Many sports injuries are sudden and unmistakable—a twist, a “pop,” sudden pain, and you know something has gone wrong.

woman running outside Runners who switch to a different surface may be at risk for a stress fracture.
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Stress Fracture Causes

But what about when an injury starts slowly and subtly, with symptoms like a deep-seated dull ache? This is the characteristic of a stress fracture.

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Who’s at risk for a stress fracture?

Unlike acute bone fractures that occur as the result of an accident and cause sudden intense pain, a stress fracture starts with a small hairline fissure in the bone, which bring on non-distinct pain slowly.

Stress fractures often occur in the lower limbs and feet, which is why athletes who put repetitive stress of their legs and feet are most vulnerable: runners, dancers, soccer players and basketball players.

See Stress Fracture Risk Factors

This is particularly true for these athletes during times when some aspect of their training is changed—like new shoes or a different running surface—or drastically intensified—like longer or more frequent workouts in preparation for a race or event.

Stress fracture signs to watch for

It’s important to know the signs of a stress fracture. If they’re left undetected and untreated, they can get worse and even permanently sideline an athlete.

Watch for these symptoms of a stress fracture:

  • Deep aching pain within a limb or joint
  • Dull pain that occurs with activity (sometimes midway through the activity), then disappears with rest
  • Pain that doesn’t improve despite rest or RICE treatment measures
  • Weakness or loss of performance in the affected area
  • Aching pain that progressively gets worse and starts occurring not just during activity
  • Pain that gets worse in the evening or at night
  • Pain the starts about a week after an increase in training or intensity

See a complete symptom list: Stress Fracture Symptoms

Stress fractures are rarely treated with surgery, but the treatment process is pretty demanding and time-consuming, often involving weeks or even months of of rest, bracing, and physical therapy.

See Stress Fracture Treatment and Prevention

But there's good news too: If athletes follow their treatment protocol—and take steps to correct the training error that triggered the stress fracture in the first place—they have a good chance of a full recovery.

Learn more:

Stress Fracture Diagnosis

Treating Acute Sports and Exercise Injuries in the First 24 to 72 Hours