Stress Fractures

What are they? How are they caused? How are they treated? And how do you prevent them?

What are they?

Stress fractures are, as the name suggests, a fracture (crack) in a bone. Generally small and difficult to detect by x-ray, especially when they are fresh. 

What causes them?

They are caused by a chronic imbalance in the degeneration and regeneration of bone. In essence more bone is being broken down than created. When this is first occurring, we refer to it as a stress reaction. These are common, often asymptomatic, and only some; with continued overload, will progress to a fracture. 

This imbalance can be caused through many forms of overload, and it is important to remember that decreased tissue/load tolerance is just as important as overload. 

Causes of overload

Causes of decreased tolerance

  • Overtraining
  • Poor technique
  • Poor equipment (shoes etc.)
  • Drugs, including some medication and steroid use
  • Inadequate rest
  • Inadequate nutrition
  • Hormonal changes (particularly in female athletes)
  • Poor sleep
  • Physical, emotional and/or mental stress

Obviously if we dive into any of the above factors, we can apply specific examples and many sub-categories that vary hugely among individuals. 

How are they treated?

It is all about regaining balance. So, just as the factors above can be the cause, recalibrating them can also be the solution. Initially this calls for an often-dramatic limit to loading. When the body is in this state of chronic focal overload, it is not simply a case of de-loading back to when you felt ok, instead dropping the load right back to a position that gives the body the best chance of getting ahead of the curve. From there, it is about working with your health professional, to begin a gradual re-introduction of loading, gently nudging the tolerance to cause positive tissue adaptation. This is often symptom guided. Naturally all factors affecting tolerance should be addressed throughout recovery e.g. nutrition, sleep hygiene, technique, stress etc.


Again, we can look at the tabled factors above. It is essentially about managing overload and tolerance. Good sleep, nutrition and mental well-being help maintain a high tolerance to load. While well programmed training, good technique, and appropriate equipment limit unintended overload.

If you are concerned about your personal “load balance” then make a time with one of our team. We spend the time to look at all the factors involved and will help get you on an even keel. 

– James Sincock

Sign up to our newsletter for the latest tips and tricks to stay injury free

Success! We'll keep you updated

Sign up to our blog to get all our articles delivered straight to your inbox

Success! We'll notify you when the next blog post goes live!

Pin It on Pinterest

Share This