The Endurance Paradox: Bone Health for the Endurance Athlete

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The endurance athlete faces a paradox—you’re going farther and faster, you’re feeling stronger, but your bones are getting weaker. New, compelling evidence shows that the very activities that expand our mental and physical abilities may be reducing the durability of our skeletons. In this book, Thomas Whipple, a leading orthopaedic clinical specialist, and Robert Eckhardt, a scientist specializing in the musculoskeletal system, team up to explain how athletes at any level can maintain the delicate balance between endurance exercise and optimum bone health over a lifetime. Translating important scientific advances into accessible language, they explain the muscle-bone connection, and cover training strategies and exercises, nutrition, calcium, stress fractures, rehabilitation, running mechanics, footwear, posture, and pharmaceuticals. An essential guide and ideal text for exercise physiologists, endurance athletes, fitness enthusiasts, and coaches.

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Editorial Reviews

From the Publisher
"The Endurance Paradox is well-researched and provides a wealth of valuable training and dietary information on an important topic which has long been overlooked and misunderstood by the endurance sports market. I highly recommend it to athletes and coaches."

- Joe Friel, Head Coach, Training Bible Coaching, and co-author, Paleo Diet for Athletes

"Many endurance athletes perform strength-training that causes harm to their bodies, impairing their overall goals of better performance. This notably includes the full spectrum of bone loss leading to common injuries. The Endurance Paradox will help you positively address this common problem. Authors Thomas J. Whipple and Robert B. Eckhardt clear up many misconceptions about bone and muscle health and fitness, and in an easy-to-apply, holistic way, discussing simple, short, and effective workout plans you can perform at home. Just as important, they discuss how diet, nutrition, hormone balance, and other lifestyle factors influence bone health.

The Endurance Paradox is also a must for all coaches and healthcare professionals who work with endurance athletes.

This is truly an intelligent approach to a subject all endurance athletes should read. The notion of weight lifting to improve bone strength without inducing muscle fatigue and stress is natural, safe, and complimentary. And, it fits well into an overall endurance program."

—Dr. Philip Maffetone, author, The Big Book of Endurance Training and Racing

"As an orthopaedic surgeon and sports medicine specialist who provides care for all levels of athletes who challenge their limits by participating in endurance sports, I have come to understand that many of these athletes underestimate the cumulative forces absorbed by their skeleton on a daily basis. Even fewer athletes know how to train, eat and recover in a way that may lessen their chances of an overuse/overload injury such as a stress fracture. Stress related bone injury need not be an expected outcome in the endurance athlete, and neither does the long-term, under appreciated complication, osteoporosis. The Endurance Paradox is a valuable guide for clinicians, coaches and athletes who strive not only to maximize sports performance but also strive to maximize long term bone health and long term wellness. Thomas Whipple and Robert Eckhardt have teamed up to provide us all with a concise yet complete review of current scientific knowledge as it applies to the bone health, nutrition, training and the rehabilitation of all those who are involved in endurance sports. The authors very effectively bring the laboratory science to life by illustrating the practical application of evidence based strategies used by some of the most accomplished and successful endurance athletes and coaches in the world."

-John R. Deitch, MD, Director of Sports Medicine, Wellspan Health (York, PA)

"The importance of this book appears through the authors’ reference to the words of Dr. George Sheehan who wrote that 'each of us is an experiment of one.' Unfortunately, in the case of bone health the long term consequences of our choices in diet and exercise may be neither desirable nor reversible. Whipple and Eckhardt provide practical advice for athletes and the sports medicine professionals who care so that one outcome of the endurance athlete’s experiments in search of success is optimal bone health. The book is extensively referenced and covers the key issues related to diet, exercise and bone health. The reader learns where the evidence for change lies as well as areas of continuing uncertainty and gains invaluable insight into the Endurance Paradox."

- Craig Denegar PhD, PT, ATC

"I am very surprised and impressed by this book because the authors have seen through the fog of the plethora of research in this field and have made sensible, logical and clear recommendations. The book is well researched and offers excellent practical advice."

