Stress fractures are a type of overuse injury. Stress responses occur when the demands imposed on the bone exceed what can be tolerated. This can lead to bone tissue deteriorating faster than it can repair, often causing localised weak points. Stress fractures commonly occur in athletes involved in running or jumping activities/sports. In severe cases, stress fractures can lead to complete fractures if they are not managed appropriately and/or found quickly.
The leg comprises two bones: the tibia (shin) and fibula (a smaller, narrow bone on the outside). The tibia bears 90% of the weight on the leg making it more susceptible to stress fractures.
Most stress fractures occur due to a sudden increase in overall training volume over a short period. Other risk factors include a sudden change of training surface, low calcium and vitamin D levels, relative energy deficiency (RED-S) and older females (bone density decreases with age more than men). Common presentations of stress fractures are pain worsening with training, pain weight bearing, localised point tenderness and pain with any impact exercises.
Treatment for stress fractures involves a thorough assessment to make an accurate diagnosis which may involve a referral to get an MRI scan and a review with a Sports Physician. Once confirmed, complete offloading may be required for several weeks, especially in high-risk zones to allow the bone time to heal, and this plan is dictated by the Sports Physician. In severe cases, a referral to an orthopaedic surgeon will be required to determine if surgery is required.
Successful management of all stress fractures requires a multifaceted approach, addressing not only the injury itself but also the contributing biomechanical, nutritional, and training-related factors.
Physiotherapists play a central role in both rehabilitation and prevention by:
Designing individualized strengthening programs to address muscle imbalances and improve load distribution.
This proactive approach empowers individuals to return to sport or activity with greater resilience and confidence.
Podiatrists contribute essential expertise in lower limb mechanics and foot function, which are often key contributors to stress fractures. Their role includes:
By addressing these foundational elements, podiatry helps to minimize recurrence and support long-term musculoskeletal health.
Nutrition is a critical yet often overlooked factor in stress fracture management. Accredited Practising Dietitians (APDs) provide:
Optimal nutrition not only accelerates healing but also fortifies the body against future injury.
Other conditions of the leg that can present like a stress fracture include calf strains (gastrocnemius, soleus), compartment syndrome, tendinopathy and tendon tears. Thus, it is important to be assessed by an experienced Physiotherapist at The Optimal Health Lab to receive an accurate diagnosis and appropriate referral if it is required. Please reach out and book a Physiotherapy consultation promptly if you’re worried via a call to 9431 5955 and/or you can book online via the Client Portal.
