About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Home Print this page Email this page Users Online: 318

 Table of Contents  
Year : 2017  |  Volume : 17  |  Issue : 1  |  Page : 1-6

Common stress fractures in runners: An analysis

Department of Orthopaedic Surgery, General Hospital of Grevena, Grevena, Greece

Date of Web Publication3-Jan-2017

Correspondence Address:
Dr. Angelo V Vasiliadis
Smyrnis 8, 55535 Pylaia, Thessaloniki
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-6308.197457

Rights and Permissions

Stress fractures are common injuries in both professional and recreational runners. This type of injury occurs more frequently in the lower extremities and can be caused by a number of both extrinsic and intrinsic factors. A wide variety of stress fracture locations have been reported in the literature, but the tibia is most frequently involved followed by the metatarsals, the fibula, the tarsal navicular, and the femur bone. Marathon training and average weekly running distances over 64 km have been consistently demonstrated as factors in the development of a stress fracture. Recent changes in the training regimen, prior injury, and running or training on hard terrain, such as trail running, are among additional considerations when evaluating runners with stress fractures.

  Abstract in Arabic 

تحليل لكسور الإجهاد الشائعة للعدائيين
تعدّ كسور الإجهاد من الإصابات الشائعة بين العدائيين المحترفين والهواة. وهذا النوع من الإصابة يظهر غالباً في الأطراف السفلى وقد يحدث نتيجة للعديد من العوامل الداخلية والخارجية. وقد تم تسجيل اختلافات عريضة لمواقع كسر الاجهاد في الكتب لكن كسر عظم الساق الاعظم هو الاكثر تكراراً يليه عظام مشط القدم، عظم الساق الاصغر، الرسغ والفخذ. ولوحظ أيضا ان تمارين المارثون ومعدل الجري لمسافة أكثر من 64km من العوامل التي ينتج عنها كسر الاجهاد. ان التغيير الذي يجرى حاليا في نظام التمرين، قبل الإصابة والجري أو التمرين في الحقل الصلب مثل الة الجري هي ضمن الاعتبارات الإضافية التي يجب ان توضع في الاعتبار عند تقييم العدائيين المصابين بكسر الاجهاد.

Keywords: Athletes, lower extremity, running, stress fracture

How to cite this article:
Vasiliadis AV. Common stress fractures in runners: An analysis. Saudi J Sports Med 2017;17:1-6

How to cite this URL:
Vasiliadis AV. Common stress fractures in runners: An analysis. Saudi J Sports Med [serial online] 2017 [cited 2023 Sep 21];17:1-6. Available from: https://www.sjosm.org/text.asp?2017/17/1/1/197457

  Introduction Top

Stress fractures are a major musculoskeletal problem occurring frequently in professional runners which may lead to significant disability and loss of time from sports training and competition and therefore require particular attention. Nowadays, with the ongoing development of public participation in sports, stress fractures can also affect recreational runners.[1],[2] It is believed that numerous factors contribute to the development of the pathogenesis of stress fractures in runners. These factors are typically grouped into two major categories; extrinsic and intrinsic risk factors [Table 1].[3],[4],[5] In addition, stress fractures can be divided into high- and low-risk stress fracture sites based on the likelihood of uncomplicated healing with conservative therapy [Table 2].[3],[6],[7],[8],[9] The incidence of such fractures in runners accounts for up to 21.1% of all injuries sustained.[10],[11],[12] The most commonly involved bone is the tibia, but the metatarsals, tarsal navicular, femur, and pelvic skeleton are also susceptible to these fractures [Table 3]. Most of the stress fractures develop gradually and usually occur as a result of repetitive overload and/or overuse of the bone, when mechanical stresses exceed bone remodeling and adaptive capacity.[21]
Table 1: Extrinsic and intrinsic risk factors contributing to the pathogenesis of stress fractures

Click here to view
Table 2: High‑ and low‑risk fracture sites according to their propensity to heal without complication with conservative therapy

Click here to view
Table 3: Percentage distribution of stress fractures in runners by bone: A panorama of the literature

Click here to view

Stress fractures can affect any physically active person at any age if he/she participate in repetitive sports activities such as running. This article reviews the common stress fractures in runners with an aim to present the location of stress fractures according to kilometers run per week.

