Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Mention ‘stress fracture’ to an athlete or coach and there is instant concern. Frequently occurring at the beginning of an athletic season or in the lead up to a major competition, there is awareness that diagnosis invariably disrupts participation. The term ‘stress fracture’ has deep roots in our vernacular. Its use in the literature has risen steadily since the 1970s/1980s and shows no sign of waning. But are we all talking about the same thing, and does it matter?
Most bone stress injuries are not stress fractures
Stress fractures are a type of ‘bone stress injury’ (BSI).1 A BSI represents the inability of a generally normal bone to withstand repetitive loading leading to localised bone weakness and pain. A history of repetitive loading distinguishes BSIs from insufficiency-type injuries occurring with ageing and disease, although some athletes share a similar phenotype of compromised general bone health.
Stress fractures are characterised by a discernible fracture line on imaging. Only one-in-five athletes presenting with a BSI have a stress fracture.2 The other 80% have stress …
Twitter @StuartJWarden, @drkateackerman, @AdamTenfordeMD
Contributors SJW developed the initial draft. All authors revised and approved the final version.
Funding This contribution was made possible by support from the National Institutes of Health (NIH/NIAMS P30 AR072581) and the Indiana Clinical Translational Science Award/Institute (NCATS UL1TR002529-01).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.