4 Stress Fracture Factors that Increase Your Risk


stress fracture factors

Stress Fractures are one of the most common injuries among runners. Why is that so and what can be done about it? In this article, we explore the reasons why runners are prone to stress fractures, the 4 factors that increase your risk of stress fractures and how to combat them to ensure a injury free running journey.

What is a stress fracture?

Stress fractures are hairline cracks in bones – often occurring on the weight bearing bones on the lower limb such as the shin bone. Stress fractures are common on the shin bone as it absorbs most of the impact when you run or walk. However, stress fractures could also occur on the bones in your foot from the impact when you push off while running or walking.

Stress fractures are typically an overuse injury usually caused by high impact repetitive motions such as jumping or running long distance. 

Runners have the highest risk of stress fractures, but stress fractures are not exclusive to runners. It is an overuse injury that could happen to anyone, even non-active individuals who start on a new training programme without giving their body time to condition and adapt to the increase in physical activity levels.

What factors increase your risk of stress fractures?

Even though runners are prone to stress fractures, there are certain factors that can increase your risk of getting one. Here, we dive into the 4 factors that can increase your risk.

Weakened bones

If you have conditions like osteoporosis where your bones are already weak and fragile, your risk of stress fractures increases. This is due to the lower bone density which causes your bones to be more prone to cracks.

Increased activity level

If there is a sudden increase in intensity or frequency of physical activity, your risk of stress fractures increases as well.

Improper Running Technique

Inefficient running techniques could result in your bones experiencing greater impact than normal as it alters the way your foot is meant to absorb shock. This could also increase your risk of stress fractures as it affects the distribution of weight and might require a bone to handle more weight and impact than it was meant to. For instance, favouring your dominant foot when it comes to running could increase the risk of stress fractures occurring on the same foot.

Worn out shoes

The most important equipment needed for most runners is a pair of good running shoes. In order to prevent stress fractures, good pair of running shoes should have thick cushy soles and shock absorbing capabilities to minimise the impact on your feet and shin. Most runners are aware of this and often spend top dollar purchasing their running shoes – but they continue to wear the same pair of shoes for years without ever changing them. Like car tyres that need to be replaced, running shoes wear out and lose their efficiency.

How to reduce your risk of stress fractures

Cross train

Mix up your exercise routine – don’t simply focus on high impact activities alone. Include low impact activities such as swimming to hit your cardio goals and get your heart rate up – without placing any stress on your weight bearing bones. This decreases the total amount of repetitive impact and stress on your bones, helping you to reduce your risk of stress fractures in the long run.

Change your running shoes

It can be tough to bid goodbye to a pair of shoes that has seen you through multiple races – so when should one change their shoes? A good guideline would be to change your running shoes every 500 to 700km to ensure that they still efficiently serve their purpose. Change your shoes if you often experience new aches and pains that you never used to have after a run. If the sole of your shoes are worn out, get a new pair.

Stress Fracture Warning Signs


Pain is often an indicator that something is not quite right with your body. If you experience pain that occurs and intensifies during weight loading and gets better with off-loading the weight, it could be a warning sign.

Swelling and Tenderness

Swelling might occur at the injured area causing the skin to feel tight and puffy to touch. When touched, the area might also feel painful. These symptoms usually have the tendency to worsen with time if left untreated instead of feeling better in the case of a joint sprain or muscle strain.

What should i do if i have a Stress Fracture


It is important to stop the activity that is causing you pain and rest. Adopt the RICE method for 1 to 6 weeks and rest, ice, compress and elevate the injured area. Avoid all high impact activities until you feel better to prevent further damage.

Seek medical advice

If you have had a stress fracture before or if the injury does not get better with RICE, do seek medical advice from a qualified physiotherapist. A physiotherapist is able to analyse your movement biomechanics and make changes to the way you move so that stress fractures can be avoided in future. In some severe cases, you may require a protective cast or the use of crutches to prevent further damage. Surgery may be required for full recovery. Thus it is essential to seek advice from a physiotherapist who is able to assess your condition and develop a treatment plan suitable for you. 


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