  General Review Top


The tibia is the most common site of a stress fracture in the lower body in runners, accounting for between 25% and 59% of all stress fractures reported.[13],[14],[15],[16],[17],[19],[22],[23],[24] Fractures may occur at different locations within the tibia. Tibia stress fractures typically occur in the proximal and distal parts of the bone and over the medial posterior surface of the tibia, with the midpart of the bone and the anterior diaphysis being far less susceptible.[25],[26] Recreational and professional runners are prone to developing a stress fracture on the posterior medial side of the tibia,[27] while an anterior tibia stress fracture may result from sports demanding frequent jumps,[28] or which include a multitude of other movements, such as trail running. The scientific evidence shows that a significant number of runners suffer a tibia stress fracture even when running modest distances of 30-40 km/week.[29] It is important to note that an anterior tibia stress fracture is a serious injury potentially and adversely affecting an athlete's career or even leading to its premature termination.[25]


The first report of a stress fracture was described by Breithaupt in 1855 and involved the metatarsals of Prussian soldiers after marching long distances.[30] Overall metatarsal stress fractures constitute between 10% and 25% of all lower extremity stress fractures. Typically, metatarsal stress fractures occur in the distal second and third metatarsal shafts, which are thinner and often longer than the adjacent first metatarsal, while the fifth metatarsal rarely presents stress fractures.[13],[14],[15],[16],[19],[23],[31] There are two distinct areas in the metatarsals where stress fractures can develop: (i) Nonproximal (distal) and (ii) proximal (at the base), the latter may often require surgical intervention and a prolonged recovery period.[32] Metatarsal stress fractures are not limited to high-level athletes or military recruits; this type of injury presents in runners of all levels, as well as in ballet dancers, rheumatoid arthritis patients, and in people involved in jumping sports.[33],[34],[35] Runners who run 90-110 km/week are more likely to present a metatarsal stress fracture.[36]


Problems with the fibula account for 7%-23% of all stress fractures.[14],[15],[16],[17],[18],[19],[23] These are not as common as tibia stress fractures because the fibula is not used in load bearing in the same way. The most common sites of stress fracture occur in the distal third of the bone,[37],[38] proximal to the lateral malleolus. Runners (marathon) and especially trail runners (running on hard surfaces) have the highest incidence of developing fibula stress fractures, but many other types of athletic activity may contribute to this, such as jumping sports, ballet, and/or aerobics.[24],[35],[39],[40],[41] Weekly running over 25 km/week was associated with a significantly increased risk of a stress fracture in the fibula.[41]

Tarsal navicular

Tarsal navicular fractures are the most common stress fractures of tarsal bones and are classified as high-risk stress fractures.[21] Tarsal navicular stress fractures account for 1%-3% of all stress fractures,[16],[22],[23],[42] but a study conducted in Germany presented a disproportionately larger percentage of 20%.[15] The most common site for stress fractures occurs at the proximal dorsal central one-third of the navicular bone.[43],[44],[45],[46],[47] This fracture is often associated with sprinting, jumping, and hurdling sports, such as athletics generally, basketball, soccer, and/or lacrosse.[44],[45],[48],[49],[50],[51] However, this type of stress fracture can occur in long-distance runners when their training programs have regimens of 80-160 km/week.[46],[47],[52]


Stress fractures may occur at various sites in the femur including the head, neck, and diaphysis region, but the most common location is the femoral neck.[53],[54] Femur stress fractures are rare and represent 2%-11% of all stress fractures in runners.[14],[15],[16],[19],[23] These fractures may occur among people who do high-impact athletic activities such as marathon running, cross-country running, skiing, football, and lacrosse,[1],[55],[56],[57],[58] although the literature includes an uncommon femoral neck stress fracture in a 15-year-old girl that incurred while swimming.[59] A training regimen of between 30 km and 70 km/week appears to be a crucial factor for the development of a femur stress fracture.[55],[58],[60],[61],[62],[63]

