Stress Fracture Risk Factors

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 basketball1
  • Military participation, especially during basic training1,2
  • Female gender3,4
  • Caucasian or Asian race, as lighter-skinned people are at higher risk of lower bone density due to poor Vitamin D production and absorption1,3
  • Low bone density, especially in women whose menstrual cycles are suppressed due to low body fat percentage and/or natural menopause3,5
  • Uneven leg and/or foot alignment1,5
  • High foot arches or flat feet (pes planus)1,3
  • Age, with athletes over 40 and under 18 most at risk3
  • 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 fracture1,5
  • Dietary factors, including low calcium intake, low protein intake, and/or high caffeine intake1,6
  • Prolonged use of oral corticosteroids or other drugs that can decrease bone density7

See Diagnosing a Scapula Fracture


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 follows2:

Associated Sports Injury Site
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.

See Common Running Injuries