You can’t run from stress fractures

The half marathon was just a few weeks away, and you were a little behind in your training, so you amped up the distance in your daily runs. This sudden increase in training resulted in severe pain in your shin and you feared the worst, those two words no runner likes to hear – stress fracture.

Orthopedist and sports medicine specialist, Ljiljana Bogunovic, MD, explains, “A stress fracture is a tiny crack in a bone that usually happens from overuse.  Stress fractures are more common in repetitive impact sports such as long distance running, track and field, gymnastics, and basketball.

The weight-bearing bones of the foot and lower leg are especially vulnerable to stress fractures because of the repetitive forces they must absorb during activities like walking, running, and jumping.”

The injury occurs when the stress on the bone exceeds the bone’s ability to repair itself. The end result is an accumulation of microcracks which then lead to a facture.

Symptoms of a stress fracture

  • Localized dull pain (can pinpoint specific area)
  • Pain that occurs sooner each time you start to run or exercise
  • Mild swelling and redness
  • Possible bruising
  • Pain initially occurs with activity and is relieved with rest.  As the fracture progresses, the patient can develop pain at rest.
  • Usually pain only in one leg

Treating stress fractures

There are two main groups of stress fracture: high and low risk. While low-risk stress fractures typically resolve with rest and activity limitation, high-risk fractures may require surgical treatment.

Non-surgical treatment for low-risk stress fractures includes:

Rest – if you are a runner, stop running until cleared by a doctor.   A rest period of six to eight weeks is needed for a stress fracture to heal.  Attempting to rush back sooner can cause re-injury. 

Ice — Use ice to reduce swelling.

Compression — To prevent additional swelling, lightly wrap the area in a soft bandage.

Elevation —   As often as possible, rest with your foot elevated higher than your heart.

In addition to the RICE protocol (rest, ice, compression, elevation) your doctor may recommend that you use crutches to keep weight off your foot until the pain subsides.

Dr. Bogunovic adds, “Depending on the site of the fracture, you can usually cross train through a stress fracture with any activity that doesn’t cause pain during or after. Swimming, deep-water running, biking are good alternative choices for most people. “

Prevention of stress fractures

Eat a healthy diet. A balanced diet rich in calcium and Vitamin D will help build bone strength.

Use proper equipment. Old or worn running shoes may lose their ability to absorb shock and can lead to injury. In general, athletic shoes should have a softer insole, and a stiffer outer sole.

Start new activity slowly. Gradually increase your time, speed, and distance. In most cases, a 10 percent increase per week is appropriate.

Cross train. Vary your activities to help avoid overstressing one area of your body. For example, alternate a high-impact sport like running with lower-impact sports like swimming or cycling.

Add strength training to your workout. One of the best ways to prevent early muscle fatigue and the loss of bone density that comes with aging is to incorporate strength training. Strength-training exercises use resistance methods like free weights, resistance bands, or your own body weight to build muscles and strength.

Stop your activity if pain or swelling returns. Rest for a few days and if the pain continues, see your doctor.

To make an appointment with Dr. Bogunovic, or any of our sports medicine specialists, please call 314-514-3500.

Patients are seen at:

Washington University and Barnes-Jewish Orthopedic Center, 14525 S. Outer 40 Drive, Chesterfield, MO 63017

Center for Advanced Medicine – South County, 5201 Midamerica Plaza, St. Louis, MO 63129