Pelvic skeleton

Stress fractures of the pelvic skeleton normally account for 1.3%-7% of stress fractures seen in runners.[14],[15],[16],[17],[23] However, a report exists of a study conducted in Japan, which describes an unusual high rate of 35% for stress fractures in the pubic bones.[13] The most common sites for stress fractures in the pelvic skeleton are the sacrum and pubic ramus. Stress fractures of the sacrum predominantly appear in long-distance runners, particularly females with a combination of female athlete triad (disordered eating, amenorrhea, and reduced bone mineral mass).[64],[65],[66],[67],[68] Sacrum stress fractures have also been reported in a soccer player, a basketball player,[68] an amateur tennis player,[69] a volleyball player,[70] and a weightlifter.[71] It is notable that a running training program up to approximately 100 km/week appears to contribute to the development of a sacrum stress fracture.[65],[66],[67]


Stress fractures of the patella are uncommon, only representing approximately 3% of all stress fractures in runners.[16] Patella stress fractures can take a variety of forms, with studies identifying transverse stress fractures as more common than longitudinal.[20],[72],[73] Running is reported to be the predominant cause of stress fractures,[73] but other sports also contribute to their development such as tennis,[74] skiing,[75] volleyball, and soccer.[20] Running up to 145 km/week may be a crucial factor for developing patella stress factor.[73]

Great toe sesamoids

Sesamoid bones are bones present within a tendon. The great toe sesamoids are small and seemingly inconsequential; however, they are susceptible to stress fractures.[28] Great toe sesamoid stress fractures are relatively rare and constitute approximately 0.4% of all running injuries.[76] Regarding great toe sesamoid stress fractures, the medial (tibial) sesamoid bears most of the weight-bearing force during running and thus it is more prone to be affected than the lateral (fibular) sesamoid.[77] Great toe sesamoids stress fractures are often associated with sports requiring increased pressure on the forefoot such as running, jumping sports, and ballet dancing.[77],[78],[79],[80]


Calcaneus stress fractures are the third most common stress fracture in the foot, following metatarsal and tarsal navicular stress fractures. Calcaneus stress fractures typically occur at the posterosuperior aspect of the calcaneus,[81] overall accounting for 1.3%-5.7% of all stress fractures.[14],[16],[19] Calcaneus stress fractures are common among certain populations including active young people, runners,[81],[82] military recruits,[83] and in persons with osteopenia.[82] Runners with an average training distance of 90 km/week are at a risk of developing a calcaneal stress fracture.[84]

  Discussion Top

Running is generally held to have many positive effects, including cardiovascular and skeletal health. However, running can potentially cause injuries, such as stress fractures, specifically relating to the lower extremities. A stress fracture is defined as a solution for partial or complete continuity of a bone caused by reported mechanical stress which over time exceeds the intrinsic ability of the bone to repair itself.[6] Runners can get a wide variety of stress fractures, but the most common locations in the lower extremities include the tibia (25%-59%), metatarsals (10%-24.6%), fibula (7%-22.9%), and tarsal navicular (0.7%-20%), while less common locations include the femur, pelvic skeleton, patella, great toe sesamoid, and calcaneus.[3],[6],[12],[13],[21],[24],[85] A summary of the distribution of stress fracture sites from previously reported studies is shown in [Table 3]. Nowadays, stress fracture is one of the most feared running injuries, and more than one in five runners will sustain a stress fracture in their athletic career.

