John Davis

Written by John Davis


The Ultimate Runner’s Guide to Stress Fractures: Causes, Risk Factors and How to Return to Training

That sinking feeling in the pit of your stomach.

This is not just shin splints or minor soreness in your foot; this hurts too much when running. You know it probably is the two words that strike fear into every runner; stress fracture.

But, how can we know for sure without getting an expensive MRI or bone scan?

And if you do have a stress fracture from running, just how long does a stress fracture take to heal?

Well, we are going to answer those questions, along with the causes of stress fractures (and why runners are so prone to them), how you can speed recovery if you have a stress fracture from running, and what you can do in the future to get back to running as soon as possible.

We wish we did not have to share this with you, but if you do have a stress fracture, hopefully this will give you some reassurance that you will get back to running, and prevent having another in the future if you follow our steps (and yes, that does include getting a good pair of running shoes!).

Stress fracture. Two words no runner ever wants to hear. How do you know if you have one? What causes a stress fracture? How can I make sure I never get one again? These are all questions runners have when returning to running after a stress fracture. We look into the causes, symptoms, and best treatment options to get you back to running as quickly as possible.

A stress fracture from running is one of the most frustrating injuries a runner can face.

While bad cases of some injuries do have a reputation for sticking around longer than the duration of a normal stress fracture, a stress fracture is a much bigger baseline setback than most soft tissue injuries: at least six weeks of no running at all—some of your time off may even need to be on crutches or in a “boot.”

Definitely something to bring about the runner blues.

As the name suggests, a stress fracture is a small crack in any of the weight-bearing bones of the body.

Runners can get a wide variety of stress fractures, but the most common stress fractures in runners are (in order) tibia (bigger shin bone), metatarsal, femur, fibula and navicular.

How Long Will My Stress Fracture Take to Heal?

Stress fractures can be grouped into “low risk” and “high risk” categories:

A low risk stress fracture will typically heal on its own just fine, and may not even require any time spent in a boot or on crutches.

Low risk stress fractures include most types of tibial and fibular (shin) stress fractures, and metatarsal stress fractures.

A high risk stress fracture, however, is one in an area which is known to heal poorly.

Stress fractures to the navicular, pelvis, and femur, however, are often high-risk, and tend to require significantly more time away from running and a more cautious approach to returning to running.

Fortunately, these high-risk stress fractures are rarer than the low-risk types.

Stress fractures above the knee are particularly troubling from a medical standpoint, as the femur, pelvis, and low back are among the strongest bones in the body. A stress fracture to these areas may indicate underlying medical problems.

What are the Symptoms of a Stress Fracture?

Bone, like most tissue in the body, can adapt and become stronger when it’s subjected to a stress.

However, unlike muscles and tendons, which can adapt and strengthen in a period of days or weeks, it takes many months for bone to become stronger after it’s been put under an increased level of stress.

In fact, there’s even a window of about a month where bone becomes weaker after an increase in training stress because of the way the body remodels bone.

Your body first tears out some walls in the bone structure before it can put in new ones, much like remodeling your house.

A stress fracture typically feels like an aching or burning localized pain somewhere along a bone.

Usually, it will hurt to press on it, and the pain will get progressively worse as you run on it, eventually hurting while walking or even when you’re not putting any weight on it at all.

Sometimes, if the stress fracture is along a bone that has a lot of muscles around it, like the tibia or femur, these muscles will feel very tight.

If you suspect you have a stress fracture, you should see an orthopedist as soon as possible to get it diagnosed.

X-rays are nearly useless for diagnostic purposes, so your doctor should conduct a bone scan or, preferably, an MRI to confirm the presence of a stress fracture.

While bone scans are highly accurate and reliable, they are very expensive.

An MRI can allow your doctor to get a better idea of the severity of your stress fracture, which might allow him or her to give you a better estimate of when you can return to training.

Sometimes, you can catch a stress fracture early on—at this point, it is classified as a stress reaction and may only require a few weeks’ time away from running.

Here’s the deal:

It’s very important to heed your doctor’s advice, since continuing to run on a stress fracture can cause it to progress to a real bone fracture, which will land you on crutches for several months and will put any future running in real jeopardy.

This is especially true with high-risk stress fractures.

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It’s a PDF with the treatment options for runners with stress fractures.

What Causes Stress Fractures?

The scientific literature is unclear on whether the main cause of stress fractures is impact loading forces or active forces.

Impact loading force is the degree of shock that travels up your foot and leg when you initially hit the ground, while active forces are generated when you are pushing your body off the ground.

Some research has found that runners with a history of tibial stress fractures have high impact loading rates, while other studies have predicted that the strain on the bones of the body is greatest when pushing off the ground.

Fortunately, these two are not mutually exclusive—strategies that can reduce impact loading rates will also likely reduce active forces.

Because there’s no known treatment, aside from rest, that can speed your recovery from a stress fracture, most research has been directed at methods to prevent a stress fracture in the first place (or avoid another one in the future).

That being said, you can make sure you include lots of healthful, nutritious foods that will help your body to speed recovery. 

Strategies for prevention are mostly focused on reducing the stress on your bones and building or maintaining their strength. It is also important to look at your training as a whole, making sure that you incorporate down weeks into your training to allow for that bone to become stronger.

How Do I Avoid Stress Fractures?

Since a stress fracture is a fairly serious injury, sustaining one involves a thorough examination of your training, running mechanics, and overall health.

First off, you need to examine your training history to see if you made any drastic changes in mileage or intensity in the past month or so.

As mentioned in the introduction, when bone is stressed, it is actually weaker for about a month after a change in training stress before it becomes stronger. Because of this, it may make more sense to change up how you increase mileage.

