Cracking the Code: How to Diagnose a Stress Fracture

It’s no secret that running and other high impact activities can take a toll on your body. While regular exercise can be incredibly beneficial to your overall health, it also puts you at risk for injuries. One of the most common injuries among athletes, particularly runners, is a stress fracture. Stress fractures are tiny cracks in a bone that occur over time due to repetitive stress. They can be difficult to diagnose, but catching them early is essential to avoiding more serious problems down the road. In this article, we’ll go over everything you need to know about diagnosing a stress fracture.

What is a Stress Fracture?

A stress fracture is a small crack in a bone that is caused by repetitive stress. They occur when the muscles surrounding a bone become fatigued and can no longer absorb the shock of impact. As a result, the bone begins to absorb more of the shock, leading to tiny cracks or fractures. Stress fractures can occur in any bone, but they are most common in the bones of the leg and foot.

What are the Symptoms of a Stress Fracture?

Symptoms of a stress fracture can vary depending on the severity of the injury. However, some of the most common symptoms include:

  • Pain that gets worse with activity and goes away with rest
  • Tenderness to the touch
  • Swelling
  • Mild to moderate bruising
  • Limping or favoring one leg

Who is at Risk for Stress Fractures?

Anyone who participates in high impact activities on a regular basis is at risk for stress fractures. This includes athletes who run, jump, or lift weights, as well as military personnel who engage in frequent and intense physical training. However, there are certain factors that can increase your risk for stress fractures. These include:

  • Wearing improper or worn out shoes
  • Increasing the intensity of your workouts too quickly
  • Having weak bones or osteoporosis
  • Having a history of stress fractures in the past
  • Having certain medical conditions, such as diabetes or eating disorders

Diagnosing a Stress Fracture

Medical History

The first step in diagnosing a stress fracture is to gather a complete medical history. Your doctor will ask about your symptoms, when they started, and what activities you were doing when they first appeared. They will also want to know about your exercise routine, any previous injuries you have had, and any medical conditions that may affect your bone health.

Physical Exam

After taking your medical history, your doctor will perform a physical exam to assess your symptoms. They will look for areas of tenderness, swelling, or bruising around the affected bone. They may also check your range of motion and strength.

Imaging Tests

If your doctor suspects a stress fracture, they may order imaging tests to confirm the diagnosis. The most common tests used to diagnose stress fractures are X-rays, MRI scans, and bone scans. X-rays are the most commonly used imaging test for stress fractures, but they may not show the fracture until it has started to heal. MRI scans and bone scans are more sensitive than X-rays and can often detect stress fractures earlier.

Treatment for Stress Fractures


The most important treatment for a stress fracture is rest. You will need to avoid the activity that caused the injury and give your body time to heal. Depending on the severity of the fracture, you may need to stay off your feet completely for a period of time.

Ice and Elevation

To help control pain and swelling, you should also apply ice and elevating the affected area. This will help reduce inflammation and speed up the healing process. You should ice the affected area for 20 minutes at a time, several times a day, until the pain and swelling have subsided.


In some cases, your doctor may recommend immobilizing the affected bone with a cast, brace, or walking boot. These devices help to protect the bone and prevent further damage while it heals.

Physical Therapy

Once the fracture has healed, your doctor may recommend physical therapy to help you regain strength, range of motion, and flexibility. This can also help you avoid future injuries.

Preventing Stress Fractures

Wear Proper Shoes

Wearing proper shoes that fit well and are appropriate for your activity can help reduce your risk of stress fractures. Be sure to replace your shoes regularly to ensure they are providing the support and cushioning you need.

Gradually Increase Intensity

When starting a new workout routine or increasing the intensity of your workouts, do so gradually. This will allow your body to gradually adapt to the new demands and reduce your risk of injury.


Engaging in a variety of activities can help reduce your risk of overuse injuries like stress fractures. Cross-training can also help you maintain your fitness level while giving your body a break from high impact activities.

Eat a Balanced Diet

Eating a healthy, balanced diet can help keep your bones strong and reduce your risk of stress fractures. Be sure to consume plenty of calcium, vitamin D, and other important nutrients that help build strong bones.


Stress fractures can be a frustrating and painful injury, but with proper diagnosis and treatment, you can recover quickly and avoid future problems. If you suspect you have a stress fracture, don’t hesitate to seek medical attention. Catching the injury early is key to successful treatment and recovery.

Frequently Asked Questions

  • How long does it take for a stress fracture to heal?
  • The length of time it takes for a stress fracture to heal can vary depending on the severity of the injury. In general, it can take anywhere from 6 to 12 weeks for a stress fracture to heal completely.

  • Can stress fractures be prevented?
  • While stress fractures cannot always be prevented, there are steps you can take to reduce your risk. This includes wearing proper shoes, gradually increasing the intensity of your workouts, cross-training, and eating a balanced diet.

  • Do stress fractures require surgery?
  • In most cases, stress fractures do not require surgery. However, in severe cases or if the fracture fails to heal properly, surgery may be necessary.

  • Can you continue to exercise with a stress fracture?
  • No, you should avoid any activity that causes pain until the fracture has healed completely. Continuing to exercise can cause further damage and delay the healing process.

  • How can I tell if my stress fracture is healing?
  • The best way to determine if your stress fracture is healing is to visit your doctor for follow-up imaging tests. They can assess the progression of the healing process and determine when it is safe to return to physical activity.


  • American Academy of Orthopaedic Surgeons. (2018). Stress fractures.–conditions/stress-fractures/
  • Mayo Clinic. (2020). Stress fractures.
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2016). What are stress fractures?

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