What is a Stress Fracture and how to fix it? | Upwell Health

What is a Stress Fracture and how to fix it? | Upwell Health

Updated April 6th 2021

Stress fractures are a common problem for athletes and gym goers. Runners and basketball players have the highest risk. In general, these injuries occur due to overtraining, improper footwear, or impact on a hard surface. Basically, they cause small cracks in the bone, leading to pain and inflammation. Overuse appears to be the primary risk factor.


Stress Fractures at a Glance

Statistics show that up to 70 percent of runners experience overuse injuries each year. A stress fracture is an overuse injury of the bone. It occurs gradually as a result of accumulated trauma from high-impact activities, such as jumping and running. For this reason, most stress fractures affect the legs and feet. The metatarsal bones of the feet are injured in 25 percent of cases.


From baseball and soccer to running and dancing, most sports can cause stress fractures. This injury may also occur in sedentary people who start an exercise program. Their bones and muscles are not used to the task, which puts stress on the body. Rowing, crickets, and other sports that require repetitive movements may cause a stress fracture too.


When you’re dealing with this type of injury, a thin crack develops in your bones. Stress fractures can affect the navicular, the outer bone of the lower leg, or the metatarsals of the foot. In rare cases, they occur in the neck.


These injuries account for about two percent of all sports injuries. Even though they can be quite painful, the symptoms go away within months. Treatment usually involves immobilisation, decreased activity, and proper rest.


Types of Stress Fractures

Based on their severity, stress fractures can be divided into two categories:


  • Low-risk stress fractures, which heal on their own.


  • High-risk stress fractures, which take a long time to heal and may cause complications. These usually involve injury to the femur, pelvis, and lower back. A stress fracture to these bones may indicate underlying health conditions.


Treatment depends on the type of fracture and the severity of symptoms. In both cases, you must stop any activity and see a doctor immediately.


What Causes Stress Fractures?

Your bones are constantly repairing themselves and adapting to exercise. Over time, their healing ability drops. Repetitive stress on the bone leaves you vulnerable to injury. If you’ve had stress injuries in the past, your risk of developing a new one increases.


Both the muscles and muscles absorb shocks during physical activity. Certain factors, such as muscle fatigue and overtraining, decrease their ability to cope with exercise. Hormonal imbalances play a role too.


Research shows that women are more likely to develop a stress fracture than men too. When their estrogen levels drop during menopause, the risk of osteoporosis goes up. This condition weakens the bones, leaving them prone to injuries.


A stress fracture can also occur when you’re increasing workout duration or intensity. If your bones are not used to the stress, they may not be able to remodel and repair themselves fast enough.


Certain sports, such as tennis, long distance running, gymnastics, and ballet increase the risk of stress fractures. The repetitive motion can alter the biomechanical and biological properties of the bone, causing excessive stress and poor recovery. Other risk factors for stress fractures include:


  • Muscle imbalances
  • Poor flexibility
  • Leg-length inequality
  • Amenorrhea
  • Sudden changes in training duration and intensity
  • Improper equipment (such as worn footwear)
  • Poor exercise technique
  • Poor nutrition (especially calcium and vitamin D deficiencies)
  • Foot problems (rigid arches, high feet, or flat feet)
  • Weakened muscles and bones
  • Bone insufficiency
  • Poor conditioning
  • Change in running or playing surface
  • Eating disorders


Improper shoes, for instance, may not be able to absorb shocks, leading to injury. Overtraining can put you at risk for a stress fracture too. Doing too much too soon puts stress on your bones. For this reason, it’s recommended to gradually increase workout intensity and training time. Without adequate rest between workouts, athletes are more likely to develop a stress fracture.



Stress fractures develop gradually, so you might barely notice the pain at first. Over time, the pain gets worse. You might also notice bruising, tenderness to touch, redness, and localised swelling. Most people experience a decrease in pain at night or during rest.


If the pain doesn’t go away, seek medical help. Stress fractures rarely require surgery, but take a long time to health. You might need to stop training for weeks or months to recover from injury. In general, it’s recommended to rest for six to eight weeks before resuming your workouts.


Treatment Options

This type of injury is diagnosed with X-rays. In rare cases, an MRI or CT scan may be required. Treatment involves physiotherapy, rest, footwear modification, and bracing,


Depending on your needs, the doctor may recommend wood-soled therapeutic sandals, shoe inserts, stiff-soled shoes, or casts. Vitamin D and calcium supplements are commonly prescribed.


If left untreated, stress fractures may cause further injury and chronic pain. Additionally, the fracture can get worse. In this case, surgery may be required. Early treatment can help you heal faster and prevent complications.


Does Physiotherapy Work for Stress Fractures?

Along with proper rest, physiotherapy can speed up healing and restore your range of motion. A skilled therapist will assess your condition and recommend appropriate treatment. He may prescribe progressive muscle strengthening, orthotics, and immobilisation devices as well as water exercise programs.


Your training routing can include cycling, stretching, and conditioning exercises that accelerate healing. Workout intensity is gradually increased so your body can restore its mobility. Exercise also helps preserve muscle and reduces catabolism, which further lowers your risk of injury.


The physiotherapist can also help you choose the right shoes for your sports of choice, teach you proper lifting technique, and offer advice on resuming your workouts. He will recommend exercise programs and treatment options that you can implement at home, such as ice therapy. The treatment plan will also include advice on how to prevent injuries and return safely to exercise once the injury has healed.

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