Stress fractures are tiny, incomplete breaks or cracks in a bone. They can occur many places in the body, but runners most often get them in the feet. They’re caused by too much repetitive stress to bones that are overworked. That’s why stress fractures occur gradually—over time, the bones are asked to do just a little bit more than they’re ready for, and the shock is great enough to cause a slight crack. Stress fractures are different from a standard broken bone because with a stress fracture, there’s not a sudden, obvious incident when the bone breaks. Rather, the pain begins gradually, usually as a slight twinge, and only intensifies as you continue to run on it. Trust me, though—if you get a full-blown stress fracture, there will be no mistaking that you’re hurt. With every step, sharp pain will shoot from your foot up your leg, and it will get worse the longer you run on it.
Stress fractures are almost always caused by some of the errors that I outlined earlier in this chapter—increasing mileage and intensity too quickly, wearing shoes without enough cushioning, and doing too much of your running on hard surfaces. Runners who don’t include enough calcium in their diets are also susceptible.
Unfortunately, when you have a stress fracture, you need to stop running. Otherwise, you’re just asking for it. The bone will continue to rupture, and you could develop a complete break, which will add considerably to your downtime. So if you feel the beginnings of a stress fracture, take a few days off and ice the area (which will probably be a little tender and swollen, and maybe even a bit warm to the touch at first). If you definitely have a stress fracture, you’re best off not running for at least two weeks, as well as avoiding other weight-bearing activity during this time. If it’s still bad when you restart, stop again, and see a doctor.
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