Stress Fracture
A stress fracture is a small crack in a bone caused by repeated load, most often affecting runners and people who've recently increased their training. Because early identification and load management matter more here than with typical training soreness, assessment focuses on identifying it and managing load appropriately.
30-minute appointments as standard · No referral required
What is Stress Fracture?
A stress fracture is a small crack or area of bone weakening that develops from repeated, cumulative load — rather than a single traumatic injury. It’s most common in the lower leg and foot, particularly among runners and people who’ve recently increased their training volume, intensity or frequency.
This is a more cautious presentation than general training-related aches. It’s usually characterised by pain that’s localised to a specific point on the bone, gets worse with continued loading, and doesn’t ease the way muscular soreness typically does. Because early identification and load management make a real difference to recovery time, it’s worth being assessed promptly if a stress fracture is suspected, rather than continuing to train through it.
How We Assess Stress Fracture
Assessment starts with understanding your training history, how your pain developed, and its exact pattern — including whether it’s localised to one point and how it responds to load and rest.
We assess the affected area, your lower limb strength and movement, and how your symptoms respond to specific loading tests, to build a picture of what’s likely happening. Where a stress fracture is suspected, imaging or a referral for further investigation may be recommended, since this is a presentation where confirming what’s happening changes management.
Treatment and Rehabilitation Approach
Management centres on modifying load to allow the bone to heal, followed by a careful, staged return to running and training as your capacity allows. This is typically a longer process than muscular injuries, and progressing too quickly is a genuine setback risk.
This sits within our broader foot and ankle pain and sports physiotherapy approach, with particular attention to training load and running-specific factors that may have contributed.
Looking for help with a Stress Fracture?
An assessment can help identify the factors contributing to your symptoms and guide the next steps.
Symptoms
Localised pain over a specific point
Pain that can usually be pointed to with one finger, rather than a general ache spread across the area.
Pain that builds with continued loading
Symptoms that worsen the longer you run or train, and may eventually be present with walking or at rest.
Pain that doesn't settle with usual rest
Unlike typical muscle soreness, discomfort that persists or worsens despite reducing training.
Causes and Risk Factors
Rapid increases in training load
A sudden increase in running volume, intensity or frequency is one of the most common contributing factors.
Insufficient recovery between sessions
Limited recovery time can prevent bone from adapting to increased training demands.
Bone health and nutritional factors
Factors such as energy availability and bone health can influence a bone’s capacity to tolerate load, and are part of what’s considered at assessment.
Return-to-Sport Considerations
Allow adequate healing time
Bone healing takes longer than muscular injuries, and this stage isn’t typically able to be rushed.
Reintroduce load gradually and specifically
Running and training load is reintroduced in carefully staged increments, guided by your symptoms and assessment.
Address contributing training factors
Where training load, footwear or other factors contributed, these are addressed as part of reducing the risk of recurrence.
Frequently Asked Questions
Is a stress fracture the same as a normal fracture?
No — a stress fracture develops gradually from repeated load rather than a single traumatic break, and is generally managed differently.
Can I keep running with a suspected stress fracture?
This isn’t generally recommended until it’s been assessed, since continuing to load the area can delay healing or worsen the injury.
Do I need a scan for a stress fracture?
Imaging is often part of confirming a stress fracture, and your physiotherapist can discuss what’s appropriate, including any referral needed.
How long does a stress fracture take to heal?
This varies depending on the location and severity, and is usually a longer process than a muscle or tendon injury — your physiotherapist can give you a clearer timeframe after assessment.