While the traditional recommendation is a 10% increase in mileage every week, the dynamics of bone remodeling suggest that taking “down weeks” every 3-4 weeks with a 10-20% drop in mileage might be a better idea. A series of weeks under this model might look like this:

36 miles

40 miles

44 miles

36 miles

44 miles

Another option is an “equilibrium” model, where mileage jumps 20-30% every 3-4 weeks, but with no change of mileage in the intermittent weeks. A series of weeks under the equilibrium model might look like this:

30 miles

30 miles

30 miles

40 miles

40 miles

What Else Puts a Runner at Risk of a Stress Fracture?

While training is a critical component, it is not the only important factor.

Many runners can run well over 100 miles a week without developing a stress fracture, while others come down with them at 15 or 20 miles a week. Make sure you are able to find your optimal mileage by being conservative as you test it out.

Could genetics play a part?

One reason changes in training do play a role is that the bone’s capability to handle stress is directly related to its size and strength.

Multiple studies have connected narrow, weak bones with an increased risk of stress fracture. Furthermore, it appears that the muscles surrounding a bone influence its size and strength as well.

One study found that women with a larger calf circumference are at a lower risk of tibial stress fracture, and another found that women with larger muscular cross-sectional area in their calf were at a lower risk of any kind of stress fracture.

While you probably won’t be able to do any strength training during your recovery, improving the strength, size, and endurance of the muscles in your legs—especially your calves—is a good strategy for the future.

Too much speedwork?

The speed at which you train is also something to take into consideration.

Many dedicated runners run themselves into trouble by maintaining a fast pace on many of their runs.

Since both impact and active forces have been connected to stress fractures, it makes sense that a faster training pace would make you more vulnerable: running fast necessarily means incurring greater impact and active forces when your feet hit the ground.

If you are a speed demon on your easy days, think about slowing down the pace once you’re beginning your comeback. Remember, we also found that running 80% easy led to 23% faster races!

Running form increasing your risk

Stride frequency is another factor that affects your impact and active forces.

To run a given pace with a low stride frequency, you’ll be hitting the ground and pushing off harder than if you were running with a higher stride frequency.

Of course, there are upper limits on how high of a stride frequency you can maintain. But elite runners (and, in my experience, runners who are better at avoiding injury) tend to maintain a stride frequency of 180 steps per minute or more, even at slow paces.

This will also encourage your body to stop overstriding, which will reduce the impact in your legs, which puts them at a lower risk of fractures in the future.

Females may be at a higher risk

Stress fractures may be indicative of underlying health issues, especially in women.

Because of the hormonal dynamics of the menstrual cycle, women who miss their period because of insufficient caloric intake in their diet are at a significantly higher risk for sustaining a stress fracture.

If you are amenhorreic (missing your monthly period), you should talk to your doctor as soon as possible, as it can affect not only your immediate injury risk, but your bone density for the rest of your life, which is a problem much bigger than a running injury.

What shoes are best for runners after a stress fracture?

Yes, your shoes may plan a part in this, especially if you wear them for too long and all the support has gone from the shoes.

If you are a heel striker or tend to overstride, it is especially important to make sure you read the wear pattern on your shoes and consider rotating shoes to prevent future fractures.

If you want to listen to the advice of Born to Run Author, Christopher McDougall and run barefoot, you will naturally adapt your running form to limit your risk of stress fractures, but as Dr. Daniel Liberman states, this must be a change that is made gradually.

What Should I Do If I Do Have a Stress Fracture?

If you suspect you have a stress fracture, you need to see a podiatrist or an orthopedist to have it diagnosed.

They will be able to determine the exact location and severity of your stress fracture, as well as what, if any, protective measures (boot, crutches, etc.) you will need to take while it heals.

It is exceptionally important to heed the advice of your doctor when it comes to stress fractures, because pushing too hard on a stress fracture can put your running in jeopardy for months to come.

While you recover, your doctor will probably lay out a schedule of when you can return to various cross-training activities. We recommend listening to this podcast episode about cross training where you can learn about how you can maintain your running fitness for up to 6 weeks if you do it correctly!

Some non-weight bearing cross training methods, like aqua jogging (which we found to be the best cross training tool for runners), can often be started right away, though you may have to wait several weeks to be able to use the elliptical or exercise bike.

Again, this depends on the specifics of your stress fracture, and is something you’ll want to ask your doctor about.

Maintaining your aerobic fitness while you are injured is not always fun, but will make your comeback a lot easier once you’ve been cleared to run again.

Use your recovery time to review your training, diet (5 foods that might be robbing your bones of calcium), and lifestyle to identify factors that might have contributed to your injury.

Taking a calcium and vitamin D supplement which provides 200% of your RDV of both nutrients is not a bad idea either, as a 2007 study found that this can reduce the risk of a stress fracture in female Navy recruits.

As you return to running after your time off, examine your running form, with particular attention to your stride rate and usual training pace, since a low cadence or excessively fast everyday speed can increase loading through your foot, lower leg, thighs, and hips, causing problems if you are susceptible to stress fractures.

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It’s a PDF with the treatment options for runners with stress fractures.

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What Treatment is There for Stress Fractures?

Conservative measures

These are simple, well-backed by research, and carry a relatively low risk of extra complications. These preventative measures should be taken by anyone who’s suffered a stress fracture, or believes that they are at risk for one.

