's plenty of if you just type in like calcium content of foods, there's probably lists you can find the USA USDA, I think has some lists of foods and calcium content.
• 30:29
  SPEAKER_00: So it's pretty easy to find those things.
• 30:31
  SPEAKER_00: So just looking that up and kind of okay, this has this much, and then just kind of maybe doing a little inventory of how much calcium you think you're getting in a day in general, based off what you're eating, might be worth it just to make sure you're getting enough.
• 30:44
  SPEAKER_00: Um, but that's gonna be our most important nutrient, and then vitamin D, I've all also mentioned.
• 30:49
  SPEAKER_00: And vitamin D we get predominantly from the sun.
• 30:52
  SPEAKER_00: I think people kind of get scared of the sun because of skin cancer, and I understand that.
• 30:57
  SPEAKER_00: But if you can spend an athletes, we tend to spend a lot of time in the sun, so but a lot of times we are lathering up with sunscreen, and so if you can spend like 30 minutes in the sun, ideally before 10 a.m.
• 31:07
  SPEAKER_00: and maybe after like 2 or 4 p.m.
• 31:09
  SPEAKER_00: So it's not in the the time of day when the UV rays are really intense, um, you should be able to get enough.
• 31:17
  SPEAKER_00: But you know, winter time, I don't go outside because I don't I mean I have yeah, I have stuff all over.
• 31:22
  SPEAKER_00: I don't so I do sub I personally supplement in the winter.
• 31:25
  SPEAKER_00: This is one that's easy to um test.
• 31:29
  SPEAKER_00: Like calcium's a little harder because we really tightly regulate calcium in our um blood.
• 31:34
  SPEAKER_00: So if we do like a you can get a calcium in like a comprehensive metabolic panel, but it's not it's not really gonna show much unless it's out of range and something really problematic is happening because our body tried to really tightly control that, so it's harder to measure.
• 31:49
  SPEAKER_00: But vitamin D, you can go get a test and ideal like 30 below, depending on the person you're talking to, maybe 20 or below is deficient, 30, 30 to 20, 20 to 30 or below.
• 32:00
  SPEAKER_00: Ideal might be more like 50 to 75.
• 32:02
  SPEAKER_00: Again, it may depend on who you're talking to.
• 32:05
  SPEAKER_00: Um, but you can get a vitamin D.
• 32:07
  SPEAKER_00: And I think that's nanograms per milliliter.
• 32:10
  SPEAKER_00: I think if you you can do that and see, and if you're in that deficient state, you might want to supplement with like anywhere between a thousand and five thousand international units a day would be probably adequate for supplementation.
• 32:24
  SPEAKER_00: In high doses, you don't want to be like doing 50,000 unit international units a day, like unless you're working with somebody like a physician to very quickly increase your vitamin D status because too much, you know, it's just that's like a overload, and vitamin D is a fat-soluble vitamin, so it can be um toxic.
• 32:44
  SPEAKER_00: I mean, it doesn't have less risk toxicity than some of the others, but we just want to be kind of careful with it.
• 32:50
  SPEAKER_00: Um, but just making sure you're maybe if you're worried about it, maybe just taking a low dose, like thousand or five hundred IUs a day, is probably safe, you know, for most people, but if you want to test it, you can.
• 33:04
  SPEAKER_00: And then there's some nutrients.
• 33:05
  SPEAKER_00: I think people think of those too for bone formation, right?
• 33:09
  SPEAKER_00: For absorption and bone for formation.
• 33:12
  SPEAKER_00: There are others too that I want to mention.
• 33:14
  SPEAKER_00: Um, I'm not gonna go into extreme detail because there's actually several that have some sort of um whether they're part of the bone structure or they are part of like an enzyme that regulates bone formation, but there's several that are important.
• 33:29
  SPEAKER_00: And so I think I'm just gonna go through these and just mention them because I want people to understand that it's actually like a lot of nutrients that really are part of this.
• 33:38
  SPEAKER_00: So iron iron is one that I think is another one that's important to mention because it is involved involved in bone formation and when you and it's actually required for like collagen production and bone matrix um formation, but it's um important if you have a vi an iron deficiency, which a lot of endurance athletes have kind of low iron, right?
• 34:02
  SPEAKER_00: If they're anemic, it's especially a problematic, but even a low level of iron can be problematic.
• 34:07
  SPEAKER_00: So what we really want to do is be aware of that and make sure if you're testing ferritin testing for iron deficiency or low iron and be able to like um supplement or get more iron-rich foods, because that is a connection I don't think most people know, but it's an important one.
• 34:25
  SPEAKER_00: And so sometimes even when I'm asking people or uh going through like what could this be, if they tell me they have like a history of anemia or like low iron, sometimes that kind of is one thing I'll definitely kind of flag if they're like I have a stress fracture and I also have this history, because it could there could be a connection potentially there.
• 34:46
  SPEAKER_00: Um so iron's important, vitamin K is important.
• 34:49
  SPEAKER_00: There's a couple of vitamin K2, vitamin K1.
• 34:53
  SPEAKER_00: Um, I think they're both important, but vitamin K, uh, vitamin C for collagen and iron absorption, collagen formation, it also helps to potentially suppress the osteoclast um activity, which is the one that breaks down bone.
• 35:10
  SPEAKER_00: So we want to have vitamin C.
• 35:12
  SPEAKER_00: Protein is actually really important for bone health.
• 35:15
  SPEAKER_00: There used to be a school of thought years ago that because when people ate a lot of protein, they would have more calcium in their urine.
• 35:21
  SPEAKER_00: And so we would they would, oh, you know, cal protein is really bad for bones.
• 35:26
  SPEAKER_00: But what we've actually found is that protein is really important for bone health.
• 35:31
  SPEAKER_00: And um even eating a little too much protein isn't necessarily negative, it's not going to negatively impact your bones.
