Newsroom Hospital for Special Surgery

How to Distinguish a Stress Fracture From Other Common Running Injuries—Before It Costs You Months of Training

Sat, 18 Jul 2026 16:38:00 -0400

Runner's World reported on how to distinguish a stress fracture from other common running injuries featuring insight from Todd McGrath, MD, sports medicine physician at HSS.

A stress fracture occurs when your bone literally cracks because of repeated stress. Based on that definition, you’d think the symptoms of this injury would be super obvious. Unfortunately, stress fractures aren't that straightforward.

“Even in medicine, we probably miss it sometimes or don't think about it as much when maybe we should,” said Dr. McGrath.

Treating a BSI early “shortens the duration of the treatment, as well as prevents a lot of excess treatment [such as surgery],” Dr. McGrath emphasizes.

Read the full article at runnersworld.com. A subscription is required to access.

Dariq Whitehead in good spirits after shin surgery: "I pretty much know what to expect"

Tue, 30 Jan 2024 10:05:00 -0500

Sports Illustrated reports on Brooklyn Nets Dariq Whitehead's recovery after having surgery to address the stress reaction in his left shin.

The surgery was performed by Martin J. O'Malley, MD, foot and ankle surgeon at HSS. The surgery turned out to be successful, and he is expected to have a healing period of approximately three months.

Read the full article at si.com.

Former tennis player uses a holistic training approach to conquer the TCS NYC Marathon

Sun, 05 Nov 2023 15:24:00 -0500

Elizabeth Laub is ready to hit the starting line of this year's TCS New York City Marathon.

This former Division I tennis player set her sights on the sport of running after college but setbacks almost had her sitting on the sidelines.

"I'd run a lot, I would get hurt, I would rest. I would run, get hurt, rest, and I felt like I was kind of trapped in this cycle of repeated injuries and nothing was really making it go away," she explained. "And I wasn't even sure why it was happening in the first place. So when I decided that this was the year I was going to take on the marathon, I knew I had to do something different."

She was diagnosed with stress reactions that can lead to stress fractures.

Enter HSS and and its running performance services, connecting Elizabeth with resources like Kate Baird, MA, ACSM-CEP, CSCS, exercise physiologist who offered a more holistic approach to marathon training.

"Like she said, she was kind of stuck in a cycle and she didn't know why this was happening," Baird said. “Between her work with Marci A. Goolsby, MD, sports medicine physician at HSS, Asma Mohammadi PT, DPT, OCS, FAAOMPT, CSCS, USATF-1, the physical therapist who did her running analysis and introduced her to me - and then the actual programming and the fitness testing, we were able to figure out, I think pretty clearly, what sort of factors were contributing to that and manage them across a 14-week program.”

Read the full article at abc7ny.com.

Are Breastfeeding Runners at Greater Risk of Bone Injuries?

Fri, 04 Aug 2023 14:34:00 -0400

Runners World reports on stress fractures and how to prevent them during the postpartum period according to experts including Jessica Rachel Starr, MD, endocrinologist at HSS.

Postpartum stress fractures in female runners can be common. Hormonal changes during pregnancy and breastfeeding combined with factors such as sleep deprivation contribute to these injuries.

Dr. Starr says, “Hormones govern this process: Estrogen regulates the breakdown of old bone and the growth of new bone. Levels rise during pregnancy, drop upon delivery, and remain lower lower during breastfeeding.”

“Lactating also stimulates the release of parathyroid-related hormone, which tells the body to break down bone,” explained Dr. Starr.

When Dr. Starr treats athletes with other vulnerabilities—such as pre-existing low bone density or an eating disorder—she’ll discuss the pros and con of breastfeeding, and when to wean, in their specific situation. Still, she rarely advises against breastfeeding altogether.

Read the full article at runnersworld.com.

Nets’ T.J. Warren discusses his progress back onto the court

Sun, 23 Oct 2022 12:41:00 -0400

AMNY reports TJ Warren (Brooklyn Nets) will be reassessed next month for return to play following two procedures for consecutive stress fractures in his left foot. Warren’s second surgery was performed by Martin J. O’Malley, MD, foot and ankle surgeon at HSS and Nets team orthopedist.

Read the full article at amny.com.

