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  • Writer's pictureDr Daniel Mogoai

"A Basic Guide for Stress Fractures for Female Runners & Athletes"

If you're an athlete or an athletic person whose hobby is running, jumping, and bearing a lot of weight during these activities, you are more prone to stress fractures. Stress fractures are small cracks in the bone from continuous usage without proper recovery.

In pain? Book an Osteopathy assessment here

An image of a woman practising her running at the beach
Running contributes greatly in boosting health of your vital organs such as heart and lungs by improving circulation.

This blog includes the following:

  • How do Stress Fractures occur

  • What are The Early Signs of Stress Fractures

  • What are the Causes of Stress Fractures

  • Tips to Prevent Stress Fractures

How do Stress Fractures occur?

Stress fractures occur when there is continuous micro-trauma to the bone during physical activity, leading to minor fractures in the periosteum and inflammation, or periostitis. In some cases, the fractures can extend through the inner and stronger portion of the bone, called the cortical bone, resulting in complete fractures that require medical attention.

Various athletes, including track and field athletes, soccer players, runners, hikers, and ballet dancers, are more susceptible to partial stress fractures due to the high impact and repetitive loading on their bones. It is also noteworthy that female athletes are more prone to stress fractures than male athletes due to greater hormonal fluctuations, having lower amounts of muscle mass, and biomechanical differences.

An image of foot showing a fractured bone caused by stress
A sample of stress fracture in a woman's foot. Image source: Foot and Ankle Partners of El Paso

According to a journal article published in the Journal of Science and Medicine in Sport, a study conducted on 229 female athletes in Australia revealed that 12.7% of them had suffered a stress fracture in the past.

The study also found that the most common sites for stress fractures were the tibia, metatarsals, and fibula. This highlights the need for athletes, especially female athletes, to take proper precautions to prevent stress fractures and seek medical attention if they experience any symptoms.

Get relief from pain and discomfort today - Book an appointment with our trusted Osteopath now!

Image of Dr. Daniel Mogoia at the beach
It is best to speak with the Osteopath at One Motion Athletic if you suspect a stress fracture.

What are The Early Signs of Stress Fractures?

It's important to recognise the early signs of stress fractures so that they can be treated promptly and prevent further damage to the bone. Here are the top 6 early signs of stress fractures and recommended treatments:

Pain: Pain is the most common symptom of a stress fracture. Initially, it may be mild and occur only during activity. As the injury progresses, the pain may become more severe and occur even at rest. Rest is the best treatment for pain associated with stress fractures.

Swelling: Swelling around the affected area is another early sign of a stress fracture. Applying ice to the area for 20-30 minutes several times a day, can help reduce swelling.

Bruising: If a stress fracture is left untreated, bruising may appear around the affected area. Applying a compression wrap to the area can help reduce bruising and swelling.

Tenderness: The affected area may be tender to the touch. Avoid activities that cause pain, and rest the affected area as much as possible.

Weakness: Muscles around the affected area may become weaker due to decreased activity. Performing gentle exercises recommended by an Osteopath can help maintain strength in the surrounding muscles.

Changes in gait: Stress fractures can alter how a person walks or runs, leading to changes in gait. Our Osteopath at One Motion Athletic can help develop a treatment plan that includes exercises to improve gait and reduce stress on the affected bone.

If you suspect that you have a stress fracture, it's important to seek medical attention. Treatment may include rest, ice, compression, elevation, and possibly immobilisation with a brace or cast.

Pain relief medications may also be recommended. In severe cases, surgery may be required. Following an Osteopath's recommendations is important to ensure proper healing and prevent a recurrence.

Need treatment? See our Osteopath..

What are the Causes of Stress Fractures

Stress fractures can occur when an individual increases the intensity, duration, or frequency of their exercise routine too quickly, or when they do not allow sufficient time for rest and recovery between workouts.

An image of Chanise Konstantinidis' foot stretching
The body's capacity to retain balance is aided by correctly stretching the feet. Other advantages include becoming flexible and having limber muscles, which may prevent heel pain and injury to the Achilles tendon.

In some cases, stress fractures may also be caused by trauma or a sudden injury. It is best to speak with the Osteopath at One Motion Athletic if you suspect a stress fracture.

Our Osteo will assess your training load and symptoms, as untreated stress fractures can lead to more serious injuries and long-term complications.

Book an Osteo appointment today to prevent further injury..

1. Training Errors.

Training mistakes such as continuously using old running shoes or exercising on uneven terrain may increase the likelihood of stress fractures.

An image of a good running shoes for female athletes
Image from: Swirlster

Fixing your running technique can be one of the most efficient ways for field athletes and runners to reduce the likelihood of stress fractures of the foot and tibia.

When running, aim to run on the ball of your foot to avoid heel striking. This will take greater advantage of the spring mechanism found in the fascia at the bottom of your foot and make your running more efficient and less fatigue on the muscles of the legs.

