Bone stress injuries & RED-S Blog

Between one third and two thirds of competitive endurance runners have a history of bone stress injury (BSI)1-3. A BSI demonstrates the inability of bone to endure repetitive loading, which ultimately results in bone tenderness and pain, and structural fatigue1. Bone stress injuries are a concern for marathon and long-distance runner’s due to their frequency, length of rehabilitation, and their tendency to recur1.

Females have been found to be at a higher risk of BSI’s as a result of the Female Athlete Triad (FAT)4. The FAT is a complex condition that involves three components: 1) low bone mineral density, 2) low energy availability with or without an eating disorder, 3) menstrual dysfunction4-6. More recently, the term Relative Energy Deficiency in Sport (RED-S) has been used to expand the concept of the FAT to recognise other outcomes, and the inclusion of male athletes4. Research has suggested that an athlete with one or more components of the FAT has an increased risk of developing bone stress injuries4-6. Individual’s with RED-S and components of the FAT experience short and long-term impacts on both health and athletic performance4. Given that one component of the FAT is low bone mineral density, this increases an athletes risk of bone injuries such as stress reactions and potentially stress fractures. Additional risk factors for stress reactions include underlying poor bone health, menstrual dysfunction, low BMI, compulsive exercise, eating disorders, and prior BSI’s4. It is crucial to detect RED-S early in order to prevent long-term health consequences, and improve performance4.

A BSI generally occurs prior to a diagnosis of RED-S/FAT, and so health care professionals need to be able to identify those individuals at risk7. It is common that an athlete may require cessation from sport following a BSI in order to correct their energy deficit, and to allow recovery from the BSI7. However, to allow improvements in bone health and prevent recurrence of BSI’s, exercise is an important aspect of the rehabilitation process. Optimal rehabilitation from a BSI involves a balance between performance of appropriate loading and rest from aggravating activities1. Evidence suggests that key areas to focus on include strength, endurance, and control at the knee, ankle, and the hip1.

It is well established that improvements in bone mineral density occur as a result of mechanical load the bone is subjected to9. Athletes with reduced bone mineral density should undergo resistance training programs at least 2-3 days per week7,8. Positive outcomes on bone strength has been demonstrated following periods of progressive high intensity RT and multi-directional impact activity, both of which should be incorporated into end stage strengthening rehabilitation when treating reduced bone mineral density8. Management should also include weight bearing conditioning in the form of a graduated return to running program once appropriate.

Other important considerations are the potential presence of faulty running mechanics which could hinder the healing process or contribute to repeated BSI’s1. As bone loading relates to ground reaction forces, therapy interventions that reduce GRF and improve shock absorption during running may reduce BSI recurrence1. Such gait retraining techniques include altering stride rate, and modifying initial contact1.

While most BSI’s readily heal following a period of activity modification and a progressive return to loading, strength training and running activities, there is a need to address underlying causative factors to prevent BSI recurrence1.Management of the FAT requires input from a multidisciplinary team to ensure that the athlete’s psychological wellbeing and energy availability is maintained7. Patients require ongoing review with sports physicians, and physiotherapists, and may benefit from review by a sports dietician and sports psychologist. Evidence has suggested that management of exercising women with low BMD should include resumption of menses, optimising weight gain, and increasing energy availability5. In order to increase energy availability, an individual’s energy status should be normalised through modifications to exercise training and diet5. Studies have shown that restoring or normalising body weight is the key to successful resumption of improved bone health and normal menstrual function5.


  1. Warden SJ, Davis IS, Fredericson M. Management and prevention of bone stress injuries in long-distance runners. J Orthop Sports Phys Ther. 2014;44(10):749.765. doi:10.2519/jospt.2014.5334
  2. Biz C, Berizzi A, Crimì A, Marcato C, Trovarelli G, Ruggieri P. Management and treatment of femoral neck stress fractures in recreational runners: a report of four cases and review of the literature. Acta Biomed. 2017;88(4S):96-106. doi:10.23750/abm.v88i4-S.6800
  3. Pegrum J, Crisp T, Padhiar N. Diagnosis and management of bone stress injuries of the lower limb in athletes. BMJ (Int Ed). 2012;344(7854):35-40. doi:10.1136/bmj.e2511.
  4. Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014;48:491-497. doi:10.1136/bjsports-2014-093502
  5. De Souza MJ, Nattiv A, Joy E, et al. 2014 Female Athlete Triad coalition consensus statement on treatment and return to play of the Female Athlete Triad: 1st International conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013. Br J Sports Med. 2014;48:289. doi:10.1136/bjsports-2013-093218

WA Top 10 Marathon Times

One of WA’s most loved runners Dean Menzies has just become the 7th West Australian to break 2.20 for the Marathon at Lake Biwa, Japan – with a 3min last kilometre no less, well done Dean!  