It is well documented that the risk of developing a stress fracture is influenced by many factors, categorized as intrinsic and extrinsic factors.[3],[86] In this multifactorial etiology of stress fracture, some alteration in training regimen seems to play a central and crucial role.[11],[86] It seems that the more kilometers per week a person runs, the greater the incidence of stress fracture. Studies show that marathon training[1],[22],[60],[61],[62],[63],[87] and running more than 64 km/week involve a much greater risk of developing stress fractures.[88] However, there are studies in which a training program of about approximately 25 km/week can also lead to a stress fracture.[55],[56] Running different weekly distance schedules can lead to stress fractures in different topographical locations of the bones in the lower extremities [Figure 1]. In addition, a sudden increase in the kilometers run per week, a transition to training on hard terrain, running in worn-out or unsuitable footwear, and insufficient recovery period after previous injuries are also contributory factors.[89] Stress fractures can also occur in both sedentary people who suddenly start running on a weekly basis and in professional runners who exercise regularly and energetically.[90]
Figure 1: Topographical location of stress fractures in runners according to the weekly running (kilometers load) schedule

Click here to view

  Conclusion Top

Today, stress fractures have become commonplace in professional and recreational runners and are caused by repetitive application of a greater amount of force than the bones of lower extremities normally bear. Stress fractures may be due to multiple factors including bone quality, nutritional status, hormone imbalance, and anti-inflammatory drugs, but stress fractures often arise in runners who are in training when they suddenly increase distance or start training on a hard surface (trail running). Marathon training and weekly running of more than 64 km are typically considered as highest risk for stress fractures. The location of such fractures can vary with the weekly distance run.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Farkas TA, Zane RD. Comminuted femur fracture secondary to stress during the Boston Marathon. J Emerg Med 2006;31:79-82.  Back to cited text no. 1
Karagounis P, Prionas G, Armenis E, Tsiganos G, Baltopoulos P. The impact of the Spartathlon ultramarathon race on athletes′ plantar pressure patterns. Foot Ankle Spec 2009;2:173-8.  Back to cited text no. 2
Mayer SW, Joyner PW, Almekinders LC, Parekh SG. Stress fractures about the foot and ankle in athletes. Duke Orthop J 2013;3:8-19.  Back to cited text no. 3
Pepper M, Akuthota V, McCarty EC. The pathophysiology of stress fractures. Clin Sports Med 2006;25:1-16, vii.  Back to cited text no. 4
Warden SJ, Burr DB, Brukner PD. Stress fractures: Pathophysiology, epidemiology, and risk factors. Curr Osteoporos Rep 2006;4:103-9.  Back to cited text no. 5
Behrens SB, Deren ME, Matson A, Fadale PD, Monchik KO. Stress fractures of the pelvis and legs in athletes: A review. Sports Health 2013;5:165-74.  Back to cited text no. 6
Boden BP, Osbahr DC. High-risk stress fractures: Evaluation and treatment. J Am Acad Orthop Surg 2000;8:344-53.  Back to cited text no. 7
Diehl JJ, Best TM, Kaeding CC. Classification and return-to-play considerations for stress fractures. Clin Sports Med 2006;25:17-28, vii.  Back to cited text no. 8
Mayer SW, Joyner PW, Almekinders LC, Parekh SG. Stress fractures of the foot and ankle in athletes. Sports Health 2014;6:481-91.  Back to cited text no. 9
