How Do I Know If I Have A Stress Fracture?
If you’re a runner in Atlanta logging miles on the BeltLine or training for local Atlanta races, chances are you’ve felt some leg pain along the way. But how do you know when that dull ache is just training fatigue and when it could be something more serious? That becomes an extremely important questions for Atlanta runners to answer to make sure they don’t find themselves developing a stress fracture.
Stress fractures are one of the most frustrating overuse injuries in runners. They often sneak up slowly, starting as a mild ache that becomes sharper and more persistent if ignored. Recognizing the signs early can make the difference between a few weeks of modified training and having to cancel race plans.
What Is a Stress Fracture?
A stress fracture is a small crack in a bone, usually caused by repetitive impact that exceeds your body’s ability to recover.
In runners, these most often occur in the:
Tibia (shin bone)
Metatarsals (foot)
Femur (thigh bone)
Hip or pelvis (less common but serious)
Unlike an acute fracture, you might not recall any single moment of injury. Most of the runners we work with at Tempo Physical Therapy will explain that they just gradually experienced worsening pain with running.
What Are Key Signs and Symptoms of a Stress Fracture
Here’s what typically separates a stress fracture from general soreness, such as shin splints:
1. Localized Pain
You can often point to the exact spot that hurts. With shin splints, pain tends to be more diffuse and spread over a larger area while a stress fracture in the shin will have a very precise spot of pain when palpated. At other common stress fracture sites in runners, the pain will also be pinpoint and tender to the touch.
2. Pain That Worsens With Impact
Walking, running or hopping makes it significantly worse. The pain often lingers even after stopping activity. At our Atlanta clinic, we will take runners through a series of clinical examinations to properly identify if there is a potential stress fracture present.
3. Swelling or Tenderness
There may be slight swelling or a tender “bump” over the bone. This is particularly true for a stress fracture in the shin bone or foot.
4. Pain That Progresses Over Days or Weeks
This is where runners usually mess up. The pain starts as mild discomfort that runners will typically ignore over a series of weeks. The pain steadily worsens with each run until even daily activities like walking or standing begin to hurt. Stress fractures do not come out of nowhere for runners. There are signs and knowing what to look out for is key for runners in Atlanta.
5. Pain at Rest or at Night
If your pain persists when you’re not running, that’s a red flag that something more serious (like a stress fracture) may be going on. Runners will describe the discomfort as a deep ache or throbbing when they are sitting or laying down at night.
How to Tell the Difference Between a Stress Fracture and Shin Splints
Shin Splints
Pain Location: Broad area along shin
When It Hurts: Mostly at the start of runs
Swelling: Minimal
Palpation: Diffuse Tenderness
Severity: Mild to moderate
Stress Fracture
Pain Location: Small, pinpoint spot
When It Hurts: During & after run; at rest
Swelling: Possible localized swelling
Palpation: Sharp, localized tenderness
Severity: Moderate to severe
If you’re unsure, schedule an appointment with a running specialized physical therapist. To be safe, assume it could be a stress fracture since running through it can turn a small crack into a full fracture.
When to See a Running Specialized Physical Therapist or Sports Medicine Provider
If your pain has lasted more than a few days and worsens with impact, it’s time to stop running and get evaluated.
A running specialized physical therapist can:
Assess your symptoms and running mechanics
Refer you for imaging (if needed) to confirm diagnosis
Create a modified training plan to keep you active safely
Address contributing factors (training load, shoes, strength, running form)
At Tempo Physical Therapy in Atlanta, we specialize in helping runners recover from stress fractures and prevent them from returning. Our 3D gait analysis identifies the subtle movement patterns or muscle imbalances that contribute to bone stress injuries so you can come back stronger.
How Stress Fractures Are Treated
Stress fracture treatment runners get at Tempo Physical Therapy will always depends on the location and severity of the fracture, but most cases involve:
Relative rest (not total rest) involving cross-training such as cycling or pool running.
Gradual return to impact under PT guidance.
Strength and mobility training for the hips, calves and core to reduce load on bones.
Gait retraining to improve stride mechanics.
Nutritional support and appropriate referral to interdisciplinary care professionals for runners.
Preventing Future Stress Fractures
The biggest risk factor for a stress fracture in runners in a previous stress fracture. That means, as a runner, you really want to make sure you get the rehab process right so you don’t have to experience it again. At our physical therapy clinic, we shift our focus to prevention once you’ve healed which looks like:
Building mileage gradually.
Incorporating 2–3 days of strength training weekly.
Rotate shoes and replace worn pairs regularly.
Add low-impact cross-training during higher mileage weeks.
Get a running gait analysis to identify risk factors early.
Local Insight: Where Atlanta Runners Are Most at Risk
We often see stress fractures spike around race season, especially leading up to the Peachtree Road Race or Atlanta Marathon, when runners ramp up mileage on hard pavement. If you’ve been training on hilly routes like Kennesaw Mountain or spend a lot of time on the sidewalks around Atlanta, you may be putting extra load on your lower legs and increasing injury risk.
Final Thoughts: Don’t Ignore That Persistent Pain
If you suspect a stress fracture, don’t try to “run through it.” Early diagnosis and targeted rehab can make a huge difference in how quickly you get back to running pain-free.
At Tempo Physical Therapy, we help Atlanta runners recover from stress fractures with personalized treatment, strength training and gait analysis designed specifically for runners.
If you’re a local runner in Atlanta, book your FREE consultation call with us to get back to running pain free.