Dean is now the 2nd Western Australian Front Runner to now be placed inside WA fastest all-time top 10 marathoners. 

Western Australian All time Male Top 10 list:??

1. Ray Boyd 2.13.25 (1999, Chicago)
2. Nic Harman 2.14.04 (2019, Fukuoka)
3. Michael Bonner 2.16.05 (1987, Frankston)
4. Alan Thurlow 2.16.07 (1985, Melbourne)
5. Graham Clews 2.17 (1983, Rotterdam)
6. Jim Langford 2.18.08 (1979, Herne Hill)
7. Dean Menzies 2.19.56 (2020, Lake Biwa)
8. Clive Hicks 2.22.21 (1983, Sydney)
9. Tim Walsh 2.22.43 (1985, Herne Hill)
10. David Eltringham 2.23.06 (1985, Perth)


After regular interclub racing throughout the Summer, the annual State Championships provided our elite team with a chance to test themselves against WA’s best runners over the Middle Distance events. Friday night saw some terrific results over 1500m with every Open & U/20 squad member either medalling or running a PB – including the Open Women who claimed the Trifecta! Full results can be seen below:
  • Open Women’s 1500m:
    • Angie Ross GOLD 4.37
    • Rachel McCormick SILVER 4.38
    • Keely Waters BRONZE 4.48
  • Open Men’s 1500m
    • Luke Burrows SILVER 3.50 PB
    • Tom Moorcroft 6th 3.54 PB
    • Kai Metzner 7th 3.55 PB
  • U/20 Women’s 1500m:
    • Zoe Griffiths 4th 5.07 PB
  • U/20 Men’s 1500m
    • Josh Keatch GOLD 4.07 PB
    • Lachlan Taylor-Greaves BRONZE 4.22 PB 
Sunday saw the focus switch to the tactical beast that is the 800m. Some more terrific results were achieved from the Open & U/20 squad members who all translated their training into results when it mattered most, including the Open Men who claimed the quinella – keeping the State 800m title in the squad for a 2nd year after Alain Dutton’s triumph in 2019! Full results can be seen below:
  • Open Women’s 800m
    • Angie Ross 4th 
  • Open Men’s 800m
    • Luke Burrows GOLD 1.53 
    • Tom Moorcroft SILVER 1.54
    • Kai Metzner 5th 1.56
  • U/20 Men’s 800m
    • Josh Keatch SILVER 2.00
A big shout out must also go to Brendon Warren who debuted at the State Champs this year and claimed a medal in arguably the toughest event of the whole weekend – the 3000m Steeple-Chase! Brendon took out BRONZE in a time of 12.35!
Finally, well done to our junior emerging squads on some terrific performances over the weekend as they continue their long term progression under the guidance of coach Jaz Long. Their enjoyment of the sport and passion for self improvement will hold them is good stead as they continue to develop into Senior athletes.
As the track season draws to a close, the next goal is the upcoming National Track & Field Championships in Sydney at the end of March. Congratulations and all the best to the follow team members who will be participating:
  • Luke Burrows: Open Men’s 800m
  • Tom Moorcroft: Open Men’s 800m
  • Keely Waters: Open Women’s 1500m
  • Ethan Wyatt-Smith: U/17 Boy’s 3000m
  • Ellie Glands: U/16 Girl’s 2000mSC 

Rodgers selected for IAAF World Championships

Front Runner elite, Rochelle Rodgers has been selected to represent Australia at the 2019 IAAF World Championships in Doha.

