Duke Raleigh Hospital

Stress fractures are micro cracks in a bone. They originate from repetitive force most commonly in running or repeatedly jumping up and down. They can also occur with normal use of a bone that’s compromised by a condition such as osteoporosis. Athletes in track and field, basketball, dance or gymnastics are more at risk for this injury.

In runners, stress fractures commonly occur in the bones of the feet, legs and pelvis. Symptoms of a stress fracture are increased pain and swelling during activity in a certain bony spot which decreases with rest.

Diagnosis of a stress fracture is usually by physical exam and imaging with X-ray. Occasionally advanced imaging with MRI may be needed. Treatment includes rest and non-weight bearing activities until the bone heals.

What is the best prevention for stress fractures?

• Avoid dramatic increase in running duration and intensity. Follow the 10% rule: only increase your mileage or duration of physical activity 10% each week.
• Include a daily Vitamin D and Calcium supplementation in your diet – 400-1,000 iu daily of Vitamin D depending on your age and 1000-1200mg daily of Calcium for a typical healthy athlete.
• Moderate consumption of caffeine and alcohol.
• Add strength training in your exercise routine to help prevent osteoporosis. Learn more about the benefits of strength training for runners.
• Use proper footwear and changing it regularly if worn out, at least every 250 miles.

Running partners Dr. Jocelyn Wittstein and Melissa Raddatz, NP, work together at Duke Orthopaedics & Sports Medicine. Dr. Jocelyn Wittstein is Assistant Professor of Orthopaedic surgery at Duke. She specializes in adolescent and adult sports injuries. She has run several marathons and is an age group competitor. She previously coached Team in Training marathon groups in Eastern North Carolina. Melissa Raddatz, NP enjoys treating athletes and sports enthusiasts of all ages and levels. She ran Division I Cross-Country and Track at William & Mary. She has run a 2:50 marathon and is a five time nominee for New York Road Runners “Runner of the Year.”