Stress Fractures
Bone-stress injuries from repetitive load — particularly common in runners, military recruits, and athletes increasing training load too quickly.
Stress fractures need the right diagnosis fast. Missed or ignored, they can progress to complete fracture or non-union.
What stress fractures are
Bone is dynamic tissue that responds to load with adaptive remodelling. When repetitive loading exceeds the rate at which bone can repair, microdamage accumulates — the result is a stress reaction or, ultimately, a stress fracture.
Common sites in the lower limb include:
- Metatarsal stress fractures — particularly the 2nd and 3rd metatarsals
- Tibial stress reactions — often confused with shin splints
- Navicular stress fractures — less common but high-risk for non-union
- Calcaneal stress fractures — can mimic plantar fasciitis
- Femoral neck stress fractures — rarer, urgent — high-risk site
Some stress fractures are urgent
Femoral neck and navicular stress fractures are high-risk for non-union or progression to complete fracture, and require urgent imaging and orthopaedic referral. If you have hip-region pain in a runner, do not delay — book an assessment promptly.
Common symptoms
Clinical assessment with imaging escalation
Stress fractures often don't show on plain X-ray for the first 2–4 weeks, so X-ray is unreliable for early diagnosis. MRI is the gold standard. Ultrasound has limited utility for bone but can identify periosteal reactions and surrounding soft tissue changes.
Our role is to take a detailed clinical history, examine carefully (point tenderness, hop test, bone stress signs), use ultrasound where useful, and refer for MRI without delay where the picture is consistent with stress fracture.
Once the diagnosis is established, treatment is protected weight-bearing, training load management, and addressing biomechanical or training-load contributors so it doesn't recur.
Diagnostic Injury Assessment
45 minutes · €160. Clinical examination, gait and load history, ultrasound where useful, and onward MRI referral when indicated.