Bone stress injuries (BSIs), including stress reactions and stress fractures, are frustrating. Frequently occurring in the lead up to a major event or competition, these injuries invariably require interruption to training as the prodromal pain and risk of progression to complete fracture is real. This Masterclass aims to provide an overview of BSIs-from pathophysiology to risk factors and to management. Risk factors and subsequent preventative measures are divided into the loads applied to the skeleton and the ability of the skeleton to resist those loads. Signs and symptoms of BSIs are discussed along with their clinical diagnosis. The Masterclass concludes by discussing the management approach for treating a low-risk metatarsal BSI, including the rationale and use of a graduated loading program.