Stress Fractures- What you need to know

A Stress fracture is a small crack in a bone that develops over time due to repetitive stress,

rather than a single injury. We often see this in runners and active individuals who have

recently increased their activity levels.

Foot displaying stress fracture

What causes stress fractures?

Your bones are constantly adapting to the loads placed on them. With the right balance of

activity and rest, they become stronger. However, when the body is exposed to repeated

stress without enough recovery, the bone cannot repair itself quickly enough.

This leads to a gradual build-up of microscopic damage, which can eventually develop into a

stress fracture. This is part of what clinicians refer to as the Bone Stress Injury continuum,

where early bone stress can progress if not managed properly.

Who is at risk?

Stress fractures can affect anyone, but are more common in:

• People who suddenly increase training intensity or volume

• Runners and athletes involved in high-impact sports

• Individuals returning to exercise after a break

• Those with poor footwear or training on hard surfaces

Other contributing factors include muscle fatigue, reduced bone strength, and inadequate

nutrition.

Common areas affected

Stress fractures most often occur in weight-bearing bones, including:

• The shin bone (tibia)

• The foot (metatarsals)

• The hip (femur)

Signs and symptoms

The symptoms usually develop gradually and may include:

• Localised pain that worsens with activity

• Pain that improves with rest (early stages)

• Tenderness when pressing on a specific area

• Swelling in some cases

If ignored, the pain may persist even at rest.

How physiotherapy can help

In clinic physiotherapy assessment

Early diagnosis and management are key.

Without appropriate management, a stress fracture can worsen into a complete fracture,

leading to a longer recovery time and potential complications. At E4physio, we focus on:

• Accurate assessment to identify the severity and contributing factors

• Activity modification to allow the bone to heal

• Strength and conditioning programmes to improve load tolerance

• Biomechanical assessment to address movement patterns

• Gradual return-to-activity planning to prevent recurrence

In some cases, imaging such as MRI may be required to confirm the diagnosis.

Whether you’re a recreationally active individual or a competitive athlete, our team’s

experience—including working with professional athletes—enables us to provide efficient

and effective care. We focus on the accurate diagnosis and tailored treatment of Stress

fracture to support a safe and timely recovery, while helping reduce the risk of future injury.

If you are experiencing symptoms of a stress fracture or ongoing bone-related pain, you can

get in touch with one of our physiotherapists here.