Injuries are inconvenient and some take a while to heal and that throws a wrench in your training schedule. Stress fractures take six to eight weeks to heal, and they’re more common than you think. One in five women who run will develop a stress fracture at some point in their life. In fact, women are at a two-fold greater risk of developing a stress fracture relative to men.
The reason women are at higher risk is because of several factors, including the fact that women have lower bone density relative to men and they have a different hormonal makeup. These two factors naturally make women at greater risk of developing a painful stress fracture that keeps them from training for a while. Another factor is nutrition. Women are more likely to restrict calories and not get adequate nutrition. Anatomy plays a role too. Women also have wider pelvic bones, and this increases the load on the lower body.
What Are Stress Fractures?
A stress fracture is a small crack in a bone caused by placing excessive stress on a bone without giving the bone enough time to recover before stressing it again. Your body constantly breaks down old bone and replaces it with new, healthier bone through a process called bone turnover. If you stress a bone too much through excessive exercise, the rebuilding process can’t keep up with bone breakdown and small breaks can develop in the bone. Most stress fractures occur in the lower leg or foot.
The group most susceptible to stress fractures are long-distance runners, but athletes who do any kind of high-impact exercise can develop them too. Now, let’s look at some ways to lower the risk of developing a stress fracture if you run or do high-impact exercise.
Check Your Feet
If you do a lot of running or high-impact exercise, a trip to the podiatrist could save you some headaches. Certain foot anatomical problems place you at a higher risk of stress fractures. Flat feet or an unusually high arch are both anatomical factors that place you at greater risk of stress fractures since they place added stress on the bones in your lower legs and feet. A podiatrist can fit you with proper arch support or a shoe that will take some of the stress off your legs and feet. Make sure you’re wearing supportive footwear and replace your shoes every six months. As shoes wear, they don’t absorb force as well, and it transfers to your feet and legs.
Eat a Nutrient-Dense Diet and Get Sufficient Calories
Good nutrition maximizes bone stress and bone mass so you’re more resistant to stress fractures. Make sure your diet contains enough calcium and vitamin D to support bone building. Don’t skimp on calories too much if you’re trying to lose weight. Your body needs more calories if you’re running or doing intense exercise. Women who over-exercise and restrict calories, especially those who lose so much weight that they stop their periods, are at a significantly higher risk of developing stress fractures and long-term problems, like infertility and osteoporosis.
Don’t Advance Your Training Too Quickly
Don’t be so ambitious that you get yourself in trouble. You might want to get into shape quickly but doing so comes with downsides. Sudden changes to your exercise routine predispose to stress fractures. The classic example is someone who aggressively increases the time or distance they run over a short period. Doing this doesn’t give your bones enough time to recover between sessions. Practice moderation. If you run, don’t increase your distance by more than 10% each week. If you do any type of high-impact exercise, don’t increase the intensity, length or frequency of your training sessions too fast. Take it slow and let your body slowly adapt to the stress you’re placing on it.
Cross-Train
Just as you shouldn’t increase the frequency, duration, or volume of your training too fast, don’t overdo the high-impact exercise. Also, don’t let your training get too redundant, so you’re doing the same type of training every time you work out. Runners mostly run, and that’s why they have the highest incidence of stress fractures. Vary the type of exercises you do by cross-training. Using this approach can also maximize your physical fitness because you’re challenging your body in different ways.
Watch the surfaces you exercise on too. Softer surfaces with more give absorb the stress of running and jumping better. The worst surfaces are concrete, asphalt, and cement floors. If you exercise on these surfaces, wear a pair of shoes with good support.
Kick Bad Habits
One study found that smoking or drinking more than 10 alcoholic drinks per week was linked with a higher risk of stress fractures in female military recruits. The nicotine in cigarettes also delays the time it takes for bone fractures to heal. In addition, smoking increases the risk of osteoporosis, so it’s a habit to give up if you’re focused on keeping your bones healthy and injury-free.
The Bottom Line
Preventing stress fractures can save you lost training time and lots of discomfort. If you ignore a stress fracture, it can heal up poorly or progress to a full fracture and chronic pain and limitation of function. Do what you can to prevent them. Now you know some steps you should take to lower your risk of a bone fracture. Keep them in mind when you work out.
References:
- Military Medicine, 176, 4:420, 2011.
- Physiological Factors of Female Runners With and Without Stress Fracture Histories: A Pilot Study. Sports Health: A Multidisciplinary Approach, 2020; 12 (4): 334 DOI: 10.1177/1941738120919331.
- Curr Rev Musculoskelet Med. 2013 Jun; 6(2): 173–181.Published online 2013 Mar 28. doi: 10.1007/s12178-013-9167-x.
- Arch Pediatr Adolesc Med. 2006 Feb;160(2):137-42. doi: 10.1001/archpedi.160.2.137.
- Osteoporos Int. 2001;12(1):35-42. doi: 10.1007/s001980170155.
- Int J Sports Med. 2012 Nov;33(11):940-6. doi: 10.1055/s-0032-1311583. Epub 2012 Jul 20.
- PM R. 2010 Oct;2(10):945-9. doi: 10.1016/j.pmrj.2010.05.006.
- Barrington Orthopedic Specialists. “The Effects of Smoking on Bone Healing”
- Pohl, M. B.; Hamill, J.; Davis, I. S., Biomechanical and Anatomic Factors Associated with a history of plantar fasciitis in female runners. Clinical Journal of Sports Medicine 2009, 19, 372-376.
