Principles of stress fracture management. The whys and hows of an increasingly common injury.

As the patient population becomes more involved with athletics, informally or in an organized fashion, risk of stress fracture increases. Rapid and safe recovery is best ensured with early diagnosis and expedient conservative therapy. A history of progressive pain, initially with exertion and ultimately at rest, suggests the diagnosis. Plain radiographs often do not reveal fractures, and specialized studies, such as bone scanning, SPECT, or MRI, may be necessary to confirm the diagnosis. Simple rest with progressive reintroduction of activity is the treatment of choice for most stress fractures.