• 35:38
  SPEAKER_00: So, and there is um there is a potential like correlation maybe between having um good bone health and um being, you know, must having enough muscles and being muscular or having you know adequate protein and having adequate um muscular health as well.
• 35:55
  SPEAKER_00: Like so sarcopenia is what I'm thinking of where people lose a lot of muscle mass, especially as they age, that often correlates with like stress fracture risk.
• 36:04
  SPEAKER_00: So it's important to have yeah.
• 36:07
  SPEAKER_00: I think probably they're kind of hand in hand.
• 36:09
  SPEAKER_00: I don't know, because it that's that's a whole different topic, but it it is important to get enough protein and there's no difference between plant or animal-based proteins in terms of um bone health.
• 36:20
  SPEAKER_00: So just making sure you're getting adequate amounts of protein.
• 36:24
  SPEAKER_00: And I think we've done that protein talk.
• 36:26
  SPEAKER_00: So if you're curious about what that means that is, go back to that episode.
• 36:30
  SPEAKER_00: Uh other nutrients are magnesium, um, vitamin A, potassium, boron, selenium, copper, phosphorus, and zinc.
• 36:38
  SPEAKER_00: So there's a lot, a lot of them that, and they all have a function.
• 36:42
  SPEAKER_00: I don't want to go in a deep dive onto all of those, but as you can see, like there's a lot of nutrients that are necessary.
• 36:48
  SPEAKER_00: And if you happen to be low or not getting enough of any one of them, I don't know if that would necessarily cause a stress fracture, but um it it contributes.
• 36:59
  SPEAKER_00: So we do want to make sure we're eating a nutrient-dense diet and getting all of these nutrients because so many of them are involved in bone health.
• 37:06
  SPEAKER_00: So but the big two are three, I guess would be calcium, vitamin D, maybe iron, um yeah, and the others are important too, but those are kind of the big ones.
• 37:17
  SPEAKER_00: Any qu I don't know.
• 37:18
  SPEAKER_00: Does that make sense?
• 37:19
  SPEAKER_00: I don't I don't want to bore people with that.
• 37:22
  SPEAKER_00: But yeah.
• 37:22
  SPEAKER_02: No, no, no, not at all.
• 37:24
  SPEAKER_02: I I think it's important to at least understand, okay, then you know, what is it that I should be looking for?
• 37:31
  SPEAKER_02: And you know, I I don't want them to just kind of blindly say, okay, well, I'm I'm I feel like I'm eating well, but it doesn't I I want to make sure that they have that distinction.
• 37:43
  SPEAKER_02: It's like, okay, well, what's the difference between eating well and eating nutrient-dense food?
• 37:47
  SPEAKER_02: Uh they may not be the same thing.
• 37:49
  SPEAKER_00: So And like I said, I mean with athletes, usually if we're just trying to get a good amount of healthy food in and eating well overall, because as long as we're eating our meeting our energy needs, um, you know, we sh should hopefully be getting enough of these nutrients.
• 38:04
  SPEAKER_00: So I don't want anyone to be like freaking out and like, oh, I've got to do some sort of really expensive test to be to see what my status is on all of these.
• 38:12
  SPEAKER_00: Um, some of them are hard to test, but you can if you're if you want to.
• 38:16
  SPEAKER_00: I mean, there are some you can do that measure like intracellular levels, and that's a little better than like blood levels, because like I said, our body tight tightly controls the levels we have in our blood.
• 38:27
  SPEAKER_00: So it's harder to measure some of these because it's probably gonna be like if it's way out of the range, it's like a big problem, but it's not gonna really pick up on minor, um, minor deficiencies or things that are just kind of on the low end of the levels that you might want to, you know, maybe supplement or eat more of.
• 38:46
  SPEAKER_00: So that's always an option to test.
• 38:49
  SPEAKER_00: One thing you could do, I use chronometer, I've had you use chronometer.
• 38:53
  SPEAKER_00: If you just log your food in there, that's not a perfect thing, but if you do over a period of time, there is like the my all those micronutrients that it shows in there.
• 39:02
  SPEAKER_00: You can kind of look, do like a nutrient analysis of like the past month if you're like able to log in there consistently and go into like all the micronutrients.
• 39:11
  SPEAKER_00: And if you see one that just flags as low consistently or on the lower end of the range that it wants you to get, that might be a way to do it too, and be like, oh, you know, that's really weird.
• 39:20
  SPEAKER_00: I just don't seem to be getting enough selenium.
• 39:23
  SPEAKER_00: So maybe add some Brazil nuts or something, you know, to your diet.
• 39:26
  SPEAKER_00: And I don't know, whatever it is that you need to add to get more of that nutrient.
• 39:30
  SPEAKER_00: But that could be one way to do it too.
• 39:32
  SPEAKER_00: It's probably cheaper than a$200 or$300 test.
• 39:37
  SPEAKER_00: But yeah.
• 39:38
  SPEAKER_00: Um, so those are just some ways to look at that, or um, because I don't want people to be like, well, how am I gonna figure out if I'm getting enough of those?
• 39:48
  SPEAKER_00: I think the basic big ones are the most important.
• 39:51
  SPEAKER_00: I think in terms of nutrients, that's the most important thing.
• 39:54
  SPEAKER_00: But I do think what we could maybe talk about would be to kind of stick onto that um theme, would be maybe like really emphasizing the low energy piece of this, because I think this is a major issue.
• 40:07
  SPEAKER_00: And then maybe we can go back to like the training piece and what we would maybe recommend an athlete incorporate or do in terms of training and what they might want to think about in terms of bone mineral density and how they're loading their body correct correctly, or how maybe they can prevent or um build strong bones.
• 40:26
  SPEAKER_00: Um, but I do I know you mentioned we talked about the weight loss, and I do want to just really emphasize the low energy availability.
• 40:33
  SPEAKER_00: It's also known as if it's a true, true thing that's happening, it's not just like a couple days of low energy, but somebody is like days and weeks and months of low energy.
