Episode 11: Nathan Carlson, DPT - Diagnosing bone stress injuries in runners

Ready to Run

Nathan Carlson is a physical therapist, coach, and business owner based out of Kansas City. He specializes in the management of bone stress injuries, managing the high school and collegiate runner, and implementing resistance training with endurance athletes. Nathan teaches nationally and internationally on these topics. Nathan has two digital resources - A Guidebook to Running After a Stress Fracture and A Guidebook to Navigating High School Running.

In this episode, we have an in-depth conversation on bone stress injuries. Our conversation was packed with so much valuable information that we broke it down into two episodes. In part one, we discuss bone physiology, factors that contribute to bone stress injuries, clinical perils, and radiographic tools for diagnosis.

Bone stress injuries are one of the most complex and frustrating injuries for runners. After our discussion with Nathan, we hope that you will have a better understanding of the training, nutrition, and metabolic factors that need to be considered with diagnosing and treating these injuries.

What we talked about:

3:10- Introduction to Nathan

6:40- Weight lifting for high school athletes

8:25- Defining a bone stress injury

11:00- Differences between a stress reaction and stress fracture and what causes them

22:05- Obtaining a more in-depth background of an athlete to learn more about the injury

25:45- Diagnosis and prognosis of bone stress injuries

38:05- Testing and imaging for bone stress injuries

Show notes:

Nathan's website

Nathan on Instagram

References:

• Bergman AG, Fredericson M, Ho C, Matheson GO. Asymptomatic tibial stress reactions: MRI detection and clinical follow-up in distance runners. AJR Am J Roentgenol. 2004 Sep;183(3):635-8. Hoenig T, Ackerman KE, Beck BR, Bouxsein ML, Burr DB, Hollander K, Popp KL, Rolvien T, Tenforde AS, Warden SJ. Bone stress injuries. Nat Rev Dis Primers. 2022 Apr 28;8(1):26.
• Kaeding CC, Miller T. The comprehensive description of stress fractures: a new classification system. J Bone Joint Surg Am. 2013 Jul 3;95(13):1214-20.
• Wright AA, Hegedus EJ, Lenchik L, Kuhn KJ, Santiago L, Smoliga JM. Diagnostic Accuracy of Various Imaging Modalities for Suspected Lower Extremity Stress Fractures: A Systematic Review With Evidence-Based Recommendations for Clinical Practice. Am J Sports Med. 2016 Jan;44(1):255-63.
• RED-S CAT - https://bjsm.bmj.com/content/bjsports/49/7/421.full.pdf