Running Injury Spotlight: Stress Fractures

Running Injury Spotlight: Stress Fractures

What are Stress Fractures?

Stress fractures are tiny breaks in a bone that usually occur after loading the bone in the same (abnormal) way over and over again. Stress fractures of the legs affect athletes that perform repetitive movements, especially runners. Female runners are at a higher risk for stress fractures than males and most stress fractures in runners occur in the feet and shins, however runners may also get stress fractures in the pelvis or anywhere throughout the body with abnormal loads to the bone.

 

What does a Stress Fracture Feel Like?

A stress fracture will usually feel like a sharp pain in a very localized spot on a bone. It will usually hurt to press on that spot with your fingers and cause you sharp pain during and achy or throbbing pain after running. You may or may not have swelling over the tender spot.

 

What Causes a Stress Fracture?

• Biomechanical Errors / Running Gait or Form Errors
  • Your running gait or technique is of the utmost importance to understanding what movements are causing the excess stress to the injured area.
  • Over-pronation
  • Under-pronation
  • Over-striding
  • Lacking push off
  • Lacking hip and pelvic control and muscular endurance
  • Abnormal movements at the foot, ankle, knee, hip and back can all cause excess stress anywhere in the legs or pelvis and cause stress fractures.
  • Any abnormal movement (poor running form) causes certain muscles to pull on the point of attachment on a bone over and over – causing excess stress to that one spot. This can eventually cause a stress fracture at the point of excessive pulling. Stress fractures can also be caused by abnormal impact loads (not just abnormal muscle pulling). For example, if your hip joints are tight (see hip mobilization video here) and  you can’t have a full push off in your stride, this will cause more compression stress to the hip joint and pelvic bones, which can cause stress fractures at the point of end range of your full motion at the pelvis or hip.
• Training Errors
  • Adding too many miles, too quickly, without proper muscular strength, endurance or training base
  • Adding in aggressive speedwork without a proper base
  • Adding in aggressive hill training or other workouts without preparing your body
  • Not performing individualized strength and mobility work (see reasons why, above)
• Nutrition Problems
  • Lacking proper dietary energy (not enough total or quality calories) or Vitamin D
  • Excessive alcohol intake
• Equipment Issues
  • Wearing footwear that isn’t appropriate for your foot type, your running form or mechanics

 

What to do if you Suspect a Stress Fracture

• Set up an appointment to get in immediately and determine if you do have a stress fracture. Set up an appointment here.
• Stop impact activities until a stress fracture can be ruled out / in. Yes, that means holding off from running for the time being. It takes multiple weeks for bone to start healing after a stress fracture and continuing to run will cause the fracture to get worse. Try non-impact cardiovascular exercise like cycling or pool jogging or swimming (depending on where you have the pain).
• Get a video running gait assessment or analysis. If you were injured during running, it’s imperative that you get assessed during the sport that is causing you pain so we can determine the best intervention for you. Even runners with a stress fracture in the same location will have different causes for their injuries – you won’t be able to heal and prevent your stress fracture by following the same suggestions for someone else’s injury. Click here to learn more about video gait running assessments and how to schedule yours in-person or online.