Bone Stress Injuries

Bone stress injuries also known as stress fractures are a common cause of pain in runners and active individuals. Often the pain is pin point to one area of the leg with swelling. Active movements such as walking, running, or jumping are sharp and painful. There may even be some pain when at rest (sitting, sleeping).

The key questions to answer about BSI are:

1.What is a Bone Stress Injury (BSI)?         

2. How is a BSI diagnosed?          

3. When can I return after a BSI?          


What is a BSI?

Bone stress injuries are overuse injuries of the bone. Often the bone is stressed beyone its capacity to recover with too little rest.

This may occur after starting a new workout program or a sudden increase in race training. When the bone is unable to recover it develops inflammation and may break down. Common areas include the inner hip, shin and foot.


How is a BSI diagnosed?

There are a few screening tests that are used (see video) for BSI. However imaging is used to confirm the diagnosis. Generaly x-rays are less accurate and "miss" the stress fracture. For this reason MRI is the gold standard for these injuries, it also grades them creating a standardized rest period. See below


MRI Grading Scale (1-4):

o  Grade 1: 3 weeks rest

o  Grade 2: 3-6 weeks rest

o  Grade 3: 12-16 weeks rest

o  Grade 4 (Fracture) : 16+ rest


How do I recover from a stress fracture or BSI?

It is possible to return to activity after a bone stress injury. Each person's timeline is guided by their "grade" and their specific sport. Generally activity modification and a period of "active rest" can increase recovery. Also strength training has been shown to help bone quality and strenght. And finally your nutrition must be evaluated to reduce risk of recurrence. 

In order to return as quickly and safely as possible one ought to see a specialist or a provider with experience in BSI.


At Norwood Chiropractic  our providers work to provide a thorough examination in order to give out patients an accurate diagnosis. If you are experiencing what you believe to be a BSI, call to book an appointment today or this week . We will get to the bottom of this together.  

Dr. Tyler Kemp

Dr. Tyler Kemp

DC, Dry Needling Specialist, Acupuncture Certified

Contact Me