  • Examine your training to see whether you made any drastic changes in volume or intensity in the past month or so. These may have caused your stress fracture, as bone becomes more vulnerable to injury in the month following an increase in stress. Consider changing to a training model which includes “down weeks” every 3-4 weeks or an “equilibrium” model which maintains new levels of mileage for longer before increasing again.
  • Check your stride frequency by counting how many times your right leg hits the ground in 30 seconds while running, then multiplying by four. Ideally, you’d be hitting 180 steps per minute or more. If you are significantly lower than this, do your best to increase your cadence by 5-10%. This will decrease the loads that have to be carried by your joints and bones.
  • Speak with your doctor to see whether you have any underlying health issues that could have contributed to your stress fracture. This is especially relevant for women, for whom amenorrhea is a major concern and also a major health risk even outside of running.
  • Once you have recovered, incorporate more lower-body strength training into your regimen. Muscle size and strength are linked to bone size and strength; additionally, there is some evidence that stronger muscles will absorb more shock, leaving the bone less vulnerable to high impact loading.
  • Re-examine lifestyle issues like a lack of sleep and improper diet which could impede your body’s ability to repair your bones.

Aggressive prevention measures

These are preventative measures that have some backing evidence, but it is either circumstantial or only indirectly linked to bone stress. Additionally, they may carry the risk of increasing your risk for other injuries. If you have suffered multiple stress fractures and have not had success preventing them with conservative measures, consider trying these.

  • Try using a custom orthotic if you have a history of tibial or metatarsal stress fractures. Some doctors have proposed that custom orthotics can alter how forces are transmitted up your leg, theoretically leading to lower peak stresses on the bone. Be aware that this theory currently has no experimental evidence to back it up!
  • Alternatively, if you have a history of tibial or fibular stress fractures, you may also consider running in thin, low-profile “minimalist” shoes. Wearing a thin shoe will force you to maintain a high stride frequency, and will also encourage a midfoot or forefoot strike, which should reduce impact loads on your leg. The tradeoff for this is increased stress on your foot and metatarsals; some doctors have warned that wearing minimalist shoes can even increase your risk for a metatarsal stress fracture.
  • Take a calcium and vitamin D supplement that provides 200% of your RDV of both. This carries a small risk of kidney stones if your dietary calcium intake is already high, however.
  • Change the surface you typically run on. Many runners anecdotally report that soft, natural surfaces like dirt trails and grass fields feel kinder on their bodies than hard, even surfaces like roads and sidewalks. However, there’s no experimental evidence that runners that train on any particular surface are more or less at risk for injury. In fact, there’s some suggestion that soft surfaces may increase the loading on your bones somewhat, as they demand your body maintain a higher overall leg stiffness. This may be counterbalanced by the fact that soft surfaces are usually more irregular, and hence stress your body slightly differently every step. You’ll have to experiment with running surfaces to see what type you feel is more beneficial for you.

Returning to training after a stress fracture

When it comes to returning to running, you will have to follow the directions of your doctor. Typically, stress fractures require 6-8 weeks away from running.

Once you begin to run again, you will likely start with very short sessions with alternating bouts of walking and jogging. One example might be six sets of 5min, each consisting of 1min of jogging and 4min of walking. This can gradually build up to 3-4min of jogging per 1min walking, and eventually progress into continuous runs.

You may experience some mild soreness in your initial runs because of the scar tissue and bone remodeling that’s happening at your injury site, but it should not resemble the pain you initially felt when you had a stress fracture.

As long as the pain is mild, goes away quickly after your run, and isn’t a dull lingering pain, you should be ok. Return to your doctor if you continue to have pain at the site of your injury.

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4. Murray, S. R.; Reeder, M. T.; Udermann, b. E.; Pettitt, R. W., High Risk Stress Fractures Pathogenesis Evaluation Treatment. Comprehensive Therapy 2009, 32 (1), 20-25.
5. Franklyn, M.; Oakes, B., Tibial stress injuries: aetiology, classification, biomechanics and the failure of bone. In An international perspective on topics in sports medicine and sports injury, Zaslav, K. R., Ed. Intech: 2012; pp 509-534.
6. Fredericson, M.; Bergman, A. G.; Hoffman, K. L.; Dillingham, M. S., Tibial stress reaction in runners: Correlation of Clinical Symptoms and Scintigraphy with a New Magnetic Resonance Imaging Grading System. American Journal of Sports Medicine 1995, 23 (4), 472-481.
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56 Responses on “The Ultimate Runner’s Guide to Stress Fractures: Causes, Risk Factors and How to Return to Training

  1. I think I may have astress fracutre I am a very avid martial artisit and my shin has been hurting when I walk, run or even if I am laying down. When I look at my shin it feels like I have 2 different bumps on the lower half of my leg and there is some tenderness when I touch it is this something to be concerned about?

    • Since you are having pain whilst laying down this is a good incpdication if a stress fractured. My best advice is to ice, elevate take voltaren or Panadol for pain relief and to dirty and reduce the swelling. It would be a good idea to see a physiotherapist or a sports doctor for further advice.
      Hope this helps

  2. Between April 2012 and April 2013 I sustained four stress fractures, one after the other in the same place in my fibula. Only in the past few weeks was I diagnosed with severe vitamin D deficiency. Though I had had more than 10 blood tests since my first fracture vitamin D was never tested for before. I was injected with it and now take supplements. The lack of the vitamin meant my healing time was slower than 8 weeks so I kept returning to running when it actually hasn’t healed even though the doctors thought it would after 8 weeks.
    Perhaps you should add to the article that if someone is having recurring stress fractures they should get their vitamin D checked. I had MRIs and bone density scans but it was all showed nothing. If I had been tested in April 2012 for vitamin D I would not have missed out on over 8 months of training!

  3. Hi John,
    I am a 27 year old female recently diagnosed with osteopenia in my lumber spine following a spate of stress fractures (N.B. I had anorexia nervosa as a teenager). Are there any further considerations as to how I should approach my running training given my known low bone density? Or is it just the above, perhaps with a bit more caution with any training increases? I assume my bones may take more time to adapt to increased training loads than healthy bones? Thank you.