• 40:42
  SPEAKER_00: It's chronic.
• 40:43
  SPEAKER_00: It's called red S, relative energy deficiency in sport.
• 40:47
  SPEAKER_00: It's generally happens a lot when training volume increases.
• 40:50
  SPEAKER_00: So this is where generally this is what I actually do see a lot with stress fractures, is maybe someone's increased their training volume and they've done so in a progressive manner.
• 41:00
  SPEAKER_00: Like they're they've done it and they've done it well.
• 41:02
  SPEAKER_00: But what they didn't do is also then increase their intake of food.
• 41:06
  SPEAKER_00: So they're increasing their um training, but they haven't increased their nutrient intake or their food intake.
• 41:13
  SPEAKER_00: That's a thing I commonly see.
• 41:15
  SPEAKER_00: That's one thing that could lead to this.
• 41:17
  SPEAKER_00: Like appetite too, you know, sometimes that's my issue, is when I'm increasing my training, I have to be really aware of this because my appetite actually sometimes either doesn't increase or it goes down a little bit with intense training or with higher volume, especially in the heat.
• 41:32
  SPEAKER_00: And so I know for me personally, I have to be I'm really aware of this and I have strategies that I have in order to make sure I'm getting enough.
• 41:41
  SPEAKER_00: So just something that can happen.
• 41:43
  SPEAKER_00: And this would be like things that maybe someone isn't intentionally under-eating.
• 41:47
  SPEAKER_00: They're just things that tend to happen to athletes.
• 41:49
  SPEAKER_00: Um meals are maybe skipped, you know, around training because the other thing, too, I'm thinking of like training for an Iron Man.
• 41:56
  SPEAKER_00: This is just something I'm thinking about because I have some people I'm working with that are doing an Iron Man coming up, and so they maybe um have a really long training session on Saturday or Sunday, like five-hour ride and like a run or something like that.
• 42:12
  SPEAKER_00: Like it's a big because they're trying to get ready for this race, a huge portion of their day is training and they're taking in stuff properly during, but they're never going to be able to replace their calories that they're expending during.
• 42:24
  SPEAKER_00: And so they sort of end up, you know, it's like they start in the morning and now by the time they're done, it's like mid-afternoon or something, you know, and it's like to make up that energy the rest of the day is very hard.
• 42:34
  SPEAKER_00: And so if you're not kind of thinking about that on the other days or the like carb loading the day before, and then kind of having maybe a little extra the day after to make up for that a little bit, and you're doing that week after week or even, you know, a couple times during the week, that could be a problem, right?
• 42:50
  SPEAKER_00: That could lead to low energy.
• 42:52
  SPEAKER_00: Um, carbohydrate intake is low for whatever reason.
• 42:55
  SPEAKER_00: Maybe, you know, I think we've kind of come away from this whole low carb movement and running and during sports, I hope, with this high now, it's like this high carb fueling thing.
• 43:06
  SPEAKER_00: But um, yeah, that's a big, big problem.
• 43:09
  SPEAKER_00: Um, not eating enough carbohydrate and then um intentionally trying to lose weight, like we've already talked about, like, or have a low body weight, or the schedule is just hard.
• 43:18
  SPEAKER_00: Like you have a busy schedule and you just don't have time to eat because you're trying to train and work and then you just forget to eat.
• 43:23
  SPEAKER_00: So those are all kind of the red things ways that this could happen to someone, or someone's just truly having um maybe they are developing some sort of disordered eating patterns, and that's maybe where it's really more scary.
• 43:35
  SPEAKER_00: It's both well, all of those scenarios are concerning, but you know, that's where somebody maybe coming into me, I would be able to differentiate between what was really going on, and um over time it's just going to affect that bone remodeling process because basically you don't maybe have the nutrients you need, and then your hormones are going to be um disrupted, like estrogen, like testosterone, some of those like critical.
• 44:00
  SPEAKER_00: um new hormones that we need for bone formation will be disrupted and then we can be at risk for um a stress fracture.
• 44:08
  SPEAKER_00: So just um that's a big one, I think, for people who are listening and they have chronic stress fractures, I would highly recommend seeking someone out that they can that can um analyze their intake and make sure they're getting enough.
• 44:24
  SPEAKER_00: You know, sometimes we think we're getting enough, but we're not.
• 44:27
  SPEAKER_00: And sometimes having somebody that can calculate that all for you and make sure um in it's okay to be in a little bit of an energy deficit if you're trying to lose weight, maybe, but it's just the magnitude of that deficit that maybe become problematic.
• 44:42
  SPEAKER_02: So or the longevity of it.
• 44:44
  SPEAKER_02: No, like how long you're actually trying you stay in that state.
• 44:47
  SPEAKER_02: Right.
• 44:48
  SPEAKER_02: Yeah.
• 44:49
  SPEAKER_02: So makes sense.
• 44:50
  SPEAKER_00: Yeah, if it's a long period of time it's probably puts you at more risk.
• 44:55
  SPEAKER_00: In terms of nutrient perspective, those are all going to be critical.
• 44:59
  SPEAKER_00: So if you have, if you're like, yep, I'm doing great, I'm eating well, I've got I'm doing well with all of those nutrients, then um you probably will generally have lower risk of stress fracture, but it doesn't mean it won't happen.
• 45:11
  SPEAKER_00: So I think there's obviously other things here.
• 45:13
  SPEAKER_00: Like that, those are just the building blocks the building blocks, the nutrients are the building blocks, but how we actually form the bone and whether or not running or some of these sports are actually protective against this is a is a different question.
• 45:27
  SPEAKER_00: I think that's kind of where I would feel like we should go with this conversation.
• 45:32
  SPEAKER_02: Well we just we just did a whole series on the aging athlete so the master's athlete talk about talk about how hormone changes impact uh bone health I mean a lot of our listeners I've looked at the statistics for our listeners and many of them tend to be in their late 40s into 50s and all of our hormones are changing at that age so what do we need to do as we get as we age to to accommodate for those bone outside of of hormone replacement therapy what should we be looking for as we get older to protect ourselves from from uh stress events like that yeah I mean I think unfort unfortunately I mean both men and women are impacted by osteopenia and osteoporosis.
