Running is a very “available” mode of exercise. It is a sport with only a few variables . . . shoes, training surface/location, strength of will and time. With the number of runners out there on the road and trail whether they are adequately trained to be there or not, associated injury is very likely to occur at some point. These include overuse syndromes like patellar and Achilles tendonitis, plantar fasciitis, and IT Band Syndrome. One particular overuse injury, that is often misdiagnosed, is the stress fracture.

A stress fracture is an overuse injury caused when the body is unable to repair bone in response to a repetitive strain. Stress fractures cannot be pinpointed to a single event and may result from either repetitive overloading to the bone or from muscle forces stressing the bone beyond its tolerance point. Common areas where stress fractures occur are the second and third metatarsals of the foot, the heel (calcaneus), the outer bone of the lower leg (fibula), and the navicular, a bone on the top of the midfoot.

Runners who develop a stress fracture frequently describe their symptoms as beginning not long after they have increased their workout intensity or weekly mileage. Initially, the individual will experience only an onset of mild pain near the end of a run. This is a key symptom that endurance athletes need to recognize but often ignore. Because the symptoms are initially not experienced at rest, the athlete attempts to “work through the pain”. Continuing to run will actually make the stress fracture worse. As the symptoms worsen, the runner will experience pain throughout the run and at rest. Other symptoms that may be present are swelling on the top of the foot or the outside of the ankle, tenderness to touch at the site of the fracture, and possible bruising. If these symptoms are present it is important that you seek medical attention from your primary care physician.

Many factors can contribute to the development of a stress fracture. Common to runners are: Rapid increase in mileage or intensity of run, high weekly mileage, old or poor quality foot wear, hard or uneven training surfaces, poor general conditioning prior to initiating training program & biomechanical malalignment of the lower extremities.

So what can you do to prevent a stress fracture? Here are some ideas that can help you as you begin your training regimen.

• Increase Mileage Gradually-no more than 10 to 20 percent a week.
• Increase Intensity Gradually-intense workouts (hills, intervals, tempo runs-should make up no more than 20% of your training). Never add more than one of these elements to your training at a time.
• Increase Mileage Before Speed- by building a base of solid mileage at a slower, steady speed, you prepare your body to handle the stresses of faster workouts to come.
• Wear the Right Running Shoes- The right shoe for your foot type will minimize your biomechanical abnormalities whereas the wrong shoe can exacerbate such problems