  4. Thank you for this article. I believe I have a stress fracture but each time I have gone to the doc office they just say it’s possibly shin splints and never have given me the option of getting an MRI and tho this has been happening for years (literally) I didn’t know what to do. I knew the fact that a tap on my shins can bring me to tears meant that it had to be something else. At least now I can suggest to the docs what I think I have and possibly start running again (I haven’t ran consistently in a few years b/c of the pain). BTW I also have been tested for vit. D deficiency which I did have but have spent the last year trying to get that regulated.

  5. I developed a pretty severe stress fracture through my right lower tibia and fibula in June. It was bad enough it was delectable on an x ray and of on an MRI.
    I was non weight bearing for 4 weeks, then in a boot for another 4 weeks, then I could gradually return to exercise and running. I am an avid distance runner so this was music to my ears.
    I should add, a gradual return is tricky bc I’m a boot camp instructor and a personal trainer.

    Fast forward to October, 4 months of healing, and gradually introducing running, I am in pain in the same spot. A new MRI shows that I still have a fractures and edema in the bone.
    The dr only will say ” just rest” … I’m getting sick if this. Everything I have read, even here, tells me 6-8 weeks is how long healing takes, well here I am, 4 months later and little improvement.
    Shold I be aggressive even tho my dr isn’t, wear my boot for another and try a fresh start again? Why the long long healing process? My dr ordered labs, still waiting on those results.

  6. 7/8/13- Discovered pain at the top of foot- the pain just appeared. I didn’t hit it on anything or did anything abruptly that would cause pain. It started off sore then started to swell and became worse.

    7/29/13- Went to Podiatrist who performed an x-ray and diagnosed it as a stress fracture. Also, mentioned that bone was slightly bent. Suggested I wear medical boot.

    8/3/13- began wearing medical boot

    9/23/13- went for a follow up. Podiatrist was concerned that I was still in pain and wearing medical boot. Suggested an MRI

    9/26- Exam: MRI Left foot
    Clinical indications: 2nd METATARSAL FX
    Technique: Multiplanar multisequence imaging is performed of the left midfoot without the use of intravenous contrast.
    Findings: dorsal pain marker at the level of the proximal 2nd metatarsal shaft.
    Minimal STIR hyperintensity is present in the proximal 2nd metatarsal shaft with mild adjacent periosteal thickening and edema.
    No discrete fraction line.
    No dislocation
    Lisfranc joint and ligament are intact.
    Midfoot tendons are intact without tenosynovitis.
    Equivocal T1 hypointense nodule in the 2nd webspace measuring 0.4 x 0.3 x 0.4 cm (coronal T1 series image 9 and axial T1 series image 24). Cannot exclude tiny Morton’s Neuroma in the appropriate clinical scenario.
    Trace 2nd and 3rd intermetatarsal fluid is present.
    Trace fluid is present in all MTP joints.
    No significant arthopathy.
    No osseous erosion

    10/7- went for a follow up visit with podiatrist who stated that based on my MRI results, he still believed that I had a stress fracture and suggested RICE.

    10/12- went to a sports rehab chiropractor who stated that based on my x-ray and MRI results I did not have a stress fracture, but couldn’t explain or give advice on why I still had the inflammation. He recommended me to schedule appointment with an Orthopedic.

    Medications Podiatrist prescribed: Naproxen, Ibuprofen, Hydrocodone. The Podiatrist also recommended a BONE STIMULATOR, but everything I read about it relates to repairing broken bones, which nothing is broken. So I’m uncertain if it will help.

    I have constant pain in my foot that will not go away. It’s always heated, aching, sharp pains. I wake up and go to sleep with pain. At times, it hurts so bad I feel the pain going up my leg. I’ve been wearing a medical boot for 15 weeks now. PLEASE HELP!

    Based on the information that I’ve presented to you, what do you think is my actual diagnosis? What is it that I really have and how can it be fixed without surgery? The Podiatrist also recommended a BONE STIMULATOR, but everything I read about it relates to repairing broken bones and I don’t have broken bones. So I’m uncertain if it will help.

  7. Was diagnosed with a stress fracture about 8 weeks ago. Went for my first run and still have pain. I was told to not do impact exercises while healing like running, jumping etc. but what about non impact exercises like weight training. Squats etc? Are these ok?

  8. Thanks for the info! I have been away from training for 12 to 13 months. I resumed training 2 weeks ago. I have been working on my musclar strength which involves road works, using steps nd weight lifting. But immediately after my first match training on 2 days ago, i have been having this stress reaction all over my body. Pains on my two groin, my back and the lower back, my waste. Can’t i use any pain relife drugs?

  9. Hi there,

    I fractured my distal fibula in March 2014 while roller skating, had a supination external rotation injury. Wore cast for 6 weeks and was off the cast then for a month. Although I still used to have slight pain and lots of swelling. The pain gradually increased and then my doc told me I have a stress fracture. Now I am on crutches plus cam walker boot, in a non-weight bearing status for 4 weeks now. My doc has not given me a date for getting rid of crutches and the boot. However, has suggested 3 more weeks of non-weight bearing from today onwards. I am not an athlete or runner. I just work in a hospital and that requires at least 12 hours of brisk walk here and there and up and down on the floors. Can anyone tell me when I am going to be able to walk normally 🙁