- Dr. Graham Fletcher, PhD, Sport Scientist, The Univeristy of Fraser Valley, Former British Triathlon National Team Coach

“This book is a must read for athletes of all sports, ages and abilities, although targeted specifically for endurance athletes, it is also a must read for coaches, trainers, sports doctors, physical therapists and in fact anyone wishing to maintain or manage bone health. It educates the reader about the factors related to achieving good bone health and gives sound, evidenced based suggestions. It also appears that pursuing good bone health will improve performance and well-being, they are all related. The book is very easy to read, well researched and provides many new insights for the reader. Its information we all need when pursuing an active life.”

-Graeme Nuttridge, Physical Therapist, Faculty Member
of the McKenzie Institute and Advanced Practitioner in Sports and Orthopaedics

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Product Details

  • ISBN-13: 9781598746174
  • Publisher: Left Coast Press
  • Publication date: 3/1/2011
  • Pages: 220
  • Product dimensions: 6.30 (w) x 9.10 (h) x 0.80 (d)

Meet the Author

Tom Whipple has been working with both recreational and competitive athletes as an orthopaedic physical therapist for over 20 years. He holds academic degrees in Physical Therapy (Northwestern University) and Orthopaedics (Georgia State University) as well as a certificate in Mechanical Diagnosis and Therapy from the McKenzie Institute, U.S.A.  He was recognized as an Orthopaedic Clinical Specialist by the American Physical Therapy Association (2000) and was certified by Nicholas Romanov, PhD as a Pose Running Coach in 2004. His clinical
practice at Penn State Sports Medicine is dedicated to the prevention and rehabilitation of musculoskeletal injuries in athletes with a special interest in stress fractures. He has held university teaching positions and has provided continuing education courses for practicing clinicians across the United States. In collaboration with scientists from The Pennsylvania State University he is pursuing research related to bone physiology in response to different exercise, nutritional, and hormonal states. He is married to Jody where together in central Pennsylvania they are raising their two children, Jacob and Abbey. Robert B Eckhardt, PhD, is Professor of Developmental Genetics and Evolutionary Morphology in the Department of Kinesiology at the Pennsylvania State University, where he is head of the Laboratory for the Comparative Study of Morphology, Mechanics and Molecules. He has been conducting and publishing research for over forty years, specializing in the development and evolution of the human musculoskeletal system. His research has been supported by the National Institutes of Health, the Australian Research Council, and several private foundations. He has published numerous scientific papers and books, most recently Human Paleobiology (Cambridge University Press, 2000). His laboratory was part of a research team that proved that the origin of bipedal locomotion occurred two million years earlier than previously realized. Dr. Eckhardt was an active recreational runner for several decades before shifting to vigorous daily walking for a more optimum balance between cardiovascular and biomechanical outcomes.
Margot Putukian (Foreword author), MD, FACSM, is Director of Athletic Medicine at Princeton University and former president of the American Medical Society for Sports Medicine. She also has served on the NCAA's Competitive Safeguards and Medical Aspects of Sports Committee and the Strategic Initiative Task Force for Active Girls and Women.
Bernd Heinrich (Foreword author) is Professor Emeritus in the Department of Biology, University of Vermont. He is a record-setting distance runner, a member of the American Ultrarunning Association Hall of Fame, and author of over fifteen books based on his research into the physiological and behavioral adaptations of animals to their environments.
Nicholas Romanov (Foreword author), PhD, is a world renowned authority on running and founder of the Pose Method, which enhances efficiency and performance in running, jumping and throwing, swimming, cycling, gymnastics, speed skating, cross-country skiing and many other athletic events. Dr. Romanov is a two-time Olympic Coach who has worked with many national teams and is author of the internationally bestselling book The Pose Method of Running. Currently he conducts clinics and seminars all over the world in association with sports clubs, national governing bodies, and universities.

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Table of Contents

Foreword Margot Putukian 7

Foreword Nicholas Romanov 9

Foreword Bernd Heinrich 11

Acknowledgments 13

Introduction 17

1 Strength Training 19

2 Nutrition 39

3 Hormones 49

4 Energy Balance and Metabolism 57

5 Protein 65

6 Dietary Fat 79

7 Inflammation 85

8 Acid-Base Regulation 103

9 Calcium 119

10 Nutrient Timing 133

11 Quality Training 149

12 Measurement of Bone 163

13 Stress Fractures 169

14 Rehabilitation of Stress Fractures 183

Glossary 201

Index 213

About the Authors 219

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