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Common Running Injuries: Stress Fractures

In this article we will learn about stress fractures – what they are, how they develop, how to treat them, and how to prevent them from happening. Stress fractures are extremely painful and require a lot of downtime when injured – so it’s very important to make sure you prevent them.

What Are Stress Fractures?

Stress fractures are another classic overuse injury (do you sense a theme in these articles yet?). They are very tiny fractures, usually in weight-bearing bones in your lower leg. They sometimes occur if you get shin splints and refuse to rest and recover. They also often occur in feet.

How Do You Get Them?

  • Overuse. Stress fractures usually happen when you increase your training too quickly, in any way. This means a sudden increase in distance (total or an individual session), intensity, a change in shoes, switching surfaces, or anything that is dramatically different from what you currently do.
  • Muscle Fatigue. This relates to overuse. When you do not allow your muscles the proper amount of time to recover, they lose the ability to absorb further stress. At that point, the stress shifts to your bones to absorb the shock. If your bones are absorbing stress faster than they can repair, they will start to weaken and crack. This is the point where you develop a stress fracture.


Stress fractures have pretty consistent symptoms. They usually begin with a dull, aching pain while running (or exercising). The pain worsens, but not too much (because you’ve ignored it or dismissed it as typical soreness). Soon, the dull pain becomes constant, even when sitting. At that point, you may even see some swelling. Stress fractures are most common in your shins and feet.

Treating and Preventing

It is not a good idea to treat stress fractures on your own. You need to see a doctor who can give you an x-ray to confirm a diagnosis. Sometimes, stress fractures are so small that you may need a CT scan and/or a bone scan to determine the extent of the injury.

  1. See a doctor, immediately. Leaving a stress fracture untreated could result in a complete fracture of your bone.
  2. Get a walking boot. Your doctor will usually give you a walking boot. You need to keep all of your weight off of the injured bone to give it a chance to heal.
  3. Rest. Stay off your feet as much as possible. You usually need to rest for several weeks.
  4. Rehab. Your doctor will usually prescribe physical therapy and will refer you to a center where you can begin treatment. At PT, you will do exercises to improve your strength and flexibility.
  5. Resume Training. After you complete therapy, be extremely careful. When you’re out of shape it’s easy to develop an overuse injury and start the entire process over again.

Here’s how to prevent a stress fracture from occurring:

  1. Learn proper running form. Proper running form can help you avoid stress fractures and other repetitive stress induced running injuries caused by the impact forces caused by your feet striking the ground.
  2. Strengthen your feet and shins. Most stress fractures occur in the lower half of your leg. Strengthening the muscles will allow them to absorb the forces so that your bones stay safe.
  3. Increase your training slowly.  Moderation is key to preventing overuse injuries.
  4. Warm up before you run and stretch afterwards. Warm up before your run to loosen your muscles. Stretch afterward to improve your flexibility without injuring yourself. I don’t advocate stretching before a run, because you’re more likely to pull a cold muscle when stretching. If you insist on stretching before a run, at least jog for a bit first.

Stress fractures are potentially serious injuries that can be avoided with a little common sense. If you think you may have one, see a doctor immediately. Don’t wait until it’s too late.

This is a post in a series of articles about common running injuries. These articles are purposely broad and intended for your education. Do not use this information as a substitute for doctor’s advice or a professional medical opinion. To see the entire series, click here.

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March 20th, 2012
Written By: Brett

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