What is a Stress Fracture?


One of the most common injuries that runners face is the stress fracture. Because of the long time it takes for completely heal a broken leg (anywhere from 4-8 weeks), it is also one of the most feared injuries. Stress fractures can absolutely ruin and training program and season. Therefore, runners should understand the symptoms of stress fractures how to treat them.

The pounding that human bones must endure during a training program is intense. To deal with the stress, bones are in a constant state of repair. Specifically designed cells called osteoblasts help to restore bone that has been damaged through trauma caused by running. However, if a runner trains too hard, the amount of bone damage becomes more than what the osteoblasts can repair and the bone becomes weakened.

Stress fractures do not occur suddenly – they gradually develop over time. A site in the bone that has experienced trauma initially qualifies as a “stress reaction,” which involves a critical state of weakness that will lead to a stress fracture if the runner does not stop training. The difference between a stress fracture and stress reaction is that the bone cortex (the outer part of the bone) remains intact in a stress reaction and is fractured in a stress fracture.


Once a runner feels localized, pinpoint bone pain, he or she should back off of training and see a physician. Sometimes it is difficult to distinguish between shin splints and stress fractures. The general rule is that shin splint pain involves aching and discomfort that involves a large part of the leg. Stress fractures involve a sharp, pinpoint pain located at a specific site of bone.

Another home test I have heard for stress fractures involves a tuning fork, which is a two-pronged metal fork that vibrates. Many people believe that when a tuning fork is struck near a stress fracture, the sound waves will cause ends of the fracture to rub against each other causing pain. I have no idea if this test actually works, but it might be something to try if a runner is unable to see a doctor quickly.

A physician will diagnose a stress fracture by first taking an x-ray of the painful area. However, x-rays are often negative for stress fractures that have recently occurred. Therefore, an x-ray often is followed by a bone scan, which is a special test that can identify new areas of bone growth or breakdown. Because a bone with a stress reaction or stress fracture will have an accelerated rate of bone growth as the body tries to repair the damage, the bone scan is a very effective test to find both stress reactions and stress fractures. Once diagnosed, a physician will tell a runner to refrain from any impact training for a number of weeks, and may even prescribe a protection boot for the runner to wear.

Stress fractures are serious injuries that can cause complete breaks of the bone if a runner ignores the pain. It is so important for runners to be vigilant in listening to their body, especially when increasing mileage rapidly. The possibility of stress fractures should be more than enough to motivate a runner to be very careful about over training.


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