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How to Prevent Foot and Shin Stress Fractures

Updated: May 10, 2022

Written by: Dr. Lisa Bodratti, PT, DPT

Tibial (shin) and metatarsal (foot) stress fractures can be common injuries in the running community. A stress fracture is not your classical bone “break,” but rather a cluster of very, very small fractures in your bone due to repetitive stressor like running or jumping. There are some known risk factors and prevention techniques we will share with you in this week’s blog.

Risk factors:

  1. Previous history of a bone stress injury (BSI) - this is the number one risk factor for a BSI. If you have had multiple BSI, there are likely some other mechanisms at play other than just repetitive stress; these may include: low body weight (BMI <18.5), compromised bone properties, relative energy deficit syndrome (formerly known as female athlete triad), and delayed menarche (for females).

  2. Nutritional or vitamin/mineral deficits: a lack of calories and general nutrition can have a direct impact on the maintenance and healing of any bone or tissue injuries. To meet appropriate energy requirements, our body needs a wide array of nutrients such as carbohydrates, proteins, fats and vitamins/minerals.

  3. Increasing your running volume too fast: as a general rule, increasing your total weekly running volume >10% each week increases overall injury risk. If you are new to running, try to run 2-3 days per week, starting with walk/jog intervals for up to 30 minutes. If you are an established runner, try not to increase your total mileage more than 10% of the previous week.


Implement a jumping program: shoot for adding some level of a jumping program into your routine 3 days/week. These sessions should take place on days that are lower in mileage, or are cross training days. Some easy to implement jump exercises include:

  • Vertical jump for height: from a squat position jump as high as you can, land softly

  • Long jump for distance: from a squat position, jump as far as you can forwards with both feet

  • Lateral jump: from a squat position, jump as far as you can to one side

  • Box jump: facing a raised platform, start from a squat position and jump onto the box/bench/step. Start with a low height and progress.

Gait retraining: Taking a look at your cadence can help to improve your overall running efficiency and reduce injury risk. Your cadence is synonymous with the number of steps you take per minute. If you use some sort of wearable technology/smart watch or run with your cell phone, you can generally find your cadence on those. If you run with a cadence >165 steps per minute, try and increase that number by 7.5% to improve your efficiency.

If you have been diagnosed with a bone stress injury or are having a hard time getting back into your sport afterwards, please reach out to our therapists at The Green Room! We are passionate about getting you back to the activities you love! We have two locations: Troy and Clifton Park, NY. You may request a free consultation here:

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