A cast is usually not required for a stress fracture. Unlike a fracture caused by a blow to the body which injures the skin, muscle, and bone, a stress fracture involves only the bone.
If pain occurs while walking, crutches or a cane should be used to keep weight off the injured extremity. Returning to activity will be a gradual process. Swimming or biking, both non-weightbearing activities can be done to maintain cardiovascular and muscle conditioning in the early period after the stress fracture.
Gradually, impact activities like walking can be added. When the patient can walk rapidly without pain, running can be started. Jumping should only be done when running does not cause any pain. A gradual increase of stress to the bone is the key. Each increase in activity should be done slowly and for short amounts of time. After a while, the activities can be done at a higher intensity and a longer duration. Eventually the level of activity can be increase (see charts 1 and 2).
If, when advancing to the next level of intensity, pain occurs, the patient should return to the lower level for several days before trying again. The physician will guide the patient through these steps and can monitor the degree of fracture healing with X-rays.
It should be noted that while the normal amount of calcium required for bone repair is 1500 milligrams in postmenopausal women and 1000 milligrams for all other adults, increasing calcium intake above this level will not help the stress fracture heal more rapidly.