Bennell KL, Malcolm SA, Thomas SA, Wark JD, Brukner PD. The incidence and distribution of stress fractures in competitive track and field athletes. A twelve-month prospective study. Am J Sports Med 1996;24:211-7.  Back to cited text no. 10
Fredericson M, Jennings F, Beaulieu C, Matheson GO. Stress fractures in athletes. Top Magn Reson Imaging 2006;17:309-25.  Back to cited text no. 11
Tenforde AS, Sayres LC, McCurdy ML, Sainani KL, Fredericson M. Identifying sex-specific risk factors for stress fractures in adolescent runners. Med Sci Sports Exerc 2013;45:1843-51.  Back to cited text no. 12
Iwamoto J, Takeda T. Stress fractures in athletes: Review of 196 cases. J Orthop Sci 2003;8:273-8.  Back to cited text no. 13
Korpelainen R, Orava S, Karpakka J, Siira P, Hulkko A. Risk factors for recurrent stress fractures in athletes. Am J Sports Med 2001;29:304-10.  Back to cited text no. 14
Csizy M, Babst R, Fridrich KS. "Bone tumor" diagnostic error in stress fracture of the medial tibial plateau. Unfallchirurg 2000;103:993-5.  Back to cited text no. 15
Brukner P, Bradshaw C, Khan KM, White S, Crossley K. Stress fractures: A review of 180 cases. Clin J Sport Med 1996;6:85-9.  Back to cited text no. 16
Dowey KE, Moore GW. Stress fractures in athletes. Ulster Med J 1984;53:121-4.  Back to cited text no. 17
Sullivan D, Warren RF, Pavlov H, Kelman G. Stress fractures in 51 runners. Clin Orthop Relat Res 1984;187:188-92.  Back to cited text no. 18
Smith LS. Stress fractures in runners. Med Sci Sports Exerc 1982;14:140.  Back to cited text no. 19
Orava S, Taimela S, Kvist M, Karpakka J, Hulkko A, Kujala U. Diagnosis and treatment of stress fracture of the patella in athletes. Knee Surg Sports Traumatol Arthrosc 1996;4:206-11.  Back to cited text no. 20
Kahanov L, Eberman LE, Games KE, Wasik M. Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners. Open Access J Sports Med 2015;6:87-95.  Back to cited text no. 21
Matheson GO, Clement DB, McKenzie DC, Taunton JE, Lloyd-Smith DR, MacIntyre JG. Stress fractures in athletes. A study of 320 cases. Am J Sports Med 1987;15:46-58.  Back to cited text no. 22
Orava S, Puranen J, Ala-Ketola L. Stress fractures caused by physical exercise. Acta Orthop Scand 1978;49:19-27.  Back to cited text no. 23
Patel DS, Roth M, Kapil N. Stress fractures: Diagnosis, treatment, and prevention. Am Fam Physician 2011;83:39-46.  Back to cited text no. 24
Liimatainen E, Sarimo J, Hulkko A, Ranne J, Heikkilä J, Orava S. Anterior mid-tibial stress fractures. Results of surgical treatment. Scand J Surg 2009;98:244-9.  Back to cited text no. 25
Popp KL, Hughes JM, Smock AJ, Novotny SA, Stovitz SD, Koehler SM, et al. Bone geometry, strength, and muscle size in runners with a history of stress fracture. Med Sci Sports Exerc 2009;41:2145-50.  Back to cited text no. 26
Boden BP, Osbahr DC, Jimenez C. Low-risk stress fractures. Am J Sports Med 2001;29:100-11.  Back to cited text no. 27
Cruz AS, de Hollanda JP, Duarte A Jr., Hungria Neto JS. Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes. Knee Surg Sports Traumatol Arthrosc 2013;21:1447-50.  Back to cited text no. 28
Castro SD, Joosse P, Unlu C, Steller EP. Stress fractures of the tibia after jogging. J Trauma Treat 2014;S2:6.  Back to cited text no. 29
Breithaupt MD. The pathology of the human foot. Med Zeitung 1855;24:169-75.  Back to cited text no. 30
Harrast MA, Colonno D. Stress fractures in runners. Clin Sports Med 2010;29:399-416.  Back to cited text no. 31
Tsukada S, Ikeda H, Seki Y, Shimaya M, Hoshino A, Niga S. Intramedullary screw fixation with bone autografting to treat proximal fifth metatarsal metaphyseal-diaphyseal fracture in athletes: A case series. Sports Med Arthrosc Rehabil Ther Technol 2012;4:25.  Back to cited text no. 32
