By Kyla Nelson, DC & Acupuncture Provider

Running has long been a popular form of exercise. In recent years, participation in long distance marathons and ultra-marathons has continued to grow in popularity. Given this – it’s important to acknowledge the injury rate, which has been reported to be as high as 30-80% per year. Over the course of the next few weeks we will discuss some of the more common lower extremity injuries sustained during running, as well as rehabilitation and treatment options.

Stress Fractures

Today’s discussion will look at the menacing stress fracture! Stress fractures are one of the most common over-use injuries sustained by runners. They account for up to 16% of running injuries.

A stress fracture is caused by a “repeated abnormal strain from chronic weight-bearing activity” (1). Anatomically, a stress fracture is a small crack in the bone (it is not a complete fracture). It is also commonly referred to as a “hairline fracture”.

In the early stages a runner may present with insidious (no history of trauma) localized pain that typically occurs towards the end of their runs. As the injury progresses the pain will occur earlier and earlier in their run, as well when the runner is at rest.

Risk Factors include:
  • Increase in training intensity
  • Change in training surface
  • Smoking
  • Reduced Vitamin D
  • Females > Males

Stress fractures typically heal within 6-8 weeks, however this can vary depending on the severity and location of the stress fracture. Given this – treatment options for stress fractures focus on an initial rest period and modalities used to reduce pain levels. After the pain levels have been reduced your therapist will introduce re-strengthening exercises focussed on the lower extremity to ensure a prompt and proper return to an individual’s lifestyle.

Stay tuned for HLHC’s next blog post on running injuries –> Plantar Fasciitis!

If you have more questions about stress fractures and conservative management please contact Holland Landing Health Centre at or 905-853-7900.

  1. Pelletier-Galarneau, Matthieu, et al. “Review of running injuries of the foot and ankle: clinical presentation and SPECT-CT imaging patterns.” American journal of nuclear medicine and molecular imaging 5.4 (2015): 305.


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