Stress Fractures: From Trail to Icy Sidewalk

by Megan Peach, DPT, OCS, CSCS

Snow flurries don’t stop most runners from running here in the Gallatin Valley and while running may continue well into cooler temperatures, don’t let a running injury inhibit your ski season! Especially a stress fracture. Up to 10% of runners may suffer from a stress fracture at some point during their running career, and the majority of these injuries are due to training error. Many runners don’t consider a change in terrain a change in training, but a change from trail to icy sidewalk can make a big difference in impact. A stress fracture begins with repetitive stress to the bone such that eventually causes microdamage.

Normally, the bone will repair the microdamage and new bone will form that is stronger and better able to take on the stress. Occasionally, the microdamage occurs faster than the bone is able to repair itself and a stress fracture occurs. This can happen after a change in running surface from concrete to dirt or vice-versa, or a change in training regime such as increased mileage or speed. In fact, 86% of athletes can identify some change in training prior to the onset of pain from a stress fracture. Faulty running mechanics may also play a role creating increased impact between the leg and the ground and therefore requiring increased shock absorption by the bones and increasing the risk of a stress reaction or fracture.

Pain from a stress fracture typically begins as a mild diffuse ache with a specific activity such as running. Although the symptoms usually continue as the activity is continued, they cease when the activity is stopped and can easily be ignored. Continued training will result in increased symptoms and pain may actually inhibit running activity as time goes on. If you think you may have a stress fracture, it’s important to be evaluated by a medical professional as management of the injury will be dependent on the site and severity of the injury. Initial recommendations will likely involve a period of time of reduce activity, especially refraining from running or impact activity and recovery time is very dependent on the severity of the stress fracture as well as the site of the injury. A stress fracture is a serious injury that should be addressed as it can progress to a complete fracture or very serious complications if not treated properly.

Megan Peach, DPT, OCS, CSCS of Excel Physical Therapy in Bozeman and Manhattan, Montana is an Orthopedic Clinical Specialist and Certified Strength and Conditioning Specialist.