Stress Fractures in Runners

June 15, 2023

A stress fracture is a micro crack in the bone. It is caused by repetitive stress on the bone, such as running or jumping which exceeds the body’s ability to repair the bone. One of the big factors which may affect the body’s ability to repair bone include having enough energy in your diet. Stress fractures can occur in anyone, but they are more common in athletes, especially runners.

The symptoms of a tibial stress fracture include:

● Localised tenderness over the bone
● Pain at night
● Pain with hopping or running

If you think you have a stress fracture, it is important to see a physiotherapist or get a referral for a sports physician. They will likely order an MRI to confirm the diagnosis. If the MRI is negative, but a stress fracture is still suspected, the sports doctor may order a bone scan.

Treatment of stress fractures typically involves an offloading period potentially in a boot or crutches followed by pain free walking and gradual loading through resistance training, low level plyometric loading and a graded return to run. The time to recover depends heavily on the site affected with low risk sites having a good prognosis and high risk sites taking longer to heal.

Here are some tips to help prevent stress fractures:

● Gradually increase your activity level. Don’t try to do too much too soon.
● Listen to your body. If you are feeling pain, stop and rest.
● Strength training is a great way to improve bone mineral density reducing susceptibility to stress fracture
● If you’re new to running or increasing your running consult a dietician to make sure you’re getting enough energy in. Poor energy availability is one of the main risk factors to developing a stress fracture.

If you are an athlete, it is important to work with a coach or physiotherapist to develop a safe and effective training program. They can help you to gradually increase your activity level and advise on capacity building activities to support your running.

Stress fractures have a high risk of re-fracture and it’s important to address all factors which may have contributed to it developing to avoid another.