5 Ways to Prevent Stress Fractures

Anyone who says, "exercise is a pain" doesn't know the half of it unless they've had a stress fracture, one of the most common sports injuries.  Stress fractures are an overuse injury in which worn-out muscles make the bones carry some of their heavy load.  If the bone can't take it, that heavy load can cause a tiny crack called a stress fracture.  It's a painful yet preventable game stopper.  

Bones don't make excellent shock absorbers, especially when the shock happens again and again. Most stress fractures occur in the weight-bearing bones of the lower leg and foot. The American Academy of Orthopedic Surgeons estimates that more than 50 percent occur in the lower leg and are the result of increasing the amount or intensity of an activity too rapidly.  They're also caused by a change in the way muscles distribute weight in response to repetitive impact; like when a runner switches from one surface to another (treadmill to trail running).  Sometimes, using the wrong equipment for a sport (like running with worn-out tennis shoes) can cause excess stress.  Sometimes, stress fractures are just the result of "weekend warrior" syndrome-going all out on the court or trail without proper conditioning.  

Women get more stress fractures then men, but people of all ages who do repetitive high-impact sports like running, tennis and basketball are at risk. People who don't have proper muscle condition to absorb impact-shock and those who don't rest properly between workouts are at particularly high risk for developing stress fractures.

How do you know if you have a stress fracture?  They hurt with activity and the pain stops with rest.  While x-rays and sometimes CT scans are commonly used to diagnose fractures, stress fractures can be so small they don't show up on film.  That's why it's important to see a sports physician or orthopedist with experience treating sports injuries.  

How do you prevent getting stress fractures?  Follow these tips developed by the American Academy of Orthopedic Surgeons:

  • When participating in any new sports activity, set incremental goals. For example, don't immediately set out to run five miles a day; instead, gradually build up your mileage on a weekly basis.

  • Cross-train—alternate activities that accomplish the same fitness goals. Instead of running every day, run on even days and bike on odd days. Add strength training and flexibility exercises for the most benefit.

  • Maintain a healthy diet that includes calcium and vitamin D-rich foods

  • Use the proper equipment. Do not wear old or worn running shoes.

  • If pain or swelling occurs, immediately stop the activity and rest for a few days. If pain persists, see an orthopedic surgeon.

Don't forget the rule of 10-only increase intensity, duration, weight, or speed of any sporting activity by 10 percent at a time.  Wait a week or two before bumping up any further.  Where stress fractures are concerned, no pain is a total gain.