LIPUS For Stress Fracture Healing

Can LIPUS Help Heal Stress Fractures?

Stress fractures are common overuse injuries affecting athletes, runners, and military personnel. These tiny cracks in the bone typically result from repetitive loading with insufficient recovery. Frequently the can prove to be difficult to heal. Especially in high-risk areas, or patients with underlying health issues. An increasingly recognized treatment option is LIPUS for stress fracture healing. LIPUS or, Low-Intensity Pulsed Ultrasound is a non-invasive therapy. Biological stimulation to support faster, more complete bone repair.

What Is LIPUS?

Low-Intensity Pulsed Ultrasound, is a therapeutic modality that uses pulsed sound waves at intensities far below those of traditional diagnostic or therapeutic ultrasound. Unlike continuous-wave ultrasound, LIPUS emits sound energy in short pulses that stimulate bone and tissue healing without generating significant heat. It has been shown to enhance cell activity at the fracture site. Promote new blood vessel formation (angiogenesis), and increase the expression of key growth factors. Such as VEGF (Vascular Endothelial Growth Factor) and BMPs (Bone Morphogenetic Proteins).

LIPUS for Stress Fracture Healing

LIPUS can be used for stress fractures, particularly in situations where healing is delayed or when the fracture is located in a high-risk area. Clinical studies have shown that LIPUS may shorten healing time and reduce pain in bone injuries by enhancing the biological repair process. It is especially helpful when treating stress fractures in areas with limited blood supply. Such as the navicular bone or the anterior cortex of the tibia, where healing is typically slower.

According to a randomized controlled trial published in the American Journal of Sports Medicine (Busse et al., 2002), LIPUS accelerated the healing of tibial fractures, including stress-type injuries, by stimulating cellular processes at the site of injury. Another review in the Journal of Orthopaedic Research highlighted that LIPUS enhances the migration and proliferation of osteoblasts and mesenchymal stem cells, both of which are critical to bone repair.

Suitable LIPUS for Stress Fracture Healing Candidates

LIPUS may be a useful adjunct therapy in the following situations:

• Stress fractures in high-risk locations (e.g., femoral neck, navicular, anterior tibia)
• Delayed union or non-union observed at follow-up imaging
• Patients with metabolic conditions such as diabetes or osteoporosis
• Athletes requiring accelerated return to sport

While standard care such as rest, activity modification, and nutrition remain foundational. LIPUS for stress fracture healing offers an additional tool to enhance biological healing, and reduce the overall time to recovery.

How Is LIPUS Applied?

LIPUS treatment involves placing a small transducer directly over the fracture site. Treatment sessions typically last 20 minutes and ideally are performed once daily. The therapy is painless and can be done in-clinic or at home with a rented or purchased device provided by a physiotherapy practice. Please note: At Sydney Physio Clinic we do not currently hire out LIPUS devices.

For optimal results:

• Start LIPUS as soon as possible after diagnosis
• Ensure accurate placement over the fracture site (guided by imaging, or professional instruction)
• Use the device consistently, every day, for at least 4 to 8 weeks

Are There Any Limitations?

While LIPUS is generally safe, there are a few contraindications to its use:

• It should not be used over areas of active infection
• It is ineffective if metal hardware fully obstructs the ultrasound path
• It may not be suitable if the fracture site is deeply buried or inaccessible for transducer placement

LIPUS is an evidence-based, non-invasive tool that can support healing in stress fractures. Particularly when traditional healing is slow, or when faster return to function is a priority. By enhancing cellular activity, increasing blood supply, and stimulating key growth factors, LIPUS bridges the gap between passive rest and active recovery. If you suspect a stress fracture or are dealing with one that’s slow to heal. Please call Sydney Physio Clinic to see if LIPUS is right for your recovery plan.