Femoral Stress Fractures in The Female Runner: Causes, Symptoms, and Treatment

Femoral Stress Fractures in The Female Runner: Causes, Symptoms, and Treatment

Femoral Stress Fractures in The Female Runner: Causes, Symptoms, and Treatment


Running is a popular sport among women, providing numerous health benefits, including improved cardiovascular fitness, mental health, and overall well-being. However, high-impact activities like running can sometimes lead to injuries, one of the most concerning being femoral stress fractures. This blog post will explore the causes, symptoms, and treatment options for femoral stress fractures in female runners. If you're considering physiotherapy in Oviedo, FL, contact B Physical Therapy today to schedule an appointment.


What is a Femoral Stress Fracture?

A femoral stress fracture is a small crack or severe bruising within the femur (thigh bone) that occurs due to repeated mechanical stress rather than a single traumatic event. These fractures are common among runners, particularly female runners, due to various physiological and biomechanical factors.

Causes of Femoral Stress Fractures in Female Runners

1. Repetitive Stress

The primary cause of femoral stress fractures is repetitive stress on the femur. Running exerts repetitive loads on the bones, which can lead to micro-damage. If the bone does not have enough time to repair itself between runs, these micro-damages can accumulate, resulting in a stress fracture.

2. Bone Density and Hormonal Factors

Female runners are at a higher risk of developing stress fractures due to lower bone mineral density compared to their male counterparts. Factors like menstrual irregularities, low estrogen levels, and conditions such as the Female Athlete Triad (disordered eating, amenorrhea, and osteoporosis) can significantly affect bone health.

3. Training Errors

Rapid increases in mileage, intensity, or frequency of training without adequate rest periods can overwhelm the body’s ability to recover, leading to stress fractures. Additionally, insufficient warm-up, poor running form, and inadequate footwear can contribute to the risk.

4. Nutritional Deficiencies

Calcium and Vitamin D are crucial for bone health. A diet lacking in these nutrients can weaken bones, making them more susceptible to stress fractures. Female athletes, in particular, need to ensure they’re consuming enough calories to support their activity level and maintain bone health.

5. Biomechanical Factors

Biomechanical abnormalities such as overpronation, leg length discrepancies, or muscle imbalances can alter the distribution of forces across the femur during running, increasing the risk of stress fractures.

Symptoms of Femoral Stress Fractures

Identifying the symptoms of a femoral stress fracture early can prevent further damage and facilitate quicker recovery. Common symptoms include:

1. Pain

  • Location: Pain is typically felt in the groin, thigh, or hip area.
  • Nature: The pain usually starts as a dull ache and becomes more persistent and severe with continued activity.
  • Timing: Pain may initially occur only during running but can progress to being present even at rest if the fracture worsens.

2. Swelling and Tenderness

Swelling and tenderness over the affected area of the femur can occur, though this is less common.

3. Difficulty Weight-Bearing

As the fracture progresses, placing weight on the affected leg can become increasingly painful and difficult.

4. Altered Gait

To avoid pain, individuals may develop a limp or altered gait, which can further strain other parts of the body and lead to additional injuries.

Diagnosis of Femoral Stress Fractures

Early diagnosis of femoral stress fractures is crucial for effective treatment. Healthcare professionals, including physiotherapists, use a combination of patient history, physical examination, and imaging studies to diagnose stress fractures.

1. Patient History

A detailed history of the patient’s training regimen, symptoms, and any previous injuries is collected to identify potential risk factors and the likely cause of the fracture.

2. Physical Examination

A physical exam may reveal tenderness over the femur, pain with hip rotation, and other signs indicative of a stress fracture.

3. Imaging Studies

  • X-rays: Often the first imaging test performed, though early stress fractures may not be visible.
  • MRI: Provides detailed images and is highly sensitive in detecting stress fractures.
  • Bone Scan: Can detect stress fractures but is less specific than MRI.

Treatment of Femoral Stress Fractures

Treatment for femoral stress fractures focuses on relieving pain, promoting healing, and preventing recurrence. Here are some common treatment strategies:

1. Rest and Activity Modification

  • Initial Phase: Complete rest from running and high-impact activities to allow the bone to heal.
  • Gradual Return: A structured return-to-running program under the guidance of a physiotherapist to avoid re-injury.

2. Physiotherapy

Physiotherapy plays a vital role in the recovery and prevention of femoral stress fractures. At B Physical Therapy in Oviedo, FL, our team of experts can design a personalized rehabilitation program that includes:

  • Pain Management: Techniques such as ice, heat, and electrical stimulation to manage pain and inflammation.
  • Strengthening Exercises: Focus on strengthening the muscles around the hip and thigh to support the femur and improve biomechanics.
  • Flexibility Training: Stretching exercises to maintain flexibility and reduce muscle tension.
  • Gait Analysis and Correction: Assessing and correcting any biomechanical issues to prevent future stress fractures.

3. Nutrition

Ensuring adequate intake of calcium, Vitamin D, and overall caloric intake to support bone health and recovery.

4. Medications

In some cases, doctors may prescribe pain relievers or recommend supplements to aid in bone healing.

Prevention of Femoral Stress Fractures

Preventing femoral stress fractures involves a combination of proper training, nutrition, and regular monitoring of bone health. Here are some tips to help female runners stay injury-free:

1. Gradual Training Progression

Increase running mileage and intensity gradually, allowing the body time to adapt and recover.

2. Cross-Training

Incorporate low-impact activities such as swimming or cycling to reduce repetitive stress on the femur while maintaining cardiovascular fitness.

3. Proper Footwear

Wearing appropriate running shoes that provide adequate support and cushioning can help prevent biomechanical issues.

4. Strength Training

Regular strength training exercises targeting the lower body can improve muscle balance and support for the femur.

5. Nutritional Support

Maintain a balanced diet rich in calcium and Vitamin D, and ensure adequate caloric intake to support bone health and overall performance.

6. Regular Check-Ups

Regular visits to a healthcare professional or physiotherapist for monitoring bone health and addressing any early signs of stress fractures.



Femoral stress fractures are a serious concern for female runners, but with proper understanding, early diagnosis, and effective treatment, recovery is achievable. Preventive measures, including gradual training progression, proper nutrition, and regular strength training, can significantly reduce the risk of these injuries.

If you're a runner experiencing symptoms of a stress fracture or looking to prevent such injuries, considering physiotherapy in Oviedo, FL can be a proactive step. At B Physical Therapy, our experienced team is dedicated to helping you maintain optimal health and performance. Contact us today to schedule an appointment and take the first step towards a healthier, injury-free running journey.

By understanding the causes, symptoms, and treatment options for femoral stress fractures, female runners can take proactive steps to protect their health and continue enjoying the many benefits of running. Remember, early intervention and preventive measures are key to staying injury-free and performing at your best.

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