Stress Fracture Explained

In brief: A stress fracture is a small crack in a bone caused by repetitive impact rather than a single trauma. In runners it most often affects the bones of the foot and the shin. It typically causes a localised, pinpoint pain that worsens with activity and may persist at rest. Unlike many soft-tissue niggles, a stress fracture needs proper rest from impact and medical assessment, as continuing to run on it risks a more serious break.

What is a stress fracture?

A stress fracture is a hairline crack in a bone that develops when repeated load is applied faster than the bone can repair and strengthen itself. It is an overuse injury, distinct from a sudden break caused by a fall or impact. In runners the most commonly affected sites are the metatarsals in the foot and the tibia, or shin bone.

What causes them in runners?

The main driver is a rapid increase in training load without enough recovery, so the bone never catches up with the repair it needs. Risk is higher with low bone density, inadequate energy or nutrition intake including low calcium and vitamin D, hard surfaces and worn footwear. In some runners, particularly with under-fuelling, stress fractures can signal a wider issue with bone health that needs medical attention.

Symptoms to recognise

The typical sign is a localised, pinpoint pain over the affected bone that builds with running and impact. Unlike many soft-tissue injuries, the pain often does not fully settle with rest and can be present during everyday walking, and the spot may be tender to press and sometimes swollen. Any deep, focal bone pain that worsens with activity should be treated as a possible stress fracture.

Treatment and recovery

A stress fracture requires rest from impact to allow the bone to heal, often for several weeks, and sometimes a protective boot, guided by a clinician. Diagnosis may need imaging, as early stress fractures can be hard to see. Low-impact cross-training can maintain fitness once advised it is safe, and a gradual, structured return is essential. Because of the risk of a worse break and underlying bone-health issues, this injury should always be medically assessed.

Stress Fracture and your running kit at OD's

While footwear cannot prevent a stress fracture on its own, adequately cushioned shoes replaced before they wear out, combined with sensible mileage progression, reduce the repetitive bone loading that contributes. At OD's Designer Clothing we stock premium running footwear from On, Saucony and Salomon, with fitting advice in St Helens. We offer next-day delivery and free click and collect.

Please note: This guide is general information for runners, not medical advice. If you have pain that is severe, persistent or getting worse, see a GP, physiotherapist or qualified sports clinician for diagnosis and treatment.