Stress fractures, or small cracks in the bone, are common in runners and individuals who perform repetitive high-impact activities. While rest, modified activity, and strength training are usual approaches to managing stress fractures, new technologies can accelerate the healing process and speed up the return to sport. One such technology is LIPUS treatment, a particular type of ultrasound therapy.

What is LIPUS?

LIPUS, or Low-Intensity Pulsed Ultrasound, is an ultrasound technique that uses low-intensity sound waves delivered in short pulses to stimulate bone healing. Initially developed to treat traumatic fractures, it has since gained traction for treating complicated stress fractures, which are known for their slow recovery due to limited blood supply.

How does LIPUS work for stress fractures?

LIPUS machine used for upper limb fracture

We think that the impulses from LIPUS improve healing by various methods:

  • bone cell stimulation helps to build up bone
  • improving blood supply, assisting the delivery of oxygen and nutrients to the damaged area
  • assisting calcium deposition, making the bones stronger

Who should use LIPUS?

Alongside other treatments, LIPUS can help heal high-risk stress fractures such as:

Recent evidence suggests that LIPUS is effective for slow-healing stress fractures. A recent study showed that navicular stress fractures treated with LIPUS showed a significant reduction in healing time and pain, achieving healing 40% faster than those with conservative treatment alone. Another study found that individuals with anterior tibial stress fractures were successfully treated with LIPUS therapy.

How to use LIPUS treatment

Typically, LIPUS therapy is applied daily for 20 minutes directly onto the stress fracture site using an attachment strapped to the limb. Ultrasound waves penetrate the skin and soft tissue, stimulating bone growth and blood flow.

Additional treatments for healing stress fractures

Other treatments will enhance the effect of LIPUS on bony healing, including:

  • Relative rest from impact activity supplemented with offloading devices such as walking boots or crutches. Cross-training, including swimming and aqua jogging, can maintain fitness while you rest to allow the fracture to heal.
  • Optimising vitamin D and calcium intake is critical to help with fracture healing. Low vitamin D and calcium levels will slow bone healing, delay union, and return to sport. In some cases, extra tests such as blood and a DEXA scan may be needed to assess bone health.

Final word from Sportdoctorlondon about LIPUS treatment

Low-intensity pulsed Ultrasound (LIPUS) and supportive therapies like relative rest, vitamin D and calcium offer a comprehensive approach to healing complex stress fractures. LIPUS can help reduce recovery time and improve outcomes by enhancing bone healing and increasing blood flow.

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