Article
Do you have a stress fracture?
How to know if you might have a stress fracture, and a guide to when you need to see a health care practitioner and potentially get imaging.
What is a stress fracture?
Stress fractures are the flashy words for big overuse injuries of our bones. When a bone is loaded too much by repetitive activity, particularly impact activity like running and jumping, it can start to break down and weaken. If this is pushed far enough and the bone cannot keep up, it can break down to the point of breaking. This is known as a bone stress injury, and if it reaches the point where the bone is cracked then it is classed as a stress fracture.
The cardinal signs of a stress fracture
- Pain over a bone
- Pain at rest or at night
- Pain greatest on impact loading
Any combination of two or more of the above is enough for you to strongly consider a stress fracture. Early stress fractures, known as bone stress injuries, are less severe and the pain can be milder, which is exactly why two out of three is the threshold rather than all three.
Common locations
These are the areas we most commonly see stress fractures of the lower body in any sport, but particularly in runners, military personnel, basketball players, dancers and footballers.
- Inside of the shin
- Forefoot
- Midfoot
- Heel bone
Must check locations
These are urgent, high risk locations. Any suspicion of a stress fracture in any of the following areas needs to be checked by a healthcare practitioner immediately. Any of the cardinal signs in these areas should be checked straight away.
- Front of the shin
- Inside ankle bone
- Inside top of the arch
- Outside knobbly part of the midfoot
- The hip bone. This can feel like a tight groin or even thigh muscle soreness. Any runner, dancer or basketball player with groin pain needs to be treated with a high degree of suspicion for a stress fracture.
- Under the big toe
Why you cannot mess around with stress fractures
Stress fractures are one of the most significant injuries you can get. They take twice as long to recover from as a normal, traumatic fracture, and they tend to have worse outcomes, with the high risk injuries sometimes requiring surgery, having extensive complications, leading to chronic pain and failing to return to sport.
Missing a stress fracture when it is small or early on, a bone stress injury rather than a stress fracture yet, can mean you quickly end up with a much bigger injury and a much longer recovery. In the worst cases a stress fracture can lead to the entire bone snapping, failed healing, or a dangerous location that requires surgery or prolonged time on crutches or in a boot.
Catching these injuries before they become a big deal means you get back to what you love quicker, and you avoid potentially needing months off your feet or surgery. This is why it is extremely important to have any injury that could possibly be a stress fracture checked.
This article is intended to give you some ideas for seeking care. It is not intended for diagnosis and should not be used as medical advice. If you require medical attention, please see a health practitioner.