  10. I would love to see some feedback from these questions, I haven’t seen one addressed. I too was recently diagnosed with a femoral stress reaction. What I would like to relay is my symptoms. I feel if my Dr had listened to my symptoms closer I could’ve had a quicker diagnosis. I went to PT for 2.5 weeks with the PT telling me I could run as long as it didn’t hurt. Well my pain threshold must be high because I could run with minimal pain, it was uncomfortable but as an avid runner we usually have to be in severe pain before we give up. So I contiued running while all along I had a stress reaction unseen by X-ray. Pain was more in the hip area & front of thigh. Dr diagnosed me with bursitis & tendinitis. Finally after I realized it wasn’t muscular because I was consistently limping with a burning sensation I had MRI that showed both right & left femurs had a stress reaction. My suggestion is go straight for MRI to rule out a fracture if you have any doubt about your diagnosis

    • same here. Doctor was convinced I had a pulled thigh muscle thru x-rays. Had a MRI after 5 months. I have a stress reaction in my right thigh. Thank God I did not truly fracture it as in the mean time I was exercising, weight bearing etc.

  11. So… Probably can’t diagnose this without an exam, but…

    I am 14 years ild and have recently been diagnosed with Sinding Larsen Johanasson Syndrome… Which is nothing severe, just hurts when I run occasionally and stuff. (It’s a knee growth plate problem) I also had a fracture of the heel (in the growth plate) due to Severs Disease (heel growth plate problem). During my last softball tourney (4 weeks ago, state championship) my mom said I was running very hard on my feet and I told her it was cuz of my knee. She agreed that that would make me run flat footed and heel striking. I just started back to school softball three days ago. The first day, I noticed at dull pain in my tibia. I thought it was shin splints from me running flat. But then the second day, the pain localized into about an inch in radius about four inches from my knee. It hurts running, walking up the stairs, down the stairs, walking after walking for awhile, bending my knee, and transferring weight to that leg when standing. It feels like a bruise, kind of, except more intense. When I get up from a chair sometimes I feel a little poke like sharp but not bad, but mostly that bruise feeling. Could this be a fracture? Or the start of one?

  12. After two plus years of constant pain with Sever’s disease, my oldest son (15) developed a navicular stress fracture (complete break) as well as 3 stress reactions in his feet. He spent four months sitting out until I got in contact with Dr. Amis, a foot specialist in Cincinnati. Dr. Amis had us purchase and use the “one stretch”. (You can buy this online.) My son used his one stretch for 5 weeks and now is back playing competitively. (We had visits with 6 other ortho guys and all wanted him to have surgery – bone graft and screws.) My 12 year old son has recently started complaining about his heel pain. I put him immediately on the one stretch and he is feeling better after 2 weeks. Both of my boys use the one stretch every night. There are some nights that they will jump out of bed and do these stretches because they forgot to do them earlier in the night. The cost of this one stretch is so minimal compared to all the heel cups, arches, surgery and doctor visits. We even take ours on vacation because it has helped them so much.

    (Please note – With our navicular stress fracture, my son was nonweightbearing for 6 weeks, used a bone stimulator, and took vitamin D and calcium supplements. It took 4 1/2 months to recover. He did not start running again until 4 months. It was a complete fracture.)

    Stacey, mother of 2 very active and athletic boys in Texas

  13. I just came out of my moon boot after having major surgery in the foot this morning I have a burning sensation on the side of my foot I’ve had heaps of stress fractures in the past could this be another one

  14. 3months post surgery from a complete femoral hip fracture that occurred during a half marathon. Still on crutches but interested to hear from anyone about their experiences on getting back to running.

  15. Hello, I have a level 1-2 stress fracture in my hip (compression in the neck) from running. Doctor said I can swim which was music to my ears, but also makes me nervous. I am in week one of healing. I am swimming and I feel the fracture as I swim. Not major pain. Just strange. Can a bone heal, especially a hip bone while swimming? Seems strange it can with my hip moving so much as I kick. I am on crutches and am supposed to have no wieght on foot. I have three children so many times have to toe tap or short walks without crutches. This worries me too, but there is no other way to care for my children. The pain it not increasing. Can I heal this way? Doc says if things go well, I won’t need surgery.

    • Hi Elleanor, sorry to hear about your fracture. If your doctor says you can swim, then you are probably okay. It is more the weight bearing and impact that can increase the healing time, and as swimming removes most of your body weight from the exercise, it is probably okay. Feeling it is unlikely to be doing any harm. I actually had a stress reaction myself once, and I remember when swimming I would feel it too, but it did not seem to do any more harm, and I healed as anticipated. However, if it is making you worry, stress will increase the time it takes to heal, so you would be best not to add that stress to your life. Hopefully we put your mind at ease though. If there is one stroke over the other that does not bother it, try to focus on that, or put the block between your legs to use your arms only for a good amount of time.

      As for walking without crutches, life does get in the way, and that is most important. As long as you are doing the best you can, and using those crutches as often as you possibly can (especially at home). I am afraid we cannot help any more with that. Hope this helps!

  16. I was just recently told by my doctor I have a stress fracture in my foot I’m a avid walker and runner. Are there any other low impact exercises can do while healing?

  17. Hello all,

    I am very new to running. I have never been a runner and gained a lot of weight over the last 4 years due to some medical issues. I decided to purchase a treadmill recently to get back into shape. I started in November at a slow pace. One mile turned into two and now I am running and jogging not walking for over 3.5 miles in 25 minutes, which may not be much but is a huge accomplishment for me as I am 35 and just started. Now for about 3 weeks I have had pretty severe pain post run in my lower left shin. I do have vitamin D deficiency and have had hyperparathyroidism for 5 years now. Which really messes with the calcium levels in bones and blood.
    I can feel a specific spot where the pain sends me through the roof, it’s hot to the touch and hurts even at rest now.
    I am concerned about a stress fracture but don’t want to freak myself out by reading too much.
    I am enjoying running so much and really do not want to stop. Any advice someone can give me would be much appreciated.

