Stress fractures


Tiny cracks in a bones, known as stress fractures are caused by overuse and repeated force, such as excessive jumping or running long distance. They can also arise from regular use of a bone that has been weakened by an illness like osteoporosis
The lower leg and foot’s weight-bearing bones are the most common site of stress fractures. The shin bone, or tibia, is the most commonly injured, accounting for 20% to 75% of all stress fractures and is typically caused by strenuous activity. The foot is composed of numerous small bones, including the metatarsals, which connect to the toes. Each foot has five metatarsals, with stress fractures most frequently occurring in the second and third bones. Stress fractures have also been documented in the hip (proximal femur), lower back, and heel (calcaneus).
Stress fracture can occur to anyone but track and field athletes and military recruits carrying heavy loads over long distances are at the greatest risk. For example, starting a new exercise routine and doing too much too soon can result in stress fractures.


The pain associated with a stress fracture may not be intense at first, but it typically worsens over time. The pain usually starts in one specific area and improves with rest. There may also be swelling near the painful area. If your discomfort persists or becomes worse, even with rest or sleep, it is important to see a doctor.


Sudden increases in the quantity or intensity of physical activity are often the cause of stress fractures. Bones gradually adapt to increased stress through a normal process called remodeling. This process speeds up as the force on the bone increases, and it involves the resorption and reconstruction of bone tissue. When bones are subjected to excessive force without adequate time for recovery, the resorption of cells outpaces the rate at which they can be replaced, making you more vulnerable to stress fractures.

Risk factors

The following factors can increase your risk of stress fractures:

  • Certain sports. Individuals who engage in high-impact sports such as track and field, basketball, tennis, dance, or gymnastics have an increased risk of stress fracture.
  • Increased activity. People who go from a sedentary lifestyle to an active training routine too quickly or who increase the intensity, duration, or frequency of training sessions too fast are more prone to stress fractures.
  • Sex. Women are more susceptible to stress fractures, particularly those who have irregular or no menstrual cycles.
  • Foot problems. People with flat feet or high, rigid arches are at higher risk of developing stress fractures and worn footwear can exacerbate the issue.
  • Osteoporisis. This condition weakens bones and increase the risk of stress fractures.
  • Previous stress fractures. You have an increased risk of developing stress fractures if you’ve already had one or more.
  • Poor nutrition. Stress fractures in the bones can be exacerbated by eating problems, a lack of calcium, and vitamin D.