A bone stress injury (BSI) sits on a spectrum that runs from early bone stress reactions through to complete stress fractures. It occurs when repetitive loading outpaces the bone’s ability to remodel and repair itself, leading to microscopic damage and, eventually, pain.
Bone stress injuries are particularly common in runners, military recruits, dancers and athletes in jumping or cutting sports. They most often affect the tibia (shin), metatarsals (forefoot), femur (thigh), pelvis and navicular bone. Some locations — such as the femoral neck, anterior tibia and navicular — are considered high-risk and require urgent, specialist-led management to avoid complications such as non-union or complete fracture.
Frequently Asked Questions
Bone stress injuries usually start as a vague, activity-related ache and become progressively more defined as loading continues. Common features include:
Recurrence usually points to an unresolved underlying issue — training error, low energy availability, hormonal or bone-health problems, or biomechanical factors. A specialist assessment is designed to identify and address these drivers rather than just treating the current injury.
Frequently Asked Questions
Dr. Liam West will take a detailed history of your training, symptoms, nutrition and menstrual health (where relevant), followed by a thorough clinical examination. MRI is usually the investigation of choice — it can identify bone stress long before a true fracture is visible.
If you have suspected bone stress or a stress fracture, early assessment can dramatically shorten your recovery. Book an appointment with Dr. Liam West, our Specialist Sports and Exercise Physician at Melbourne CBD Physiotherapy and Sports Medicine Clinic. You can also learn more about our complete Sports Medicine service.
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Dr Liam West is a Specialist Sport and Exercise Medicine (SEM) Physician and Head Doctor of Hawthorn Football Club. He brings extensive experience across AFL, Athletics (Track and Field) and Football (Soccer), with specialist expertise in bone, muscle, tendon and joint injuries. Liam served as Sports Doctor for the Australian Athletics Team at the 2018 & 2022 Commonwealth Games, and holds a Masters of Sports and Exercise Medicine and Fellowship of the Australasian College of Sport and Exercise Physicians.
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Bone Fractures | Adolescent Sports Injuries | Exercise for Chronic Medical Conditions | Tendinopathy
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Usually yes — just not in a way that continues to load the injured bone. Cycling, swimming, deep-water running and upper-body strength work are commonly used to maintain fitness.
Most low-risk stress fractures heal in 6–12 weeks with appropriate management. High-risk fractures may take considerably longer. A graded return to running typically begins once pain on daily activity has resolved.
Usually yes — just not in a way that continues to load the injured bone. Cycling, swimming, deep-water running and upper-body strength work are commonly used to maintain fitness.
Often yes. X-rays frequently miss early bone stress injuries, and MRI is currently the most sensitive and reliable investigation. Dr. West will arrange imaging where clinically indicated.
