Later, as the process continues, the bone will become tender in a very localized area and will often ache at night or at rest. Ultimately, if left untreated, continued weight bearing may cause a true fracture within the weakened area of bone. This process typically takes 2 to 4 weeks. Stress fractures are usually not casted when strict non-weight bearing or partial weightbearing instructions can be assured. A program of lower extremity strengthening exercises should be started as soon as tolerated.
True fractures require a period of immobilization that varies depending on the bone involved.
However, after the cast has been removed, the extremity should undergo a reconditioning program. After the weight-bearing restriction has been lifted, the individual can begin a reconditioning program for running. A return to running should ideally be initiated on a treadmill. This allows the individual to customize increases in duration and speed, while monitoring pain at the stress fracture site. When running pain free for 15 minutes, increase pace.