Stress fracture: returning to sport step by step
Pain localised on a precise point of a bone (shin, foot, hip), which increases on impact and may persist at rest.
Why it happens
Too fast an increase in load, insufficient recovery, insufficient energy intake, weakened bone.
Coming back in four stages
- 1
Rest from impact according to medical advice: walking only if it is allowed.
- 2
Pain-free walking, then cycling or swimming, if your doctor allows them.
- 3
Very gradual alternation of walking and running, only when approved by your doctor.
- 4
Easy continuous running, with volume built back up very slowly.
Each stage often lasts several weeks. Only move to the next one with your doctor’s explicit approval.
Movements to postpone
Strengthening exercises
For this injury, strengthening follows the protocol of your doctor, physiotherapist or surgeon. Rehab does not offer exercises in its place.
What your physio will probably work on · Stress fracture
General guidelines to help you understand your rehab and talk it through with your physio. Every protocol is different, especially after surgery: what your clinician says comes first.
- Stage 1 Ease the pain and protect the bone: what is allowed (walking, partial weight-bearing, brace or offloading shoe) and what is off limits for now.
- Stage 2 Keep fit without impact (cycling, swimming, deep-water running) and start strengthening calves, hips and trunk without loading the bone.
- Stage 3 Bring impact back in small doses (brisk walking, very light hops, walk-run intervals), checking bone pain the next day.
- Stage 4 Build running volume up slowly and look for the cause: training load, shoes, technique, nutrition and energy availability.
Questions to ask your physio or doctor
- How much bone pain is acceptable during and after exercise, and what should make me stop?
- Do I need a follow-up scan before running again?
- Which impact-free activities are allowed right now?
- Is there a cause to check (nutrition, irregular periods, vitamin D, shoes)?
- How fast can I increase volume once I am running again?
When to stop and see a professional
Any precise pain on the bone that comes back: stop and see a doctor. This is the injury where you must never push through.
Rehab’s advice
Return only with your doctor’s explicit approval, slower than for other injuries. Any precise pain on the bone is a stop signal.
What the Rehab plan does for this injury
The plan starts at 25% of your previous training volume and builds up to 75%, with a consolidation week every three weeks. If your discomfort reaches 3 out of 10, it stops and refers you to your doctor or physiotherapist.