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 basketball
• Military participation, especially during basic training^,
• Female gender^,
• Caucasian or Asian race, as lighter-skinned people are at higher risk of lower bone density due to poor Vitamin D production and absorption^,
• Low bone density, especially in women whose menstrual cycles are suppressed due to low body fat percentage and/or natural menopause^,
• Uneven leg and/or foot alignment^,

• High foot arches or flat feet (pes planus)^,
• Age, with athletes over 40 and under 18 most at risk
• 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 inflexibility
• Prior history of stress fracture^,
• Dietary factors, including low calcium intake, low protein intake, and/or high caffeine intake^,
• Prolonged use of oral corticosteroids or other drugs that can decrease bone density

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:

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.