2. Hormonal Balance.

This is an important component of bone health in female athletes. Oestrogen plays a significant role in bone metabolism and maintaining ideal amounts of estrogen are pivotal to optimise peak bone mass between 20-30 years of age.

An image of pills and a text of hormonal imbalance
Having hormonal imbalance may represents many different hormone-related conditions

Complications of the menstrual cycle can also contribute to lower levels of bone mineral density. Other factors that can contribute to the development of stress fractures include poor nutrition, hormonal imbalances, and certain medical conditions such as Osteoporosis.

3. Weight.

If you're underweight as a female athlete, you’re likely not meeting your energy requirements and may be deficient in vitamins or minerals. You are also likely to have lower muscle mass, all factors which impact bone mineral density and pose additional risk variables for stress fractures.

Not eating enough? Get in touch with our Sports Dietitian.

An image of a weighing scale
Overweight individuals are at increased risk of suffering stress fractures in the lower back as well as the feet and lower extremities.

4. Anatomy

If you have altered foot biomechanics or problems like Achilles tendinopathy, low or high arches, bunions and blisters, these can affect your foot when on the ground.

An image of a man suffering from Achilles tendinopathy
Achilles tendinopathy is an injury to the band of tissue (tendon) that connects the muscles in your lower leg to your heel bone.

5. Nutrition

Nutrition plays a critical role in preventing and managing stress fractures. Adequate intake of calcium, vitamin D, and other essential nutrients is essential for bone health and healing. Calcium is the primary mineral in bones, and vitamin D helps the body absorb calcium.

An image of foods rich in vitamin D
Vitamin D is an essential nutrients for bone health and healing

Additionally, maintaining a balanced diet rich in fruits, vegetables, whole grains, and lean protein sources provides the body with essential vitamins, minerals, and nutrients necessary for optimal bone health. Adequate hydration is also essential for bone health and healing, as dehydration can increase the risk of stress fractures.

Research studies have also demonstrated the importance of nutrition in preventing stress fractures. For example, a study published in the Journal of Athletic Training found that female cross-country runners who consumed more calcium and vitamin D had a lower incidence of stress fractures.

Similarly, a study published in the Journal of Sports Sciences found that male military recruits who consumed a diet rich in calcium and vitamin D had a lower incidence of stress fractures during basic training.

To prevent or reduce the risk of Osteoporosis, get in touch with our Sports Dietitian who can assist you in creating a suitable and personalised diet plan.

Image of One Motion Athletic's trusted Dietitian, Chanise Konstantinidis
Your health is important to us. Book an appointment with our caring Dietitian and take the first step towards better health.

Tips for Stress Fractures

Here are some tips for dealing with stress fractures:

Rest: Rest is the most important part of the recovery process. Avoid putting weight on the affected area and give it time to heal.

Ice: Applying ice to the affected area can help reduce swelling and pain. Apply ice for 20 minutes at a time, several times a day.

Compression: Using compression bandages or sleeves can help reduce swelling and provide support to the affected area.

Elevation: Elevating the affected area can also help reduce swelling and promote healing. Try to keep the affected area elevated above the level of your heart whenever possible.

Pain relief: Over-the-counter pain medications such as ibuprofen can help manage pain and inflammation. Be sure to follow the recommended dosage and speak to your doctor if you have any concerns.

Rehabilitation: Once the pain and swelling have subsided, it's important to work with a Osteopath, Physiotherapist or Exercise Physiologist to gradually return to physical activity.

You can book online with our Osteopath here.

Proper nutrition: Eating a balanced diet with adequate amounts of calcium, vitamin D, and other important nutrients can help support bone health and prevent future stress fractures.

Remember, if you suspect you have a stress fracture, it's important to seek medical attention and follow the advice of your healthcare provider.


Wearing proper shoes is one simple way to prevent stress fractures. Athletes' footwear should be checked and changed regularly. A proper running shoe, for example, should be changed for every 300 miles used.

You may also choose to rotate between running shoes to allow the foam in the base of the shoe to return to normal.


Proper warm-up and cool-down should be followed. Following a strength and conditioning program similar to our female athlete program, can help avoid unnecessary overtraining and help you to progress at a steady rate.

Good conditioning will also help manage levels of fatigue, which means you’re less likely to establish a poor running cycle or change direction in sloppy fashion.

Regular Checkups.

If you are having difficulties with an eating disorder or experiencing menstrual abnormalities, please make sure to get in contact with a medical professional such as an Obstetrician or Dietitian with a background in sports physiology.

Never ignore early signs of stress fractures; regular checkups and proper nutrition should be given equal care.

Pay closer attention to your rest and recovery post-training or sports competition as preventive measures for stress fracture.

Book your appointment with our Osteopath for an assessment and specialised advice about your pain.


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