{"id":929732,"date":"2026-10-12T03:04:11","date_gmt":"2026-10-12T03:04:11","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/929732\/"},"modified":"2026-10-12T03:04:11","modified_gmt":"2026-10-12T03:04:11","slug":"stress-reaction-causes-treatment-prevention","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/929732\/","title":{"rendered":"Stress Reaction: Causes, Treatment, Prevention"},"content":{"rendered":"

Many runners feel occasional aches pop up, especially as mileage increases<\/a>. Most of the time, with rest, strength training, and recovery practices, you can address the discomfort. But certain types of aches signal early bone stress injuries that can lead to hanging up your shoes… for months.<\/p>\n

In runners, these types of injuries most often occur in the tibia (shinbone), but they can also happen throughout the lower body, including in the foot, thigh, and hip bones, Todd McGrath<\/a>, MD, a primary sports medicine physician with Hospital for Special Surgery in New York City, tells Runner\u2019s World.<\/p>\n

One type of bone stress injury is known as a stress reaction, and knowing the difference between stress reactions versus stress fractures can save you weeks of precious training time.<\/p>\n

Here\u2019s everything experts want you to know, and what you can do to prevent aches from worsening.<\/p>\n

The Difference Between a Stress Reaction and a Stress Fracture <\/p>\n

Bone stress injuries are when a bone cannot withstand a load or force placed on it, and as a result, experiences a structural failure, physical therapist Nicole Haas, PT, DPT<\/a>, founder of Boulder Physiolab<\/a> in Boulder, Colorado, tells Runner\u2019s World.<\/p>\n

In the case of a stress reaction, a bone can weaken and swell, but it doesn\u2019t actually crack, McGrath explains. If left untreated, a stress reaction can eventually crack, which is when it then becomes a stress fracture. Basically, a stress reaction is a precursor to a stress fracture<\/a>.<\/p>\n

Bone stress injuries typically occur on a spectrum, though, so sometimes it\u2019s difficult to tell the difference between a severe stress reaction and an early stress fracture, explains John Vasudevan<\/a>, MD, associate professor and director of the running and endurance Sports Medicine Program at Penn Medicine.<\/p>\n

Causes of Stress Reactions<\/p>\n

Typically, the most common cause of stress reactions is a large ramp-up in training without enough rest, Haas says, as this can overload your bones.<\/p>\n

How much is too much<\/a>? Well, depending on your overall fitness and weekly running volume<\/a>, increasing your mileage by more than 10 to 20 percent per week can elevate your risk, McGrath says.<\/p>\n

If your mileage is on the lower end (say, 10 miles a week) then a 20 percent jump week to week may be fine. If you\u2019re logging lots of miles (for example, 100 a week), it\u2019s probably wise to limit jumps to no more than 10 percent weekly, McGrath advises, though what your body can tolerate will depend on your fitness level, plus other factors.<\/p>\n

Keep in mind running isn\u2019t the only way to overload your bones. It\u2019s possible to place more stress on them in other ways. For example, by taking lots of long power walks every day, or joining an intramural sports team, in addition to ramping up your running routine, Haas says.<\/p>\n

Faulty biomechanics<\/a> can also increase your risk, Haas adds. Overstriding<\/a>, in particular, can increase ground reaction forces (basically, how much force is translated into the ground and then back into your body with every footstrike), which can then place your bones under elevated stress.<\/p>\n

Another possible culprit: Nutritional issues. \u201cIf you\u2019re not getting the energy you need, your body finds a way to get energy and sometimes that\u2019s stealing it from the bone turnover, which can further weaken the bone,\u201d McGrath explains. Those affected by Relative Energy Deficiency in Sport (RED-S)<\/a>\u2014basically, a condition of low-energy availability<\/a> caused by chronic underfueling\u2014can experience these bone stress injuries.<\/p>\n

Combating nutritional risk factors means not only taking in enough calories, but also getting enough calcium and vitamin D<\/a>, as well as protein<\/a>, Vasudevan says. He also says hormone imbalances can play a role in bone stress injury risk, particularly in adolescents and postmenopausal women.<\/p>\n

Signs of Stress Reactions<\/p>\n

Understanding the signs of a stress reaction can help you determine when it\u2019s time to seek help.<\/p>\n

One big symptom: Pain that crops up or worsens with running and improves with rest<\/a>. \u201cSometimes it progresses to just pain with walking,\u201d McGrath says, and as a reaction gets more severe, it can morph into chronic discomfort in a particular area, he explains.<\/p>\n

By comparison, overuse soft tissue injuries, like tendonitis<\/a>, usually cause lingering pain after activity and feel sore and stiff in the mornings, whereas sprains and strains<\/a> are typically caused by a sudden, severe injury and can be distinguished based on hearing the history of what led to the pain, McGrath explains.<\/p>\n

Tendon issues also typically feel better as you do activity and get warmed up, whereas stress reactions feel worse with more activity, Vasudevan adds.<\/p>\n

Another sign of stress reactions is that the pain is usually point tenderness, meaning you can take one finger to demonstrate a specific location where it hurts, versus sweeping your hand across a broad area, Haas explains. If pushing on a bone causes or increases pain, that\u2019s another likely sign of a stress reaction, McGrath adds.<\/p>\n

