How to avoid stress fractures

An important thing to know about stress fractures is how to avoid them. A stress fracture is a tiny crack in a bone that happens when your muscles can’t absorb shock and transfer stresses to the bone. Most occur in the lower extremities, especially the lower leg and foot.

A stress fracture is usually an overuse injury that develops over a long period of time—from weeks to months. They’re especially common among military recruits, in about 3% of men and 9% of women. And since it can take several weeks to months for a stress fracture to heal, the best approach is to avoid getting one. Here are some tips for prevention:

  • Use the progression principle of training: Gradually increase your training intensity, usually by no more than 10% weekly if you exercise 3 or more days a week. Slowly incorporate higher-stress activities such as jumping and interval training into your workout. Set incremental goals to help you develop your training routine step-by-step.
  • Check your footwear and make sure it matches your training routine. Replace old or worn footwear.
  • Check your form. Are you moving properly when you exercise or does your form put you at risk of injury?
  • Pay attention to early signs of injury. Unusual muscle soreness and other aches and pains can be a sign of injury and/or imbalances that could worsen if they aren’t addressed early.
  • Monitor your diet, specifically calcium and vitamin D intake. To learn more, read the National Institute of Health’s Dietary Supplement Fact Sheet on calcium.

It’s important to recognize a stress fracture and get medical help early, as described by the American Academy of Orthopaedic Surgeons. The Mayo Clinic provides more information on symptoms. And check out HPRC’s Injury Prevention section for more on how to avoid injury.


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References

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Schnackenburg, K. E., Macdonald, H. M., Ferber, R., Wiley, J. P., & Boyd, S. K. (2011). Bone quality and muscle strength in female athletes with lower limb stress fractures. Medicine & Science in Sports & Exercise, 43(11), 2110–2119. doi:10.1249/MSS.0b013e31821f8634

Wentz, L., Liu, P., Haymes, E., & Ilich, J. (2011). Females have a greater incidence of stress fractures than males in both military and athletic populations: A systemic review. Military Medicine, 176(4), 420–430.