Ankle & foot Post-Fracture Rehabilitation
Stress Fracture
- Pain that builds during activity and eases with rest
- Localised bone tenderness at one point
- Pain that progresses to occur at rest
- Recent increase in training load
Quick answer
A stress fracture is a small crack in bone from repeated loading rather than a single injury, most often in the foot, shin or hip. The pattern is pain that builds during activity and eases with rest. It needs a period of reduced loading, then a graded return over six to twelve weeks.
Typical recovery
6–12 weeks, longer for high-risk sites
A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.
Bone remodels constantly in response to load. A stress fracture happens when loading outpaces the bone's ability to rebuild — typically a training volume increased too quickly, a change of surface or footwear, or an underlying problem with bone density or energy availability.
The pattern that identifies it
Pain that builds during activity and settles with rest, gradually starting earlier in each session, and eventually present at rest or at night. Tenderness is localised to one specific point on the bone, unlike the diffuse tenderness of soft tissue problems.
Not all sites are equal
Most stress fractures — the shin, the outer metatarsals — heal reliably with reduced loading. Some sites have a poor blood supply and carry a real risk of not healing or of progressing to a complete fracture: the neck of the femur, the front of the shin bone, the navicular in the foot, and the base of the fifth metatarsal. Suspected fractures at these sites need imaging and orthopaedic input before rehabilitation, not after.
The question that often gets missed
Repeated stress fractures, particularly in women, warrant assessment for low bone density and for relative energy deficiency — inadequate energy intake for the training load, with associated hormonal and menstrual changes. Treating the bone without addressing that guarantees the next one.
How physiotherapy helps
- Offloading appropriately during the healing phase, while maintaining fitness through non-impact work
- A graded return-to-loading programme, progressed by symptoms
- Identifying and correcting the training error that caused it
- Strengthening and mechanics work to reduce recurrence
- Referral for bone health or nutritional assessment where the pattern warrants it
How long it takes
Six to twelve weeks for low-risk sites. High-risk sites take longer and are managed jointly with an orthopaedic team.
Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026