Stress Fracture Causes

Stress fractures of the lower limb, are commonly seen in the bones of the foot and lower leg (shin). Stress fractures are common in endurance and high impact athletes.  They are the consequence of repetitive sub-maximal loads which creates an imbalance between bone resorption (breakdown) and bone formation (building).

This causes a crack initiation or stress reaction, usually at the location of highest stress.  If excessive loading continues and the crack cannot heal the damage will increase and can progress to a true stress fracture in the bone.

Stress Fractures Symptoms

A stress fracture will usually starts as a dull ache during weight bearing and training.  Usually, pain gets worse over time with activity and eventually the pain may be so persistent even without activity and become constant over time.

If you sustain a stress fracture you may feel a sharp, pinpoint pain brought on by loading or pressing on the affected bone (usually only the size of a single finger) and mild swelling or bruising may be present also.

From a muscle perspective, stress fractures may be a consequence of a fatigued muscles, which means the bone absorbs excessive force.  The bony alignment, muscular balance and movement patterns of the lower limb can also be important in preventing a stress fracture due to variations in these leading to a change in load that may place extra stress on certain points of a bone/s.

Stress Fracture Risk Factors

Activity level, high impact loading
Bone density or osteoporosis
Steroid and anti-inflammatory use
Diet factors
Hormone imbalances
Sleep deprivation

Did you know that high level female athletes are the most vulnerable to sustaining stress fractures!  This is because of the potential for the “athlete triad”; 1) Low energy availability (essentially an energy deficit between amount of food eaten and amount of energy burnt) with or without disordered eating, 2) menstrual dysfunction, 3) low bone density.

Stress Fracture Treatment

Physiotherapy rehabilitation for an early stage stress fractures can take around 6-8 weeks on average to return to full activity. However, more severe cases require longer rehabilitation and may even require medical intervention.  Your qualified Physio will identify the risk factors that contributed to sustaining stress fractures and develop a plan to continue to exercise around the injury, manage the injury and ensure a smooth road to recovery.

Our East Perth Trained Physio’s can provide a thorough assessment of your current and previous training, taking into account all lifestyle factors that may be adding to your injury or pain state.  A full body and movement assessment will identify any weakness, imbalances or loading issues and can provide you with movement re-training and strength and conditioning programming and load management advice to keep you training and prevent or resolve any current injuries!  BOOK ONLINE TODAY!

Written by: Olivia Strelein

BSc. Physiotherapy (Honours)
BSc. Exercise and Sport Science
Personal Trainer