• 46:21
  SPEAKER_00: It's not as though men don't I think we it's like commonly thought of as like a w a female thing, but it also affects men.
• 46:27
  SPEAKER_00: It's just that predominantly maybe like higher numbers of women get osteoporosis because with women it's the major change that happens around perimenopause and menopause where our estrogen levels just drop and estrogen is extremely important for bone formation.
• 46:44
  SPEAKER_00: It's a very important hormone and men have some decline.
• 46:48
  SPEAKER_00: I mean with there's small amounts of estrogen men have it's not like the same kind of levels exactly but it's still it still happens there's a decline it's just not such a drastic just like like go off the plateau and hit the bottom you know kind of drop like women have with uh kind of menopause where just like the kind of really minimum amounts um you know testosterone may may play a role there too in some of the other hormones as well but I think estrogen's the major one.
• 47:17
  SPEAKER_00: So women are just more affected by that.
• 47:20
  SPEAKER_00: So I think that's where if you're a woman of the age of 4050 in your 40s and 50s especially like having that conversation with your physician about this a little bit or should if you decide you're not going to replace that estrogen with hormone replacement, that is totally fine.
• 47:40
  SPEAKER_00: You know, that is a decision that you need to make but that's probably the most protective thing you could do for bone health.
• 47:46
  SPEAKER_00: If you're not going to do that I do think that's where it becomes like important to do the dexascans and just make sure that um you're watching your bone I mean either way you want to kind of watch bone density but that's that is unfortunate is that as aging athletes we kind of have this extra layer of um bone uh concern right because there's this this hormonal piece that we can't really we can control for maybe but it's just a natural part of aging.
• 48:13
  SPEAKER_00: So we may be at more risk and I think that's unfortunate but it's a part of it.
• 48:18
  SPEAKER_00: So I think when we're aging then I think sometimes there's things that we want to incorporate just like any age we should incorporate these things but I think for the aging athlete specifically to incorporate things like strength training or maybe even some jumping exercises like things like that that basically you're trying to um stimulate bone growth or bone density or maintaining bone density to some level and that in order to build bone it's not like you just eat calcium and that's going to be enough.
• 48:52
  SPEAKER_00: It's not enough the bone actually has to be stimulated it has to have some sort of force upon it to say hey this is this is too much or this force is a little bit more not that you can handle because you'd obviously break the bone but it's like this force is a little bit much some sort of signal to the bone to build it a little bit stronger or to maintain that density where it's at the only way to do that is to have certain forces that you put upon the bone and the big, you know, the sometimes just running and and doing our daily activities that we've always done although helpful um it's definitely someone like you or me Justin or any of our listeners who are active are definitely probably better off than their sedentary counterparts in terms of bone density because we're maintaining activity which is critical.
• 49:42
  SPEAKER_00: So that is the big piece of it is just being active but I think in order to prevent stress fractures or to maintain our bone health as much as we can, I think we need to consider other things that if we haven't already considered like strength training or like some biometrics to to help stimulate the bone a little bit or trying a new activity like tennis or pickleball or something that you're doing where you're moving in different directions and you're sort of putting different forces on your body and your bones in different ways.
• 50:12
  SPEAKER_00: In other words um so I don't know what your thoughts are like I don't know if you talk with people about bones and in in terms of like when you're working with someone do you ever talk to them about bone mineralensity or no I can I can say it it hasn't come up.
• 50:28
  SPEAKER_02: I mean it's come up in just casual conversations with other athletes where where I hear these stories of of uh stress reactions and then eventually leading to like you know stress fractures and things so but none of my athletes have ever had that kind of experience under m under my watch.
• 50:47
  SPEAKER_02: I mean I'd yeah I've just I just say I I've just never had the opportunity to work with someone who's either come back from a stress fracture or is dealing with one.
• 50:58
  SPEAKER_00: Um but no I I haven't yeah I have athletes that I come to me because they have a stress fracture and they want to heal but they're not athletes I'm actively coaching.
• 51:07
  SPEAKER_00: They're usually they've usually been to a PT who's said who's then referred them to me because they're worried they have some sort of energy deficiency or they're lacking something in their nutrition.
• 51:17
  SPEAKER_00: And so I'm working with them from that perspective but I haven't actually had an athlete that I've worked with because it sucks if you're working with someone and they get a stress fracture right.
• 51:25
  SPEAKER_00: You know so it's a good thing I've and I haven't had anyone that's like thou coming to me and they've I haven't had too many that have had a history of stress fractures.
• 51:34
  SPEAKER_00: I've had other um maybe maybe maybe but not not very commonly usually it's other injuries that they've had and they're coming to me and they they want a different approach or they they haven't had a coach before and they're looking for some guidance.
• 51:47
  SPEAKER_00: So I haven't actually had that that experience um because I know the benefits of strength training for just like muscle you know um for for for being able to do the training and and being able to um be more resilient and be able to be a stronger runner, I recommend strength training to all of the athletes I work with.
• 52:07
  SPEAKER_00: So and I generally highly encourage it.
• 52:10
  SPEAKER_00: It's something I really do sort of like okay this is kind of a component I really think is important.
• 52:15
  SPEAKER_00: So most of the people I work with have some component of that in there.
• 52:18
  SPEAKER_00: And because of that like I may mention the bone piece I always talk about the muscle piece but I always forget to talk about the bone piece.
• 52:26
  SPEAKER_00: And it's so important especially for athletes and for any athlete but for any of us who are like in our 30s and 40s and beyond because of how protective it is for bone health.
• 52:37
  SPEAKER_00: So it's making me think yeah I should really if I'm trying to sell it do you sell it in that way too because the only way we're gonna be able to stimulate bone is is some sort of load and a really great way to do that is to strength train um because you're adding that weight component to it.
