Runners: Prevent Stress Fractures

Don’t be sidelined by a stress fracture during your marathon training. This common overuse injury keeps many runners from the start line. Here’s how to prevent a stress fracture and what to do if you suspect you have one.

What Is A Stress Fracture?

A stress fracture is a small, fine break in a bone; they are very common overuse injury for runners and other athletes.

What Causes A Stress Fracture?

Stress fractures are caused by continuous overuse. While stress fractures may occur in bones that are subjected to repetitive activities, the bones of the legs and feet are at greatest risk. For runners, such as those doing long-distance race training, the bones in the midfoot (metatarsals) are especially vulnerable to stress fractures.

“Stress fractures in the foot and ankle usually happen when a person changes or intensifies his or her activity level,” said Matthew Rachwalski, DO, a Michigan City sports medicine doctor with Franciscan Physician Network. "When people think of bones, they think they're hard like metal, but the bones in the feet are more like tree branches. They can bend a little bit, but if you bend them enough times or severely enough, they may crack."

What Are Symptoms Of A Stress Fracture?

“The main symptom is pain, usually worsening when doing weight-bearing activities,” Dr. Rachwalski said.

Pain from a stress fracture may appear after long or intense periods of exercise or normal daily activities, and the pain may go away during rest and return when exercise is resumed.

Other symptoms of a stress fracture include:

• Swelling at the top of the foot or the outside of the ankle
• Tenderness when the fracture area is touched
• Bruises at the site of the fracture

What Should I Do If I Have Stress Fracture Symptoms?

If you think you have a stress fracture, immediately stop doing any activity that causes discomfort. Rest is the primary treatment for a stress fracture. If pain comes on suddenly, apply ice and elevate your foot.

If it's not better after a few hours or if you have pain on days when you're not exercising or playing sports, seek medical care. Untreated, a stress fracture could develop into a complete break of the bone.

How Can Runners Prevent Stress Fractures?

During long-distance marathon training, take important steps to prevent stress fractures. Dr. Lyon recommends these diet and exercise tips for long-distance runners:

• Eat a healthy diet rich in calcium and vitamin D.
• Make sure your shoes are in good shape. Change your shoes out every 300 to 400 miles.
• Increase your activity slowly, by about 10 percent per week.
• Cross-train to keep from overstressing your feet and legs.
• Add strength training to your workout.
• Don't exercise through returning pain.
• Ensure you get enough rest between workouts.

Check with your doctor if pain continues.