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Int 21(8):669–672, 2000.66 LOWER EXTREMITY STRESS
FRACTURE
Michael FredericsonINCIDENCE- Stress fractures have been shown to account for
0.7–20% of all injuries presented to sports medicine
clinics (Bergman and Fredericson, 1999). A recent
prospective study specifically involving US college
athletes found that track and field athletes had the high-
est incidence of stress fractures compared with athletes
in other sports, such as football, basketball, soccer, and
rowing (Johnson, Weiss, and Wheeler, 1994). - The site of stress fractures varies from sport to sport.
For example, among track athletes stress fractures of
the navicular, tibia, and metatarsal are the most
common while in distance runners it is the tibia and
fibula, and in dancers the metatarsals.
ETIOLOGY- A stress fracture may be best described as accelerated
bone remodeling in response to repetitive submaxi-
mal stresses. Histological studies of stress fractures
have shown that repetitive response to stress leads to
390 SECTION 4 • MUSCULOSKELETAL PROBLEMS IN THE ATHLETE