Stress Injury

Stress injuries are a common cause of pain and morbidity and have become commonplace among the members of our increasingly active society. There is some confusion regarding the numerous terms used to describe these injuries, and the clinical diagnosis of stress fractures can be difficult. Symptoms are often vague, and soft tissue injuries may mimic bony abnormalities. Stress injuries represent a wide spectrum of osseous and soft tissue injuries that occur in response to changes in the mechanical environment. They account for at least 10% of the cases encountered in a typical sports medicine practice. Although the reported incidence of stress fractures in the general athletic population is less than 1%, the incidence in runners may be as high as 20%. Stress fractures occur at all ages, and there is no sex predilection. Athletics, or track and field sports, account for 50% of stress fractures in men and 64% in women. People today are more concerned about physical fitness, and with the increasing popularity of running, stress fractures of the lower extremity, especially the tibia, ankle, and foot, have been common. Stress fractures can involve multiple bones, can occur bilaterally, and can be considered as a multifocal entity. In both men and women, stress fractures tend to recur. Approximately 60% of individuals with a stress fracture have had a clinical history of a previous stress fracture.