Stress Fractures
A stress fracture is an overuse injury that occurs to the bone. Repetitive stresses that break down bone occur with
endurance training. Normally, the body is able to repair the bone as it is broken down. If the stresses are too much, the
bone eventually breaks down and is unable to repair itself. The process is called a stress reaction and this leads to a stress
fracture. Symptoms of a stress reaction start off with mild pain and gradually worsen with continued activity. The most
common symptoms of a stress fracture are point tenderness over the bone, night pain and pain that doesn’t improve with
rest.
The three most common sites of a stress fracture in endurance athletes are:
1) the metatarsal (foot);
2) the tibia (lower leg) and;
3) the femoral neck (upper thigh).
Factors contributing to developing stress fractures include:
1. Over-training and biomechanical factors.
2. Progressing training “too much, too hard or too frequent” This is the most common training error that leads to
stress fractures.
3. Poor biomechanics, such as ankle over-pronation and poor running form.
4. Poor flexibility and muscle imbalances.
If you suspect that you may have a stress fracture, it is important to have your symptoms evaluated by a sports medicine
specialist. Stress fractures can be diagnosed by an X-ray but often require a special test called a bone scan.
Treatment of a stress fracture is complete rest. Deep-water running and swimming may continue. Progression back to
running is gradual and carefully monitored.
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