Epidemiology of stress
fractures in collegiate student-athletes, 2004-2005 through 2013-2014 academic
Rizzone KH, Ackerman KE,
Roos KG, Dompier TP, and Kerr ZY. J Athl Train. 2017. [Epub Ahead of Print].
Home Message: A collegiate athlete is at high risk for a stress fracture during
preseason and if they are female.
Stress fractures are a common injury in
activities that require repetitive stress on bone. While many NCAA athletes
take part in these activities, little is known about how often stress fractures
affect collegiate athletes. A better understanding of when stress fractures
occur and which athletes have an increased risk of stress fracture would allow
clinicians to improve stress fracture prevention, implement more appropriate
screening methods, and develop training techniques and protective equipment to
decrease the risk of injury. Therefore, Rizzone and colleagues analyzed data
from the NCAA Injury Surveillance Program to assess the incidence of stress
fractures among collegiate athletes. All injury data from the 2004-2005 through
2013-2014 academic years were analyzed. The authors defined an Athlete-exposure
as 1 student athletes participating in 1 game or practice. Season was
categorized by the research team as either preseason, regular season, or
postseason. Overall, 671 stress fracture which resulted in a minimum of 24
hours of missed time were recorded out of 11,778,145 athlete-exposures. Stress
fractures were most common in women’s cross country, women’s gymnastics, and
women’s outdoor track. Among sex-comparable sports (for example, soccer,
basketball), a woman’s risk of stress fracture was about twice that of a male
athlete. Stress fractures was most common in the preseason than in either the
regular or post-season. About 1 in 5 stress fractures was a recurrent injury
and roughly 1 in 5 stress fractures was season ending injuries.
Overall, these results are significant because
it highlights that females, particularly those competing in cross country, gymnastics,
and outdoor track need to be closely monitored for stress fractures and need
strategies to reduce their risk for these fractures. For example, clinicians and
coaches should adapt preseason training to reduce the risk of stress fractures
or consider off-season conditioning programs that slowly reintroduce the body
to sport-specific repetitive stresses prior to preseason. While these programs still
need to be developed, clinicians can immediately begin closely monitor
high-risk athletes for stress fractures and discuss with other members of the
sports medicine team low-risk options to reduce the risk of stress fractures in
Questions for Discussion: Do you feel that your clinical
experience is in line with the findings of this study? If so, what and how have
you used this to decrease the impact of stress fractures on your athletes?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban
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