When I was going into 11th grade, I started experiencing pain in my lower leg during pre-season football training.  At first, it was just annoying, but over time it became unbearable.  I saw a doctor, but they said nothing was wrong, so I kept playing. By the second week of the season, I was taking 12–15 Advil a day to manage the pain. At first, it helped, but the relief quickly faded. Eventually, I returned to the doctor, who ordered an x-ray and diagnosed me with a stress fracture.

If I knew then what I know now, I would have handled the situation differently. Here are some key considerations for athletes dealing with stress fractures:

Managing Training Volume

Understanding training volume—also known as player load—is crucial in reducing the risk of a stress fracture. Athletes should follow a structured program that gradually increases their capacity to handle the demands of daily practices.  At UCLA, we used a “currency system” where each drill had a cost, and if a player ran out of currency, they were shut down for the day. This type of monitoring is used at elite college and professional levels, but unfortunately, high school athletes often don’t get access to these resources.

Low-Level Laser Therapy

Another effective sports therapy for stress fractures is low-level laser therapy (LLLT), also called photobiomodulation. Unlike red light therapy, which has become popular, LLLT works in a more concentrated way to directly impact cells and boost mitochondrial function, leading to faster recovery.

Recent research suggests that green light, rather than red, has the greatest effect on stimulating osteoblast activity—cells responsible for building bone.  This makes it especially useful for treating stress fractures. Green light therapy promotes intracellular calcium levels, which are essential for cell growth and repair. For high school athletes, LLLT is a safe and non-invasive option.

The Role of Supplementation

In addition to a balanced diet, specific supplements can support the healing process:

• Vitamin D: Many athletes are deficient in vitamin D, which is essential for calcium absorption and bone health. Testing vitamin D levels and aiming for optimal (not just standard) levels can speed up recovery.
• Collagen: When combined with the right exercises, collagen can improve bone, joint, tendon, and ligament strength. Look for products that contain Tendoforte, Fortigel, Verisol, or Fortibone, as these have shown benefits for bone health, especially when paired with high-quality vitamin C.
• Omega-3 Fatty Acids: Omega-3s support cell membrane health, which is crucial for recovery. An omega-3 index evaluation can identify deficiencies, and proper supplementation can help optimize cellular repair.

Return-to-Play Training

Recovering from a stress fracture requires a well-planned return-to-play protocol.  Weight training with isometric exercises (where the muscle doesn’t change length) can help stimulate bone healing through a process called mechanotransduction. This approach ensures that forces applied to the bone are targeted, promoting faster recovery.

In my case, focusing on exercises that stimulated growth in the tibia would have made the most sense. While one leg was injured, I could have trained the other leg and continued with upper body workouts to maintain overall fitness.

Once healing begins, it’s important to reintroduce forceful ground contact with a gradual approach. Start with short distances and work your way up, ensuring proper sprint mechanics, including arm action, leg drive, and posture.  Drills like A-walks, skips, and marches are great for rebuilding athletic movement patterns.

Conclusion

By addressing training load, utilizing low-level laser therapy, supporting recovery with the right supplements, and following a structured return-to-play program, athletes can improve their chances of a full and efficient recovery from stress fractures. These strategies offer a holistic approach to healing that incorporates metabolic, neurological, and biomechanical factors—ensuring the athlete returns to the field stronger and healthier.