Additional coverage:

Zach Collins Undergoes Ankle Surgery

Tue, 29 Jun 2021 11:26:00 -0400

The NBA reports Portland Trail Blazers forward/center player Zach Collins underwent a successful second revision surgery to repair a left medial malleolus stress fracture on June 29, performed by Martin J. O'Malley, MD, foot and ankle surgeon at HSS.

Read the full article at NBA.com.

Additional coverage: NBCsports.com.

Getting Back Into Exercise? Take It Slowly to Avoid Stress Fractures

Wed, 09 Jun 2021 17:55:00 -0400

Autumn Years reports on how to avoid stress fractures featuring insight from David A. Wang, MD, sports medicine physician at HSS Paramus, Mark C. Drakos, MD, foot and ankle surgeon at HSS in Manhattan and Long Island and Jessica Rachel Starr, MD, endocrinologist at HSS.

A gradual return to exercise is key to avoiding injury. “The challenge is that when you have been inactive for a long time, the body gets weaker and cannot handle an activity at the previous intensity,” explained Dr. Wang.

“The foot is particularly vulnerable [to stress fractures],” said Dr. Drakos, “When people think of bones, they think they are hard like metal, but the bones in the foot are more like tree branches. They can bend a little bit and if you bend them enough times, they can crack.”

Dr. Wang recommended seeing a doctor if pain persists after a few hours of continuing an activity, or if people start experiencing pain on days when they not working out. “The ‘no pain, no gain’ mantra should be banished from our vocabulary. Pain is our body’s way of telling us that something is wrong,” he noted.

“It is also important to figure out what led to the stress fracture in the first place,” noted Dr. Wang. “The prevention part is just as important as the treatment part.”

A deficiency of vitamin D can affect healing, according to Drs. Wang and Drakos. Dr. Starr explained the daily recommendations for calcium and vitamin D, and noted that at least half of our calcium intake should come from foods such as dairy products, dark, green leafy vegetables and high-calcium fish like salmon and sardines.

Dr. Drakos emphasized the importance of wearing the right shoes for activity and supportive footwear when not exercising. “Most of us take more than a million steps a year. So, if you take 5,000 to 10,000 steps a day in shoes that are not giving you support, it is that much extra stress on your feet with every step you take.”

This article appeared in the June 2021 print edition and online at Omagdigital.com.

Getting Active Again Safely Following Sedentary Pandemic Lifestyles

Fri, 21 May 2021 11:52:00 -0400

Director of the non-surgical Foot and Ankle Service at HSS, Rock G. Positano, DPM, MSc, MPH, DSc, discusses trends in exercise and injuries during the COVID-19 pandemic. Dr. Positano shared that generally people have increased their walking mileage since the pandemic, which is an effective and safe mode of transportation. However, when increasing mileage suddenly, people are more predisposed to developing injuries like stress fractures in the bones, muscles, tendons and ligaments.

He encouraged people to be gradual about getting back into an exercise routine – if you aren’t accustomed to a certain amount of activity, you run the risk of overuse problems, particularly in muscle groups in the foot, ankle and back.

Dr. Positano’s tips for getting back into exercising: start slow (as rapid return to activity can be dangerous), feet and back pain are particularly common, and to avoid a self-diagnosis - advising to consult with a doctor about any issues.

This segment appeared during the 8am news hour on May 21, 2021.

Spring Activity Can Sometimes Bring Stress Fractures

Sun, 28 Mar 2021 16:08:00 -0400

HealthDay News reports if you're getting back into walking, running or outdoor sports this spring, you could be at risk for a common injury known as a stress fracture. According to HSS foot and ankle surgeon Mark C. Drakos, MD, a stress fracture is a small break or crack caused by repeated impact on a bone that is starting to weaken from overdoing it, and feet are particularly more vulnerable.

“Stress fractures often occur in runners, people who play high-impact repetitive sports and in older people who have weakened bones,” explained Dr. Drakos. Individuals who don’t get enough rest between workouts or who keep playing a sport despite exhaustion are also susceptible, as are people who take steroids, he added. Pain, swelling and bruising are symptoms of a stress fracture. If you think you have one, immediately stop doing any activity that causes discomfort, advised Dr. Drakos. Rest is the primary treatment. If pain comes on suddenly, apply ice and elevate the foot. If it's not better after a few hours or if you have pain on days when you're not exercising or playing sports, see a doctor, reccomended Dr. Drakos.

