The pathophysiology of stress fractures.

Stress fractures can occur in any active individual, from the weekend warrior to the elite athlete. As these injuries occur, it is important to understand how bones respond to the stresses placed on them. The understanding of potential intrinsic and extrinsic causes is important in treatment of these injuries. The proper identification and prevention of these stress injuries allows for athletes to return to activity expeditiously.

[1]  A Simkin,et al.  Combined Effect of Foot Arch Structure and an Orthotic Device on Stress Fractures , 1989, Foot & ankle.

[2]  T J Scully,et al.  Stress fracture--a preventable training injury. , 1982, Military medicine.

[3]  C. Milgrom,et al.  The effect of pretraining sports activity on the incidence of stress fractures among military recruits. A prospective study. , 1989, Clinical orthopaedics and related research.

[4]  C. Milgrom,et al.  The area moment of inertia of the tibia: a risk factor for stress fractures. , 1989, Journal of biomechanics.

[5]  C. Milgrom,et al.  Effect of Fatiguing Exercise on Longitudinal Bone Strain as Related to Stress Fracture in Humans , 1998, Annals of Biomedical Engineering.

[6]  C. Milgrom,et al.  Stress fractures and tibial bone width. A risk factor. , 1987, The Journal of bone and joint surgery. British volume.

[7]  T. Brudvig,et al.  Stress fractures in 295 trainees: a one-year study of incidence as related to age, sex, and race. , 1983, Military medicine.

[8]  B L Drinkwater,et al.  Bone mineral density after resumption of menses in amenorrheic athletes. , 1986, JAMA.

[9]  J. Kelsey,et al.  Disordered eating, menstrual irregularity, and bone mineral density in female runners. , 2003, Medicine and science in sports and exercise.

[10]  H. Vaitkevicius,et al.  Ethnic differences in titratable acid excretion and bone mineralization. , 2002, Medicine and science in sports and exercise.

[11]  C. Tsalamandris,et al.  Osteoporosis in anorexia nervosa: The influence of peak bone density, bone loss, oral contraceptive use, and exercise , 1992, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[12]  C. Melby,et al.  Stress fractures in female army recruits: implications of bone density, calcium intake, and exercise. , 1998, Journal of the American College of Nutrition.

[13]  C. Milgrom,et al.  An analysis of the biomechanical mechanism of tibial stress fractures among Israeli infantry recruits. A prospective study. , 1988, Clinical orthopaedics and related research.

[14]  R. Kronmal,et al.  Stress fractures in ballet dancers , 1992, The American journal of sports medicine.

[15]  W J Bremner,et al.  Bone mineral content of amenorrheic and eumenorrheic athletes. , 1984, The New England journal of medicine.

[16]  S. Horvath,et al.  Athletic amenorrhea: a review. , 1985, Medicine and science in sports and exercise.

[17]  J. Eisman Vitamin D receptor gene alleles and osteoporosis: An affirmative view , 1995, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[18]  J. Brooks-Gunn,et al.  Nutrition and the incidence of stress fractures in ballet dancers. , 1990, The American journal of clinical nutrition.

[19]  B. Dawson-Hughes,et al.  The BsmI vitamin D receptor restriction fragment length polymorphism (BB) predicts low bone density in premenopausal black and white women , 1995, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[20]  A. Nattiv,et al.  Stress injury to bone in the female athlete. , 1997, Clinics in sports medicine.

[21]  W. Gillespie,et al.  Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. , 1999, The Cochrane database of systematic reviews.

[22]  D. Cumming,et al.  Reproductive hormone responses to resistance exercise. , 1987, Medicine and science in sports and exercise.

[23]  K. Reinker,et al.  A comparison of male and female orthopaedic pathology in basic training. , 1979, Military medicine.

[24]  Anne B Loucks,et al.  Dose‐Response Relationships Between Energy Availability and Bone Turnover in Young Exercising Women , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[25]  C Milgrom,et al.  Are overground or treadmill runners more likely to sustain tibial stress fracture? , 2003, British journal of sports medicine.

[26]  J. Knapik,et al.  Effect of rest from running on overuse injuries in army basic training. , 2000, American journal of preventive medicine.

