# 13: From Pool to Pavement: Low Ferritin, Bone Stress Injuries, and the Swimmer-to-Runner Trap

Page: https://stenobird.com/podcast/interdisciplinary-case-miles-7475175/13-from-pool-to-pavement-low-ferritin-bone-stress-injuries-and-the-swimmer-to-runner-trap
Text version: https://stenobird.com/podcast/interdisciplinary-case-miles-7475175/13-from-pool-to-pavement-low-ferritin-bone-stress-injuries-and-the-swimmer-to-runner-trap.md
Podcast: [Interdisciplinary Case Miles](https://stenobird.com/podcast/interdisciplinary-case-miles-7475175)
Published: 2026-02-20T12:00:02+00:00
Episode link: https://www.spreaker.com/episode/13-from-pool-to-pavement-low-ferritin-bone-stress-injuries-and-the-swimmer-to-runner-trap--70112978
Audio file: https://api.spreaker.com/download/episode/70112978/idcm_13_femoral_shaft_stress_fracture.mp3
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JSON: https://stenobird.com/v1/public/podcasts/interdisciplinary-case-miles-7475175/episodes/13-from-pool-to-pavement-low-ferritin-bone-stress-injuries-and-the-swimmer-to-runner-trap
Duration seconds: 1466

## Resource

What happens when a highly conditioned collegiate swimmer transitions into marathon training too quickly? In this episode of Interdisciplinary Case Miles, a 23-year-old former swimmer increases weekly mileage from 15–20 miles to 40 miles, adds hills and speed work, and begins to worry about low ferritin when performance stalls.What initially appears to be an iron concern reveals a broader picture involving low energy availability, fueling gaps, training load errors, and bone stress injury risk, ultimately resulting in a diagnosis of femoral shaft stress fracture.Dr. Sara Raiser (running medicine physician), Kelsey Pontius (sports dietitian), and Dr. Kate Mihevc Edwards (physical therapist) discuss: Why ferritin is often a marker of a larger issue The relationship between nutrition, iron stores, and bone health Unique injury risks when transitioning from non-weight-bearing sports How cardiovascular fitness can exceed musculoskeletal readiness Rehabilitation principles, plyometric loading, and safe return-to-run progressions This episode is essential listening for runners, clinicians, coaches, and endurance athletes navigating performance concerns, injury prevention, and the demands of marathon training. 00:00 – Welcome to Interdisciplinary Case MilesMeet the hosts and the evidence-informed approach behind real runner cases. 02:10 – The Case Introduction A former collegiate swimmer increases mileage from 20 to 40 miles/week while marathon training. 04:45 – “Is It My Ferritin?” Why athletes fixate on iron and ferritin when performance plateaus .07:30 – Ferritin vs Iron Explained What ferritin actually represents and why it changes slowly. 10:15 – Red Flags for Low Energy Availability Sleep, libido, GI symptoms, recovery, and early warning signs of REDs. 15:40 – Nutrition,…

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