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Stress Fracture

Published: 11 Feb 2025

Stress Fracture: How Physiotherapy Can Help You Recover and Prevent Future Injury

Stress fractures are a common overuse injury, particularly among runners, dancers, and athletes who engage in repetitive impact activities. Unlike a sudden broken bone from a fall or accident, stress fractures develop gradually due to repeated strain on the bone. If you’ve had this injury – you know it is painful.  If left untreated, they can worsen and lead to more serious injuries.

At The Healthy Body Company, our expert physiotherapists are highly experienced in diagnosing, managing, and preventing stress fractures. In this article, we’ll explore what stress fractures are, how they develop, and how physiotherapy plays a vital role in recovery and prevention.

What Are Stress Fractures?

A stress fracture is a micro crack in a bone that occurs due to repetitive force. Bones naturally go through a process of breaking down and rebuilding, but when they are put under too much stress without enough recovery time, small cracks can form. Over time, these tiny fractures can worsen, causing pain and limiting activity.

Foot stress fractures commonly occur in the second metatarsal.

Stress fractures most commonly occur in weight-bearing bones, such as:

• Shin (tibia) – The most frequent site, especially in runners.
• Foot (metatarsals) – Often seen in long-distance runners and dancers.
• Thigh (femur) – Common in endurance athletes.
• Pelvis (pubic bone) – Found in female athletes and runners.
• Midfoot (navicular bone) – A high-risk area due to its poor blood supply.

Why Do Stress Fractures Happen?

Stress fractures result from a combination of excessive impact and insufficient recovery. Several factors can increase the risk of developing a stress fracture:

1. Sudden Increase in Training Load

• Rapidly increasing training intensity or duration places excessive stress on bones before they have time to adapt.
• Common in runners, military recruits, and athletes who increase their activity levels too quickly.

2. Poor Footwear and Training Surfaces

• Worn-out or unsupportive shoes fail to cushion impact forces properly.
• Training on hard surfaces (e.g., concrete or indoor courts) increases shock to bones.

3. Weak Muscles and Poor Movement Patterns

• Fatigued or weak muscles are less effective at absorbing impact, transferring more stress to the bones.
• Poor running technique or foot posture (e.g., overpronation) can lead to uneven force distribution.

4. Nutritional and Bone Health Factors

• Low calcium and vitamin D levels reduce bone strength.
• Inadequate nutrition (common in athletes with restrictive diets) can limit bone repair.
• Hormonal imbalances (e.g., in female athletes) can weaken bones over time.

How Do You Know If You Have a Stress Fracture?

Stress fractures don’t happen suddenly—they develop gradually. The key signs to watch for include:

✔ Pain that starts as a dull ache and worsens with activity
✔ Tenderness when pressing on a specific spot on the bone
✔ Swelling in the affected area
✔ Pain that improves with rest but returns when resuming activity
✔ Changes in the way you walk or run due to discomfort

If you experience these symptoms, it’s crucial to seek physiotherapy for early assessment and management. Ignoring the pain can lead to a more serious fracture, requiring extended rest and rehabilitation.

How Physiotherapy Helps with Stress Fractures

At The Healthy Body Company, our physiotherapists use a comprehensive approach to help you recover from a stress fracture and reduce the risk of re-injury.

1. Load Management and Activity Modification

• Initially, reducing impact activities (such as running or jumping) is necessary to allow healing.
• Protective footwear or bracing may be recommended to offload stress on the injured bone.
• A structured return-to-sport plan ensures that loading is reintroduced safely over time.

2. Strength and Conditioning for Injury Prevention

Weak muscles or poor biomechanics can increase bone stress. Our physiotherapists design specific exercise programs to:

• Strengthen supporting muscles, including the calves, quadriceps, and glutes, to improve shock absorption.
• Improve balance and stability to correct movement patterns and reduce uneven loading.
• Increase joint mobility and flexibility where restrictions may contribute to excessive stress.

3. Gait and Running Analysis

For active individuals and runners, gait assessment is an essential part of rehabilitation. By analysing your movement, we can:

• Identify biomechanical issues that may have contributed to the stress fracture.
• Provide technique adjustments to optimise impact distribution.
• Recommend custom orthotics or footwear if necessary.

4. Pain Management and Rehabilitation

Physiotherapy plays a key role in managing pain and supporting healing using:

• Manual therapy – To release tight muscles and reduce compensatory strain.
• Taping or bracing – To stabilise and support the affected area.
• Non-weight-bearing exercises – Activities such as swimming or cycling help maintain fitness without overloading the healing bone.

How to Prevent Stress Fractures

In the case of stress fractures, prevention is better than cure. Our physiotherapy team recommends the following strategies:

✔ Gradually increase your training load – Avoid sudden spikes in activity and follow structured progressions.
✔ Wear proper footwear – Ensure your shoes provide the right support and cushioning.  Most importantly, make sure that you have the best fitting shoes for your feet.
✔ Mix up your training – Include low-impact activities like swimming or cycling to reduce repetitive stress.
✔ Strengthen your muscles – A strong, balanced body is better at absorbing impact forces.
✔ Optimise nutrition – Ensure adequate calcium and vitamin D intake to support bone health.

When to See a Physiotherapist for a Stress Fracture

If you suspect a stress fracture, early intervention is key to preventing more severe injury. Seeking physiotherapy can help you:

• Confirm the diagnosis and identify contributing factors.
• Develop a structured recovery plan that allows safe healing.
• Improve strength and movement mechanics to reduce the risk of recurrence.

At The Healthy Body Company, our physiotherapists are committed to helping you recover fully and get back to the activities you love.

🔹 Book an appointment today and take the first step toward recovery with expert physiotherapy care!