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Stress Fractures: Causes, Symptoms, Treatment and Exercises

What is a Stress Fracture?

stress fractures - physiotherapy and sports medicine treatment torontoA stress fracture is a common sports injury that can appear to come out of nowhere. It can affect people of all ages and activity levels, though it is generally associated with an increase in activity or repetitive activities. A stress fracture occurs when the body does not have sufficient rest, or building blocks (nutrients), to repair bone that is broken down during activity. This can result in pain with activity, local swelling and tenderness. The pain comes on gradually, and is usually relieved with rest. If the stress fracture worsens, the pain will also worsen and begin to appear in regular daily activities, sometimes even becoming chronic pain (>6 weeks). The most common location for a stress fracture to occur is in the foot or ankle.

What Causes a Stress Fracture?

The main cause of stress fracture is repetitive activities without proper rest periods or gradual load. When a bone is repeatedly stressed in the same way, it breaks down. If the body has sufficient rest, this cyclical process is completed and the bone is built up again (about 48hrs). If there is not sufficient rest, or there is not sufficient calcium in the body, the bone weakens in that area, forming tiny cracks that can progress to fractures through the thickness of the bone.

Who is at Risk for a Stress Fracture?

Anyone who has a recent increase in activity is at risk for a stress fracture. If you are a runner who has recently upped your mileage, have just decided to get in shape and have gone from zero workouts per week to boot-camp class five nights a week, or have commenced an intensive sport training program, you may be at risk. Women are also more at risk than men, especially if their menstrual cycle is irregular. This can be a sign of a calcium deficiency, and calcium is an essential building block for bone. Even sports like soccer, tennis, and basketball can put people at risk for a stress fracture.

What are the Symptoms of a Stress Fracture?

Since stress fractures come on gradually, the symptoms do as well. Initially there can be pain with the offending activity which is relieved with rest. As the tiny cracks in the bone increase in size, the pain can become more intense, and can be felt during regular activity as well as sporting activity. If left untreated this can progress to chronic pain. The pain is usually well localized to the injured area, and can be accompanied by point tenderness and mild swelling.

What to do if you Think you have a Stress Fracture?

The most important step is to get the right diagnosis. An appointment with one of our registered physiotherapists, chiropractors or sports medicine doctor will determine the issue at hand. Further imaging ordered by your family doctor or our sports medicine doctor may be required to confirm the diagnosis. Since stress fractures are usually very small they may not show up on an X-ray, additional imaging such as an MRI or a Bone Scan may be required to confirm the diagnosis.

Physiotherapist and Chiropractic Treatment for Stress Fractures

The main treatment for stress fractures is rest. If there are underlying cause of bone weakness your doctor may prescribe medication, or have you see a registered dietitian to ensure you are providing your body with the required building blocks for your bones. If the fracture has progressed, a brace, walking boot, or crutches may be required to allow the bone time to heal.

Physiotherapy or Chiropractic care may be required to create an individualized strengthening program to reduce stress on the area. They can also help with joint mobilizations above and below the injury site to ensure proper movement and force dispersion in the area.

How to Treat a Stress Fracture at Home?

Once diagnosed you can try the following steps to aid in your recovery:


It is going to be important that the area get sufficient time for the bone to heal. You are going to have to stop painful activities and if every day activates are painful, like walking, you may need to protect the area with a brace or walking cast. If your symptoms are this severe to brace it is important to be assessed by a medical doctor. The normal duration should be around 6 weeks.

Re-evaluate and Possibly Change your Lifestyle Habits

Make sure you are eating right, getting lots of sleep and balancing your activities with rest.

Maintain Strength and Flexibility Above/Below the Area

For example if you have a stress fracture in your foot. You may not be able to do exercises around the site (especially in weight bearing) but you should be able to build or maintain core, hip and lower leg strength along with flexibility.

How Long does it take to Recover from a Stress Fracture?

Once you have been properly diagnosed and taking the correct action your recovery should take 6-8 weeks for the bone to complete a healing process. You will also need to gradually re-introduce that aggravating activity.

A stress fracture is a serious injury and if you think you may have one it is important you seek professional help from a physiotherapist, chiropractor, or sports medicine doctor.  Please contact us today.

Alishah Merchant, FCAMPT Physiotherapist

Alishah Merchant is a FCAMPT physiotherapist practicing at Rebalance Sports Medicine in downtown Toronto.

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Yonge & AdelaideRebalance Clinic Yonge Adelaide
110 Yonge Street Suite 905
Toronto, ON M5C 1T4
T: (416) 777-9999
E: [email protected]
University & KingRebalance Clinic University King
155 University Avenue Suite 303
Toronto, ON M5H 3B7
T: (416) 306-1111
E: [email protected]

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