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Common Runners’ Injury: Stress Fractures of the Foot

Common Runners’ Injury:  Stress Fractures of the Foot

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By Tara Parks, DPM, Foot and Ankle Surgeon
Podiatry at Boulder Medical Center

Stress fractures of the foot have become more common in runners since the Covid-19 Pandemic began. Many people changed their workout routine to include running outside or at home on a home treadmill rather than engaging in low-impact activities at the gym.

This increase in running activities, especially among beginning runners, is contributing to an increase in repetitive overuse injuries, including stress fractures of the foot.

In my clinic, I find that inexperienced runners increase their mileage too quickly, don’t have appropriate shoe gear, and don’t allow enough rest between runs. A lack of experience coupled with the repetitive impact placed on the feet during each run can cause hairline breaks in the foot bones. I also see this condition in experienced runners. Those who increase their mileage too quickly or change to a more intense training phase may be more susceptible to a stress fracture due to increased force on the foot bones.

How to Prevent Stress Fractures

  • Increase Mileage Slowly — A general rule of thumb is to increase mileage by no more than 10 percent each week.
  • Rest and Recover — Schedule adequate rest time between runs to help decrease the risk of fracture. Check out this article from Runners World about rest days and recovery.
  • Wear Proper Footwear — Runners at all levels are at higher risk for stress fractures if they wear improper shoes while running or training, suffer from flatfoot or other foot deformities, or have osteoporosis. It is recommended to replace running shoes frequently at about 300 to 400 miles.
  • Get a Professional Shoe Fit — Here in Boulder County, we are fortunate to have several locally owned running shoe stores where highly qualified professionals can help you choose the best shoe and fit. In addition to purchasing quality, well fitting shoes, I also recommend to my patients that they invest in a few pairs, as alternating between running shoes is another way to prevent overuse injuries.
  • Choose Your Surface — Types of running surfaces can also contribute to increased stress on your foot bones. I recommend trying to run on a soft dirt or limestone trail, rather than concrete (sidewalks) to decrease the impact. Running on a treadmill at the same pace and incline can also increase repetitive stress on the bones. I recommend changing the speed and incline throughout the workout.
  • Understand Your Biomechanics — If you suffer from abnormal mechanics in the foot, such as overpronation or hypermobility, custom orthotics can help. , Designed to properly align your feet to avoid and treat injuries, orthotics are available over the counter or prescribed by podiatrists

Stress Fracture Symptoms and Treatment

Signs of a stress fracture can include pain, swelling, redness and bruising of the area, along with tenderness directly on the bone upon palpation. Stress fractures can occur anywhere in the foot and can lead to a complete break of the bone if left untreated. Early diagnosis and treatment are essential to ensure proper healing.

If a break is suspected, immediately follow the RICE protocol — Rest, Ice, Compression, and Elevation. If pain and swelling last longer than a few days, an appointment for an x-ray and diagnosis is in order.

In most cases, treatment includes rest and immobilization with casting or orthopedic boot placement of the foot. Surgery may be required in certain instances to repair and stabilize a stress fracture that has progressed into a full fracture.


Get to Know Tara Parks, DPM
Podiatrist  |  Foot and Ankle Specialist

As a member of the American College of Foot and Ankle Surgeons (ACFAS), she is trained to diagnose and treat patients with any foot and ankle pathology or condition, including:

  • Common Foot Disorders
  • Reconstructive Foot and Ankle Surgery
  • Foot and Ankle Trauma
  • Sports Medicine and Biomechanics
  • Diabetic Limb Salvage
  • Resources

Dr. Parks is available for appointments in Boulder and Louisville. Please call (303) 440-3036 for an appointment.
Click here to learn more about Tara Parks.

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