• 52:55
  SPEAKER_00: And then sometimes things like jumping movements where you do a little bit of jumping um you know side to side or do some sort of components that you're not just like what is it uni lateral or or ones only going in one direction to try to bring in movements that you're going from side to side so you can stimulate your bones that way too is really important.
• 53:18
  SPEAKER_00: So I do try to bring in some of that in some different like pliometric things that do kind of bring in some jumping movements.
• 53:24
  SPEAKER_00: But I do that mostly for the benefits that people get in terms of performance and maybe um you know speed but I I I rarely bring it up in terms of bone health and it makes me think yeah we I need to be better about that.
• 53:40
  SPEAKER_00: But I think someone coming back from or who's had a stress fracture, you're obviously doing this like once they're kind of healed, I think the first step would be like focusing on nutrition, you know, focusing on healing making sure you're you're eating all these nutrients to make your sure you're healing up the bone and then once you're healed I think then it's kind of this really cautious cautiously adding these things in we're not like oh now it's time to add all this these different components because your bone you know we want to make sure you don't like have another stress fracture but I do think these are all things that somebody might want to consider in the their routine if they haven't already for bone health I do want to mention I think a lot of runners think oh I'm pounding the pavement I'm running and there's lots of forces on my bones and that's enough.
• 54:28
  SPEAKER_00: And it it can be like it's not that there aren't forces it's just that our bones adapt and then they're and then if we're doing the same or similar amounts of running all the time it's not forming new bone it's not increasing bone density because for me for me for instance unless I decided to increase my mileage a lot or do something more drastic like that maybe but my bone mineral density isn't getting increased at this point from running because I've been running for so long and my body's so used to it and the force is upon it, you know, upon it when I go running.
• 55:00
  SPEAKER_00: So maybe if I decided to go run on pavement every single day instead of the dirt, maybe that would do something but generally it's kind of like probably going to be about the same.
• 55:09
  SPEAKER_00: So if I wanted to really stimulate bone mineral density I would have to do more than that like strength train and then cycling and swimming really has no impact on bone density.
• 55:22
  SPEAKER_00: So I think that's important to mention there is none.
• 55:26
  SPEAKER_00: There's no gravity or basically swimming is like anti not that it's not going to like take away the bone density but it's like there's no there is nothing there to stimulate bone density.
• 55:36
  SPEAKER_02: There's no impact stimulus.
• 55:38
  SPEAKER_02: There's no impact stimulus.
• 55:40
  SPEAKER_00: So for someone who's a triathlete they they do get it a little bit from running um but for like a swimmer cyclist especially cyclists can be pretty prone to issues with bone mineral density so it's very important to do something that loads their bones um because there is really not any with um with those sports.
• 56:01
  SPEAKER_00: So also I think important to keep in mind for those individuals.
• 56:06
  SPEAKER_02: I think this is a a really great point that we're making in that it really pertains to beginners.
• 56:13
  SPEAKER_02: You know somebody who's just now entering into the sports so they're coming off the couch and becoming active and we have done I think we did another episode where we talked about you know what is this fascination with you know 5K's and 10 Ks as people are just now like starting to run.
• 56:32
  SPEAKER_02: And I think it's it's relevant because they haven't built up the tolerant or the bone hasn't built up the tolerance in order to to handle the load and when when they start picking this volume just out of nowhere and they just pick it because it it sounds fine or it sounds impressive you know what's the what's the injury rate for these particular athletes and not just tendon and ligament issues but actually like bone issues.
• 57:03
  SPEAKER_02: So I think it's it's more evidence or supporting evidence on the the slow accumulation of volume as you if you're new to the sport or you're trying something new period you know rather than just saying oh I'm a fit person so I should be able to handle this it's as if a a cyclist you know who's used to doing century rides and everything else and they want to become a runner.
• 57:30
  SPEAKER_02: Well they can't say well you know I'm extremely fit and I'm strong and so I'm just gonna go out and I'm just gonna run a marathon.
• 57:36
  SPEAKER_02: I mean that's it's it's a different kind of fit and it's a different kind of strong.
• 57:41
  SPEAKER_02: So you know it it it lends caution to the assumptions that oh physical fitness and being fit means that you're strong and can handle the load and the impact of a sport especially of that's of high impact like running.
• 57:59
  SPEAKER_02: So you know because I see a lot of conversations on social media of people it's like oh you know I've always been a physically fit person I'm active or I was an athlete in high school or college and now they're in their 40s which is irrelevant.
• 58:12
  SPEAKER_02: I don't care how much of an athlete you were 20 years ago what does that matter?
• 58:16
  SPEAKER_02: But they you know they jump back into the sport and they're just like okay you know because I'm active okay well what does active mean?
• 58:24
  SPEAKER_02: Active doesn't necessarily mean that your body can absorb impact you know so I I think that this is just a really important distinction that that we have to make is you know strength and fitness doesn't necessarily mean that your body can handle handle the load.
• 58:40
  SPEAKER_00: So yeah even like running if you're strong yeah even if you're lifting weights and then you decide to run the impacts are a little bit different.
• 58:49
  SPEAKER_00: So even though strength training is helps build strong bones it doesn't mean that you're guaranteed now to be able to handle the impact of the running forces on your body so that is a that's an interesting yeah that's an interesting question is does weight lifting does strength training lead to stronger bones or is it just time under tension?
• 59:11
  SPEAKER_00: So it's really tendon, ligament and and muscle strength and durability from that perspective but does strength training lead to stronger structure like stronger bones it's like there's the forces on the bone from strength training are usually quite great as well like I mean depends on what type you're I mean thinking of power lifters where they're lifting like heavy heavy loads they tend to have pretty strong bones because they're lifting those heavy loads um so it kind of depends like would Pilates do it?
• 59:41
  SPEAKER_00: Probably not not enough not enough um weight right you know not even any any weight at all.