There aren\u2019t many visual clues, but in some cases\u2014especially if it\u2019s a stress reaction in your foot bones<\/a>\u2014you may notice swelling around the tender area, McGrath says.<\/p>\n

When to See a Doctor<\/p>\n

In the case of suspected stress reactions, it\u2019s important to get checked out sooner rather than later to prevent things from progressing to a stress fracture. Haas recommends athletes come in for an evaluation if it\u2019s been two weeks and their pain is getting intense or more pervasive with each run.<\/p>\n

Another sign to book a doctor\u2019s appointment is if you have pain while running<\/a> that gets better with rest but then comes right back as soon as you lace up again, she adds.<\/p>\n

McGrath advises people who notice pain in the region of a bone as they\u2019ve ramped up their running volume<\/a> or intensity<\/a> to also get checked out by a doctor.<\/p>\n

Once you\u2019re at the doctor, there are a few ways they may diagnose a stress reaction. In some cases, they can identify it based on doing an exam and hearing your history, McGrath explains. Otherwise, they may X-ray the tender area to confirm there are signs of bone changes that indicate a stress reaction, or do an ultrasound to get a better look, he says. They may also order an MRI if other imaging tests aren\u2019t conclusive, McGrath adds.<\/p>\n

Prevention Tips<\/p>\n

No runner likes to be told not to run. But if you have a suspected stress reaction, your wisest course of action is to take a beat from lacing up until you\u2019ve been evaluated by a medical pro.<\/p>\n

Bone stress injuries are \u201cprobably one of the very few injuries that I will tell runners to stop running,\u201d Haas says. And that\u2019s because continuing to place stress on a bone that\u2019s already overloaded will only exacerbate the issue\u2014and could potentially lead to some pretty serious complications (not to mention even more time on the sidelines).<\/p>\n

\u201cIf you keep running on a stress fracture, the fracture won\u2019t heal and it can potentially widen and you could even have displacement of the fracture and then need surgery to fix it,\u201d says McGrath.<\/p>\n

\u201cI try to emphasize to my athletes: Give me just one to two weeks of rest and cross-training<\/a> and you can prevent six to eight weeks of a halt to your training,\u201d Vasudevan adds.<\/p>\n

Now, if you have a suspected stress reaction, you don\u2019t need to glue your butt to the couch while waiting for a doctor\u2019s appointment. \u201cAs long as it\u2019s doing better with relative rest, until you get it looked at, I don\u2019t think you have to immobilize it totally or unweight it totally,\u201d McGrath says. Instead, simply avoid activities that make your tenderness worse and generally aim to take things \u201ca little bit easy,\u201d he says.<\/p>\n

So, this likely means steering clear of things like running, jumping, excessive walking, and plyometric exercises<\/a> and instead focusing on low- or no-impact activities like swimming, cycling, deep water pool running, yoga<\/a>, and Pilates<\/a>, McGrath says. Resistance training<\/a> is also typically okay so long as it doesn\u2019t involve lifting heavy loads while standing or weight-bearing, he adds.<\/p>\n

If you\u2019re like most runners, we know it\u2019s probably not in your nature to lay low, but think of it this way: By taking a relatively short pause from training now, you can prevent the need for a longer hiatus down the road.<\/p>\n

\"Lettermark\"<\/p>\n

Jenny is a Boulder, Colorado-based health and fitness journalist. She\u2019s been freelancing for Runner\u2019s World since 2015 and especially loves to write human interest profiles, in-depth service pieces and stories that explore the intersection of exercise and mental health. Her work has also been published by SELF, Men\u2019s Journal, and Cond\u00e9 Nast Traveler, among other outlets. When she\u2019s not running or writing, Jenny enjoys coaching youth swimming, rereading Harry Potter, and buying too many houseplants.\u00a0<\/p>\n

\"Headshot<\/p>\n

John Vasudevan, M.D. is an associate professor at the University of Pennsylvania. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He is a Team Physician for UPenn Athletics and \u00a0medical director of the Broad Street Run and Philadelphia Distance Run, and previously for the Rock ‘n’ Roll Half-Marathon and Tri-Rock Triathlon in Philadelphia. He is a director of the running and endurance Sports Medicine Program at Penn Medicine. \u00a0Dr. Vasudevan provides non-operative management of musculoskeletal conditions affecting athletes and active individuals of all levels, and combines injury rehabilitation with injury prevention. He utilizes a variety of ultrasound-guided procedures and regenerative approaches such as platelet-rich plasma and percutaneous ultrasonic tenotomy. He sees patients at the Penn Medicine and the Philadelphia Veterans Administration hospital. Dr. Vasudevan attended medical school at the University of Wisconsin School of Medicine and Public Health in Madison. After his Transitional Year in Tucson, Arizona, he went to residency in PM&R at Thomas Jefferson University in Philadelphia and onwards to Stanford University for his fellowship in Sports Medicine. He has been in practice at the University of Pennsylvania since 2012.\u00a0<\/p>\n