What is a Stress Fracture? Symptoms and Treatment

Stress fracture is one of the most common sports injuries. It is an overuse injury . It is especially seen in the load-bearing bones of the foot. When the muscles are tired and unable to absorb shock, the extra load placed on the bone can lead to bone cracking.

Foot metatarsal (comb bones), navicular bone, calcaneus (heel bone), leg tibia (shin bone), fibula (calf bone), femur (thigh bone), neck of femur bone, anterior part of pelvis (pubic rami), sacrum (the rump bone) are the places where this problem is most common.

Fractures usually occur as a result of sudden and severe trauma. Stress fractures are different. It develops as a result of many strains exceeding the bone’s endurance.

Who Happens?

If the intensity of physical activity increases rapidly in a very short time, the risk of stress fracture increases. Bones need time to adapt to the increased load. Bone tissue is reshaped by continuous destruction and building processes. Stress fracture may occur if the loading suddenly increases without allowing the bone to form.

Factors such as moving to an unfamiliar floor, use of inappropriate shoes, and insufficient rest time between workouts are also effective. It is a more common problem in tennis, athletics, gymnastics, basketball players, and soldiers walking with heavy loads for long periods of time. Prolonged exposure of the foot to stress, the jumping motion can traumatize the foot.

Stress fractures are more common in female athletes than in males. This is explained by the concept of the female athlete triad. Eating disorders (blumia or anorexia), amenorrhea (reduction in menstrual frequency), and osteoporosis (osteoporosis) are components of the female athlete triad. Bone resorption predisposes to fractures.

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Structural differences such as flat feet or arches that are too high can pose a risk.


Pain with movement is the most common symptom of a stress fracture. Pain decreases with rest. Sensitivity may occur at a certain point. Swelling may be seen.

In the first periods, if the pain is neglected towards the end of the exercise, the pain may become felt from the beginning of the exercise. If it progresses further, it may not go away even with rest.


It is very important to question the risk factors of the person during the examination. X-rays may not always show stress fractures, or they may become visible on films a few weeks after symptoms begin. Therefore, advanced imaging methods such as computed tomography and MRI (MRI) may be required.


The first step of treatment is rest. Activities that cause pain should be stopped. Cold application can be applied to reduce edema. A rest period of 6-8 weeks is sufficient for most stress fractures to heal. If activity is resumed early, a larger and more difficult-to-heal fracture may occur. In order not to lose the condition, if the doctor allows, a different sport such as swimming, which does not load on the bone, can be done during the rest period.

Insoles or other orthoses that can be worn inside shoes, orthoses that reduce the load on the foot, devices that take the load such as crutches can help recovery.


When starting a new sport activity, the goals should be increased gradually. For example, instead of running 10 kilometers immediately, it is recommended to start with 2-3 km and increase it within weeks.

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To gain fitness, cross-training should be done instead of doing the same exercise over and over. Instead of running every day, jogging one day and cycling the next. Strengthening and flexibility exercises should not be neglected for the balanced development of muscles.

A healthy and balanced diet and a diet rich in calcium are recommended.

Sports shoes should be worn.

If there is pain and swelling, sports should be interrupted for a few days. If the complaints do not go away, a doctor should be consulted.

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