Stress fractures can sometimes be season-ending injuries. While receiving such a diagnosis may be distressing, only a small proportion of stress fractures actually require extended rest.

LOW-RISK STRESS FRACTURES

Most stress fractures are classified as “low risk”. That means they seldom require imaging or extended periods away from impact activities. For example, stress fractures to the inner part of your shin bone, or to your third or fourth toes, can all be managed based on symptoms.

People with low-risk stress fractures typically benefit from a few days away from running. Maybe that will take up to two weeks. But once they can walk pain free for 30 minutes, they can go back to running.

That first run, however, will only be 3 x 1 minute at slow speed, alternating with walking. It HAS to be pain free. Then, minutes of running can be added gradually, as long as there’s no pain.

HIGH-RISK STRESS FRACTURES

On the other hand, “high-risk” stress fractures need to be taken more seriously. That’s because some bones tend to not heal as well or as fast, and are subject to more complications such as bad consolidation or necrosis of the bone.

A runner diagnosed with a high-risk stress fracture should avoid weight-bearing, and consult a medical doctor (ideally a sports doctor) to confirm or rule out the diagnosis using imaging.

If a high-risk stress fracture is confirmed, the runner will have to stay away from running for several weeks, often with limited weight-bearing. Follow up imaging might be necessary to provide the green light to start reloading. In severe cases, surgery may be indicated to help the bone heal properly.

Here are the most common locations for high-risk stress factures: