Stress Fractures – What are they, and how are they treated?


You’ve probably heard the word ‘stress fracture’ before, but few people understand what exactly this refers to. Typically this is experienced as  pain in the front of the shin bone.  Physiotherapists regularly treat individuals with overuse injuries such as stress fractures. In many cases, people are unaware they have injured themselves until the pain starts to become severe. It is caused by when the stressful forces going through the shin bone far exceed the bone’s ability to repair itself. This is common in runners or athletes who have made large and sudden increases in their training without allocating enough recovery between sessions- leading to an overuse bone injury.

It is important that you catch the warning signs early and visit your physiotherapist as soon as possible so that a treatment plan can be put in place. Shin splints and stress fractures are not injuries to leave unattended. Physiotherapists see too many patients who have caused themselves ongoing pain and discomfort simply due to not having the issue seen earlier. In this blog post, we’ll be providing an overview of the causes, symptoms and treatment options for stress fractures.

What exactly is a stress fracture, and who experiences them?

A stress fracture is an overuse injury which impacts upon your bone structure, causing tiny cracks to occur. At first the pain may be barely perceptible because the cracks are microscopic in nature, but over time they will continue to grow, and the pain will worsen.

Anyone can experience stress fractures, but they are most common in:

  • Runners
  • Hikers
  • Basketballers
  • Footballers
  • Gymnasts
  • People with osteoporosis and poor bone density

It is important that you don’t push yourself too hard during sports and other physical activities, as your feet and lower limbs need time to recover from the stress of repetitive load bearing. Don’t try to ramp up your routine too quickly, instead take things day-by-day to give your body time to adjust.

Bones are remarkably strong due to the collagen and calcium contained within, but as a living and growing tissue they still need time to recuperate between sessions.

You can’t completely eradicate any chance of suffering stress fractures, but there are steps you can take to minimise your risk:

  • Wear quality and comfortable running shoes that fit well and offer good support
  • avoid exercising on hard, slanted or uneven surfaces
  • increase exercise intensity and length gradually
  • warm up and stretch before exercising
  • don’t just push through the pain, listen to your body.

Symptoms of Stress Fractures

Stress fractures can occur in any weight bearing bone of your body. This includes the metatarsal and navicular bones in your feet, calcaneus (heel bone), tibia (shin bone), femur and pelvis. More than 50% of stress fractures occur around the lower leg and foot.

If you notice any of the following, you should book an appointment with your physio as soon as possible:

  • Pain which becomes more acute during physical activity, then subsides during rest
  • Unexplained pain
  • Pain which arose immediately after a change in exercise routine, equipment used etc.
  • Swelling and Tenderness around the affected area

Diagnosis and Treatment of Stress Fractures

In some cases your GP or physiotherapist will be able to diagnose a stress fracture through a physical examination, but X-rays, MRI and bone scans may be necessary to determine the extent of damage and gain a better understanding of your bone structure.

Stress fractures are unique, and as such your physiotherapist will develop a tailored management plan to suit your condition and lifestyle needs. The management process generally involves the following:

Initial Stage – Rest

You should cease all unnecessary physical activity so that your stress fracture can start to heal naturally. Crutches or the use of a weight bearing boot may be necessary in more severe cases.

Rehabilitation and Strengthening

Once the bone has started to heal, the rehabilitation process can commence. Your physiotherapist will offer guidance to help you return to your usual activities with safety and confidence.

The rehabilitation and strengthening process usually involves a combination of rest, bracing and physical therapy to help restore the whole lower limb, core muscle and joint function.

Return to Normal Routine

There is often more than one professional involved in the management of stress fractures. Erko Physio we work in close consultation with local sports physicians and GP’s, orthopaedic surgeons, sports dietitians and podiatrists who will be involved in monitoring your condition. Once you have regained function and been given the all clear, you can gradually return to your normal routine.

Start Your Recovery Journey Today – Contact Erko Physio

Injuries shouldn’t disrupt your life any longer than necessary, get back to doing what you love sooner with a little help from the professional team of physiotherapists at Erko Physio. If you suspect you may be suffering from a stress fracture, please contact us today on 02 9557 9272.