    • Hi Christina, you should be proud of yourself, you have come a long way. You will need to be careful with that shin, it may be a case of too much too soon. You would definitely benefit from reading this post, as it sounds like you could have a stress fracture if the pain is that bad. Your best bet is to check with your physician. If it is hurting at rest, unfortunately there is a good chance it is a fracture. The only way you can know for sure is by making an appointment with a doctor. Do not be disheartened. Running has a lot of ups and downs, and you will be able to get back to fitness. This article may be helpful to you as a new runner and it would also help you out to sign up to our newsletter to hopefully prevent some of these issues in the future. Hope this helps, best of luck!

  18. I am a 60 yr old Ret. Marine working in the USPS for 19 yrs, I work on the dock dispatching mail on to the trucks. My job is mostly pushing, pulling, & lifting all day long. I have been diagnose with a stress fracture on my r/shin bone. Besides rest & no weight bearing what else can I do to heal this up. I am wearing a walking boot but sometimes it feels like it hurts more when I take it off. The pain would raidait up to the knee & down to the ankle, but it would go away after I rest up & raise my leg on a pillow. I been down already for a month. Injury occur at work on 9 Feb. 2015, & I just found out 9 march 2015 that it is a stress fracture.

    • Hi Lou, sorry to hear that, but your best is to continue to rest it, and listen to the advice we have given in this post. Try to reduce the swelling, and add in the exercises to strengthen the muscles around it, to hopefully prevent it from happening again in the future. Hope this helps!

  19. I am a 23 year old and started running in November 2014. I have always been fast at sprinting but due shin splints I was never brave enough to run for longer than 0.7, 0.8 miles. Nevertheless, I started slowly and built up to running a mile in 7:06 and 5 km in 27 minutes. I have lost 10 kg (91 kg to 81 kg nowadays!) in the past 6 months , etc, everything seemed perfect and I was/am in route to having the shape I always wanted, however a month ago, by the point I had lost around 5 kg (86 kg, 170 cm) I started having pain in my right shin after running those 5 km, I stopped running and the pain is improving but is still there when I press the area and I feel a small bump. Should I see a doctor or wait a little bit longer… I have been doing elliptical but decided to stop it until I feel no pain anymore. Is it ok to lift weights?

  20. I have had a stress fracture to the 3rd metatarsal for eleven weeks now.I am a little apprehensive about returning to running too soon as I do not want the injury to return.The problem I have is that I have missed so much training but I have to get back into shape before my championship races which are at the beginning of August.I am a middle distance runner so how should I go about this?

  21. While doing physical exercises,I developed stress fracture in neck of femur (right leg).
    I never had stress fracture in my body so initially I ignored it thinking it as muscular pain and continued running,waliking ang jumping.When pain became unbearable and there was large scale limping then I consulted an orthopaedic surgeon. Stress fracture was detected in CT Scan report.
    Doctor just advised me rest for 4 weeks . He did not mentioned about any calcium/vitamin D diet .
    Will my femoral neck stress fracture recover just by bed rest ?
    Is it safe to swim in this condition or swimming will have negative impact on stress fracture of femur neck?

    • Hi Abhishek, it would be best for you to listen to your doctors advice by resting, but if you feel as though you need to do something, swimming with a float between your legs will provide you some workout, without the risk of further damaging your femoral stress fracture. In the meantime, it would be beneficial to you to work on strengthening the other areas of your body to prevent future injuries. You may enjoy our podcast where we talk about injuries in depth. Here is a link. Hope this helps, and good luck!

  22. I think the question we’re all getting at is that we have rested on our stress fractures long enough and they still persist. Is there anything we can do to run again other than “just rest for a while”. I haven’t resumed my running regiment in nearly a year, and am showing no signs of improvement. Running and sports are the only things I do to keep healthy and have gained weight since this ordeal started. What can I do to start running now?

    • Hi Steven, there really is not anything you can do to speed the healing of the bone itself, but you can do exercises that do not irritate it. Depending on where your fracture is of course. The best thing to do is to try out different exercises, and if they do not cause any pain during or after, you can continue. If it has been a year, your fracture should have healed….have you talked to your physician about this. We cannot make specific recommendations on your case, but most fractures do allow some form of cross training during recovery. You may enjoy this podcast about injuries and how to cross train

      Hope this helps!

  23. I have had Stress Fractures in my shins for over 12 months. I’m 15 and I’m completely sick of them. I am a huge sport person. Every day I am watching my mates play sport at school while I am sidelined. I can not play any of my weekend sports either and I have to sit out and watch them as well. I have seen about 5 different physio’s and none of them have done anything to help heal my shins, even though at the start they all said that stress fractures in the shins do not take longer than 12 weeks to heal! I have been religious with any exercises or stretches put forward to me by these physio’s and still haven’t seen much improvement. Please if there is anything anyone knows that could help me than PLEASE tell me I’m so sick of them I will do anything.

  24. Thanks very much Tina, I appreciate what you are saying and the videos that you have given me. However I do not try and do any sport at all. I’m which could slow down the recovery of my shins, yet all I hear is that it should take only between 6-8 weeks to heal. I have had MRI scans and bone scans confirming that they are only mild stress fractures.

