How do you avoid injuries like stress fractures?

Runners can be susceptible to injuries, therefore, I suppose you could call it the nature of the beast.  Some of the most common injuries (in order of frequency) are; runner’s knee, achilles tendonitis, hamstring issues, plantar fasciitis, shin splints, iliotibial band syndrome (ITBS) and stress fractures. The most common stress fractures for runners (in order) above all are; the tibia (main lower leg weight-bearing bone), the metatarsal, followed by the fibula, and femur.

stress -fracture
[Stress fracture – photo by Runiversity of life]
Stress fractures, generally tend to be a result of doing too much too soon, or from overtraining, and caused by overuse.  They can happen anytime, in an instant with or without warning.  Common reasons are a sudden jump up in mileage, increase in duration, intensity, or frequency too quickly. It happens when muscles fatigue and unable to absorb the added shock of running. When this is the case, they transfer the stress overload to the bone and a stress fracture occurs.

In fact, running is actually a good exercise to make your bones denser and stronger.  I bet you’re thinking if that’s the case, doesn’t running more make your bones stronger?  Unlike muscles, bones take a much longer time to adapt and strengthen.  It is essential to understand this to reduce the risk of such injuries. After being subject to the forces and impact of running, bone deposits occur in the place where the bone needs to be stronger. The process known as bone remodelling and takes time. Over time, your bones will become stronger, accustomed to the demands and loading force of running. However, you must allow them enough time to do so.

[Stress fracture x-ray – photo by Runiversity of life]
It is necessary to always gradually build up your running training base. Do not have a sudden jump up in mileage, duration, intensity, or frequency. Consistency is also key. If you’ve had a pause or time off from running, don’t expect to pick up where you left off. Furthermore, don’t suddenly throw yourself into high mileage running.  It’s safer to be slightly cautious and reintroduce yourself back to running by building up your millage again.

You’re probably thinking or asking yourself, how slowly or quickly?  That depends on you, no two of us are the same. You have to listen to your body and do what’s right for you.  A lot of this comes down to experience. However, like with many things, a lower risk approach generally results in a longer-term gain.  Overall, the longer you’ve been running, the lower the risk of suffering a stress fracture. But, remember, don’t take it for granted.

Aside from the above, there can be other contributing factors that can lead to a stress fracture.  It’s important to consider all elements to reduce the risk of an injury.  Until it happens to you, you may overlook or not even consider some aspects.

Other aspects to consider:

  • Maintain healthy bones.  To keep your bones strong and healthy you need Calcium, but also keep an eye on your vitamin D levels.  Without vitamin D your body will not absorb the much-needed calcium.
  • Periodically, check the condition of your shoe cushioning. Check to see if it has lost its springiness and/or worn out.
  • Wear the right shoes for the terrain you’re running on.
  • Listen to your body. Don’t run through aches or pains and necessarily think or say, don’t worry everything will be okay.
  • Don’t run too soon after a hard or long race. Give yourself a chance to fully recover especially your muscles as these absorb the shock from running.
  • Prepare your muscles for a run by fully warming up.  Don’t be tempted to head off without properly warming-up.
  • Increase your mileage gradually by 10% each week.
  • Reduce your mileage by 10-20% for one week, approximately every 3-4 weeks to give your bones a rest.

[Stress fracture cast boot – photo by Runiversity of life]
In my case, I suffered a stress fracture of the fibula.  The fibula’s main role is to provide stability, supporting the leg, ankle and leg muscles. It only accounts for approximately 15% of the body’s weight bearing load.  Whereas, the tibia its larger brother or sister, connects the ankle to the knee. And its role is to bear the majority of the weight.

I put my fracture down to a several elements. Perhaps not giving my muscles enough time to fully recover. Worn shoe cushioning was another one, combined with, running down steep, uneven, off-road terrain laden with stones and tree roots.

So, the moral of the story is,…. to continue running for a long period of time injury free, so we can run the miles that give us our smiles! :-) We need to; take care, listen to our bodies, take the necessary precautions, be consistent and allow sufficient time for rest and recovery.


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Stress fractures and how they can be avoided
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