• 59:47
  SPEAKER_00: So I think the type of thing or activity you choose to do is going to be important.
• 59:53
  SPEAKER_00: And that's why I kind of worry about women it's getting better but you know the history of like women you know oh you need to strength train and I have women I talk to they're like oh I go to like a bar class or I do Pilates I'm like I don't want to I mean there might be some help there for like maybe like pelvic floor abdominal exercise and being strong in your core but when it comes to like bone health no that's not that's not maybe enough.
• 1:00:20
  SPEAKER_00: I don't know it depends on if I just think Pilates from what I understand of it there's no jumpy movements and it's kind of just your body weight it's like yoga you know you're kind of doing this bodyweight exercises and you might be able to hold a a something for a while and have to hold into it and it may strengthen certain components but there's not really like a bone density piece to it.
• 1:00:42
  SPEAKER_00: So there are certain exercises that aren't really as good for that because it has to be that load um on your structure to stimulate the bone.
• 1:00:53
  SPEAKER_00: So that's the other I think important point that when I mention strength training the type you choose is going to be important.
• 1:01:01
  SPEAKER_00: Right.
• 1:01:01
  SPEAKER_02: So there's a difference between time under tension and time under load is is what we want to say.
• 1:01:08
  SPEAKER_00: Yeah I think it's more like load but having a low uh some sort of weight or load so like deadlifts probably the best for bone the best type of movements for bone density would be like obviously like weight but like deadlifts uh squats maybe the bench you know like but like where there's like heavy loads that you're trying to push and um those are probably some of the the the better I mean there's probably lots of different exercises you can do under load but yes I think for for bone it's more the load from what I what I can gather.
• 1:01:43
  SPEAKER_00: I'm I'm I can double check on that, but I think it is more that than it is like tension itself.
• 1:01:49
  SPEAKER_00: Um because that's it's that impact for it's like that um force that you have or if you're doing something where there's like both the load and like some sort of twisting movement in in there, you know, where you're some compound movement.
• 1:02:03
  SPEAKER_00: So you have to be careful with those obviously because they're more risky but you know those types of movements are probably going to build bone better than just like a band, banded exercises like I love those for certain things, but those aren't doing banded crab walks is not building bone.
• 1:02:21
  SPEAKER_01: Right.
• 1:02:22
  SPEAKER_00: Maybe you know maybe if you're brand new to it but probably not for most people who are doing the same band, you know, the same amount every time and they're just sort of doing that as a way to warm up for a run or something like that.
• 1:02:34
  SPEAKER_00: Um but if you do like some skips or some box jumps or some um jump over like a bar back and forth like laterally kind of back and forth like that kind of stuff could be potentially as long as you're not overdoing it because of that jumpy movement and the forces and doing it in different planes and stuff can be really good for bones um as well.
• 1:02:56
  SPEAKER_00: So I do recommend people who are you know 40s and 50s to incorporate some level of that you just don't want to go from like oh Katie said I should do some jumpy movements so I'm gonna spend one hour jumping today.
• 1:03:09
  SPEAKER_00: Like probably not a good idea.
• 1:03:11
  SPEAKER_00: Start with like five minutes.
• 1:03:12
  SPEAKER_00: Sometimes I jump rope and then I do one leg and then I do the other leg and then I try to go like side like I jump like side to side.
• 1:03:20
  SPEAKER_00: I actually do the jump rope and I'll listen to music.
• 1:03:22
  SPEAKER_00: It's kind of enjoyable you know and it takes a level of uh you know of rhythm to it.
• 1:03:30
  SPEAKER_00: So I've been occasionally trying to do that myself.
• 1:03:34
  SPEAKER_02: I think it's important that we make that we make it clear that we're not saying that like high volume training plans are bad for bone health then no no they're not bad.
• 1:03:45
  SPEAKER_00: It's the high volume training plan i if you it's like how quickly you get to that volume that might be the problem.
• 1:03:52
  SPEAKER_00: So how quickly but also how how that and then a high volume training plan are you eating enough?
• 1:03:59
  SPEAKER_00: Are you fueling your body adequately for that amount of training is also very important.
• 1:04:04
  SPEAKER_00: And then on top of it like are you doing some other something I mean doesn't it and I think people have to understand like strength training the amount you have to do is not incredible.
• 1:04:13
  SPEAKER_00: It could be like 10 minutes, 20 minutes, a couple times a week of just some sort of load or some sort of little dynamic movements that you're doing just it doesn't have to be like you're taking over tons of time to do this.
• 1:04:25
  SPEAKER_00: It's just some sort of time under like or time with like load having your body have putting that strength training component in it could literally be like a couple times a week it doesn't have to be much.
• 1:04:36
  SPEAKER_00: So don't think we're saying you have to spend all this extra time doing it.
• 1:04:39
  SPEAKER_00: I just think doing it is important.
• 1:04:42
  SPEAKER_00: But as long as all you're having all of those things I think you could probably have a high volume training plan and never get a stress fracture like I have to you know I'm gonna knock on wood here because like once you say something's never happened, sometimes it happens.
• 1:04:57
  SPEAKER_00: But I I um have never had a stress fracture and I've been running for 30 years and I've had some pretty high volume training.
• 1:05:05
  SPEAKER_00: So um I do have a certain probably bone structure andor like really tight tendon structure that's protective but I've been training all this time and I've been lucky to never have a stress fracture.
• 1:05:17
  SPEAKER_00: So does that mean I'm some special I don't know but I do think um it's possible you know and I didn't strength train for a really long time you know for like until I was in my 30s.
• 1:05:28
  SPEAKER_00: So I I mean I guess it's been a long time now but it it I didn't start until I was in my like mid the mid 30s or maybe early 30s but so you and you know anytime you can start is better than not starting at all.
• 1:05:44
  SPEAKER_02: Yeah I've I've never had an issue with with bones either.
