The Natural History of Bone Stress Injuries in Athletes: From Inception to Resolution.

Area of Science:

• Sports Medicine
• Orthopedics
• Exercise Physiology

Background:

• Bone stress injuries (BSIs) are prevalent in athletic populations, leading to substantial participation time loss.
• Effective prevention and clinical management of BSIs remain challenging for sports practitioners.
• Understanding BSI etiology and mechanisms is crucial for designing targeted prevention programs.

Purpose of the Study:

• To synthesize and map current evidence on bone stress injuries (BSIs) to the natural history of disease.
• To provide sports medicine practitioners with a clinically applicable framework aligning evidence with disease stages.
• To describe and map prevention strategies to primary, secondary, and tertiary levels of prevention.

Main Methods:

• Literature review and synthesis of existing evidence on bone stress injuries (BSIs).
• Mapping of BSI evidence to the established stages of the natural history of disease.
• Categorization of prevention strategies according to primary, secondary, and tertiary levels.

Main Results:

• BSIs can be effectively mapped to the sequential stages of the natural history of disease.
• A framework is presented that integrates current evidence with disease progression stages.
• Prevention strategies are aligned with specific points along the BSI continuum.

Conclusions:

• This review provides a novel framework for understanding and managing bone stress injuries (BSIs) in athletes.
• The natural history of disease model offers a structured approach to BSI prevention and clinical intervention.
• This integration aids sports practitioners in developing targeted strategies across the BSI spectrum.