What Causes a Stress Fracture?
Stress fractures develop when bone breakdown happens faster than bone formation. Over time, repetitive impact creates microdamage that your body can’t fully repair, leading to cracks in the bone. This imbalance occurs due to a mix of factors:
- Low lean muscle mass and a BMI under 19 mean less protection for bones and less energy to combat muscle fatigue.
- A previous stress fracture is one of the most significant predictors of another. In fact, runners with a history of stress fractures are up to five times more likely to sustain a new one.
- Biomechanics: while experts still debate whether forefoot, midfoot, or heel striking matters most, low running cadence is a consistent contributor to fracture risk.
- Training load and recovery, e.g. lack of rest days or rapid increases in mileage.
- Hard terrain and worn-out running shoes can also add to the problem.
How to Treat a Stress Fracture from Running
1. Recognise the Warning Signs
Early symptoms often include localised pain that worsens with activity and sticks around after rest. The pain usually pops up in high-impact areas such as the tibia, metatarsals, and tarsal navicular, but can also occur in the femur or pelvis.
2. Take the Time to Heal
The worst thing you can do for a developing stress fracture is keep running. As the injury develops due to a mismatch between load and rest, it’s essential to take some time off to let your osteoblasts and osteoclasts (responsible for removing damaged tissue and creating new tissue) do their job.
3. Wear Compression
A pair of compression socks will reduce inflammation around the area, relieving discomfort and facilitating recovery.
Sports Recovery Socks
4. Take a Load Off
Your treating physician may recommend wearing a brace or boot while you’re up and about to prevent further damage. Our b:joynz air walkers incorporate a rocker sole, adjustable straps, immobilising stays, and an air bladder to control swelling and protect the bone.
How to Avoid Stress Fracture Recurrence
1. Increase Gradually and Leave Time for Rest
The golden rule of running injury prevention is simple: don’t do too much, too soon. Gradually build up your mileage, and schedule rest or cross-training days (think swimming, cycling, or resistance training) to give your bones time to adapt and heal.
2. Eat Right for Your Bones
Nutrition plays a big part in bone health. Adequate protein, carbohydrates, and overall calories support muscle recovery and bone healing.
You may also benefit from vitamin C (1,500–2,000 mg/day) and vitamin D (800–1,000 IU/day) intake. Although research results on their impact on stress fracture prevention remain mixed, these nutrients are important for bone and overall health.
3. Improve Your Running Biomechanics
Adjusting your running form can reduce impact stress. A study in the British Journal of Sports Medicine (BJSM) found that gait retraining, which emphasises muscle activation before foot strike, can dampen early impact forces and help prevent bone stress injuries.
Strengthening key stabilisers like the calves, hips, and core can also enhance shock absorption and reduce mechanical load during running.
4. Check Your Shoes and Terrain
Your shoes absorb thousands of impacts every run. Replacing them every ~500 km helps maintain cushioning and shock absorption. Running on slightly softer or flatter surfaces can also reduce bone stress.
If you overpronate or feel uneven loading through your feet, try running insoles. Custom or contoured insoles can improve alignment and distribute pressure more evenly, lowering your risk of tibial and foot stress fractures.
Run Performance Insoles
5. Wear Running Insoles and Supports
Insoles can help redistribute pressure and promote better foot mechanics. Our Run Performance Insoles and ErgoPad Weightflex 2 are designed to cushion ground strike, guide natural foot motion, and stimulate sensorimotor feedback for smoother movement.
If you prefer the feel of taping, the MalleoTrain S and MalleoTrain Plus ankle supports offer a smart alternative. They combine a supportive figure-8 strap with medical-grade knit to enhance stability and circulation without the hassle of re-taping.
To Sum Up
A stress fracture from running doesn’t happen overnight. It’s a gradual overload that you can prevent and recover from with smart training, proper nutrition, and the right support. By managing training load, refining running form, and using orthotics or compression supports where needed, runners can protect their bones and stay stronger for longer.
