Physiotherapy For Bone Stress Injuries

Lavington Physiotherapy for Bone Stress Injuries | Enhance Physiotherapy

Have you recently experienced a bone stress injury? Are you looking for effective ways to recover and prevent future injuries? Physiotherapy might just be the answer you’ve been searching for.

Bone stress injuries, which can range along a continuum from bone fatigue to stress fractures, are common among athletes and individuals who engage in high-impact activities. These injuries occur when the bones are subjected to repetitive stress, leading to bone fatigue or stress fractures. Recovery can be a lengthy and challenging process depending on the severity of bone stress, but with the right treatment, you can get back on your feet.

Physiotherapy has proven to be a highly effective treatment option for bone stress injuries. It focuses on not only addressing the immediate pain and discomfort but also on rehabilitating the injured area and preventing future injuries.

What is a bone stress injury?

A stress fracture is a microscopic split in the bone that occurs when a bone cannot handle the repetitive stresses placed through it, resulting in localised pain over a bone area. These injuries begin as a stress reaction that does not yet result in a complete fracture but produces discomfort. If a stress reaction is not treated, it might become a stress fracture or complete fracture.

Most people complain of localised pain that worsens with activity and settles with rest; however, as a fracture progresses, pain may continue even when activity ceases.

These injuries can be pretty debilitating and necessitate medical attention, physiotherapy, and, in many cases, nutrition management.


The most common locations for a bone stress injury

  • Shin (tibia)
  • Foot (navicular and metatarsals)
  • Outside bone of the leg (fibular)
  • Thigh bone (femur)
  • Pelvis
  • Heel bone (calcaneus)

Common causes of a bone stress injury

Repetitive, high-intensity training is thought to be the significant factor that contributes to stress fractures, with the most at-risk populations being athletes, military recruits and recreational runners.

The typical progression of the disorder is as follows:

  • Excessive load
  • Overactivity of cells that break down bone
  • Stress reaction (bone microfractures)
  • Continued activity (stress/load)
  • Stress fracture
  • Break/fracture (if activity continues after stress reaction)
Lavington Physiotherapy for Bone Stress Injuries | Enhance Physiotherapy

Common symptoms of bone stress injuries

The following symptoms will typically appear in response to an increase or maintenance of a high training load or physical activity:

  • The pain gradually spreads throughout the damaged area.
  • Pain that becomes worse with exercise and gets better with rest.
  • Tenderness when touched.

The following symptoms may also be present in more severe cases:

  • The surrounding soft tissue structures aswell.
  • Pain at night or when sleeping.

Common risk factors of bone stress injuries

Intrinsic factors

  • Previous stress fracture
  • Female oligo/amenorrhea (female)
  • Early or late menstruation age (female) 
  • Low level of lean body mass
  • Ages 12.5 – 34
  • Body fat percentage is high
  • Inadequate bone mineral density

External factors

  • Inadequate vitamin D consumption.
  • Weight reduction due to insufficient energy supply.
  • New or excessive exercise patterns (especially in duration/frequency).
  • High longitudinal arch, leg length disparity, severe forefoot varus, and foot abnormalities are all biomechanical issues.

Physiotherapy treatment for bone stress injuries

Enhance Physiotherapy are experts in managing stress injuries due to their experience within the defence force and elite sporting teams.

The location and severity of the injury will entirely determine physiotherapy management. Significant bone stress fractures through weight-bearing bones, such as the navicular, may, for example, necessitate complete rest and non-weight-bearing for a while. A bone stress response in the fibula, on the other hand, may require training modification.

Management typically includes:

• Activity modification

• Muscular endurance

• Strengthening program

• Biomechanical stress-relieving measures (if applicable)

• Cross-training to maintain cardiovascular fitness

How long does it take for a bone stress injury to heal?

All bone responses and stress fractures are not the same. Treatment and healing differ substantially depending on which bone is injured and where the injury is located within that bone. The location of the stress injury influences whether the stress injury is likely to progress or not.

High-risk stress injuries occur in the front of the shin bone (anterior border of the tibia), the upper face of the hip (superior cortex of the femoral neck), and the navicular and fifth metatarsal within the foot.

Bone stress injuries at these locations frequently necessitate specific, intensive treatment, such as immobilisation, rest and a gradual return to activity before re-starting impact activities and sport that can take up to 6 months. 

Low-risk bone stress injuries occur in areas that mend quickly, such as the inside border of the shin bone (tibia), the outside leg bone (fibula), and the middle metatarsal bones at the front of the foot.

Bone stress injuries at these locations heal without treatment and with a period of reduced activity. The recovery period for a low-risk bone stress injury varies depending on whether it is a basic stress reaction or a more advanced stress fracture. Still, the average recovery time is 6-8 weeks.

Lavington Physiotherapy for Bone Stress Injuries | Enhance Physiotherapy

Final thoughts on physiotherapy for bone stress injuries

Physiotherapy is your secret weapon for a quick and successful recovery from bone stress injuries. Don’t let these injuries prevent you from enjoying your best, most active life.

Book an appointment with one of our highly qualified physiotherapists at Enhance Physio before starting a rehabilitation program. We can advise you on the best course of action for your condition.



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