Gabe Mirkin, M.D.
Stress fractures, small cracks on the surface of the
bones, usually start out as a minor discomfort in the foot or leg
that occurs near the end of a long run. Usually the pain goes
away as soon as the athlete stops running. On the next day, the
pain returns earlier in the run. If she notices that it hurts to touch
just one spot on a bone and then stops running for a week, she
can return to running quickly, but usually she ignores the pain
and develops a full- blown stress fracture that hurts all the time.
She now has to avoid the hard pounding of running, but can ride
a bike or swim for exercise until the fracture heals in 6 to 12
weeks. The most common sites for stress fractures are the
bones in the front of the feet or the long bone of the lower leg,
but running can cause stress fractures anywhere, even in the
pelvic bones.
Forty-five percent of competitive female runners develop
stress fractures. The women most likely to suffer these injuries
are those who restrict food and those who have irregular periods.
Restricting food can stop a woman from menstruating regularly,
which can stop her body from producing the female hormone,
estrogen. Lack of estrogen weakens bones. Exercise does not
cause irregular periods, but not taking in enough calories can.
Women who stop menstruating when they exercise heavily will
usually start to menstruate regularly when they eat more food.
I often prescribe bone strengthening medications such as
Fosamax or Evista to women with stress fractures that do not
heal in six months.
April 2, 2006