This will be Rodgers first international vest after over 2 decades of pursuing her running goals. Rodgers breakthrough victory at the 2019 Shizuoka Marathon in a PB of 2.34 saw her break the championship A standard and her result was rewarded by AA selectors.

Harman lowers PB at Fukuoka

Front Runner elite Nic Harman has broken through in his second marathon to record a 8min PB of 2.14.04.

After a challenging debut at Gold Coast Marathon in July, Harman put his head down over the winter months, recording second place finishes at the Perth City to Surf and Melbourne Half Marathons. At Fukuoka, he went through halfway in 67.34 and passed 30km in 30th place. In the final 12km he stormed through the field to finish in 2.14.04, finishing the second half of the race in 66.29 and ending in 13th place.

Harman will now focus his attention on recovery and planning for his 2020 campaign.

Felton PB’s in Frankfurt

Front Runner T46 International Matt Felton has continued in his push for selection at the 2020 Tokyo Paralympics.

Competing in the 2019 Frankfurt Marathon, Felton performed consistently throughout to record a big PB of 2.41.

In early 2020, Felton will chase further improvement in an early season Marathon with hopes of confirming his Paralympic place for Australia

Mighty Jarrah Trail Run Course

**Mighty Jarrah Trail Run Training Courses**
2 Courses to choose from
First Trails Beginner OR Challenge Trail Course

Team Front Runner look forward to helping you, your family and friends prepare in style for the inaugural TriEvents Mighty Jarrah Trail Run on 19 August in the beautiful Dwellingup Forest area.

These 6 week training courses are equally suited to those looking to run their first trail running event (First Trails. Mini 6 or Mighty 10) OR fitness and running enthusiasts looking to prepare in style for Perth’s biggest Trail event (Challenge Trail Course. Mighty 10 or Almighty Half Marathon). Better still, we understand time is a premium so we offer both weekend only OR a full weekday and weekend course!

We cater for all experience and ability levels.

6 week Training Courses 

Course options: First Trails Mini 6 / Mighty 10 OR Challenge Trail Mighty 10/ Almighty Half Marathon Course

Cost: $139 (weekend only) or $199 (weekend+weekday). Early bird savings Book before June 16th and receive $10 off weekend or $20 off combined course

Numbers: Strictly 20 participants per course

Choose either 1 or 2* Training Sessions week

  1. Saturday 7.00am- 9.00am (Compulsary) Various locations (Kings Park, Bold Park, Trigg Bushland, Helena Valley, Bickley Brook & Darlington)- Trail Endurance and Skills
  2. Wednesday 6.00am- 7.00am (Optional) Bold Park (Trail Intervals)

Included Educational Workshops:

  • Welcome Workshop- 6.00pm 5 July The Running Centre (West Perth). Meet your training team and our coaches, get the inside on what gear you need, what courses we will use, training plan and get an exclusive 25% off storewide (*excluding Garmin and sale items)
  • Trail Skills and Technique – In week 1 Trail star and coach Marlene Lootz teaches you all the basics so you are confident and ready for the trails
  • Nutrition and Fuel for Trails- Sports dietitian and super runner Alex Dreyer helps with practical fuelling tips!

What do Team Front Runner deliver?

  • Professional Coaches: All our coaches are Athletics Australia accredited coaches and we are trusted partners of both Athletics WA and Triathlon WA.
  • Education: Workshops scheduled to increase knowledge and build confidence
  • Community: as Perth’s most trusted and experienced running coaches group, we cater for beginners, fun runners and race winners. Any age and ability!
  • Great Value: We love running and want to see you achieve your goals. Weekend only training starts from only $139 (*) for 6 weeks and Full Course (including weekdays) $199 (*) for 6 weeks. (*- Plus Booking Fee)
  • Fun: we love running and want you to love it as much as we do!

Lets Go! We look forward to welcoming you to Team Front Runner and helping you to achieve your goals in the inaugural TriEvents Mighty Jarrah Trail Run.

Queries? Call us on 0478 841 104 or email us


Trackstars Run School Holiday Program – 2016

Does your child love to run?  Give your kids skills for running no matter what their distance or interest.  During January, we are excited to provide 3 half day running programs, with 3 different themes.  For information on our Bike Stars School Holiday half day program, please see HERE.