[27]  C. Milgrom,et al.  Prevention of stress fractures using custom biomechanical shoe orthoses. , 1999, Clinical orthopaedics and related research.

[28]  B. Specker,et al.  Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[29]  I. Swaine,et al.  Relation between bone turnover, oestradiol, and energy balance in women distance runners. , 1998, British journal of sports medicine.

[30]  R. Rizzoli,et al.  IGF-I and pamidronate increase bone mineral density in ovariectomized adult rats. , 1993, The American journal of physiology.

[31]  B. Marti,et al.  On the epidemiology of running injuries , 1988, The American journal of sports medicine.

[32]  T. Noakes,et al.  Low bone density is an etiologic factor for stress fractures in athletes. , 1990, Annals of internal medicine.

[33]  D. Felsenberg,et al.  Age at first oral contraceptive use as a major determinant of vertebral bone mass in female endurance athletes. , 2004, Bone.

[34]  S. Walter,et al.  The Ontario cohort study of running-related injuries. , 1989, Archives of internal medicine.

[35]  T J Beck,et al.  Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors. , 2000, Bone.

[36]  R. Recker,et al.  The Impact of Lifestyle Factors on Stress Fractures in Female Army Recruits , 2001, Osteoporosis International.

[37]  B H Jones,et al.  Prevention of lower extremity stress fractures: a controlled trial of a shock absorbent insole. , 1988, American journal of public health.

[38]  B. Drinkwater,et al.  The female athlete triad. The inter-relatedness of disordered eating, amenorrhea, and osteoporosis. , 1994, Clinics in sports medicine.

[39]  J. Stager,et al.  Menarche in athletes: the influence of genetics and prepubertal training. , 1988, Medicine and science in sports and exercise.

[40]  C. Milgrom,et al.  External rotation of the hip. A predictor of risk for stress fractures. , 1987, Clinical orthopaedics and related research.

[41]  A. Loucks Energy Availability, Not Body Fatness, Regulates Reproductive Function in Women , 2003, Exercise and sport sciences reviews.

[42]  D. Sartoris,et al.  Dual‐energy X‐ray absorptiometry derived structural geometry for stress fracture prediction in male U.S. marine corps recruits , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[43]  K Bennell,et al.  Risk Factors for Stress Fractures , 1999, Sports medicine.

[44]  S L Hui,et al.  Influences on skeletal mineralization in children and adolescents: evidence for varying effects of sexual maturation and physical activity. , 1994, The Journal of pediatrics.

[45]  C. Frey,et al.  Footwear and stress fractures. , 1997, Clinics in sports medicine.

[46]  R. Rizzoli,et al.  Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. , 1992, The Journal of clinical endocrinology and metabolism.

[47]  K. Cooper,et al.  Insufficiency fractures of the sacrum. , 1985, Radiology.

[48]  J. Dettori,et al.  Factors associated with stress fracture in young army women: indications for further research. , 1992, Military medicine.

[49]  M. J. Lord,et al.  Stress Fractures of the Ribs in Golfers , 1996, The American journal of sports medicine.

[50]  J. Puffer,et al.  Lifestyles And Health Risks of Collegiate Athletes: A Multi‐Center Study , 1997, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[51]  W C Hayes,et al.  Compact bone fatigue damage: a microscopic examination. , 1977, Clinical orthopaedics and related research.

[52]  C. Milgrom,et al.  Risk factors for stress fractures among Israeli infantry recruits. , 1991, Military medicine.

[53]  S. Saha,et al.  Menstrual irregularity and stress fractures in collegiate female distance runners , 1988, The American journal of sports medicine.

[54]  C. Johnson,et al.  Risk factors associated with stress reactions in female Marines. , 1997, Military medicine.

[55]  K. Jackson,et al.  Predicting lower-extremity injuries among habitual runners. , 1989, Archives of internal medicine.

[56]  R. Marx,et al.  Stress Fracture Sites Related to Underlying Bone Health in Athletic Females , 2001, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[57]  Monteleone Gp Stress fractures in the athlete. , 1995 .

[58]  L. Pezzin,et al.  The relation between stress fractures and bone mineral density: evidence from active-duty Army women. , 2000, Archives of physical medicine and rehabilitation.