David A. Wang, MD, sports medicine physician at HSS, saw an increase in stress fractures among people who were inactive during pandemic lockdowns and then resumed an activity too quickly. He noted the key is to gradually build up your activity level to make sure your body can handle it. "If you've never run before and want to start running, for example, start with walking first, then jogging and then gradually start running," advised Dr. Wang.

Read the full article at Consumer.healthday.com.

Avoid Running into Trouble: Foot Pain, Swelling Could Signal Stress Fracture

Mon, 22 Mar 2021 15:50:00 -0400

Now that spring has arrived, we’ll be spending more time outdoors. Many people will return to walking or running for exercise or playing outdoor sports after being cooped up at home over the winter. It’s the time of year doctors tend to see an increase in overuse injuries, which occur from repetitive stress on a muscle, bone or joint over time. People often develop this type of injury after ramping up a sport or athletic activity too quickly.

One of the most common overuse injuries is a stress fracture, and the foot is particularly vulnerable, according to Mark C. Drakos, MD, an orthopedic surgeon specializing in foot and ankle injuries at Hospital for Special Surgery (HSS) in New York City and medical director of HSS Long Island in Uniondale.

Repeated impact on a bone that is starting to weaken from overdoing it can eventually lead to a small break or crack. A stress fracture does not cause the bone to shift position. “When people think of bones, they think they’re hard like metal, but the bones in the foot are more like tree branches. They can bend a little bit, and if you bend them enough times, they can crack,” said Dr. Drakos, who is an assistant team orthopedist for the New York Knicks. “The foot is one of the most common locations to sustain a stress fracture because we are constantly on our feet.”

The foot is an anatomical marvel, with 26 small bones, 33 joints and a network of more than 100 muscles, tendons and ligaments that work together to support our body weight, provide stability, and allow movement. Our feet are designed to absorb a tremendous amount of force with every step we take.

Stress fractures are often seen in runners, in athletic people who participate in high-impact repetitive sports and in older people who have weakened bones, Dr. Drakos says. Individuals who don’t rest adequately in between workouts or keep playing a sport despite exhaustion are at increased risk, as are people who take steroids.

David A. Wang, MD, a sports medicine physician at HSS Paramus in New Jersey, saw an increase in stress fractures in people who were inactive during the pandemic lockdown and then resumed an activity too quickly. “The challenge is that when you’ve been inactive for so long, the body gets weaker and cannot handle an activity at the previous intensity,” he explains. “We still want people to be active, and the cliché I always use is ‘slow and steady wins the race.’ The key is to gradually build up your activity to make sure your body can handle the load. If you’ve never run before and want to start running, for example, start with walking first, then jogging and then gradually start running.”

The main symptom of a stress fracture is pain, which generally occurs in the spot where the bone is broken, according to Dr. Drakos. People may also experience swelling and bruising. Anyone who may have suffered a stress fracture is advised to immediately stop any activity that is causing the discomfort. The main treatment for a stress fracture is rest.

For pain that comes on suddenly, people can try using ice and elevating their foot to see if the pain improves. If it doesn’t get better after a few hours or people start experiencing pain on days they’re not working out, the experts recommend seeing a doctor.

A stress fracture is diagnosed based on a discussion with one’s doctor about recent activities, any possible injury and where the pain is felt. The physician will examine the foot and order X-rays. Sometimes a CT scan or MRI is also prescribed to make the diagnosis.

Surgery is rarely needed for a stress fracture, according to Dr. Drakos. “As a general rule, many fractures of the foot can be treated without surgery by wearing protective shoe wear: either an orthopedic boot or a hard-soled shoe. People can generally put weight their foot when wearing the protective footwear.” Most stress fractures heal in four to six weeks.

Dr. Drakos says lifestyle choices and good habits can lower the risk of developing a stress fracture, not only in the foot, but in other bones as well. He says people should support their bone health with adequate consumption of calcium and vitamin D. He has seen many patients who were found to be deficient in vitamin D, which can also affect healing.

He also stresses the importance of wearing supportive shoes. “Flimsy footwear such as flip flops or ballet slippers do not provide adequate support,” he says. “We take more than a million steps a year. So, if you take 5,000 to 10,000 steps a day in shoes that aren’t giving you a lot of support, it’s that much extra stress on your feet with every step you take.”