    Is there possibly a reason as to why they are taking so long?
    Do you know any ways to help them heal or any other things that may be impacting the recovery of my shins? Or is there and stretches or exercises u would advise me to do?
    Thanks so much for your help

  25. Thanks! I shall look into the diet side of things.
    I still do not understand why it is taking me 12 months when all I hear is that it should take 6-8 months. I have never heard any reasons as to why it is taking this long when I’m doing everything I can to get back on my feet. I am also struggling to understand why there is no reasons why it is taking this long because I have also found others who are struggling to get back to running as well. I just feel like I am missing a trick or two and there is something I could do about it

    Thanks heaps! I’m so sorry I keep bugging you about it but I’m really over the whole situation.

  26. I have been running for about 5 years nearly every day for long distances and started doing more uphill / downhill running in the mountains about 2 years ago. About a year ago i started noticing red swelling in the front of my shin (about midway from knee to ankle) that has now resulted in a red line that cuts (so to speak) across the front of the shin ending just below the calf muscle in the front. It does not hurt when i run on it but it does hurt to the touch. From what i understand i might have a tibial stress fracture or simply anterior shin splints. I have been icing my leg after any kind of light jogging/walking and have started resting the leg completely. I used to be really good with my diet but let myself go about a couple years ago and started eating all the wrong foods. I noticed some of the foods i was eating/drinking were robbing my bone (5 foods you should avoid to avoid stress fractures, sodas, coffee especially). While my diet may have played a part in the shin splints or stress fracture i ultimately know it was the increased uphill / downhill running that caused the initial problem.

    Question is, besides what you have written and talked about in your guides, what specifically, for this kind of injury can i expect when i go to the doctor. Would this be the kind of thing that would put me in a boot? considering the fact that it only hurts to the touch in 2 areas (outer areas of the line on left and right). There are now 2 small bumps in those locations which may be new bone from healing?

    Should i even bother getting an MRI as it is quite expensive. would an xray suffice?

    I started taking calcium supplements, cut out all soda and lowering my sugar and sodium intake and drinking more milk and decidedly started cutting coffee out of my diet, which i was drinking a lot of in the past 2 years.

    Anyways, i just want this thing to heal as fast as anyone else and will do everything i can but wanted to hear something more specific for this anterior shin splints issue. Maybe stretching exercises, which specifically?

    i have very strong calves so i don’t believe it’s due to weak leg muscles. i am 6-1 and currently 200 pounds but my average weight is 180 when i run regularly and watch my diet. Maybe the extra weight didn’t help and changed my stride especially when running downhill (which i was doing very quickly). i see all the mistakes i made now so i know how i can prevent it from happening next time along with more rest and less stress in my life, all of which i have had for the past 3 years going to sleep late at nite because of a gf who couldn’t sleep till 3 in the morning, not to put blame anywhere, but not getting enough rest is def a reason why it hasn’t healed and why i was prone to this.

    something of note i should add for those reading these comments. stress in your life, eating well and getting enough sleep are def going to help things heal faster and vice versa.

    oh that reminds me. I was told that zinc and potassium will also help the bones heal faster. Any truth in that? or should calcium carbonite tablets be better and what should my max intake of each be.

    sorry for all the questions and input. Just figured i could put a real life story for others to relate to. Hope this helps and i hope someone can help answer my questions as well.

    Hope everyone recovers sooner than later


    • Hi Sean, thanks for reaching out. Sorry this is causing you so much frustration. That is one of the most difficult parts of a stress fracture. This is a good time to reflect on what could have caused it, and sounds like you are doing so. Our recommendations in this post are going to be your best bet for recovering, we also have another post coming out on Monday, which you should check into as it should answer some more of your questions. Your physician is really going to be the best person to ask the specific questions about your diagnosis to as they are the ones who can do the tests that we are unable to do from here. An x-ray does not always show a stress fracture, but it will be the stepping stone to an MRI, so they will likely request one if nothing shows up. Then it is up to you if you decide to go through with it. Sorry we cannot help more, if you want to join our running community as an athlete we would be able to offer you more advice, but for now, most of these questions will go to your physician. Best of luck!

  27. I think I may have a femur stress fracture. I am a runner but over this summer my mom passed away and I stopped running and ate poorly . Last week I wanted to get back on track so I ran full force. I went up a hill and felt a pain so I walked rest way. Now a week later my upper thigh still hurts . Hurts more. I can’t sleep on it and when I touch the bone (I’m thin set person) it’s like a bad toothache. I can walk but feel a need to limp. Ibuprofen does help some but it hurts bad. What is your opinion?

    • Hi Heidi, thanks for reaching out. Sorry to hear about your mother passing, that has to be very tough on you, and understandable that your running was no longer a priority. It is probably a muscle cramp from shocking your body back into running after not doing it for a while. It is unlikely to be a stress fracture if you have not been running all summer, it is likely to be your muscle or a tendon. Your best bet would be to go to a doctor to find out what it is. It would be impossible for us to diagnose you from here unfortunately. Once you speak with them, and you have a plan to return to running, check back with us, and we will be happy to help! Best of luck!

  28. I am not saying this to flatter you. You have the most informed articles about running that I’ve found anywhere on the internet especially when it comes to injuries. I have read tons of running-related material but they all seem to just repeat the same songs i.e. rest, stretching, icing etc. not that these are not important but they don’t discuss the underlying causes which leaves runners not understanding the cause of their problems. Great work!

    • Thank you Aron, we really appreciate this! We hope to continue to grow to become the premier place for runners to get real advice. If you could share with friends, we would appreciate it a lot!

  29. I’ve had several routine DXA scans, so I know that I have low bone density. That means that I am susceptible to fractures, although I’ve never actually had one. I also have a 2 mm non-obstructive kidney stone, so I don’t take any calcium supplements. I do take strontium citrate, magnesium citrate, vitamin-D, vitamin-K and boron. I’m 63. So far, so good.

