Nearly every runner fears sustaining a stress fracture at some point in their career. These injuries, which can range in their severity, are tiny cracks in the surface of the bone due to overuse and excessive forces on the body. Stress fractures can occur in any weight-bearing bones of the body, but runners usually get them in the tibia, metatarsals, or the femur.

Symptoms of a stress fracture include aching or burning localized pain along a bone. It will usually hurt to press on that area. The pain will also worsen while running and may eventually hurt even while not putting any weight on the bone at all. The surrounding muscles of the affected bone may also feel tight.

If you suspect you have a stress fracture, you should visit a sports medicine physician or orthopedist as soon as you can for diagnosis. An MRI is most often used to confirm the stress fracture diagnosis.

If caught early, the injury may be classified as a stress reaction, which would only require a week or two layoff from running. But stress fractures can be extremely frustrating, requiring several months away from running. There is no known treatment for stress fractures aside from rest.

Prevention strategies focus on reducing stress on the bones and building (or maintaining) bone strength. Continuously examine your training routine, and make sure not to drastically change your mileage or intensity. Stress fractures often result from sudden training changes. It is recommended to increase your mileage by 10 percent each week—any more could put you at risk for stress fractures and other injuries. Also consider dialing back the speed of your running, as a faster pace places more impact on the bones.

If possible, try to avoid running strictly on hard surfaces, such as paved roads. Trails, tracks and unpaved roads offer a slightly softer running surface which, over time, can make a big difference.

Other risk factors for stress fractures include bone structure and strength. Weak, narrow bones have an increased risk of sustaining these injuries. The size and strength of the muscles surrounding those bones can also impact one’s risk for sustaining a stress fracture—those with larger muscles tend to have a lower risk.

If you are recovering from a stress fracture, take the time to examine your training routine. Talk to your doctor about your timeframe for healing from the injury and what types of activities can be performed at certain points along the way. Review your diet and lifestyle to see if there is anything you can do better to strengthen bones and prevent stress fractures, such as taking a calcium and vitamin D supplement. When you are able to run again, examine your running form and pay attention to your pace.

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