Aquatic exercise helps recovery from

Stress Fractures

What are the benefits of hydrotherapy after a stress fracture?

Reduce pain Buoyancy offloads pressure from the fracture site, enabling you to perform movements with reduced pain

Reduce swelling and bruising - Hydrostatic pressure and our specific water temperature increases circulation and reduces swelling

Immediate exercise, without putting stress on joints or injuries - Cardio-vascular fitness can be maintained and the affected muscle effectively strengthened or lengthened. This enables the athlete to perform activities such as running much earlier than on land

Quicker return to sport - The timeline for returning to sport after a serious sports injury using land-based therapies can be 6-9 months, however utilizing the pool tends to help keep your return closer to 4-6; this is due to being able to reinforce neuromuscular recruitment patterns earlier than is possible with land therapy.

What are stress fractures and why do they occur?

A stress fracture is a small crack within a bone that mostly occurs in the lower legs and feet with repetitive mechanical overload through activities such as running. This is commonly caused by training error but a number of factors may be attributable such as changes in running surface or footwear. Other risk factors include bone density, skeletal alignment, body size and composition, flexibility, strength, hormonal and nutritional factors.

What are the symptoms?

Symptoms will include pain with activity which subsides with rest; swelling and tenderness at the pain site may also be present. Stress fractures may be diagnosed from symptoms alone but imaging tests are often needed to confirm the diagnosis. These imaging tests may include X-rays, bone scans or magnetic resonance imaging (MRI).



I'm a long-distance runner and triathlete and frequently participate in competitions.  I've had my fair share of injuries including stress fractures and a recent torn cartilage.  Aqua Physio has enabled me to stay fit during periods of rehabilitation, although I incorporate aqua running into my training programme even when I'm not injured (it's such a good workout).   I completed the 2017 London Marathon with a PB and I'm sure the deep water running at Aqua Physio helped. The team at Aqua Physio is knowledgeable, flexible and friendly.  I recommend them highly and it is always a pleasure to come for a training session.


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In order to minimise risk an awareness of the causes of stress fractures is important. Following a carefully planned graded training regime can be a useful way to avoid overtraining issues like stress fractures.

More recent injury prevention theory points towards measuring future athletic performance against the overall workload an athlete has been exposed to previously. This should allow the athlete to accurately identify if they are in the danger zone for an overuse injury.



The main principle of treatment is to manage the bones weight bearing load with activity modification until healing occurs. As a general rule this takes 4 – 6 weeks for most bones and is achieved with activity modification and reduction in impact forces. Sometimes it may be necessary to completely offload the area by wearing a supportive boot or walking with crutches.

By modifying training methods, it is possible for athletes to maintain fitness and prevent muscle wastage during this time, whilst still allowing the bone to heal.  As time progresses the bone remodels and a pain free graded exposure to load continues to help in the healing process. Activities such as aquatic running and cycling are particularly helpful.

From 0-6 weeks treatment for stress fractures primarily involves rest from physical activities and weight bearing activities; patients often being instructed to completely offload the affected limb post-injury. Hydrotherapy offers the benefit of allowing you to move much sooner than you could on land, in turn improving circulation, reducing swelling as well as maintaining aerobic exercise. Your affected joint will also benefit from reduced load, increased range of movement as well as a reduction in swelling and pain in these initial stages of rehabilitation. Water naturally has pressurising qualities that can help reduce oedema and swelling, as well as helping to improve blood flow and lymphatic drainage.

From 4+ weeks, the main principle of treatment is to progressively improve weight bearing load, ensuring an effective healing process as a result of increased activity. Through exercising in our hydrotherapy pool, it is possible for athletes to both prevent muscle wastage and allow the bone to heal.  As time progresses the bone remodels and a pain free graded exposure to load continues to help in the healing process. Activities such as aquatic running and cycling are particularly helpful.

From 7-12 weeks our highly qualified physiotherapists will work with you to refine motor control activities and functional strengthening until you are able to transition to land. Exercises are performed to restore strength and flexibility in order to allow your foot, ankle and heel to function properly once you are able to restart weight bearing physical activities. Your physiotherapist will advise you on which exercises will suit you; getting you back to your normal level of function as quickly as possible.

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