Dr. Jordan Metzl provides advice on how to treat or prevent stress fractures.
Pain that worsens over time, limits the sufferer’s ability to load the bone, and is generally concentrated in one specific area.
What’s Going On In There?
This is the classic overuse running injury. Unlike a bone break, which is the result of a trauma such as a twist or fall, a stress fracture develops over time due to repetitive loading. The demand on the bone simply exceeds the bone’s ability to withstand force.
There are three risk factors for a lower-leg stress fracture:
Activity level. Ramping up your athletic activity too fast can cause a stress fracture, such as adding too much mileage too soon during marathon training.
Mechanics. Excessive pronation—the foot rolling inward as it strikes—while running has been correlated with a greater risk of stress fracture. Also, weak core and hip muscles can promote poor running mechanics.
Bone density. This is common sense: The more brittle your bones, the easier it is to crack them. Low bone density (osteopenia) or very low bone density (osteoporosis) has several possible causes: genetics, as it tends to run in families; inadequate dietary calcium intake (1,300 milligrams a day is the recommended minimum); and, for women, a history of menstrual disorders, e.g., not getting a period for more than 6 months in a row, which can cause a low level of circulating estrogen.
We all acquire 90 percent of our bone density for life by age 18, and women reach their maximum bone density by age 32. After that, it’s about maintenance.