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Stress Fractures

Treating and Preventing Stress Fractures

In certain situations, athletes thrive on stress. The adrenaline rush at the starting block can certainly enhance performance. On the other hand, physical stress on bones can lead to stress fractures – and benched players.

Stress fractures are an overuse injury that can affect any level athlete. When a bone doesn’t have an opportunity to recover from stress applied to it, a fracture occurs. The most common fracture locations are between the foot and lower leg but fractures can occur in any overstressed bone.


There two categories of stress fractures:

  1. normal bone subject to unusual amounts of stress
  2. unhealthy bone incapable of handling normal stress loads

In normal bone, stress fractures are often caused by significant increases in training without adequate rest time, and can strike the professional or novice athlete. They can also be caused by improper footwear for the activity, biomechanical problems with running gait or foot and knee alignment.

Osteoporosis, poor nutrition or hormonal disorders can weaken bones and make them susceptible to stress fractures in normal training situations.

Telltale Symptoms

Stress fractures typically present as pain related to the activity causing the bone stress. The pain is usually highly localized, unlike general muscle aches. This injury does not normally interfere with daily activity or disrupt sleep, though pain can progress and occur while walking or at all times.

Rest Rx

It’s important to listen to the body and avoid activities that cause pain. "Relative rest" is the best treatment for stress fractures. This means backing off of the activity that causes stress and pain, but athletes often can engage in other activities, such as swimming, yoga and elliptical trainer workouts to stay in shape while healing.

In the past, anti-inflammatory medications were often prescribed, but new evidence suggests these drugs may actually slow healing of stress fractures.

If the stress fracture is more severe – they can worsen if left untreated – and walking is painful, a brace or crutches may be needed. It’s best to catch stress fractures early and adjust activity.

It’s important that an athlete is pain-free before resuming the activity responsible for the fracture. Any pain means the bone is still being stressed.


Stress fractures are highly preventable injuries. For instance, athletes can avoid injury by purchasing footwear designed for a specific activity, and replacing frequently. Athletic footwear tends to lose its cushioning properties after several months.

Gait analysis by a professional trainer or physician, such as Optimal Runners Performance Program offered by Cleveland Clinic Sports Health, may pick up imbalances or help in designing specific training programs for avid runners. Exercises or orthotics may be prescribed to change the body’s motion and points of stress. A strengthening program also may help improve alignment and motion.

Training regimens also may be evaluated and revised to incorporate more rest and gradual increase of training.

Good nutrition helps build strong bones resistant to fracture. Adequate calcium is imperative for anyone who exercises. It’s also important to make sure that women have good hormonal balance.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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