• 1:05:47
  SPEAKER_02: Now tendons I've had a lot of issues with tendons but never had any that's another episode it's a different different episode.
• 1:05:58
  SPEAKER_00: Yeah done tendons Act differently than bones, and what we need to.
• 1:06:02
  SPEAKER_00: So yeah, I think that's important, is it's they're not the same.
• 1:06:05
  SPEAKER_00: Bone, the stimulation you need from bone isn't exactly the same as you would need for tendons.
• 1:06:11
  SPEAKER_00: Um and yeah, this is sort of a separate thing.
• 1:06:14
  SPEAKER_00: But and I think sometimes some stress fractures too, I mean, I'm not gonna get into the weeds here, but some stress fractures are probably more concerning than uh uh others, like stress fractures of the feet are pretty common in runners, and sometimes it is just look like um because of the training load or the um footwear or biomechanics.
• 1:06:34
  SPEAKER_00: Whereas if I see a stress fracture in like a runner, they have it in like their vertebrae or their hips.
• 1:06:42
  SPEAKER_00: Um what is that?
• 1:06:43
  SPEAKER_00: What there's like a specific kind of like a sacral stress fracture or something like that, where it's like those really, those bones that really should be very hardy, uh, very strong.
• 1:06:53
  SPEAKER_00: Um that is 10 tends to be where I get a lot more concerned because if that's happening there, um it's maybe a sign that they already have some osteopenia or bone loss.
• 1:07:07
  SPEAKER_00: And that's usually where I also see some sort of low energy availability because it's those are there's just certain stress fractures that are a little bit more red flag than others.
• 1:07:17
  SPEAKER_00: I mean, all are all are a problem, but um, some are just more common for overuse, and some are more common like wow, this is actually probably could be a sign of low energy availability because it's a you know, old women get hip fracture, you know what I mean?
• 1:07:32
  SPEAKER_00: Yeah like that's generally like an osteoporosis thing, so or osteopenia sort of thing.
• 1:07:38
  SPEAKER_02: So um this is a really important point to bring up is that you know, if you are an athlete and now you you just found out that you have a stress fracture, knowing or evaluating the placement of that stress fracture may be uh some valuable information in trying to determine uh the potential cause of it.
• 1:08:02
  SPEAKER_02: So it you know can help you be a little bit of a better detective.
• 1:08:06
  SPEAKER_02: So if it's like, you know, oh I've got a stress fracture in my foot, that's gonna be very different versus a stress fracture in your femur, you know.
• 1:08:13
  SPEAKER_02: So you know, something like that where it's just like, okay, well you know, kind of put it into context a little bit.
• 1:08:20
  SPEAKER_00: So yeah, and it might help determine that, yeah, the yeah, exactly.
• 1:08:24
  SPEAKER_00: What the what the cause or what a maybe um Yeah, but I think that's where also I always tend to or I would tend to, if someone came to me and said, I have a stress fracture, will you help me with my neutr nutrition?
• 1:08:37
  SPEAKER_00: I would probably also refer out to like a physical therapist because I would want to determine is this also something structural or biomechanical?
• 1:08:48
  SPEAKER_02: Um Yeah, that's what I was about to say.
• 1:08:50
  SPEAKER_02: Yeah.
• 1:08:50
  SPEAKER_00: Yeah.
• 1:08:51
  SPEAKER_00: So it's just would it be like me being like, oh, it's only nutrition or um, you know, so I think then referring out is important.
• 1:08:58
  SPEAKER_00: And that's why I think for people who maybe or coaches that are listening, also um, you know, if you have someone with a stress fracture, I high if you want that individual to be successful in the future and not continue to have stress fractures and then be like, I'm not gonna hire you again, I would highly recommend like just finding it doesn't have to be me.
• 1:09:19
  SPEAKER_00: I mean, I'd love to work with someone because I I love working with athletes, but and and this is just something I've helped people with, um, you know, quite a few individuals with who've had bone stress injuries in the past.
• 1:09:31
  SPEAKER_00: But just finding like a sports dietitian that understands this because even if you feel like you understand it okay, I think having someone you refer out to so that that person can um assess if it is a uh nutrient issue or a uh energy issue and then help that person and then they'll be more successful.
• 1:09:50
  SPEAKER_00: So that would be what I would recommend.
• 1:09:52
  SPEAKER_00: And I think it's always helpful to refer to get all of the you to have like a team of people you work with to to help your athletes out, and I think is helpful.
• 1:10:00
  SPEAKER_00: So I think we've got most of what I wanted to discuss.
• 1:10:04
  SPEAKER_00: Um I mean, I think there's like more medical things.
• 1:10:08
  SPEAKER_00: I mean, there's all sorts like absorption, like there's some deep, deeper dive things that I might go into with somebody if they specifically are working with me, and I think there's some other factor going on, like they have some sort of medical issue or some other thing that might contribute, but I think that's too too much, too much of a deep dive to go into a topic here.
• 1:10:28
  SPEAKER_00: I think we've covered it in a general way that I think should be helpful for most people.
• 1:10:32
  SPEAKER_02: So I agree.
• 1:10:34
  SPEAKER_00: Yeah.
• 1:10:35
  SPEAKER_02: All right.
• 1:10:35
  SPEAKER_02: I I think that that does it for us.
• 1:10:37
  SPEAKER_02: I think we're gonna wrap this episode up.
• 1:10:39
  SPEAKER_02: So uh I want to thank you guys for joining us.
• 1:10:42
  SPEAKER_02: This has been episode 118 of the Endurance Athlete Journey Podcast, where we've talked about bone health and its role in endurance sports.
• 1:10:50
  SPEAKER_02: Uh we want to thank you guys for the support that you continue to share the podcast.
• 1:10:54
  SPEAKER_02: It is greatly appreciated.
• 1:10:56
  SPEAKER_02: Um uh so if this episode has resonated with you, or if you know somebody who would be helped by this episode, uh I've actually I'm actually going to send this episode to a couple of the athletes that I know uh that are dealing with this particular issue.