All sessions are $39 per child, and include all of the following: –

  • Sessions delivered by Australia’s leading running coaching team, official technique and physiotherapy providers of Athletics WA, with full coaching accreditation and WWC checks.
  • A morning of guaranteed skill development, technique enhancement and of course FUN!
  • Morning tea is provided of fresh fruit and drinks
  • Book ALL THREE sessions and SAVE $20. ONLY $99. BOOK NOW
Session Details: –

Session 1: Monday 11th January 2016 – Cross Country, Strength and Agility.  (Dodd Street, Lake Monger 9.15am-12pm)
Your child will love the wide open spaces of our XC session!   Agility improves speed, balance and coordination in children.  During this session we will introduce children to the skills required to run strong with control.

Session 2: Wednesday 13th January 2016 – WA Aths Centre, Speed and Power. (Stephenson Ave, Mt Claremont 9.15am – 12pm)
Teaching your child skills and technique to run fast and with power on the track!  Lots and speed and plenty of fun to be had.

Session 3: Wednesday 20th January 2016 – Technique Rhythm and Road. (Dodd Street, Lake Monger 9.15am – 12pm)
Your child will learn the secrets of how to run well on the road, over any distance.  How to stay focussed, in control with great form and how to pace to complete a strong and confident finish.

BOOK NOW, as places are limited to 30 children per session.   Confirmation email together with event disclaimer will be emailed to parents the week prior to each event.
NEW BIKESTARS: Monday 18th January 2016 – (Dodd Street, Lake Monger 9.15am-12pm)
Bike Stars cycle drills and skills – during this session your child will be introduced to road safety, race etiquette, bicycle handing and riding with confidence….together with plenty of fun! Coached by 2* Australian Duathlon Champion Tom Bruins SIGN UP NOW

We look forward to working with your children!  For any queries, please contact Andrea on


We look forward to seeing you soon!

Raf Baugh
B.Sc Physio, Level 2 AA
Managing Director

Power for Triathlon: Blog 1/3

Training to power: An overview for triathletes.

With the improvements and advancing technology in the cycling world, power meters are fast becoming a mainstream addition to a serious triathletes machine. The benefits of training and racing to power are very applicable to cycling in triathlon, particularly long distance events.

Over this three part blog we will look at the features; benefits; options and application of Power into your training and racing plan.

About power and power meters

A power meter is able to provide you with instant feedback about the amount of physical effort you are exerting to move your bike. Power is measured in Watts and is a measurement of the force exerted from your legs to your bike’s drivetrain per second.

Power is able to show you how hard you are working at that point in time – the higher your power output is (in relation to your power zones), the harder in general you are working. When compared to heart rate, power readings are instant whilst heart rate is lagged and responds to the demands of that exertion. This allows power to be a more sensitive and responsive tool when riding a bike compared to heart rate. Consider a stretch of road with some hills and different surfaces. It will be easier to pedal downhill and over smooth surfaces than uphill and over rough surfaces. A power meter will tell you how much power you are putting through to the bike in each case, whereas the heart rate will be slower to adjust as your cardiovascular system reacts to the demands of the course.

The effects of aerodynamics and friction are so much more significant in cycling than in running and bike courses are so varied that power output required to maintain a certain speed will vary so much throughout a bike course. Consider the Busselton Ironman bike course – there are smooth patches of road, rough patches, sections of head and tail wind as well as slight inclines and declines. When riding through each of these areas, an athlete riding without power will find their target heart rate drift as well as their speed varying greatly. An athlete riding to power will simply ride to their target power zone the entire time.

Power and triathlon

Just like heart rate zones, an athlete can train to power zones to improve their performance. Threshold power can be determined just like running critical velocity or threshold heart rate can. From here, an athlete can then know what power zones they need to ride in to get the most optimal training and in term maximise their race performance. On race day the benefits are similar as an athlete knows what power zone they need to ride to throughout the race.

The benefit of power meters in triathlon is huge, and on race day power readings are arguably more beneficial to all triathletes than cyclists in a road race. This is because so much of a triathlete’s training and racing is done as individual efforts compared to road cycling where much almost racing is in groups. If you are able to know how hard to ride by yourself you will be in the best position possible complete the bike leg at an optimum level. In doing this, your run and therefore your overall race result will also benefit.

