Stress Fractures

What is a stress fracture?

A stress fracture is a tiny crack in a bone. Usually in a stress fracture the bone breaks but does not shift position. They are most commonly suffered in the feet and ankles due to the weight-bearing demands when walking, running, jumping etc.

Stress fractures usually occur when there is a moderate repetitive force applied over time. In other words, the impact that goes through the feet and ankles when doing a repetitive motion such as running can be the cause of such a fracture.

Over time and with repetitive stresses put through them, bones can become ‘weakened’ in places, which is known as a stress reaction moreover it is this weakness which increases the risk of a stress fracture.

What causes a stress fracture?

There are two common causes:

Frequent repetitive impact – this encompasses all those with healthy bones that become weakened through repetitive use. This cause can affect sports people who do high impact reoccurring activities such as, running, gymnastics, football, basketball and tennis to name a few.

Underlying conditions – some stress fractures can be attributed to preexisting underlying conditions, such as osteoporosis or a change in menstrual cycle in women(irregularity or absent). These conditions can produce low bone density which can in turn cause stress fractures as a result of low impact activity such as frequent walking.

Another few ways stress fractures can occur in otherwise healthy beings are sharp increases in training volume, new or different training surfaces and footwear selection. Increasing load by training for longer, or more frequently, will directly increase the load put through the feet and ankles.

Someone changing the surface in which they train on, can be subject to stress fractures, for example, a runner changing from a relatively soft and bouncy athletics track to road running.

Footwear such as high heels or old unsupportive shoes can potentially put a person at a higher risk of stress fractures.

What are the symptoms of a stress fracture?

Most commonly the main symptom is pain, pinpoint pain at a very specific point. Usually this can hurt to touch the exact site of the fracture. The pain will normally reduce with rest and flare up again with increased load bearing activity.

There are, as with most pains in the body, many other explanations and possible diagnoses when we are looking solely at pain. If the pain is in conjunction with any of the possible causes outlined above, there is a relatively high chance of a stress fracture. The only true way to diagnose a stress fracture is through x-ray.

What is the treatment for Stress fracture?

Private Physiotherapy can help  diagnose a stress fracture . The usual advice given to you is to take relative rest and wear protective footwear (in some cases a walking boot will be provided).

Relative rest in this case means stop doing the activity which caused your pain and reduce any other high impact activity.

Ice and elevation is important to reduce any inflammation around the injury. The majority of stress fractures , in healthy people, will heal themselves without the need for any intervention.

Most stress fractures will heal within 4-6 weeks with rest and care however there are some bones in the feet that have poor blood supply therefore healing times may be longer.

How can you prevent a stress fracture?

There are a number of ways you can help reduced your chances of stress fractures – as outlined at –

• Eat calcium-rich foods and ensure you get enough daily Vitamin D to help maintain bone density.

• Wear good shoes. Do not wear old or stiff shoes, but instead try comfortable, well-padded, and supportive shoes. It is usually a good idea to wear shoes made specifically for the sport you would like to do. Avoid high heels whenever possible.

• Do not smoke. This can lead to problems with healing.  Nicotine creates the problem likewise other gum and products containing nicotine will still prevent the bone from healing.

• Cross-train. This means that you should alternate between activities. In other words switch up jogging with swimming or cycling during the week.

• Slowly ease into previous or new sports activities. Gradually increase the time, speed, and distance. Many experts suggest a 10% increase of exercise time per week.

If you would like to find out more about diagnosing or treating your stress fracture with Private Physiotherapy please contact us at