For most distance runners who don't get enough calcium in their diets, she suggests taking 1,500 milligrams of calcium and 400 to 800 IU of vitamin D daily. Cross training -- mixing activities that give bones different stresses -- can also help strengthen bones.
Because typical runners usually won't get the same kind of care and attention as college athletes, Nattiv suggests that those who have had a previous stress fracture get a bone-density assessment before resuming their runs. Women should try to ensure they have regular menstrual cycles (a hallmark of a healthy diet and lifestyle).
And all runners should pay attention to good nutrition, run on softer surfaces in good shoes, not overdo the mileage -- and see a doctor sooner rather than later should they start to feel a twinge in the bones.
To avoid stress fractures, follow these suggestions from sports medicine experts:
* Don't "push through" pain. If a foot, leg or hip hurts, stop exercising and rest.
* If, after several days of rest, the pain persists when walking or running, consult a physician.
* Avoid sudden, extreme changes in exercise patterns. Start slowly and increase intensity and duration gradually.
* Eat a diet that includes plenty of calcium and vitamin D and enough calories for your activity level.
* Consider both calcium and vitamin D supplements, especially when adequate amounts are missing from your diet and exposure to the sun is limited.
* Get medical care for any sign of disordered eating, low weight in relation to height or, for women, irregular periods.
* Choose appropriate footwear for your activity.
* Replace athletic shoes when cushioning is worn thin.
-- Bill Becher