Lets face it, dealing with a stress fracture is frustrating. First of all, stress fractures occur because of over use. The first consideration is biomechanical. Do your orthotics actually accommodate and correct for your dysfunction? Do you have orthotics? Do you need them?

Second, stress fractures occur because of excessive training. I often see people who can run 50 to 70 miles a week without any trouble sustain a stress fracture when they push to more than 80 miles a week.

Third, if you are a high mileage runner, then you need to pay attention to the health of your shoes. Old shoes, less cushion, more stress in the skeleton.

Fourth, diet is important. A diet rich in fruits and vegetables is important in the absorption of soluble calcium important in building the skeleton.

Speaking of diet, especially in young female athletes, we are concerned about the Female Athlete Triad, a condition where disordered eating (as opposed to an eating disorder) with insufficient protein in the diet, leads to stress fractures as well as other symptoms like amenorea as warning signs along with shin splints. You can read more about the Female Athlete Triad here.

Evaluating a stress fracture is a challenge sometimes, because the fracture might be a tiny crack in the surface of the bone that is invisible to an x-ray. For this reason, that an x-ray requires a 50% change in bone density, I prefer to have the stress fracture confirmed by a bone scan, a technology that requires only a 2% change in bone density to pick up. Clinically, we try to confirm the stress fracture with a tuning fork vibrating the bone. When a stress fracture is present, the bone vibrating really irritates the periostium and the stress fracture is confirmed.

Here is a picture of a bone scan illustrating a stress fractre:

So a stress fracture is a fracture. This means that the normal healing time for a fracture is important to respect. So you will need to go non-weight bearing for 6 weeks, and then take 6 more weeks to strengthen before you return to normal training schedules.

For me, this means time in the pool swimming and running in the deep end is the best form of therapy. Beyond that, upper body weight training is OK but you need to protect against weight bearing. Once you hit the 6 week mark, then you can start building your loading times on the leg so that on a gradient you can get back to running. You should not run significant miles before 12 weeks is passed. It takes the fracture a few weeks to harden up. So be cautious once the fracture is healed.