FIB Runners Stress Fractures

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North Florida Foot & Ankle Center
(904) 236-5023

Common Runners’ Injury: Stress Fractures of the Foot
Repetitive impact on feet can increase risk of damage

Jacksonville, FL — Stress fractures of the foot are becoming more common in runners, especially first-time marathoners, according to Jacksonville foot and ankle surgeon Amanda Bartell, DPM, (FACFAS or AACFAS).

The growing popularity of marathons among beginning runners has contributed to the increase in repetitive stress injuries, including stress fractures of the foot, seen by Dr. Bartell, a member of the American College of Foot and Ankle Surgeons. Often, first-time marathoners enter a race with little or improper long-distance training. The lack of experience coupled with the repetitive impact placed on the feet during the run can produce enough stress to cause hairline breaks in the bones of the foot.

“Runners who increase their mileage too quickly or change to a more intense phase of training may be more susceptible to a stress fracture due to the increased force placed on the bones,” says Dr. Bartell. “A general rule of thumb for runners is to increase the mileage by no more than 10 percent each week. Runners who are training also need to have adequate rest time in between runs to help decrease the risk of a fracture.”

Runners at all levels of experience are also at higher risk for stress fractures if they wear improper shoes while running or training, suffer from flatfoot or other foot deformities, or have osteoporosis. Signs of a stress fracture can include pain, swelling, redness and possibly bruising of the area.

“Stress fractures can occur anywhere in the foot and can eventually lead to a complete break of the bone if left untreated,” Dr. Bartell explained. “Early diagnosis and treatment are important to ensure proper healing.”

If a break is suspected, Dr. Bartell advises runners to immediately follow the RICE protocol—Rest, Ice, Compression and Elevation. If pain and swelling last longer than a few days, an appointment for an x-ray and diagnosis is in order.

In most cases, treatment includes rest and immobilization with casting of the foot. Surgery may be required in certain instances to repair and stabilize a stress fracture that has progressed into a full fracture.

Runners can take action to prevent repetitive stress injuries in their feet by wearing supportive athletic shoes and slowly building up their activity levels according to their abilities. “If a runner suffers from abnormal mechanics in the foot, such as overpronation or hypermobility, custom orthotics can also be helpful to prevent these injuries,” Dr. Bartell, adds.

If you suspect you have a foot injury or fracture, call Dr. Bartell’s office at (904) 236-5023) for an evaluation.

For additional information on stress fractures and other foot injuries, visit

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