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Causes of repeated stress fractures with all tests normal?

Question: Causes of repeated stress fractures with all tests normal?

I am a new runner in fairly good shape. I began running last summer and within 3 weeks had a stress fracture of my tibia. Upon recovery, I diversified my training to include hill sprints, weight lifting, swimming and cycling and ran very little. Within 2 weeks of running again, I stress fractured my tibia again, same leg, different place.

I have great, new shoes professionally fit to me. I am not overweight. I do not smoke.

I have a normal DEXA scan, low vitamin D (but higher than it has been), normal thyroid and parathyroid results, normal blood calcium levels.

I have had 4 children in the past 8 years and nursed them for a total of 5 years. This means out of 103 months, I have not menstruated for 84 of those. I expected a DEXA scan to show any depleted reserves in my bone density but all of it was normal.

I want to start training for a sprint distance tri in June but at this point, feel like I'm going to have to keep running in the pool until the week of the race!

Anyone have any ideas? I'm out of them and getting really frustrated!


See a physio


The good thing about a sprint distance tri is that you only have to run 5km. That's a short enough distance that smart training should not lead to overuse injuries.

Treating runners is hard work for a physiotherapist. There are lots of external factors that lead to overuse injuries, such as proper shoes, terrain, and program. These are YOUR job to control. In addition, if you are overtraining, then enjoy the stress fractures! These types of runners drive me insane.

If you are being good, and not overtraining, I cannot help but wonder about the possibility of pelvic instability. Pregancy and delivery puts a great deal of strain on the musculature related to the pelvic girdle. If you cannot maintain pelvic stability while running, then the force is likely being transferred down the leg and leading to a stress fracture.

I agree...find a GOOD physio.


Tamara, orthopedic physiotherapist