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From the American Academy of Orthopaedic Surgeons

Stress Fractures and Overuse Injuries in Runners

by Joseph A. Bosco, MD; Christopher R. Ropiak, MD; Leon D. Rybak, MD

A stress fracture is a partial or complete fracture caused by the application of repetitive stress. Risk factors for stress fracture can be divided into extrinsic factors, such as a rapid change in training program, training errors, and training on a hard running surface; and intrinsic factors, such as female gender, bone density and size, nutritional/hormonal issues, as well as age and overall conditioning. The history and presentation of stress fractures often includes early localized pain that is not present at the start of activity, but occurs toward the end. Left untreated, this pain can occur earlier during the activity and can linger until it is constant. In general, most stress fractures will heal with nonsurgical treatment in 6 to 8 weeks. The hallmark of treatment is to refrain from the inciting activity, which is typically running. Other overuse injuries, including iliotibial band friction syndrome, Achilles tendinosis, and medial tibial stress syndrome (also known as shin splints) are also discussed.

Keywords: stress fracture, fatigue fracture, insufficiency fracture, female athlete triad, pelvic stress fracture, sacral stress fracture, femoral neck stress fracture, tibial stress fracture, fibular stress fracture, calcaneal stress fracture, metatarsal stress fracture, iliotibial band friction syndrome, Achilles tendinosis, Achilles tendinitis, medial tibial stress syndrome

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