In October of my junior year of high school, I was at the top of my cross-country game. I was running five to six days a week, knocking more and more time off my mile split, and gearing up for a big race that would finally prove I had what it took to hit varsity status. So when opportunities arose to run a few extra miles and push myself harder, I took them without a second thought.
Then came the day of the race. I�d been noticing some pain and throbbing in my shins for a few days, but assumed I just had�shin splints�something I�d dealt with many times in the past. So before my event, I popped a couple of Ibuprofen�and visualized myself totally dominating the race. Spoiler: That�s not what happened.
When the race started, I took off�and headed to the front of the pack. I kept up my pace as I wove through the trail, adrenaline surging through my body. That is, until about mile 1, when my runner�s high was interrupted by an excruciating pain in my left shin.
I tried to ignore it, unwilling to give up just yet. But the pain only got worse, and soon I was limping. Girls passed me left and right, but I kept hobbling my way across the grassy path until I reached the finish line and collapsed.
Fast forward through two doctor’s visits, an X-ray, and a bone scan. The verdict was that I had seven small stress fractures in my left shin.
My case is certainly nothing out of the ordinary. In fact, ABPM-certified podiatrist Melissa Lockwood, DPM, says nearly one in five runners she sees is for a stress fracture. But why do young, healthy people end up with this injury? Here, she explains what causes stress fractures, and shares tips for preventing and treating them.
What is a stress fracture?
Stress fractures are characterized as “overuse injuries.” They occur when a bone experiences repeated, unusual force, says Dr. Lockwood, who’s based in Bloomington, Illinois:��For example, when runners increase their distance and speed�basically anything that changes the amount of pressure they�re putting on the body.�
Dr. Lockwood typically sees these injuries happen in the metatarsals, which are the small bones right behind your toes, and the�lower leg (as in my case). According to the American Academy of Orthopedic Surgeons, more than 50% occur in the lower leg.
While stress fractures are associated with running, �they can also be caused by regular force, if the bones are weakened by other problems, such as osteoporosis or another systematic problem like an eating disorder,� adds Dr. Lockwood. Research suggests�women are more susceptible, possibly�because they’re more prone to the above-mentioned conditions.
But really, stress fractures can�affect anyone. Dr. Lockwood got one in her foot after walking around Disney World all day. (See her X-rays below.)
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What are the symptoms of a stress fracture?
�The biggest thing is to watch for increased pain with increased activity,� says Dr. Lockwood. �Meaning it doesn’t�hurt so badly first thing in the morning, but then the more you�re on it throughout the day, or after you go for a run, the pain gets worse, even excruciating.�
Unlike a strain or pull, the ache associated with stress fractures doesn’t�tend to resolve itself after a couple of days, or go away with rest. So if you still feel a throbbing pain after sitting down, that�s also pretty good indicator.
But diagnosing a stress fracture can get a bit tricky: �Typically you can�t see a stress fracture on an X-ray until two weeks after the initial injury.� For that reason doctors often order other tests, like an MRI or bone scan, to identify the injury.
If a patient describes stress fracture symptoms, Dr. Lockwood always treats it as one, she says, unless she figures out an alternative explanation.
RELATED: 4 Ways to Ward Off Shin Splints
How can you prevent a stress fracture?
Once you�ve had one stress fracture, it puts you at greater risk for another, says Dr. Lockwood. [Insert un-amused emoji here]�But luckily, there are a number of smart strategies you can use to keep your bones healthy.
For starters, invest in solid sneakers. If you�re a runner, head to a running store and find a pair that works optimally for your stride and foot type.
It�s also crucial to retire your shoes after a certain amount of use, Dr. Lockwood warns. Either toss them based on time (no more than 6 months) or miles (no more than 300).
And whether you�re an athlete or not, if you�ve suffered a stress fracture in the past, you may want to consider getting custom orthotics to make sure you�re moving with the right biomechanics, says Dr. Lockwood.
At the time of my own injury, I was stupidly wearing a pair of sneakers that were past their expiration date. So please, don�t make the same mistake, and actually pay attention to your shoes!
Don�t get discouraged
After my injury, I felt really down. I worried that my body wasn�t cut out�for running, and that this was a sign I needed to throw in the towel.
But�as Dr. Lockwood puts it,��having stress fractures does not mean your running career is over.� It may mean you need to change�how you�re training, whether that�s adjusting the distance or frequency of your runs, or running on softer surfaces (think grass vs. concrete).
For me, getting back into running�entailed everything Dr. Lockwood mentioned:�scaling back my runs, paying better attention to my form, and regularly swapping out my shoes. Today running is still a huge part of my lifestyle. I even run-commute to work sometimes. But I’m much better about�listening to my�body now,�and taking notice when it needs a break.
If you sense that something is off with your body, �don�t sit and wait to get it checked,� says Dr. Lockwood. �Or rather, don�t run and wait.