Massage therapy · Kitchener–WaterlooTibial Stress Fracture

There are two main bones in the lower leg, the tibia and fibula. The larger tibia carries most of your weight, while the smaller fibula carries much less. Either can get a stress fracture, but the tibia is by far the more common – it is the most common site of stress fractures in runners (Kahanov et al., 2015). Pain is usually felt in a specific spot along the shinbone.

Every time you run and jump, your bones break down a little and then rebuild with rest. If bone breaks down faster than the body can rebuild it, a bone stress injury occurs (AAOS, n.d.).

Common Causes of Tibial Stress Fracture

• Over-use – increasing running distance or frequency too quickly over a short period of time.
• Over-use in athletes – constant training and running without enough recovery.
• Change in gait – the way you run and jump changes the forces travelling through the legs.
• Running long distances on hard surfaces – hard surfaces such as concrete increase the force through the body (AAOS, n.d.).
• Other risk factors include being female, a previous stress injury, weak or tired muscles, not eating enough for your level of exercise (relative energy deficiency in sport, RED-S), sleeping less than 7 hours and not taking rest days, low vitamin D, and conditions such as osteoporosis that weaken bone (AAOS, n.d.).

How is a Tibial Stress Fracture Diagnosed?

Tibial Stress Fracture Anatomy

The tibia is the main lower leg bone, and the larger of the two bones. Next to the tibia sits the fibula, which is not involved in weight bearing to the same degree. This is why the tibia tends to suffer stress fractures. The main bony part of the tibia is called the shaft. The tibia joins the ankle joint at the bottom and the knee joint at the top.

How to Treat a Tibial Stress Fracture

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• See a doctor as soon as possible if you think you have a stress fracture, and do not exercise through the pain (AAOS, n.d.).
• Train on softer surfaces such as a track or trail, and avoid big sudden changes in surface.
• Wear proper footwear and replace worn-out shoes (AAOS, n.d.).
• Allow time for recovery: at least 7 hours of sleep a night and one full rest day a week (AAOS, n.d.).
• Don't try to do too much running if you are out of shape. Start gently and build it up over weeks or months.
• Eat enough for your level of exercise; vitamin D is important for bone health (AAOS, n.d.).
• Consult a sports coach to check good technique. A gait analysis can highlight lower limb biomechanical problems. I can look at how you walk and run as part of your treatment (see the My Approach tab).
• Ice can help if there is swelling: use a cold pack for 20 minutes at a time a few times a day, never directly on the skin (AAOS, n.d.).
• OrthoInfo says anti-inflammatory medicines (NSAIDs), such as ibuprofen or naproxen, can help relieve pain and swelling while you wait to see a doctor (AAOS, n.d.). (This medicine information comes from AAOS OrthoInfo, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

A stress fracture needs time away from the load that caused it. Your doctor decides whether you need a boot or crutches and when you can run again; a fracture at the front of the shin needs specialist care. If the fracture stops your normal daily activities, I need your doctor's okay before hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I look at what overloaded the bone: your training, surfaces, footwear, running and rest. If low bone density may be part of it, I keep pressure and loading gentle.

While It's Healing

• Easing the calf, other leg and back, keeping clear of the sore spot on the bone
• Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
• Pain-free exercises for lower-leg flexibility and strength, and setting up crutches if you need them
• Keeping fit with pain-free swimming, cycling or pool running

Once Your Doctor Clears You

1. American Academy of Orthopaedic Surgeons (n.d.) Stress fractures. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/stress-fractures/ (Accessed: 7 October 2026).
2. Kahanov, L. et al. (2015) 'Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners', Open Access Journal of Sports Medicine, 6, pp. 87–95. doi: 10.2147/OAJSM.S39512
3. NHS (2025) Broken leg. Available at: https://www.nhs.uk/conditions/broken-leg/ (Accessed: 7 October 2026).