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Causes Of Stress Fractures

Stress fractures are a common injury in runners. Sometimes you know the cause, sometimes you do not. They are frustrating either way, but especially frustrating when you do not know the cause. Those different causes are what I want to dive into today. 

Stress fractures are often caused by training errors. These training errors include doing too much, too soon, running with technique faults that place more force through the body, and lacking strength training so the body is not able to support itself as well. 

What you may not know, though, is that there are a number of causes that are not running related, including nutrition deficits, life stressors, hormone imbalances, and lack of sleep. 

Too much, too soon 

Too much, too soon is a frequent cause of many types of injuries, including stress fractures. This can include any and all of the following: 

  • Ramping up your mileage too quickly 
  • Making multiple changes at once, such as adding speedwork and hill training into your program at the same time 
  • Returning to running after several months off and attempting to start back where you left off 

Any time you do not allow the body to adapt to the increased forces and stresses on the body, you can create stress fractures. 

Running technique faults 

Certain running technique faults can place increased forces through the legs and body. The biggest fault that can do this is heel striking on a straight leg. These increased forces translate through the bones, which can create stress fractures, especially if this is combined with one or more of the other factors. 

Lacking strength training 

Endurance athletes need muscle, too! Even if all you do is run, your body still needs muscle to support that activity. And the longer the distance you want to cover, the more support your body needs. If you do not have good muscle strength, your body will break down under fatigue, create compensations, and create running faults that can contribute to stress fractures.  

Nutrition deficits 

This is a huge component of stress fractures, especially when you have chronic and recurring stress fractures, when a stress fracture is slow to heal, and when stress fractures occur in places that don’t typically get stress fractures. 

When talking nutrition deficits, we need to talk about several things: under fueling, lacking proper nutrition, and malabsorption issues. 

Being under fueled is a more common issue than you might think and not just someone who wants to lose weight. Many people do not realize how many calories they need to function and how much that increases when you add activity to it. When you do not give your body the fuel amount it needs to function, your body will pull the calories from your tissues and many times that becomes the bones. Over time, your bones weaken. 

Your body also needs nutrients to rebuild the body appropriately. You may be taking in the amount of fuel your body, but you may not be getting all the nutrients your body needs in that fuel. This can occur from several reasons: 1) your food choices are not quality choices, 2) because of depleted soils, the foods are not as nutrient dense as they used to be, and 3) if you are not eating a variety of proteins, fruits, and vegetables, than you are not getting a full variety of nutrients. 

And the other reason you body may not have the nutrients is if it has absorption issues. Gut health is a huge deal. If your gut is not healthy for any number of reasons, it will not absorb nutrients properly. In this state, you can eat all the healthy foods you want and it will not matter because your body will not do anything with it. 

Life stressors 

Stress fractures do not have to come from physical stress to the body. When it comes to the body, stress is stress! Even though the stress is from work, family, life, etc., your body still reads it as stress, which means hormone changes to the body temporarily. These changes can create stress injuries. 

Hormone imbalance 

Each of the hormones in your body has a job to do. Having too much or too little of any of those hormones can cause injuries, including stress fractures. What can cause hormone imbalances? Lots of things: age (yep, one of the few things I will blame on age), nutritional deficits, life stressors, and sleep deficits to name a few. 

Luckily, just because you have a hormone imbalance, does not mean it will be there forever. Regardless of the cause, there is a fix for it. The fix will vary depending on the cause, though. 

Lack of sleep 

Sleep is when your body repairs itself. If you are not getting enough sleep for what your body requires or getting quality sleep, it cannot repair itself. If you are not repairing your body on a regular basis at night, it will continue to break down until an injury occurs.  

I gave you a lot to think about and contemplate on. Have questions or comments? Send them to me at 

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