Banal F, Etchepare F, Rouhier B, Rosenberg C, Foltz V, Rozenberg S, et al. Ultrasound ability in early diagnosis of stress fracture of metatarsal bone. Ann Rheum Dis 2006;65:977-8.  Back to cited text no. 33
Finestone A, Milgrom C, Wolf O, Petrov K, Evans R, Moran D. Epidemiology of metatarsal stress fractures versus tibial and femoral stress fractures during elite training. Foot Ankle Int 2011;32:16-20.  Back to cited text no. 34
Murray SR, Reeder MT, Udermann BE, Pettitt RW. High-risk stress fractures: Pathogenesis, evaluation, and treatment. Compr Ther 2006;32:20-5.  Back to cited text no. 35
Percy EC, Gamble FO. An epiphyseal stress fracture of the foot and shin splints in an anomalous calf muscle in a runner. Br J Sports Med 1980;14:110-3.  Back to cited text no. 36
Blair WF, Hanley SR. Stress fracture of the proximal fibula. Am J Sports Med 1980;8:212-3.  Back to cited text no. 37
Hong SH, Chu IT. Stress fracture of the proximal fibula in military recruits. Clin Orthop Surg 2009;1:161-4.  Back to cited text no. 38
Bennell K, Crossley K, Jayarajan J, Walton E, Warden S, Kiss ZS, et al. Ground reaction forces and bone parameters in females with tibial stress fracture. Med Sci Sports Exerc 2004;36:397-404.  Back to cited text no. 39
Devas MB, Sweetnam R. Stress fractures of the fibula; a review of fifty cases in athletes. J Bone Joint Surg Br 1956;38-B:818-29.  Back to cited text no. 40
Lacroix H, Keeman JN. An unusual stress fracture of the fibula in a long-distance runner. Arch Orthop Trauma Surg 1992;111:289-90.  Back to cited text no. 41
Gross CE, Nunley JA 2 nd . Navicular stress fractures. Foot Ankle Int 2015;36:1117-22.  Back to cited text no. 42
Aldridge T. Diagnosing heel pain in adults. Am Fam Physician 2004;70:332-8.  Back to cited text no. 43
Coris EE, Lombardo JA. Tarsal navicular stress fractures. Am Fam Physician 2003;67:85-90.  Back to cited text no. 44
Fowler JR, Gaughan JP, Boden BP, Pavlov H, Torg JS. The non-surgical and surgical treatment of tarsal navicular stress fractures. Sports Med 2011;41:613-9.  Back to cited text no. 45
Goergen TG, Venn-Watson EA, Rossman DJ, Resnick D, Gerber KH. Tarsal navicular stress fractures in runners. AJR Am J Roentgenol 1981;136:201-3.  Back to cited text no. 46
Saxena A, Fullem B, Hannaford D. Results of treatment of 22 navicular stress fractures and a new proposed radiographic classification system. J Foot Ankle Surg 2000;39:96-103.  Back to cited text no. 47
Brand JC Jr., Brindle T, Nyland J, Caborn DN, Johnson DL. Does pulsed low intensity ultrasound allow early return to normal activities when treating stress fractures? A review of one tarsal navicular and eight tibial stress fractures. Iowa Orthop J 1999;19:26-30.  Back to cited text no. 48
Fitch KD, Blackwell JB, Gilmour WN. Operation for non-union of stress fracture of the tarsal navicular. J Bone Joint Surg Br 1989;71:105-10.  Back to cited text no. 49
Ostlie DK, Simons SM. Tarsal navicular stress fracture in a young athlete: Case report with clinical, radiologic, and pathophysiologic correlations. J Am Board Fam Pract 2001;14:381-5.  Back to cited text no. 50
Toren AJ, Hahn DB, Brown WC, Stone PA, Ng A. Vascularized scapular free bone graft after nonunion of a tarsal navicular stress fracture: A case report. J Foot Ankle Surg 2013;52:221-6.  Back to cited text no. 51
Murray SR, Reeder M, Ward T, Udermann BE. Navicular stress fractures in identical twin runners: High-risk fractures require structured treatment. Phys Sportsmed 2005;33:28-33.  Back to cited text no. 52
