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Common Running Injuries: Stress Fractures

We’re wrapping up our series of posts about common running injuries today.  If you missed the previous posts about runner’s knee, plantar fasciitis, shin splints, and IT band syndrome, be sure to check them out, too!  For our final post in this grouping, we’ll provide an overview of stress fractures, one of the most dreaded running injuries.


Stress fractures are small cracks in the bones that cause pain and tenderness.  Runners usually start noticing minor tenderness with activity that improves with rest.  The tenderness is usually very localized and runners can often pinpoint the exact spot that hurts.  This is markedly different from shin splints, a condition that tends to cause more radiating pain up and down the length of the affected bone and muscles.  If runners continue training with a stress fracture, the pain worsens and swelling may occur.  Stress fractures most often occur in the bones of the lower leg and foot since these are the bones that bear the most weight while running.


Stress fractures are overuse injuries, resulting from cumulative strain on the bone.  According to the Mayo Clinic, your bones constantly turn over cells and if your bones are subjected to force without enough time for recovery, you’ll reabsorb bone cells faster than you can replace them.  This imbalance weakens the bones, causing tiny cracks and stress fractures.  Runners particularly at risk include:

  • Runners who over-train, especially new runners.
  • Women.  Stress fractures are more common in women, likely due to nutritional deficits, inadequate caloric intake, and low estrogen levels which all impact bone health and density.
  • Runners with foot problems, especially those with high or low arches.

Treatment and Prevention

If you suspect you have a stress fracture, your doctor should be able to confirm the diagnosis with imaging in the form of an X-ray, bone scan, or MRI.  Whether you see a doctor or not, the treatment plan is the same.  You must stop running and rest in order for a stress fracture to heal.  Plan on 8-16 weeks completely off and avoid all impact activities.  If you resume running too quickly, larger, more severe stress fractures can develop and the stress fracture might never heal properly.

When you are completely pain-free while walking, you can slowly return to running.  Keep the following guidelines in mind to prevent future injury:

  • Return to running gradually, beginning with just a few minutes at a time.  It is important to allow your body to build up strength and adjust to weight-bearing activity again.
  • Listen to your body.  Don’t overdo it and stop running if you feel any pain.
  • Make sure you are getting enough calories and are eating a well-balanced diet.  Getting the proper nutrients is essential for bone health.
  • Incorporate weight training into your exercise routine to improve muscle strength and bone support.
  • Invest in a supportive pair of running shoes and consider arch supports or orthotics.

This series of five posts about common running injuries is by no means comprehensive.  We’ve highlighted some of the most common injuries and conditions, but there are many other issues that can plague runners.  To learn more about how to treat and prevent runner’s knee, plantar fasciitis, shin splints, IT band syndrome, stress fractures, and other injuries, contact us!  We can help you run stronger, smarter, and safer!