Not all stress fractures are created equal. In addition to having varied causes, different exercises cause different types of fractures. The most common ones occur in the legs and feet, which makes sense when you consider the type of repeat impacts these extremities are subject to in runners. Those that happen in the lower leg bones, and similar cumulative stress injuries, are so common that we even have a colloquial term for them—shin splints.
Other stress fractures fall into the category of injuries we don’t think about much. That persistent back pain some athletes struggle with despite excellent core strength and posture? For some, the source is lumbar disc degeneration, but in gymnasts, divers and weightlifters, the source may actually be a stress fracture in the spine, known as spondylolysis, and can require significant rehab and even surgery.
Similarly, in long-distance runners, doctors occasionally see pelvic stress fractures. These are quite uncommon but have increased with the popularity of marathon running. They can occur at several different points along the bone and can also manifest as back pain. Additionally, teens may suffer this injury if they undertake a strenuous training practice and their pelvic growth plates have not yet closed.
Though there’s no foolproof way to prevent stress fractures in serious athletes, there are several things you can do to reduce the likelihood and severity of such injuries.
First, be mindful of how your diet interacts with bone strength. In general, impact and weight bearing are good for long-term bone strength because they generate increased bone growth. For this to work, however, your body needs to have access to all the necessary vitamins and minerals. Calcium alone isn’t enough. Our bodies also need vitamin D and a mineral mix including iron, zinc, potassium and others. Athletes should also avoid smoking and consuming too much caffeine, both of which can deplete mineral stores and impact bone strength.
As mentioned above, women need to be especially careful. That’s because women are more prone to osteoporosis, a loss of bone density. Additionally, serious female athletes often experience variation in their menstrual cycles, which can result in hormonal imbalances and lead to a higher rate of bone loss and difficulty forming new bone. If your periods become irregular, see a doctor, increase your caloric intake, and consider slowing down your training.