A stress fracture is a fracture of the bone that is so small that it often cannot be picked up on X-ray. If left untreated, a stress fracture can cause significant disability and develop into a full fracture, possibly even requiring surgery.

The majority of stress fractures occur in the lower limb, being particularly common in the hip, shin and foot at points where the most force passes through when weight bearing. Stress fractures are most commonly due to increased loading which a person is not conditioned for i.e. starting a new sport or building up running distance or speed too quickly by either runners or in pre-season for team sports.

What are the symptoms?

As with many overuse injuries, the pain of a stress fracture starts gradually, beginning with pain during or after activity or sometimes the morning after. If activity continues without modification, the pain will gradually increase. Eventually most people are unable to maintain their usual activity level.

Pain (ache) is common at night in bed, and is typically easily reproduced on a hop or jump. Stress fractures are very common in sports that involve the repeated impacts of running and landing such as running, basketball, netball and football (AFL). A stress fracture will be more likely to occur in a person who has weaker bone strength, such as someone with osteoporosis, which is itself affected by many factors such as adequate calcium intake, vitamin D deficiency and a history of inactivity.

How are stress fractures treated and how long will it take to get better?

Stress fractures can easily be mistaken for other conditions such as shin splints. As the fracture is often too small to show up on X-ray, definitive diagnosis can be made using MRI or bone scan.

After diagnosis, the most important part of treatment will be resting the area to allow the bone to heal before resuming activity. Stress fractures usually need at least 6 weeks to recover fully. Some areas of the body have poor blood supply, which makes healing more complicated. For example, stress fractures of the navicular bone of the foot may need to be kept still and placed in a boot or cast for a period of time to heal properly.

Other aspects of treatment will involve correcting any factors that contributed to the original injury. There is some evidence that unsupportive footwear is a risk factor, along with poor biomechanics and weak muscles that provide inadequate support to the skeletal system during activity.

If you suspect you may have a stress fracture, would like to learn more or to book a consultation with a Sports Physiotherapist, please contact our team at your local clinic.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional, if in doubt, for advice on your individual injury.