Stress Fractures: Causes, Symptoms & Treatment

Stress fractures occur when a bone faces more force than it can handle over time. These small cracks often develop in the foot, leg or hip, especially when you return to activity after a long break or increase your training too fast.

These injuries affect people of all ages, from runners and weekend athletes to older adults with bone loss or anyone who ramps up activity without enough rest. Franciscan Health helps patients recognize symptoms early so you can stay active and recover safely.

Key Takeaways: Stress Fractures

• Stress fractures develop from repeated force, not a single accident.
• Pain that improves with rest but returns with activity often signals a stress fracture.
• Early diagnosis protects long-term bone strength.
• Treatment focuses on rest, support and the right rehabilitation plan.
• Franciscan Health offers sports medicine, orthopedic urgent care, physical therapy and advanced imaging across Indiana and Illinois.

What Is A Stress Fracture?

A stress fracture is a small crack in a bone. It forms when repeated pressure wears down the bone faster than the body can rebuild it. The American Academy of Orthopaedic Surgeons (AAOS) explains that this often happens when activity increases too quickly or when the bone weakens from overuse.

Stress fractures most often develop in:

• Foot bones
• Ankles
• Lower leg bones
• Hips or pelvis (less common)

What Causes A Stress Fracture?

Stress fractures develop for different reasons, and many patients have more than one risk factor. Common causes include:

• A rapid jump in activity level
• High-impact sports such as running or basketball
• Hard or uneven training surfaces
• Poor footwear or worn-out shoes
• Low vitamin D or low bone density
• Certain medications, including long-term steroid use
• Limited rest between workouts
• A return to activity after illness, injury or inactivity

The National Institutes of Health (NIH) said that stress fractures occur when repeated loading outpaces the bone’s ability to repair itself.

Early Signs Of A Stress Fracture

Stress fracture symptoms often come on slowly and become more noticeable with activity. They can feel mild at first but grow more intense if ignored. Common signs include:

• Pain that improves with rest
• Swelling or tenderness in a specific spot
• Bruising in the foot or lower leg
• Pain that increases when you walk, run or jump
• A feeling of weakness in the affected limb

How Stress Fractures Are Diagnosed

Because stress fractures can be hard to identify early, your provider may combine a physical exam with imaging to understand what is happening inside the bone. This approach helps confirm the diagnosis and guides the right treatment plan. Here are the tests most often used:

• X-ray (may not show early stress fractures)
• Ultrasound
• CT scan
• MRI (most sensitive for early injury)

If pain is severe or you can’t bear weight, Franciscan Orthopedic Urgent Care is available for same-day evaluation.

Stress Fracture Treatment Options

We take more than a million steps each year. When you jump to 5,000 or 10,000 steps a day and don’t build up slowly, or you wear shoes without enough support, each step adds extra stress to your feet.

Most stress fractures heal without surgery, but rest is what will help you heal faster. If you experience sudden pain, place ice on the area and elevate your foot. If pain does not improve within a few hours, or if you feel pain even on days when you are not active, it’s time to see a doctor.

In addition to rest, your orthopedic provider may also recommend:

• A walking boot or brace for support
• Reduced activity for several weeks
• Vitamin D and calcium review
• Physical therapy for safe return to movement
• Occupational therapy when daily tasks become painful
  
  

How To Prevent Stress Fractures

If you’ve never participated in sports or consistent physical activity, make sure you start slow. You can prevent stress fractures when you build activity over time. For example, if you’ve never run before and want to start, walk first, then jog and gradually increase your distance.

These additional tips can help you reduce your risk of a stress fracture:

• Wear well-fitted, supportive shoes
• Replace worn-out footwear
• Cross-train to lower repetitive impact
• Add strength training to improve bone and muscle support
• Build rest days into weekly routines
• Ensure proper nutrition with calcium and vitamin D
• Train on even surfaces whenever possible

For more information, read our blog that offers suggestions on how to increase your mileage safely and other prevention strategies.

When To See A Sports Medicine Doctor

When stress fracture symptoms do not improve or you feel unsure about the cause of your pain, it is best to check with your provider. A sports medicine doctor can confirm the diagnosis and help you avoid a complete fracture. Early care improves healing and helps you stay active with less risk. Get care if:

• Pain lasts longer than a few days
• Pain worsens with activity
• Swelling or bruising spreads
• You cannot place weight on the foot or leg
• Pain appears at rest

Franciscan Health offers orthopedic urgent care, imaging and rehabilitation to help you recover safely and return to the activities you enjoy.