  30. Also worth considering–thyroid disorders can affect bone health, especially if you have Hashimoto’s. Also, women with any history of osteoporosis in the family need to do whatever they can to help develop and (in their 30s) maintain their bone density and strength. Got some underlying mechanical problems that should be addressed more aggressively perhaps? Do it.

    Just a few little things I got to learn about when I got diagnosed with my very own pelvic stress fracture a little over a month ago. (I’m 37 and have both Hashimoto’s and osteoporosis runs in the family. And, I’ve got some scoliosis, I overpronate, and have that Morton’s toe on both feet.) Bones are within normal range according to the scan, vitamin D, hormones, etc., look good, but both the orthopedist and the rheumatologist said to think of it as a warning of things to come if I don’t stay on top of all this and get my butt to the endocrinologist when “the change” sets in.
    There are other thus far asymptomatic (knock wood) indications that my sundry biomechanical issues need more attention than they’ve gotten (minor labral tears in both hips, some iliopsoas bursitis in the opposite hip) that will have me living at the PT’s office for a time, but fortunately, I seem to be healing well–off crutches, walking an hour a day without pain on top of everyday activities, and can start slowwwly adding elliptical training next week.

    From the “woman’s perspective”, then, all I can say is, as someone who has been mindful of maintaining a healthy weight, making certain to build muscle to support the bones, etc. (possibly being mildly obsessive due to my family history), don’t assume you’re fine. If you even “think” your pain is more than a simple strain/sprain or bruise, get to an orthopedist. Better to spend 500 bucks on an MRI to be certain you’re all right than to have this creep up on you and finally get so painful that you wind up in the ER, be given crutches and a scrip for Norco, and THEN have to go to your orthopedist to get an MRI. I added easily a month (and a few thousand bucks) to all of this that could have been avoided if I had trusted my gut and gone to the doctor in the first place.

    • Thanks for sharing Danielle, we appreciate your feedback, and this may provide some comfort to other runners who have thyroid disorders in the future. Best of luck with your training!

  31. I am concerned that I may have a stress fracture…
    I was weight training and running about 3-6miles a day.
    Long story short, I began to incorporate rucking, or running with weight in preparation for my ship out day and I believe a developed a stress fracture.
    It was mild pain, but nagging…. Different than shin splints. Localized, nagging, full…. I rested a week or so and attempted to just ruck march with the same weight and I still felt the sucker. So then i rested another week and did another mild ruck march, felt nothing
    It’s been 2 weeks or 3 weeks now with really no lower impact… I ran yesterday to see how it was, about a mile, and it felt good!
    I felt the spot… But it didn’t hurt?
    I was going to give it another week or so and begin to incorporate light weight lifting and begin mild/easy runs.

    It’s sensitive to the touch, like when you have a paper cut and you touch near the cut… But it doesn’t necessarily hurt, it’s just sensitive… Mildly.
    Doesn’t really hurt
    Idk what to think of it…

  32. I rarely post but thought my story may have relevance here given I’ve seen a number of folks who like me have had a stress fracture in the tibia. Mine came after training for a half marathon earlier this year and the “no running” rule was very hard to stomach as long runs were my “mental therapy sessions” when I got a chance to decompress. Doc game me all clear a number of weeks ago whereupon I ramped up to running 2-4 miles at a clip. This was at odds with where he said to start: 1mi 3x a week and “build from there”. No surprise I am now back on the bench – same pain, same spot and same solution – weeks of no running. Should have taken it slower and I do hope that’s the end of the story (some scary posts here about year long hiatus) but in my case it’s pretty clear “too much too soon” is likely the culprit. I wanted to share since I never see anywhere what is the “right amount” to start with after a stress fracture so hopefully this gives some perspective on how small those first runs ought to be (and should have been)

  33. I have a stress fracture of the 5th metatarsal. I’m on week five of being in an air boot. it felt pretty good the first three weeks now it really hurts. Not the same pain as when it happened but occasional sharp pains and aches all night. My ankle is also swollen a bit now. Is this normal part of healing or is it getting worse? I’m supposed to be healed in another week but it feels impossible at this point. Any experiences with this would be helpful! Thanks!

  34. I just started running again after a two week break. I think i may have done “too much too soon.” My right shin hurts about an inch under my knee. It is doesnt seem like anything major but when i went for a run today i noticed that the area under ky knew was hurting really bad. It slowly started to fade as i ran but after i finished my run i took a 5 min break. I took my shoes off to run about a half mile or less on turf and my shin shot with pain. I kept going and it didnt hurt as much anymore but the pain was still there. My shin didnt hurt anymore for about half an hour after i was done but it still hurts now tho it feels only like a small bruise when i touch it. What is it thats making my leg hurt? Is it a shin splint or a maybe even a stress fracture? I would like to know if anyone can help as i am training for cross country right now and begins in a month

  35. Hi! I used to have shin splints while running cross country, mainly due to my poor form from overstriding and running on my toes. I also failed to correct my form for four months, worsening my shins as a result. Unfortunately, I was in too much pain to run indoor track. I’ve been resting my shins for five months, but whenever I return to running after feeling no shin pain, I feel it once more. Eventually, I developed a stress fracture along my left tibia bone, including a lump, and knee pain from tennis.

    How long do you think I should wait to cycle or use an elliptical as an alternative for running? I read that the bone takes about a month to remodel, so should I wait that long as well? Additionally, I currently do not have access to an indoor or outdoor pool, but I would love to know how I can work on my cardio without aggravating my stress fracture and knee pain.

  36. Hi sir I dignosied stress fracture before 3 years back o mid of my right tibia I am a hurder and after 3 years last 20 back I started training and getting pain again surround the point and I go for a m r I but not is there so what to can please u tell

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