Women Runners Are Twice as Likely To Get Stress Fractures—Here’s How To Stop Them From Hurting Your Stride

Since 1986, the number of women runners in the United States has more than doubled (leaping from 20 percent of all runners to more than 50 percent as of 2018). While it’s inspiring and gratifying to see so many hitting the streets and running some of the most competitive races in the world, women pavement-pounders are also met with more than their fair share of injuries. Most staggering perhaps is the fact that women are more than twice as likely to get stress fractures compared to their male counterparts—and new research conducted by Thomas Jefferson University suggests a handful of reason why.

Stress fractures are “tiny cracks in a bone” caused by repetitive force, often from overuse, and aren’t uncommon in long-distance runners. And the study—which was conducted on 40 female recreational runners ranging from 18 to 65-years-old—found that your training plan is the biggest contributor to your bone health, or lack thereof. By comparing runners with a history of stress fractures with those who’d remained physically healthy, researchers found that this particular brand of injury usually resultsf rom upping mileage to quickly and skipping out on cross-training in the form of lifting weights, riding your bike, or swimming.

Sports medicine doctor Laura Owczarek, MD, says that training plans, in combination with dietary choices, are often the first thing she looks at when patients who come in with stress fractures. “When the issue of stress fractures come up there is a few things that we look at. First, I would ask them about their training,” says Dr. Owczarek. “How many miles are they running, have they increased their running volume recently and if so by how much? Also what types of runs are they doing—tempo, speed, or easy miles?” Also—she usually gives them a bone density scan to see how their eating and training habits are impacting their vitamin D levels.

The ideal scenario, of course, is to train your body correctly and gradually so that those extra miles don’t tax your bones. To help her patients do just that, Dr. Owczarek sticks with the commonly-held belief that you shouldn’t increase your mileage by more than 10 percent each week. Meaning, if you’re running 10 miles a week right now—you shouldn’t run more than 11.2 next week. Or, in that same vein, if your long run is 5 miles now, it should be 5.5 miles next week. Makes sense, right?

Cross-training is the other important part of the puzzle—and this one’s especially hard for runners who (welp) just really love to run. “Adding in strength training or cross-training can also be beneficial to develop stabilizing muscles that reduce the stress on their weight-bearing bones while running. Cross training can also continue to develop your cardiovascular fitness without the additional stress on your bones,” says Dr. Owczarek. Sports like swimming, for example, give you that cardiovascular burn without demanding so much out of your joints—and that, my friends—will keep you healthy.

Doubling down on your cross-training and resisting the urge to go too far, too fast is important—but also know that stress fractures are something your doctor or a physical therapist should be on your side to prevent. “It is clear that there needs to be more guidance from healthcare providers for woman runners on how to prevent stress fractures” says Jeremy Close, MD, family and sports medicine physician at Jefferson University Hospitals. “It can be very frustrating for these women who are on a path to wellness, but are impeded by an injury that can take several months to heal. If they don’t have the proper guidance on how to return to running safely, they risk a second injury.” If you feel like something’s up with your body, ask for a bone density screening. Advocate for your run.

Start your cross-training with this quick strength-training workout: