4 Ways to Reduce Your Risk of Stress Fractures

Invisible to most x-ray scans, but incredibly painful to deal with, stress fractures can sideline even the toughest athlete. If you’re a runner, or participate in a sport where your foot is consistently hitting a hard surface, you might be at risk for this condition and not realize it.

What is a stress fracture exactly? A condition you might not know you have, as tiny hairline fractures develop and worsen with time, according to Tim Miller, MD, a sports medicine physician at The Ohio State University Wexner Medical Center. “In short, it’s a fatigue failure of the bone,” he explains. “The normal bone is overworked and not given enough time to heal. With repetitive activity, pain and discomfort increases. Over time, you start to experience bothersome symptoms with normal daily activities.”

Who’s at risk? Typically athletes or active people who participate in repetitive physical activities, like runners, rowers, basketball players, gymnasts or tennis players. Women typically experience stress fractures more than men, and conditions like osteoporosis or eating disorders that weaken bones can increase your risk of these micro-breaks. “Also, we see stress fractures a lot with ‘couch to 5K’ runners,” says Miller. “People who are trying to suddenly get in shape, and they increase the intensity of their exercise over a very short period of time.”

Unfortunately, Miller says it’s tricky to diagnose a stress fracture, because the hairline cracks don’t usually show up on an x-ray when you first start experiencing symptoms. A doctor may have to perform a bone scan or MRI to confirm the condition. To treat the issue, you usually just need to lay off physical activity that exacerbates discomfort. However, if it’s a stress fracture in the foot or leg, you might need to stop bearing weight for a while and use crutches or a boot.

Thankfully, there are some ways you can prevent the condition. Here’s how.

#1: Up Your Calcium and Vitamin D Intake

According to Miller, calcium and vitamin D are the building blocks of healthy bones—which can help prevent stress fractures. In a study from 2016, data shows athletes who like to play high-impact sports may need to get more vitamin D than the average person. “Adequate sun exposure can really help with the vitamin D levels,” says Miller. You can also ask your doctor about a taking a supplement if you’re planning to participate in activities where the risk of stress fracture is high.

#2: Adjust Your stride and Wear Proper Footwear

Of course you know how to run or jog, but are you truly running right? If you don’t have the right stride or footwear, your feet and legs might be absorbing too much impact. According to 2013 research, incorrect knee rotation and abduction angles upon landing can up your risk of stress fracture, as well as reduced knee and hip flexion angles. The fix? Learning how to create the safest stride. (Local running programs or groups often teach form to newbies.) In addition, don’t forget to wear supportive footwear; swap out your sneakers every 300 to 500 miles.

#3: Don’t Go for “Skinny”

Women are already at risk of stress fractures, especially if they’re underweight, says Miller. According to a 2017 study conducted by Miller, female runners with a BMI of 19 or less have an increased risk of hairline breaks and their injuries take longer to heal. Miller says the continuous pounding is often too much for active people who don’t have the lean muscle mass to sustain it. Maintain a healthy body weight through balanced dietary decisions, opting for enough lean protein, carbs, and healthy fats to keep up with your regimen.

#4: Increase Intensity Slowly

Don’t be the “sofa to startline” athlete who goes from zero to 60, says Miller. “It’s important to progress gradually into a new activity program,” he explains. “No quick bursts of activity, right off the bat.” In addition, watch for soreness in areas where stress fractures are common: the top, middle, and outside portion of the foot, the hip, and the tibia are frequently in the line of fire for those hairline injuries. If you feel pain during your normal exercise routine, take a day or two off until it subsides.  

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