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Stress Fractures in Athletes pp 3–11Cite as

Pathophysiology and Epidemiology of Stress Fractures

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Abstract

Stress injury of bone includes a spectrum from hyperactive bone remodeling to a discrete fracture line visible on imaging. Stress fractures can occur when bone, either healthy or osteopenic, is subject to repeated loading with a subsequent loss of normal bone metabolism and failure of remodeling. Factors that increase load, such as repetitive impact through competition or training for sports or the military, contribute to the development of a stress fracture. They are also more common in the lower extremity, which sees loads that are multiples of body weight during many activities. Similarly, factors that affect normal bone turnover such as metabolic abnormalities, nutrient deficiencies and even genetic predisposition also contribute to the risk of developing a stress fracture. The incidence of stress fractures is difficult to establish from the current literature due to a variation in the quality and method of exposure reporting between studies and the heterogeneity of stress injury by location. Data on the occurrences and incidence rate of stress fracture do suggest, however, that females, runners, and military personnel have the highest incidence rates.

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Author information

Authors and Affiliations

  1. Vanderbilt Sports Medicine, Vanderbilt University Medical Center, 1215 21st Avenue South, Suite 4300, Nashville, TN, 37232, USA

    David Wasserstein MD, MSc, FRCSC

  2. Cleveland Clinic Sports Health, Cleveland Clinic, 5555 Transportation Blvd, Cleveland, OH, 44125, USA

    Kurt P. Spindler MD

Authors
  1. David Wasserstein MD, MSc, FRCSC
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  2. Kurt P. Spindler MD
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Corresponding author

Correspondence to Kurt P. Spindler MD .

Editor information

Editors and Affiliations

  1. Assistant Professor, Department of Orthopedics, Team Physician, Department of Athletics, Physician Lead, Endurance Medicine, Sports Medicine Center, The Ohio State University, Columbus, Ohio, USA

    Timothy L. Miller

  2. Judson Wilson Professor, Department of Orthopedics, Head Team Physician, Department of Athletics, Executive Director, Sports Medicine Center, The Ohio State University, Columbus, Ohio, USA

    Christopher C. Kaeding

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Wasserstein, D., Spindler, K.P. (2015). Pathophysiology and Epidemiology of Stress Fractures. In: Miller, T., Kaeding, C. (eds) Stress Fractures in Athletes. Springer, Cham. https://doi.org/10.1007/978-3-319-09238-6_1

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  • DOI: https://doi.org/10.1007/978-3-319-09238-6_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09237-9

  • Online ISBN: 978-3-319-09238-6

  • eBook Packages: MedicineMedicine (R0)

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