Q: My 15-year-old daughter has recently taken up running and loves it - sometimes running multiple miles every day. Since this is a new hobby of hers, I'm concerned about stress fractures. How common are they and what can we do to prevent them?
A: Stress fractures, also called fatigue or insufficiency fractures, are most commonly associated with overtraining. They occur when a bone breaks down because it is subjected to repetitive stress.
The pain occurs at a specific location and worsens with activity. While pain may improve after a short period of rest, it typically returns when the athlete returns to activity.
Stress fractures most commonly occur in the shin bone (tibia) and in bones of the foot (metatarsals) in athletes participating in running-type sports. Fractures may occur when athletes increase their running mileage suddenly or if they are running too many miles.
Stress fractures also are seen when the stresses applied through the leg from the ground are overwhelming or if an athlete has a running style where he or she lands hard on the heels. Proper shoes can help prevent excessive force on the bones and sometimes a gait analysis is needed to correct an injury-prone running style.
The risk of stress fractures can be different for girls, too. If a female has not obtained her period by the time she is 15, if the length between her periods is longer than 35 days or if she skips periods, her risk for stress fracture will increase two- to six-fold.
Stress fractures need about four to six weeks of rest to heal. Always consult your child's primary care physician if you suspect your child has sustained a stress fracture.
-Dr. Anastasia Fischer is a member of Sports Medicine and the Section of Ambulatory Pediatrics at Nationwide Children's Hospital and a Clinical Assistant Professor of Pediatrics at The Ohio State University College of Medicine.