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Stress Fractures

Stress Fractures: What Are They, and How Can You Fix Them?

If you’ve ever experienced a running injury, you’ll know the nervous wait on the physio couch to find out what’s wrong. It could be a strain, a sprain or something worse – a stress fracture.

Stress fractures are the worst type of injury, as it could mean hanging up your running shoes for a while – or even for good.

But what exactly is a stress fracture, why do they occur and how can you avoid them? Read on to find out.

What are stress fractures, and why do they happen?

Stress fractures can occur in a number of weight bearing bones with the foot, shin and hip at the most risk.

As we grow up, we reach a ‘peak bone mass’ in our teens – this means our bones reach an optimal health and ability to withstand load and stress.

During exercise training (especially running!), we put additional strain on the bones and they re-model and gain strength to adapt.

BUT if your training regime isn’t in line with the amount the bone can handle (i.e. you’re running too frequently without rest days) then it does not have chance to keep up and adapt, so a stress reaction can occur. This usually happens in three stages:

– Stage 1: Inflammation around the bone

– Stage 2: Oedema within the bone marrow

– Stage 3: Finally a stress fracture

Assessing for Stress Fractures

What will I feel if a stress fracture is developing?

The early inflammatory stages will start as a wide spread ache along the bone which normally settles with rest. If you continue to train to the same intensity then you may then also develop swelling and pain at rest.

Once a stress fracture has occurred, sometimes people report night pain, pain with any weight bearing activity and have a very specific location of pain that we can pin point with a fingertip.

Am I at risk of a stress fracture?

Apart from aligning training and bone capacity, there are other factors which do increase the risk of stress fractures. These include:

  • General bone mass and structure
  • Diet and nutrition (largely intake of calcium and vitamin D)
  • Level of physical activity as a teen when your bone peak mass is developing
  • Medications such as steroids
  • Menopausal women

What to do if I suspect a stress fracture?

Diagnosis is key with stress fractures as continuing to train through pain is only going to delay the recovery process with this type of injury. Your physiotherapist can then help you identify any contributing factors, support you in finding the correct cross training activity whilst you have a period of rest from running as well as devising a personalised strength and conditioning plan for you.

When can I run again?

Running can only be re-started when you’re pain free and the time that this takes will differ between people due to the individuality of the stress reaction and what contributing factors are involved.

When returning to running, take it slowly! Make sure you only add a 10% increase to your training each week to ensure the bone can manage. Also, we recommend that only one variable is changed at a time (i.e. length of run, speed, hills etc…) to make sure that strain is re-loaded gradually.

Physiotherapy Consultation

Top 5 tips to avoid a stress fracture

1. Eat a balanced diet and ensure a good intake of calcium and vitamin D

2. Mix in strength and conditioning training to your running schedule to help your legs cope with higher demands

3. Ensure you take rest days from running at least twice a week (you can cross train with other activities if needed, like swimming)

4. Plan ahead your training and aim to increase intensity, duration and gradient by around 10% per week

5. If you start to feel the general ache in your bone then slow down, so that it doesn’t progress into a stress fracture

Stay safe out there, steppers!

For more information, or to book an appointment, call our team on 020 8901 6545.

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