02/14/2026
Pics of fibula stress fracture of 30 year old patient training for a half marathon. The left X-rays show the subtle change in the bone and right X-rays are 4 weeks after showing callus formation (bone healing). A stress fracture is a small,hairline crack in bone resulting from repetitive, impact-loading activities rather than a sudden injury. Common symptoms include pain that worsens during exercise and subsides with rest, localized swelling, and tenderness. Healing typically takes 6 to 8 weeks with rest, though some cases require 3-6 months.
Symptoms of a Stress Fracture
Pain Development: Pain typically begins gradually, intensifying during weight-bearing activities or sports.
Rest Relief: Initially, the pain may subside with rest.
Progression: If ignored, pain may persist during daily activities or even at night.
Tenderness/Swelling: Localized tenderness and swelling often occur at the site of the fracture.
Causes and Risk Factors
Overuse/Repetitive Activity: High-impact activities like running, basketball, or dancing, especially when increasing intensity or duration too quickly.
Muscle Fatigue: When muscles are tired, they cannot properly absorb shock, transferring stress to the bones.
Poor Mechanics/Equipment: Improper technique or worn-out footwear.
Bone Weakness: Conditions like osteoporosis or low vitamin D/calcium levels.
Common Locations: Weight-bearing bones of the lower leg (tibia, fibula) and foot (metatarsals, heel).
Treatment and Healing
Rest: The most crucial treatment is avoiding the activity that caused the injury.
Activity Modification: Using crutches, walking boots, or casts to take weight off the area for 2–6 weeks.
Pain Management: Ice packs and NSAIDs (nonsteroidal anti-inflammatory drugs) can be used to manage pain.
Slow Return: A gradual, structured return to activity is necessary to prevent re-injury.
Surgery: Rarely, for high-risk, slow-healing fractures, surgery may be required.
Healing Timeline
Most stress fractures heal within 6 to 8 weeks, although some, particularly those with poor blood supply, may take up to 3–6 months to heal completely.
