Running is one of the most popular exercises among women (a staggering 54% of all runners are female), and stress fractures affect 20% of runners. Stress fractures are when tiny cracks in the bone that can happen because of repetitive force or overuse. New pilot research from Jefferson is exploring the idea that physiological factors that increase the risks for stress fractures and ways to prevent them. 

“Most of the literature focuses on elite runners or athletes,” says Therese Johnston, PT, Ph.D., MBA, Professor in the Department of Physical Therapy and first author of both studies. “It was important for us to capture the regular or average female runner in these studies, and the main goal was to see how we can prevent a first or subsequent fracture.”

This study includes the same set of female runners, ranging in age, the intensity of running. The big difference in the women is that 20 had a history of stress fractures and 20 had no known history of stress fractures. Different physiological factors can contribute to the increased risk, including bone structure, density, hormone levels, and the different levels of training, including length and intensity. The results were that there was no difference in estradiol hormone levels between the two groups of women. A critical finding between the women who have had stress fractures in the past versus those who did not is that the women with a history of stress fractures had lower hip bone mineral density, meaning decreased bone strength. 

Another unexpected find is that women with a history of stress fractures didn’t know what the pain they were feeling meant. They continued to push through their workouts and were not given proper guidance when they went to a healthcare provider. It was clear that adequate guidance on handling stress fractures needs to be addressed, especially about how to prevent them. 

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