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Stress fracture healing - your questions answered

Updated: Dec 14, 2021

In this article we'll answer some of the most common questions we get asked about the healing of stress fractures.


Stress fracture healing questions answered.

We also made a video about this:

In this article:

  1. What happens if a stress fracture is left untreated?

  2. Can a stress fracture heal on its own?

  3. Will a stress fracture heal if you walk on it?

  4. Can a walking boot make a stress fracture worse?

  5. How we can help


What happens if a stress fracture is left untreated?


It will just get worse. Nobody likes taking time out from sport, but this is not an injury that you should ignore and try to train through. If you continue to train when you have a stress fracture, it will usually continue to get worse until either the pain stops you or it causes your bone to fully fracture.


The quicker you seek the correct treatment and start looking after it, the quicker you'll get back to your sport.


Can a stress fracture heal on its own?


Yes, especially if you catch it early. In most cases all that is required is to reduce your weightbearing activities (your sport but also how much you stand and walk) and to ensure that you are getting enough of the nutrients and minerals that your bones need.


Some stress fractures don't heal as well as others - examples include navicular, anterior tibial and femoral neck stress fractures. For these, your doctor may get you to use crutches or wear a boot for extra protection and to ensure that the bone has the best chance of healing. So, it's important to get it diagnosed properly and to get expert advice about what is needed.


Should this off-loading not have the desired effect, you may need to add other treatments.


Will a stress fracture heal if you walk on it?


Yes and no. It depends on how much you walk and how severe your injury is. If it hurts to walk, then it's usually a sign that you shouldn't be walking or that you should at least reduce the amount of walking to a level that doesn't cause pain.


If you don't experience pain during or after walking, then it may be OK and even beneficial. Your doctor may advise that you don't walk on it, regardless of pain levels, if your stress fracture is in an area that doesn't heal as easily. The best thing to do is to discuss this with the doctor or physio who is in charge of your rehab. They will be able to guide you.


It's usually a sign that you are overdoing things if you have more pain in the afternoon or evening than you have in the morning. If this is the case, you should probably reduce the amount you're walking or standing, even if you don't feel pain while doing it.



Can a walking boot make a stress fracture worse?


There are three reasons why a boot may make your stress fracture feel worse:

  1. It doesn't fit properly. A boot should be 100% comfortable when you put it on. If it's not, have it checked.

  2. If you're walking too much with the boot on. Your doctor may have given you a boot and told you that it's OK to walk with it, but this doesn't mean that you can walk as much as you like. It's still possible to overdo it. If the boot feels comfortable in the morning but then the pain increases by the afternoon after walking with it, it may be that your stress fracture can't yet tolerate the amount of walking you're doing. Discuss this with your doctor. It may be that you're doing too much.

  3. Wearing a boot can increase your risk of developing a blood clot in your calf or foot. If your calf or foot is suddenly quite swollen or red, more painful or throbs, then you should contact your doctor immediately. These are signs that you may have a blood clot and it should be treated immediately.

How we can help

Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.

We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.

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About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.




References:

  1. Kaeding, C. C. and T. L. Miller (2020). Classification of stress fractures. Stress fractures in athletes, Springer: 65-75.

  2. Kaiser, P. B., et al. (2018). "Stress fractures of the foot and ankle in athletes." Foot & Ankle Orthopaedics 3(3): 2473011418790078.

  3. Vasiliadis, A. V. (2017). "Common stress fractures in runners: An analysis." Saudi Journal of Sports Medicine 17(1): 1.