Why are marathon runners prone to pelvic stress fractures?

Pelvic stress fractures are considered as common overuse injuries experienced by marathon runners and can affect anyone from recreational athletes and even world-class competitors.

Various physical and environmental risk factors can instigate pelvic stress fractures, but even though the causes are often small, the effects of a fracture can be substantial and would require the individual to rest. If you want to learn more about stress fractures, click here.

What are the physiological factors?

Overuse injuries typically occur among endurance athletes such as marathon runners due to the demands of the sport as well as the overall health of the athletes. Always bear in mind that distance running entails the performance of the same movements in a repeated manner, thus subjecting the same muscles to constant movements while the joints endure continuous impact.

The situation is worsened since many often ignore the pain and simply push the muscles and joints up to the point of injury. Once the muscles are tired, the bones are forced to compensate by bouncing higher in the air during a stride, forcing the pelvis to absorb more impact. The individual might be forced to compensate in his/her stride for any imbalances in the leg length or posture, thus forcing the pelvis to absorb greater impact.

Pelvic stress fractures

Overuse injuries typically occur among endurance athletes such as marathon runners due to the demands of the sport as well as the overall health of the athletes.

Training factors

Once a runner abruptly increases his/her overall mileage more than 10% in a week or raises the intensity, the normal acclimation process of the body is skipped which places more strain on the pelvis.

By running on hard surfaces such as sidewalks and roads, especially on road surfaces that slant on the side, it puts a marathon runner at risk for a pelvis stress fracture. Even though the harshness of training can strain the pelvis of the individual, the strain can become more severe when the runner suffers from calcium deficiency, eating disorder, weakened bones or depleting of body fats used in cushioning the joints.


Many runners often confuse the starting phases of a pelvic stress fracture with a minor muscle pull. Nevertheless, unlike with the pain involved in a muscle pull, the pain of a stress fracture will not reduce during a run or loosen up with stretching.

Once a runner sustains a pelvis stress fracture, he/she might initially feel an aching, deep pain that stays localized in the hip. Nevertheless, if the injury is left untreated, the pain can eventually spread to the lower back, thigh and groin as the body tries to compensate for the weakened joint.


Just like with any injury, the ideal treatment for a pelvis stress fracture is no other than prevention. Runners must follow the 10% rule which involves avoiding an increase in the duration, frequency and intensity of the training by more than 10% every week. This will help prevent a pelvis stress fracture from occurring.

Runners can also run on soft surfaces such as crushed limestone trails or grass to reduce the impact absorbed by the pelvis. Once a runner develops a pelvis stress fracture, he/she must consult a doctor for proper assessment and must rest from running and other weight-bearing activities for 1-2 weeks. In severe cases of stress fractures, the runner might have to walk using crutches, avoid weight-bearing on the affected hip and even surgery.


No comments yet.

Leave a Reply