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Risk factors for stress fractures.

K Bennell1, G Matheson, W Meeuwisse

  • 1School of Physiotherapy, The University of Melbourne, Victoria, Australia.

Sports Medicine (Auckland, N.Z.)
|September 24, 1999
PubMed
Summary

Understanding stress fracture risk factors is key to prevention. Key factors include bone density, muscle weakness, and menstrual disturbances, though training

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Area of Science:

  • Sports Medicine
  • Orthopedics
  • Biomechanics

Background:

  • Stress fractures are multifactorial injuries.
  • Research often focuses on individual risk factors, overlooking integrated analysis.
  • Existing literature has methodological limitations.

Purpose of the Study:

  • Critically appraise existing literature on stress fracture risk factors.
  • Evaluate study designs and quality.
  • Provide a current synopsis of scientific information on stress fracture risk.

Main Methods:

  • Literature review and critical appraisal.
  • Analysis of intrinsic and extrinsic risk factors.
  • Synthesis of accumulated scientific information over 20 years.

Main Results:

  • Identified key risk factors: menstrual disturbances, caloric restriction, low bone density, muscle weakness, leg length differences.
  • Training factors (volume, intensity, surface) contribution not clearly established.
  • Lower extremity alignment, though anecdotally significant, lacks strong causative evidence.

Conclusions:

  • A comprehensive understanding of stress fracture etiology requires integrating multiple risk factors.
  • While several factors are confirmed, further high-quality research is needed, particularly on training parameters.
  • Evidence supports the role of specific physiological and biomechanical factors in stress fracture development.

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