The Relationship Between Running Cadence and Stress Fractures in Competitive Distance Runners

Running is one of the most popular sports and forms of exercise worldwide. Stress fractures are a common and potentially season-ending injury among competitive distance runners, with recurrence rates as high as 22%. Biomechanical factors, including running cadence, have been implicated in injury risk, but their precise role remains an area of active investigation. This literature review examines the relationship between cadence and stress fractures, drawing data from both observational and experimental studies. Observational studies suggest that low cadence and rearfoot striking are associated with increased risk of bone stress injuries. Experimental studies reinforce these findings, demonstrating that increased cadence reduces tibial stress fracture probability, peak hip adduction angle, and overall forces exerted on the hip and knee. Gait retraining programs incorporating cadence modifications have shown both immediate and sustained improvements in biomechanical outcomes. By synthesizing findings across multiple studies, this review highlights the potential for cadence adjustments to serve as a protective strategy against stress fractures in competitive distance runners. Future research should aim to optimize cadence recommendations based on individual characteristics such as height and body mass, while ensuring reproducibility through larger sample sizes.