"Stress fractures happen when training increases faster than the body can adapt." - Dr Jordan Metzl
Stress fractures rarely appear overnight. They build quietly over weeks - sometimes months - before finally forcing an athlete to stop.
Unlike muscle injuries, which often occur suddenly, stress fractures develop gradually as repeated impact overwhelms the bone’s ability to repair itself.
Distance runners are particularly vulnerable.
Each stride places several times bodyweight through the lower limb. Over thousands of repetitions, that load becomes significant - especially when training volume increases quickly.
Sports medicine physician Dr Jordan Metzl explains that mechanism clearly.
"Stress fractures happen when training increases faster than the body can adapt," he said.
The most common locations include the tibia, metatarsals and pelvis.
WHY THEY DEVELOP
Stress fractures typically emerge from multiple contributing factors:
• rapid increases in training load
• insufficient recovery between sessions
• poor energy availability
• biomechanical imbalances
When the balance between stress and repair shifts too far toward stress, bone health suffers.
PREVENTION STARTS WITH PATIENCE
Gradual increases in mileage, strength training and adequate fuelling all support bone resilience.
Bones adapt - but they do so slowly.
