Stress Fracture


The majority of stress fractures (70–90%) occur in runners. Female runners are 12 times more likely to develop a stress fracture in their lifetimes than male runners. In athletes, the tibia is the most commonly involved bone, whereas in military recruits metatarsal and calcaneal stress fractures are more common 2° to the biomechanics of marching vs. running. Other affected areas include the fibula, femoral neck, and pelvis. Stress fracture development is usually related to an ↑ in the intensity, duration, or frequency of training. Other contributing factors include changes in technique, overly hard or irregular running surfaces, and footwear with poor shock absorption.

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Multiple stress fractures, especially in female athletes, should prompt a workup for osteoporosis along with questioning regarding the female athlete triad (disordered eating, amenorrhea, osteoporosis).