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Running Through Pain? How to Know If It’s a Stress Fracture (And What to Do Next)

Is It Just Soreness or a Stress Fracture?
Shin pain is common in runners. But when does it go from normal soreness to something more serious, like a bone stress injury (BSI), also known as a stress fracture?

At Vertex PT Specialists, we work with runners across Columbia, Cayce, Irmo, Lexington, and Richland County who want to avoid long layoffs and come back strong. Knowing when and how to safely return is critical.

How to Know If You’re Ready to Return to Running
Here are objective tests you can try at home. These Physical Performance Tests (PPTs) are adapted from Chris Johnson one of the top clinicians in running rehab.

✅ 1. Single-Leg Calf Raise
Hold 30 to 40% of your body weight in the same-side hand while doing 6 to 8 slow, controlled reps.
✅ 2. Step Downs
Perform 15 lateral step downs from a 7 to 8 inch step without pain or compensation.
✅ 3. Pogo Jumps
Pogo in place for 60 seconds to a metronome at 150 bpm.
✅ 4. Single-Leg Hop
Hop on one leg at 150 bpm. If you can’t keep the rhythm or feel pain, you may need more prep.
✅ 5. Zig-Zag Hops
Perform 20 seconds of side-to-side hops in a zig-zag pattern. Focus on control, not speed.

If you struggle with any of the above, it’s probably too early to resume full running volume. That’s where we come in.

Our Approach: Helping Runners Return Safely
At Vertex PT, we go beyond rest and generic advice. You’ll get a customized plan including:

  • Strength and stability training (hips, calves, foot intrinsics)
  • Plyometric progression
  • Gait retraining (like cadence and contact time)
  • Guidance on footwear and training errors
  • Return-to-run programming specific to your sport and goals

We don’t guess. We test.

Serving Runners Across the Midlands
We help runners in Columbia, Irmo, Cayce, Lexington, and nearby areas get back to doing what they love without fear of re-injury.

Whether you’re training for the Governor’s Cup, qualifying for Boston, or just want pain-free jogs after work, we’ve got your back.

Start Today
Visit us: vertexpt.com
Call: (803) 973-0100

And for a deeper dive into Bone Stress Injury (BSI) research and rehab, check out the original work from Chris Johnson.

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Speed Up Healing from Stress Fractures: The Benefits of Physical Therapy for Runners

As a runner, there is nothing more frustrating than being sidelined with an injury. Unfortunately, stress fractures are a common injury among runners, and they can be particularly frustrating to deal with because the treatment typically involves rest and limited activity. However, physical therapy can be a game-changer when it comes to healing from a stress fracture.

First, let’s talk about why rest alone may not be the best approach. While it’s true that rest is essential to allow the bone to heal, too much rest can actually be detrimental to the healing process. That’s because bone mineral density (BMD) can decrease during periods of inactivity. BMD is the measure of the amount of minerals, such as calcium and phosphorus, in a certain amount of bone tissue. When there is not enough stress placed on the bone, osteoclasts (cells that break down bone tissue) can become more active than osteoblasts (cells that build new bone tissue), leading to a decrease in BMD.

This is where physical therapy comes in. Physical therapists are experts in designing exercise programs that promote healing and prevent further injury. With a stress fracture, the goal of physical therapy is to gradually introduce stress to the bone in a controlled way to stimulate osteoblasts and prevent a decrease in BMD. This can be achieved through exercises such as weight-bearing activities and resistance training, which can be tailored to each individual based on their specific injury and level of fitness.

One technique that has gained popularity in recent years is blood flow restriction (BFR) training. BFR involves using a cuff or wrap to partially occlude blood flow to the limb during exercise. This technique has been shown to increase muscle strength and size, but it may also have benefits for bone health. Research has shown that BFR can stimulate the release of growth hormone, which is essential for bone growth and maintenance. Additionally, BFR can lead to an increase in vascular endothelial growth factor (VEGF), which promotes the growth of new blood vessels and bone tissue.

In summary, physical therapy can be an effective way to speed up the healing process for runners with stress fractures. By gradually introducing stress to the bone through controlled exercise, physical therapists can promote bone health and prevent a decrease in BMD. Techniques such as BFR may also have additional benefits for bone health. If you’re a runner in The Midlands who is dealing with a stress fracture, consider reaching out to Vertex for expert physical therapy care. Our team of skilled therapists can design a personalized program to help you heal and get back to doing what you love.

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