Published on 03 June 2026
This year’s London Marathon received an astonishing 1.13 million applicants – a record-breaking figure which smashed 2025’s previous record of 840,318 and nearly doubled the figure from 2024. It’s clear from these statistics that running really is having a moment - not just at a higher level with big-city marathons, but right down at the grassroots with Parkruns, community clubs and informal running groups attracting people who never saw themselves as ‘runners’ before.
It’s evidently more crucial than ever for runners to have clear, accessible information on preventing and managing injuries, particularly overuse injuries. With the makeup of the typical running community older than it was a decade ago, the way people run, train, and participate in events has changed dramatically in recent years, and the injury landscape has changed with it.
This article explores two of the most common overuse injuries for runners: stress fractures and shin splints – and how to prevent, recognise and manage them.
What is a stress fracture?
Research indicates that around one in five distance runners develop a stress fracture at some point in their career, making it one of the sport’s most frequent - and most feared - overuse injuries.
A stress fracture is a small, hairline crack in a bone that develops when physical activity, such as playing sport or repetitive motion, puts repeated stress on the bone, meaning its natural repair cycle can’t keep up with the cumulative impact. It usually affects the weight-bearing bones in your lower body like the shin, foot or hip, forming gradually over time from a bone bruise and developing into a small crack in the bone surface.
Research suggests women are more prone to stress fractures, with some studies showing women are two to three times more likely to develop them compared to men. This is due to biomechanical factors, hormonal fluctuations, and a lower baseline bone mineral density.
What does a stress fracture feel like?
Symptoms often involve sharp, localised/pinpoint pain that worsens with activity, along with mild swelling and tenderness when pressed. Spotting these signs early and easing the load on the bone is essential, as continuing to place stress on it can allow a small stress reaction to progress into a more serious injury.
There are steps you can take to avoid stress fractures, such as:
- Gradually increasing your training volume - Avoid "too much, too soon" and don’t jump into intense, high-impact routines without a base level of fitness
- Eating a bone-healthy diet - Ensure your diet is rich in calcium (dairy, leafy greens such as curly kale, okra) and Vitamin D (oily fish such as salmon, sardines, trout, herring or mackerel; red meat, egg yolks). Vitamin D is essential for your body to absorb calcium. Our personalised nutritional therapy and lifestyle programmes can help to ensure you're at the peak of health.
- Wearing proper footwear - This can help reduce your risk of stress fractures. Good footwear lowers bone-loading forces and improves shock absorption, which are known contributors to stress fracture risk. You should consider getting your gait analysed to help identify your running pattern; this can help when choosing running shoes.
What is a shin splint?
Shin splints, otherwise known as medial tibial stress syndrome (MTSS), occur when the shin bone and its surrounding muscles and tendons are overloaded by repetitive stress or sudden increases in physical activity. Runners are particularly susceptible to developing the condition, which accounts for up to 15% of all running injuries.
Having flat feet or unusually rigid arches or inward-turning knees are factors that can increase your risk of the condition, as well as exercising in improper or worn-out footwear.
How to tell if you have a shin splint
You may feel pain and tenderness along the front of your lower leg, especially during or after running or high‑impact exercise. This pain may initially be felt as a mild, dull ache, which can worsen when the affected area is touched and become sharper over time if the underlying stress isn’t addressed.
They aren’t serious, with most people recovering in two-six weeks through immediate rest and modifying their activity.
Runners can help to prevent shin splints by:
- Avoiding sudden spikes in mileage - building their distances slowly
- Properly warming up by stretching the lower-leg muscles
- Running on softer surfaces where possible
- Wearing supportive footwear
What tests can be used to tell if I have a stress fracture or shin splint?
If you’re worried about stress fracture symptoms (persistent localised pain, pain that worsens with impact, swelling or pain at rest), it’s important to speak with a GP or physiotherapist who can assess you properly.
Our new DEXA bone density scanning service can be used to evaluate your risk of a stress fracture or shin splint. Whilst a DEXA scan cannot diagnose these conditions, it can assess whether you have a low bone mineral density (BMD), a known risk factor for bone stress injuries. It can also help a clinician understand whether your bones are more vulnerable to repetitive impact or highlight underlying issues like Relative Energy Deficiency in Sport (RED-S) - a condition that happens when an athlete isn’t taking in enough energy (food) to meet the demands of their training and daily life, resulting in poor bone health.
To book a DEXA scan, you’ll need a referral from a healthcare professional - this could be your GP, our Private GP service, or an orthopaedic consultant or osteopath.
You might also need a referral for a SPECT-CT scan or an MRI scan - the most accurate test for diagnosing stress fractures. Our recently refurbished MRI suite offers advanced state-of-the-art scanning technology enhanced with artificial intelligence, providing increased image quality and faster scan times, increasing capacity and allowing the hospital’s Imaging team to identify health issues quickly and effectively.
Find your stride again with treatment at Benenden Hospital
Dealing with ongoing pain in your lower legs or feet, or needing guidance on recovering safely and returning to running? Our team is ready to support you.
Our experienced GPs, orthopaedic consultants, podiatrists and physiotherapists offer expert assessment, access to diagnostic imaging and personalised rehabilitation programmes to help you get back to running with confidence.
To find the right support for your needs, contact our Private Patient team on 01580 363158 or complete our online enquiry form.