Kiuru MJ, Pihlajamaki HK, Ahovuo JA. Fatigue stress injuries of the pelvic bones and proximal femur: Evaluation with MR imaging. Eur Radiol 2003;13:605-11.  Back to cited text no. 53
Niva MH, Kiuru MJ, Haataja R, Pihlajamäki HK. Fatigue injuries of the femur. J Bone Joint Surg Br 2005;87:1385-90.  Back to cited text no. 54
Goolsby MA, Barrack MT, Nattiv A. A displaced femoral neck stress fracture in an amenorrheic adolescent female runner. Sports Health 2012;4:352-6.  Back to cited text no. 55
Kang L, Belcher D, Hulstyn MJ. Stress fractures of the femoral shaft in women′s college lacrosse: A report of seven cases and a review of the literature. Br J Sports Med 2005;39:902-6.  Back to cited text no. 56
Okamoto S, Arai Y, Hara K, Tsuzihara T, Kubo T. A displaced stress fracture of the femoral neck in an adolescent female distance runner with female athlete triad: A case report. Sports Med Arthrosc Rehabil Ther Technol 2010;2:6.  Back to cited text no. 57
Weind KL, Amendola A. Rare bilateral femoral shaft stress fractures in a female long-distance runner: A case report. Iowa Orthop J 2005;25:157-9.  Back to cited text no. 58
Haddad FS, Bann S, Hill RA, Jones DH. Displaced stress fracture of the femoral neck in an active amenorrhoeic adolescent. Br J Sports Med 1997;31:70-2.  Back to cited text no. 59
Clough TM. Femoral neck stress fracture: The importance of clinical suspicion and early review. Br J Sports Med 2002;36:308-9.  Back to cited text no. 60
Kerr PS, Johnson DP. Displaced femoral neck stress fracture in a marathon runner. Injury 1995;26:491-3.  Back to cited text no. 61
Polacek M, Småbrekke A. Displaced stress fracture of the femoral neck in young active adults. BMJ Case Rep 2010;2010. pii: Bcr0220102749.  Back to cited text no. 62
Scott MP, Finnoff JT, Davis BA. Femoral neck stress fracture presenting as gluteal pain in a marathon runner: Case report. Arch Phys Med Rehabil 1999;80:236-8.  Back to cited text no. 63
Featherstone T. Magnetic resonance imaging in the diagnosis of sacral stress fracture. Br J Sports Med 1999;33:276-7.  Back to cited text no. 64
Klossner D. Sacral stress fracture in a female collegiate distance runner: A case report. J Athl Train 2000;35:453-7.  Back to cited text no. 65
Knobloch K, Schreibmueller L, Jagodzinski M, Zeichen J, Krettek C. Rapid rehabilitation programme following sacral stress fracture in a long-distance running female athlete. Arch Orthop Trauma Surg 2007;127:809-13.  Back to cited text no. 66
Nusselt T, Klinger HM, Schultz W, Baums MH. Fatigue stress fractures of the pelvis: A rare cause of low back pain in female athletes. Acta Orthop Belg 2010;76:838-43.  Back to cited text no. 67
Johnson AW, Weiss CB Jr., Stento K, Wheeler DL. Stress fractures of the sacrum. An atypical cause of low back pain in the female athlete. Am J Sports Med 2001;29:498-508.  Back to cited text no. 68
Silva RT, De Bortoli A, Laurino CF, Abdalla RJ, Cohen M. Sacral stress fracture: An unusual cause of low back pain in an amateur tennis player. Br J Sports Med 2006;40:460-1.  Back to cited text no. 69
Shah MK, Stewart GW. Sacral stress fractures: An unusual cause of low back pain in an athlete. Spine (Phila Pa 1976) 2002;27:E104-8.  Back to cited text no. 70
Kendall J, Eckner JT. Sacral stress fracture in a young healthy athlete. Am J Phys Med Rehabil 2013;92:1120.  Back to cited text no. 71
Devas MB. Stress fractures of the patella. J Bone Joint Surg Br 1960;42-B: 71-4.  Back to cited text no. 72
Dickoff-Hoffman S. A case report: Longitudinal stress fracture of the patella - A cause of peripatellar pain in a runner. J Orthop Sports Phys Ther 1987;9:194-7.  Back to cited text no. 73