In part 2 Tom will talk about types of Power Meters and pro’s and con’s of each type…….


Thomas Bruins is a professional athlete and former 2012 and 2015 Oceania Professional Duathlon Champion as well as mutliple state Athletics and Duathlon champion. Tom is a qualified Engineer and Triathlon Coach who specialises in skill and performance consulting for triathlon. He can be contacted via email 

The What, Why and How of the Anaerobic Threshold

As runners become more invested in their own running and are looking for ways to enhance their running performance, the term “threshold” training will often come up. Many people may know this term and are aware of its perceived importance, however the specifics often get lost in translation. By the end of this blog, we hope you have an understanding as to what your anaerobic threshold is, how you can measure it and how you can use it to effectively train towards your next PB!


What is the Anaerobic Threshold?


Firstly, to understand our threshold (AT), we need to understand how the body uses energy when we run. Aerobic energy is simply energy that is derived from oxygen (O2). When we run, our body is breathing in O2 from the environment and taking it to working muscles via the lungs and bloodstream. The muscles then use this O2 for energy and put out carbon dioxide (CO2) as a waste product that we can then breath out. This is a very sustainable activity as there is plenty of O2 to breath in and the body has an effective method of expelling the CO2. As our exercise intensity, and subsequent demand for energy, increases, the body will continue this cycle of breathing in O2 and breathing out CO2. If we keep increasing our exercise intensity (running faster) then eventually there is a point when the body can no longer supply the energy required through O2 alone. This is where the anaerobic energy system comes in. As your O2 demand approaches its maximum capacity, the body will begin to supply energy through anaerobic sources (the details of which are beyond the scope of this blog). The advantage of anaerobic energy is that it can be supplied to the body extremely quickly, essentially topping up the energy demand that cannot be supplied by O2. The disadvantage is that the waste product of anaerobic energy, hydrogen ions (H+), cannot be dispelled as easily as CO2 (the waste product of aerobic energy).  When we use anaerobic energy, lactic acid is the initial waste product that immediately breaks down into lactate and H+. The H+ are our primary concern as when they accumulate, they create an acidic (low pH) environment in both the working muscles and the bloodstream. When the pH drops significantly, muscle function is impaired and performance is compromised. Anyone who has tried to run near their best pace for more than 30s will know the feeling! Now, without getting too complicated, a key point to understand is that to clear the H+, we need to combine them with O2. But remember we are already using all our O2 to fuel our aerobic energy. So until we reduce the intensity of our run to a point at which there is now O2 to spare, we will continue accumulating H+ and our pace will not be sustainable.


Our AT can now be defined as the point at which H+ are being produced in the muscle at the same rate at which they were being cleared into the blood. If we begin accumulating H+, we are above our anaerobic threshold.


Understanding where our threshold training sits in relation to our other aerobic zones in crucial to making sustainable improvements to your running performance

Why Should We Improve Our Anaerobic Threshold?

For runners of all levels, improving their AT is a significant predictor to distance running performance. For runners targeting distance events (>3000m) almost all of the gains in performance will derive from improving the capacity or efficiency of the aerobic system. To justify this, we must remember the proportions at which each energy system contributes to our running. If we run at our best pace for 45s, we derive ~50% of the energy from both aerobic and anaerobic sources. Going up to 2min sees us use 65% aerobic/35% anaerobic and 4min will see us use 80% aerobic/20% anaerobic. So with the time it takes to run events of 5km, 10km, 21km or 42km, our primary concerns for increasing performance lies with our aerobic system. Remember our AT is the point at which we go from being sustainable with our aerobic energy demands, to unsustainable. So if we can raise our AT (run at a faster pace for the same H+ production) our aerobic performance ceiling is increased and our distance running performance can improve significantly.

