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.







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).