Blog Post

Stress Fractures in Runners

Chelmsford Physio • Mar 25, 2024

Running is a highly popular and beneficial form of exercise, but it also carries the risk of various injuries. Among these, stress fractures are a common concern for runners. Stress fractures are small cracks in the bone that develop due to repetitive stress and overuse. In this blog post, we will delve into the causes, symptoms, treatment, and prevention of stress fractures in runners, drawing upon research from Harvard University.



1. Understanding Stress Fractures:

Stress fractures occur when the repetitive force applied to a bone overwhelms its ability to repair itself. They typically develop in weight-bearing bones, such as the tibia (shinbone), metatarsals (foot bones), and femur (thigh bone). Runners are particularly susceptible to stress fractures due to the repetitive impact forces exerted on their lower extremities during training.


According to researchers, the most common risk factors identified for stress fractures in runners include sudden increases in training volume or intensity, improper footwear, poor running form, nutritional deficiencies, and underlying bone density issues.


2. Recognising Symptoms and Seeking Treatment:

Early detection of stress fractures is crucial to prevent further damage and promote optimal healing. The symptoms of a stress fracture may include localised pain that worsens with activity and diminishes with rest, swelling, tenderness, and potentially a noticeable limp.


It is highly recommend to seek consultation with a specialist, if a stress fracture is suspected. Diagnosis typically involves a thorough physical examination, imaging tests (e.g., X-rays, MRI), and sometimes bone scans to confirm the presence and location of the fracture.


Treatment of stress fractures often involves a period of rest from running and other high-impact activities. It is important to implement a gradual return-to-running program under the guidance of a specialist. Other treatment modalities may include pain management, immobilisation with a cast or walking boot, physiotherapy, and addressing any underlying factors contributing to the fracture (e.g., correcting running technique, improving bone health).


3. Preventing Stress Fractures:

Prevention is key when it comes to stress fractures in runners. 


a. Gradual Training Progression: Avoid sudden increases in training volume or intensity. Gradually build up mileage and incorporate rest days into your training schedule to allow for adequate recovery


b. Proper Footwear: Choose running shoes that provide appropriate support and cushioning for your foot type and running style. Consult with a knowledgeable professional to ensure a proper fit.


c. Cross-Training and Strength Training: Engage in cross-training activities (e.g., cycling, swimming) to reduce the repetitive stress on your bones. Incorporate strength training exercises to improve muscle strength and stability, which can help absorb impact forces during running.


d. Balanced Nutrition: Maintain a well-balanced diet that includes adequate calcium, vitamin D, and other essential nutrients for optimal bone health. Consult with a registered dietitian or healthcare professional to ensure you meet your nutritional needs.


e. Listen to Your Body: Pay attention to any signs of pain, discomfort, or unusual changes in your running routine. Address these issues promptly and seek professional advice if needed.


f. Sleep: gaining 7-9 hours sleep at night is a key component when training for a marathon. Regularly getting less than 7 hrs sleep, doubles your risk of an injury.


Stress fractures can be a significant setback for runners, but with proper understanding, early detection, and appropriate management, they can be effectively treated and prevented. By incorporating the knowledge and recommendations derived from Harvard research, runners can take proactive steps to reduce the risk of stress fractures, ensuring a healthier and more enjoyable running experience.



Remember, when it comes to stress fractures, prevention is always better than cure. Prioritise gradual training progression, appropriate footwear, cross-training, strength training, and a balanced diet to keep your bones strong and resilient. By taking care of your body and listening to its signals, you can continue to pursue your running goals while minimising the risk of stress fractures.

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