Can I see a Physiotherapist for a Stress Fracture?
Stress fractures are common overuse injuries that occur when muscles become too fatigued to absorb the impact from activities like running, leading the bones to take on the excess load. These fractures can also result from conditions that weaken bones, such as osteoporosis. There are two main types of stress fractures:
Excessive force applied to a normal bone
Excessive force applied to an abnormal bone
Common Locations and Causes
Stress fractures frequently occur in the metatarsals, navicular bone, tibia, and femoral neck. Depending on the sport, lumbar stress fractures are also seen, particularly in cricketers and gymnasts. The primary factors contributing to stress fractures include:
Rapid increases in training volume and intensity
Changes in training surfaces (e.g., from grass to hard court in tennis)
Inadequate footwear or worn-out trainers
Poor muscle conditioning
Symptoms and Diagnosis
Typical symptoms of a stress fracture include localised, burning pain that intensifies with activity and subsides with rest, tenderness upon touch, and sometimes muscle tightness around the fracture site. Diagnosis usually begins with an X-ray; if the fracture isn't visible, a bone scan or MRI might be necessary.
Treatment and Recovery
The initial treatment for stress fractures involves rest and protected mobilisation, often with the use of a moonboot for 4-8 weeks. Physiotherapy can begin during and after this period. A thorough assessment with your physiotherapist will help identify the cause of the fracture, whether it's related to training load, surface, biomechanics, muscle tightness, or joint stiffness. Dietary calcium intake should also be evaluated, and keeping a meal diary can be beneficial in identifying deficiencies.
Physiotherapy treatments may include soft tissue release and dry needling to alleviate tight muscles and improve shock absorption and biomechanics. Joint mobilisations might also be needed to address stiffness and prevent further joint overload.
Strengthening Exercises and Rehabilitation
Your physiotherapist might prescribe strengthening exercises to enhance stability, particularly around the pelvis, knee, and foot. These could include single-leg squats, functional exercises related to running techniques, and strengthening the intrinsic foot muscles. Progressive muscle strengthening is crucial for a safe return to normal activities post-recovery and for preventing future fractures. Gentle low-impact exercises such as swimming, cycling, and using a cross-trainer can be suitable during the recovery phase.
Returning to Sport
Once the fracture has healed, a gradual return to sport is advised. This involves progressing from walking to running to sport-specific skills to help the athlete regain fitness and confidence before resuming full training and competition. Training volume should generally increase by no more than 10% per week, with a recommended reduction of 10-20% every 3-4 weeks.
Seeking Professional Help
If you suspect you have a stress fracture, contact us for an assessment with one of our experienced physiotherapists.
Physiotherapy
We specialise in the treatment and prevention of injuries and conditions. If you are suffering with any health aliments that you feel we could help you with, get in touch today. We provide treatment for a wide age range from 9 years to 90 years old.