• 1:11:12
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• 1:11:26
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• 1:11:36
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• 1:11:46
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  SPEAKER_02: So if if that's important, please review us and leave a comment because that really does help increase the exposure of the podcast.
• 1:12:04
  SPEAKER_02: So it only takes a couple seconds to do it.
• 1:12:06
  SPEAKER_02: So if you haven't, uh I hope that you'll consider.
• 1:12:08
  SPEAKER_02: We also have the Endurance Athlete Journey Podcast group.
• 1:12:11
  SPEAKER_02: So it's a closed group on Facebook that we wanted to create uh from day one, from the first episode, we we created that that platform uh to allow listeners to connect, allow us to connect to them just outside of the long content that we have.
• 1:12:26
  SPEAKER_02: Uh so uh if you are interested in participating and growing out the community, I hope that you will consider joining.
• 1:12:33
  SPEAKER_02: So you just go on Facebook and you look for the Endurance Athlete Journey Podcast group, and you'll just answer one simple question and agree to the group rules, and it lets you right on in uh and you can uh be a part of the conversation.
• 1:12:46
  SPEAKER_02: Uh we're both active coaches and bringing on athletes onto our roster.
• 1:12:50
  SPEAKER_02: Uh the time that we're releasing this episode is in September of 2026.
• 1:12:55
  SPEAKER_02: So if you're starting to look at 2027 race schedules, I know I already am.
• 1:13:00
  SPEAKER_02: So if you're uh thinking about trying something new or increasing up to a longer race, or you just you're just tired of trying to find workouts and chat GPT and all the AI platforms aren't doing it for you, uh, and you just want to turn it over to somebody else, and all you would have to do is just execute that day's workouts.
• 1:13:21
  SPEAKER_02: We hope that you'll consider one of us as your coach.
• 1:13:24
  SPEAKER_02: Uh, you can, if you're interested in run training or dietetics for any of the sports, you can go to fuel the number two run.com and you can reach out to Coach Katie.
• 1:13:34
  SPEAKER_02: If you're interested in multi-sport or single sport uh training plan and one-on-one coaching, you can go to taboularassa racing.com and you can reach out to me, Coach Justin.
• 1:13:44
  SPEAKER_02: Both of us have loads of free content on our website.
• 1:13:48
  SPEAKER_02: We have blogs, articles, uh featured podcast episodes, uh race builds, all kinds of stuff that that can help you wherever it is that you are in your journey, whatever it is that you're looking for.
• 1:14:01
  SPEAKER_02: And if you don't see something out there that you would like, reach out to us.
• 1:14:04
  SPEAKER_02: You can reach out to us through the podcast uh email, and that email will be given to you in the outro of this episode.
• 1:14:12
  SPEAKER_02: Or you can just go on to each of our respective websites and send us a direct message from that uh using that way.
• 1:14:18
  SPEAKER_02: Uh we'll definitely add things into the queue.
• 1:14:20
  SPEAKER_02: We're always coming up with topics from conversations that we're having out in the real world with other athletes, and that's how we we bring you content.
• 1:14:30
  SPEAKER_02: So if there's something that you want us to cover, reach out and we'll be more than happy to throw it into the mix.
• 1:14:36
  SPEAKER_02: Um, I think that does it for us.
• 1:14:38
  SPEAKER_02: Yeah.
• 1:14:38
  SPEAKER_02: I can't think of any other thing.
• 1:14:40
  SPEAKER_02: It's been a while, I think, since we've done like some like a housekeeping kind of thing at the end, uh, because we've had a couple guest episodes that we've recorded, and so I'm kind of out of practice.
• 1:14:50
  SPEAKER_02: So but then again, thank you guys for joining us.
• 1:14:54
  SPEAKER_02: This has been episode 118 of the Endurance Athlete Journey Podcast.
• 1:14:57
  SPEAKER_02: I've been your host, Coach Justin, along with Coach Katie.
• 1:15:00
  SPEAKER_02: Thank you guys for the support, and we'll talk to you again next time.
• 1:15:03
  SPEAKER_02: Until then, bye-bye, everyone.
• 1:15:05
  SPEAKER_00: Bye.
• 1:15:16
  SPEAKER_02: That wraps up today's episode of the Endurance Athlete Journey Podcast.
• 1:15:20
  SPEAKER_02: Endurance sports have a way of teaching us patience, humility, and resilience.
• 1:15:25
  SPEAKER_02: Lessons that carry far beyond the workout.
• 1:15:29
  SPEAKER_02: Progress in endurance sports doesn't come from shortcuts.
• 1:15:32
  SPEAKER_02: It comes from consistency, discipline, and doing the work when it's not glamorous.
• 1:15:37
  SPEAKER_02: Wherever you are on your endurance journey, keep trusting the process and honoring the work you put in each day.
• 1:15:44
  SPEAKER_02: If today's episode resonated, please subscribe, leave a review, and share it with someone to help on their endurance journey.
• 1:15:52
  SPEAKER_02: Don't forget to join the conversation on our social sites to help build and foster a community where we all learn and support one another.
• 1:15:59
  SPEAKER_02: We'll be back with more stories and insights from coach Justin and Katie.
• 1:16:03
  SPEAKER_02: Until then, visit the podcast website at the endurance athlete journey.buzzsprout.com for more episodes from the Endurance Athlete Journey Podcast.
• 1:16:14
  SPEAKER_02: Have questions or comments about the podcast?
• 1:16:17
  SPEAKER_02: Feel free to send us an email at the endurance athlete journey at gmail.com.
• 1:16:23
  SPEAKER_02: For all things coaching, visit Coach Katie at fuel the number two run dot com and coach Justin at taboo rasseracing.com.
• 1:16:33
  SPEAKER_02: Again, thank you for listening to the Endurance Athlete Journey Podcast, and remember to find joy in the journey.