Stress Fractures

What are stress fractures? – Blog By Rhian Davies

A stress fracture is an overuse injury where there is an overload of stress to the bone resulting in a tiny crack.  This occurs when the stress of repetitive loads overwhelms the ability of the bone to repair itself and these cracks begin to occur within the bone structure.


Stress fractures are often the result of increasing the amount or intensity of an activity too rapidly. Can also be due to an impact of an unfamiliar surface, improper equipment or increased physical stress.

Where do stress fractures occur?

Weight bearing bones of the body such as:

  • Metatarsal bones of the foot
  • Navicular bone in the foot
  • Calcaneus (heel bone)
  • Tibia (shin bone)
  • Femur (thigh bone)
  • Pelvis
Common bones where stress fractures occur


Most common in the weight-bearing bones of the lower leg and foot with more than 50% of all stress fractures occurring in the lower leg.

Risk Factors:

  • Repetitive sporting activities ie. Running, Basketball, Tennis, Dancing
  • Sudden increase in activity ie. Intensity, duration or frequency of training sessions
  • Poor foot posture ie. Flat feet or high arches
  • Females more likely than males
  • Osteoporosis or weakened bones
  • Previous stress fractures
  • Lack of nutrients ie. Lack of Vitamin D and calcium



  • Symptoms can vary widely but a common complaint is pain with activity which subsides with rest.
  • Pain that gradually worsens over time when continuing the aggravating activity.
  • Swelling and tenderness may also be present around the area of pain.



A stress fracture can sometimes be diagnosed through a subjective and physical examination but often imaging is needed to confirm the diagnosis.

  • MRI: Can visualize stress fractures within the first week of injury
  • Bone Scan: Can detect problems in bones but not specific to stress fractures
  • X-ray: Not seen on regular x-rays for at least several weeks up to over a month from the initial onset of pain.



If diagnosed with a stress fracture, your physiotherapist will be able to prescribe the correct management specific to you and your needs. In most cases, the initial management will include a period of rest to allow the stress fracture to heal, this may involve the use of crutches or wearing a weight bearing boot in moderate to severe cases, to reduce the bone’s weight bearing loads.

Rehabilitation and strengthening as well as a gradual return to activity are extremely important to prevent or reduce the likelihood of re-injury. Your physiotherapist will be able to develop a specific program to enable you to safely and efficiently return to your activity or sport.


Tips to help prevent stress fractures:

  • Proper footwear for specific type of exercise
  • Gradual build up when starting a new exercise program
  • Walk/warm up prior to running
  • Stretch + strengthen calf muscles
  • Cool down properly after exercise

At Total Physiocare we specialise in the accurate diagnosis, management and return to activity or sport for clients presenting with stress fractures.

Book an appointment today for your assessment!

Blog By Rhian Davies (Physiotherapist) 

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