Stress Fractures

We advise kids not to specialize in just one sport. Multi-sport athletes tend not to get as many stress fractures and other kinds of overuse injuries. And for practicing, we advise kids and coaches to alternate exercises and vary drills. In the long term, your muscle memory is better if you change up your practice exercises.

          — Orthopedic Team, Boston Children's Hospital, Orthopedic Center

What is a stress fracture?

With more and more kids playing organized sports and specializing early, there’s been a rise in the number of overuse injuries among children and teens. As a common overuse injury, stress fractures occur largely among runners and other athletes whose sports involve high-impact contact of the foot with the ground or floor — say, basketball and tennis players, track and field athletes, gymnasts, runners, and dancers. At Boston Children’s, our patients with stress fractures are usually teenagers or post-adolescents, since this is the age group that’s most likely to run and train competitively.

  • Stress fractures and other overuse injuries are sports-related microtraumas (small injuries) that result from repetitively using the same parts of the body.
  • A stress fracture results when fatigued muscles can’t absorb the shock (stress) of impact and transfer the stress load to a bone.
  • Most stress fractures occur in the weight-bearing bones of the foot or lower leg; over half occur in the lower leg — but can also occur to the hip (femoral neck).
  • Signs and symptoms of stress fractures — pain and inflammation — can resemble those of shin splints, so a proper diagnosis is important.
  • The risk of stress fractures increases if a runner has flat feet (fallen arches), which unevenly distribute the stress from impact, or trains too hard before being properly conditioned.

How can stress fractures be prevented?

  • proper conditioning and training (especially cross-training)
  • sport-appropriate equipment and protective gear
  • adequate rest between exercise sessions
  • a calcium- and vitamin D-rich diet (especially for teenage girls)
    • While boys and girls are equally vulnerable to stress fractures, adolescent female athletes experience these more often than boys.

Boston Children's approach to stress fractures and overuse injuries

You can have peace of mind knowing that the skilled team of experts in Boston Children’s Orthopedic Center has treated thousands of children, adolescents, adults, and professional athletes with injuries ranging from the minor to the highly complex. We can provide your child with expert diagnosis, treatment, and care — as well as the benefits of some of the most advanced clinical and scientific research in the world.

The Sports Medicine Division at Boston Children's has provided care to thousands of young athletes and is the health care choice of professional athletes and world-renowned dancers. We are the official orthopedic caregivers for the internationally famous Boston Marathon and the renowned Boston Ballet.