There are a number of factors that can increase an athlete’s chance of developing a stress fracture. Non-active people can also develop stress fractures, so participation in athletics is not necessarily a prerequisite.
Risk factors for stress fracture include, but are not limited to:
- Playing certain sports; track and field sports pose the highest risk for developing stress fractures, followed by dance, soccer, and basketball15
- Military participation, especially during basic training15,17
- Female gender2,6
- Caucasian or Asian race, as lighter-skinned people are at higher risk of lower bone density due to poor Vitamin D production and absorption2,15
- Low bone density, especially in women whose menstrual cycles are suppressed due to low body fat percentage and/or natural menopause2,5
- Uneven leg and/or foot alignment5,15
- High foot arches or flat feet (pes planus)2,15
- Age, with athletes over 40 and under 18 most at risk2
- Sudden increase in activity level and/or changes in training terrain
- “Weekend warrior syndrome,” in which recreational athletes train hard only one or two days a week while remaining sedentary the rest of the time
- Muscle weakness and/or inflexibility5
- Prior history of stress fracture5,15
- Dietary factors, including low calcium intake, low protein intake, and/or high caffeine intake7,15
- Prolonged use of oral corticosteroids or other drugs that can decrease bone density4
In This Article:
Common types of stress fracture, by sport
Playing different sports put athletes at risk for different types of stress fractures. Some of the stress fractures typically associated with common athletic activities are as follows:
|Associated Sports17||Injury Site17|
|Track and field, dance, basketball||Second and third metatarsals (instep bones) of the foot|
|Military drills, long distance running||Calcaneus (heel bone)|
|Running, track and field, ballet||Tibia (shin bone)|
|Running, ballet, aerobic dance||Fibula (lower-leg bone)|
|Football, basketball, long-distance running||Navicular (midfoot bone)|
|Volleyball, tennis, racquetball, squash||Ulna (forearm bone)|
|Swimming, golf, rowing, wrestling||Chest, ribs|
|Long-distance running, military training||Pubic bone|
Athletes or other persons with one or more of the above risk factors experiencing nagging pain or weakness during activity and/or at rest are encouraged to consult their doctors, who can either diagnose or rule out a stress fracture.
- Kishner S. Physical medicine and rehabilitation for stress fractures. January 27, 2014: Medscape. http://emedicine.medscape.com/article/309106-overview. Accessed December 22, 2014.
- American Academy of Orthopedic Surgeons and the American Orthopedic Society for Sports Medicine. Stress fractures of the foot and ankle. July 2009: OrthoInfo. http://orthoinfo.aaos.org/topic.cfm?topic=A00379. Accessed December 22, 2014.
- Beck, B. Stress fractures. American College of Sports Medicine, Current Comments. https://www.acsm.org/docs/current-comments/stressfractures.pdf. Accessed December 23, 2014.