 Measuring our Anaerobic Threshold

Now we know what is the AT is, we need to be aware at which running intensity the AT occurs. The gold standard for AT testing is a lactate threshold test. This test is typically performed on a treadmill and involves gradually increasing your running pace to find the point at which the AT occurs. Whilst the H+ are the measure of the AT, they are very difficult to measure in the muscle. So a far more effective method is to measure the concurrent level of lactate in the blood. Most runners will find their AT correlates very closely with a measure of 4mMol of lactate in their blood. A graduated treadmill test that measures blood lactate can then identify the pace and heart rate (HR) that leads to this 4mMol blood lactate measure. Find out more HERE


Whilst we have the ability to run over or above our AT, the resultant increase in anaerobic demand often leads to an increased recovery time for a reduced aerobic benefit from the session

 Estimates can also be made of your AT through a practical running session. At Front Runner Sports, we will often perform what’s known as a Critical Velocity (Vcr) test to assist runners in finding their AT. Due to the accumulation of H+, we know it is impossible to run at a pace exceeding your AT for >30min. So running at your best effort for 30min with the aim to cover the maximum possible distance in this time, will give an accurate estimate of your AT. The resulting average pace and/or HR that you sustained for this 30min is known as your Vcr. If a runner has put in their best effort over 30min, we expect a small amount of H+ accumulation at the end of the run. So to derive your AT pace from the Vcr testing, we recommend taking 97% of the pace you were able to run for the 30min. For example if your Vcr pace = 5min/km = 12km/h, then your AT = 12 x 0.97 = 11.64km/h = 5.09min/km

Training at Your Anaerobic Threshold

 Once you have a pace or HR that correlates with your AT, we can set about training to improve it! We know that the most effective way to improve our AT is to train on or slightly beneath our AT, not above it. As the body does not like an acidic environment, regularly going close to the point of H+ accumulation (but not over it) gives the body the stimulus it needs to enhance the aerobic capacity within the muscles (again, the specifics of which are beyond the scope of this blog) to improve the capacity at which O2 can be used as a fuel source.

How long you can spend at your AT is a reflection of your current conditioning to AT training as well as your muscular endurance. However, most regular runners should find that in training, they should be able to run for ~20min (either continuous or in long intervals) at their AT when working reasonably hard. To continue to improve your AT, we need to gradually increase the amount of time we spend running at your AT. This could be achieved by having less recovery between AT intervals or spending more time at your AT. But importantly, you should not run quicker than your AT, as we lose the aerobic stimulus required to get maximum aerobic adaptation.

As you become more competent, some runners can aim to spend up to 30min at their AT. If you can achieve this, then it would be recommend to re-test your AT to quantify the improvement you have seen. Some example sessions can be seen below:

Recreational Runner

  • 3 x 7min @ AT with 3min of walk/light jog recovery (R)
  • 2 x 10min @ AT with 3min walk/light jog R
  • 1 x 15min @ AT

 Serious Recreational Runner

  • 3 x 8min @ AT with 90s easy jog R
  • 2 x 12min @ AT with 2min easy jog R
  • 1 x 20min @ AT

 Advanced Runner

  • 3 x 10min @ AT with 90s steady jog R
  • 2 x 15min @ AT with 2min steady jog R
  • 1 x 25min @ AT


Finding a consistent and uninterrupted section of running trail is perfect for AT training

 The 3 principles of progressive overload can be applied to threshold training to improve the aerobic stimulus the session will provide:

Firstly, make the run more continuous. E.g. Instead of running 3 x 8min @ AT, run 2 x 12min @ AT. Both will stimulate the body for 24min at your AT, but a more consistent application of the training stress will make the run more difficult.

  • Secondly, a more active and shorter recovery. Typically threshold intervals should be separated by 90s – 3min of active recovery, depending on your current level of conditioning to the training. If you find you need more recovery, you will likely be exceeding your AT pace. As you train more regularly at your AT, you will find your time to recover and feel comfortable again will reduce. So initially take less time (e.g. from 3min to 2min to 90s) then try to make the recovery more active (e.g. from a walk to a light jog, to a steady jog).
  • Lastly, increase the time period you spend at your AT. If you can aim to get up to 25-30min of running at your AT, you will see a nice improvement in your AT pace when you re-test.

We trust you now have a greater understanding as to what the AT is and how you can use this knowledge to improve your running. If you wish to know more about this topic, or anything to do with your running training, please get in touch with our expert coaching team who are ready to assist you towards your next running goal! Please email or see our website.

Running Regards,

Front Runner Coaching Team