Alaska summer is in full swing! And you know what that means for Alaskans… we’ve all been getting after it as much as possible—yet somehow still wishing we were doing more. So what do we do? –MORE!!
…The more the better, right?
Sometimes not.
Injuries, stress, overuse, guilt, burnout—there are a lot of things that can come with the perfect summer. Let’s touch base on one injury that’s more common than we’d like. One that seems to creep in with the worst timing.
It can happen just as you’re about to race after months of training… when you finally dropped the big bucks on those new shoes… or when you feel like you’ve finally hit your groove and are crushing mileage like never before.
The pesky injury we are talking about is ‘shin splints.’ If not treated properly, shin splints can turn into bone stress injuries, which can then turn into stress fractures. As PTs, we want to avoid this chain reaction as much as possible and catch these injuries before they sideline the athlete!
What Are Stress Fractures and Bone Stress Injuries?
Bone stress injuries are bone fatigue injuries– where the rate of bone absorption exceeds the rate of bone formation, usually a mismatch between energy of availability and energy expenditure, combined with increased load on the muscular system and insufficient recovery. A stress fracture happens when the bone formation gives out to a small crack that can progress from there.
The exact mechanism of bone stress, injuries, and bone fractures is another topic on it’s own– Lukcilu we have a blog for that too! Check this one out from Runners’ Edge:
Understanding and Preventing Bone Stress Injuries in Runners
Now that you know what bone stress injuries are, symptoms to look for, predisposing factors, and how to avoid them, let’s talk about the return to running phase.
Returning to Running After a Stress Fracture
Have You Had Your Gait Analyzed?
Here’s the good news and bad news:
You should be cleared by your physical therapist or by your sports physician to start running. Once you are cleared, we can help you! There is no one-size-fits-all return-to-running program. But there are some key guidelines to follow.
And if you’re unsure where to begin, get a free discovery visit at Runners’ Edge.
Return-to-Run Basics
- Start with a rest day between each run day
- Use running to re-load the bone, NOT to gain cardio fitness (cross train!)
- Run at no more than 50% of your normal pace
- Only start running once you can walk for 30 minutes pain-free, and stay pain-free for 24 hours afterward
Sample Return to Running Program
Remember: don’t overdo it people—that’s what got us here in the first place!
Day 1: 9 minutes of walking, 1 minute of running (repeat 3x)
Day 2: Rest
Day 3: 8 minutes of walking, 2 minutes of running (repeat 3x)
Day 4: Rest
Day 5: 7 minutes of walking, 3 minutes of running (repeat 3x)
Day 6: Rest
Continue this pattern, gradually increasing the run time and decreasing walk time, until you can run 30 minutes straight without pain.
Once you can do that at 50% effort, start increasing your pace by ~10% with each run. Still take a rest day between each run—your bones need time to recover and adapt!
Not Ready to Progress Yet? That’s OK!
If you still have pain, go back to the last level that felt good. Then ask yourself:
- Am I strength training consistently?
- Am I giving myself adequate rest and recovery?
- Am I stretching and working on mobility consistently?
- Am I eating enough, fueling well, and staying hydrated
- Have I tried modalities like dry needling, extracorporeal shockwave therapy (ESWT), or sports massage?
- Have I talked to my Physical Therapist?
These can make a big difference in your healing and return-to-sport timeline.
Runners, Let’s Chat: Prevention Tips for Stress Fractures
Key Strategies:
- Increase your step rate and know your strike pattern
- Is your impact loud or soft? Heel striker or forefoot?
- Consider orthotics to reduce stress and prevent injury
- Make sure your shoe fits your foot, and your running gait! There is no perfect shoe, the only perfect shoe is that fits you well!
- Transition slowly when changing shoes
- Pool workouts (walk, jog, walk/jog) are a great way to stay moving without overloading bones
Tools That Can Help You Heal
- ESWT (Extracorporeal Shockwave Therapy) — AKA the magic wand!
- Dry Needling
- NormaTec Compression Therapy
- Sports Massage
- Proper nutrition and fueling
- Rest and recovery
Come by Runners’ Edge for a gait analysis, sports injury screen, or treatment session tailored to your needs.
Special Thanks
Huge shoutout to Dr. Daniel Bonanno (PhD, GradDipResMeth, B.Pod) and Learn.Physio for their expertise and return-to-run program guidance.
Listen to Your Body, Take It Slow, and Don’t Skip the Rest Days
Getting back to running after a stress fracture takes patience, but it’s worth it. Take the time to recover right and you’ll come back stronger, smarter, and maybe even a little faster. Remember, you’re not in this alone, our PTs are here to help you through it!
And hey—don’t forget to high-five your future injury-free self.