Crowther MA, Mandal A, Sarangi PP. Propagation of stress fracture of the patella. Br J Sports Med 2005;39:e6.  Back to cited text no. 74
Piétu G, Hauet P. Stress fracture of the patella. Acta Orthop Scand 1995;66:481-2.  Back to cited text no. 75
Wall J, Feller JF. Imaging of stress fractures in runners. Clin Sports Med 2006;25:781-802.  Back to cited text no. 76
Boike A, Schnirring-Judge M, McMillin S. Sesamoid disorders of the first metatarsophalangeal joint. Clin Podiatr Med Surg 2011;28:269-85, vii.  Back to cited text no. 77
Burton EM, Amaker BH. Stress fracture of the great toe sesamoid in a ballerina: MRI appearance. Pediatr Radiol 1994;24:37-8.  Back to cited text no. 78
Hulkko A, Orava S, Pellinen P, Puranen J. Stress fractures of the sesamoid bones of the first metatarsophalangeal joint in athletes. Arch Orthop Trauma Surg 1985;104:113-7.  Back to cited text no. 79
Sims AL, Kurup HV. Painful sesamoid of the great toe. World J Orthop 2014;5:146-50.  Back to cited text no. 80
Hunt KJ, Anderson RB. Heel pain in the athlete. Sports Health 2009;1:427-34.  Back to cited text no. 81
Ariyoshi M, Nagata K, Kubo M, Sonoda K, Yamada Y, Akashi H, et al. MRI monitoring of tarsal navicular stress fracture healing - A case report. Kurume Med J 1998;45:223-5.  Back to cited text no. 82
Hopson CN, Perry DR. Stress fractures of the calcaneus in women marine recruits. Clin Orthop Relat Res 1977;128:159-62.  Back to cited text no. 83
Reuteman PF, Kernozek T, Durall C, Meardon S. Calcaneal stress fracture in a competitive distance runner after incorporating minimalist footwear. J Orthop Sports Phys Ther 2013;43:A126-43.  Back to cited text no. 84
Sanderlin BW, Raspa RF. Common stress fractures. Am Fam Physician 2003;68:1527-32.  Back to cited text no. 85
Berger FH, de Jonge MC, Maas M. Stress fractures in the lower extremity. The importance of increasing awareness amongst radiologists. Eur J Radiol 2007;62:16-26.  Back to cited text no. 86
Eren OT, Holtby R. Straddle pelvic stress fracture in a female marathon runner. A case report. Am J Sports Med 1998;26:850-1.  Back to cited text no. 87
Macera CA, Pate RR, Woods J, Davis DR, Jackson KL. Postrace morbidity among runners. Am J Prev Med 1991;7:194-8.  Back to cited text no. 88
Asano LY, Duarte A Jr., Silva AP; Brazilian Medical Association. Stress fractures in the foot and ankle of athletes. Rev Assoc Med Bras 2014;60:512-7.  Back to cited text no. 89
Martin AD, McCulloch RG. Bone dynamics: Stress, strain and fracture. J Sports Sci 1987;5:155-63.  Back to cited text no. 90


  [Figure 1]

  [Table 1], [Table 2], [Table 3]

This article has been cited by
1 A study on risk factors inducing stress fractures in young Japanese long-distance runners -effects of training distance and intensity-
Jun Hamano, Ayano Tanaka, Izumi Tabata
Japanese Journal of Physical Fitness and Sports Medicine. 2022; 71(4): 319
[Pubmed] | [DOI]
2 Plantar Injuries in Runners: Is There an Association With Weekly Running Volume?
Angelo V Vasiliadis,Christos Kazas,Maria Tsatlidou,Polychronis Vazakidis,Dimitrios Metaxiotis
Cureus. 2021;
[Pubmed] | [DOI]
3 Stress fractures in military recruits: A prospective study for evaluation of incidence, patterns of injury and invalidments out of service
Puneet Takkar,Rajat Prabhakar
Medical Journal Armed Forces India. 2019;
[Pubmed] | [DOI]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
General Review
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded238    
    Comments [Add]    
    Cited by others 3    

Recommend this journal