The Navy SEAL Physical Fitness Guide - Uniformed Services ...

" A change in shoe wear (worn out shoes or boots or new running shoes or newboots)." An increase in physical activity (too much, too fast, too soon).All suspected stress fractures should be evaluated and followed by the medicalofficer. Treatment for stress fractures include:" Reduction or avoidance of impact and load bearing activities." Partial weight bearing with crutches and advancing to full weightbearing when pain free.This process typically takes two to four weeks. Stress fractures are usually notcasted when strict non-weight bearing or partial weight-bearing instructions can be assured.The reconditioning process should include swimming or water exercises (such as deepwater running) to maintain flexibility and aerobic endurance. A program of lower extremitystrengthening exercises should be started as soon as tolerated.True fractures require a period of immobilization which variesdepending on the bone involved. However, after the cast has been removed, the extremityshould undergo a reconditioning program.After the weight-bearing restriction has been lifted, the individual can begin areconditioning program for running. A return to running should ideally be initiated on atreadmill. This allows the individual to customize increases in duration and speed whilemonitoring pain at the stress fracture site. A typical “return-to-running” program ispresented in Table 12-4.210 Training and Sports Related Injuries