[59]  Alan W. Johnson,et al.  Stress Fractures of the Femoral Shaft in Athletes—More Common Than Expected , 1994, The American journal of sports medicine.

[60]  G. Carrera,et al.  Is there an association between athletic amenorrhea and endothelial cell dysfunction? , 2003, Medicine and science in sports and exercise.

[61]  P. Scranton,et al.  On the nature of stress fractures , 1978, The American journal of sports medicine.

[62]  R Rizzoli,et al.  Arginine increases insulin-like growth factor-I production and collagen synthesis in osteoblast-like cells. , 1998, Bone.

[63]  I. Jacobs,et al.  Electro-mechanical response times and rate of force development in males and females. , 1986, Medicine and science in sports and exercise.

[64]  C. Milgrom,et al.  The Role of Biomechanical Shoe Orthoses in Tibial Stress Fracture Prevention , 2002, The American journal of sports medicine.

[65]  A. Hergenroeder Bone mineralization, hypothalamic amenorrhea, and sex steroid therapy in female adolescents and young adults. , 1995, The Journal of pediatrics.

[66]  I. Swaine,et al.  Responses of bone turnover markers to repeated endurance running in humans under conditions of energy balance or energy restriction , 2000, European Journal of Applied Physiology.

[67]  S. Rudzki Injuries in Australian Army recruits. Part I: Decreased incidence and severity of injury seen with reduced running distance. , 1997, Military medicine.

[68]  J. Wark,et al.  The Incidence and Distribution of Stress Fractures in Competitive Track and Field Athletes , 1996, The American journal of sports medicine.

[69]  B. Goldberg,et al.  Stress Fractures. , 1994, The Physician and sportsmedicine.

[70]  S. Lombardo,et al.  Stress fractures of the femur in runners , 1982, The American journal of sports medicine.

[71]  D R Carter,et al.  A cumulative damage model for bone fracture , 1985, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[72]  S. Cook,et al.  A survey of running injuries in 1505 competitive and recreational runners. , 1990, The Journal of sports medicine and physical fitness.

[73]  J. Wark,et al.  Risk factors for stress fractures in female track-and-field athletes: a retrospective analysis. , 1995, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[74]  Ronald F. Zernicke,et al.  Stress fracture risk assessment among elite collegiate women runners , 1994 .

[75]  K. Häkkinen,et al.  Force production characteristics of leg extensor, trunk flexor and extensor muscles in male and female basketball players. , 1991, The Journal of sports medicine and physical fitness.

[76]  H. Frost A new direction for osteoporosis research: a review and proposal. , 1991, Bone.

[77]  M. Warren,et al.  The effects of intense exercise on the female reproductive system. , 2001, The Journal of endocrinology.

[78]  Joseph A. Buckwalter,et al.  Orthopaedic Basic Science , 2006 .

[79]  C. Milgrom,et al.  Youth is a risk factor for stress fracture. A study of 783 infantry recruits. , 1994, The Journal of bone and joint surgery. British volume.

[80]  P. Fricker,et al.  Injuries to elite rowers over a 10-yr period. , 1997, Medicine and science in sports and exercise.

[81]  E. M. Winter,et al.  Electromechanical response times and muscle elasticity in men and women , 2004, European Journal of Applied Physiology and Occupational Physiology.

[82]  C. Rubin,et al.  Does bone perfusion/reperfusion initiate bone remodeling and the stress fracture syndrome? , 1999, Medical hypotheses.

[83]  R M Neer,et al.  Osteoporosis in women with anorexia nervosa. , 1984, The New England journal of medicine.

[84]  M. Devas Stress fractures of the femoral neck. , 1965, The Journal of bone and joint surgery. British volume.

[85]  V. Frankel,et al.  Stress fractures of the femoral neck. , 1998, Clinical orthopaedics and related research.

[86]  I. Litt,et al.  Decreased bone density in adolescent girls with anorexia nervosa. , 1990, Pediatrics.

[87]  W G Hamilton,et al.  Scoliosis and fractures in young ballet dancers. Relation to delayed menarche and secondary amenorrhea. , 1986, The New England journal of medicine.

[88]  D. Schoenfeld,et al.  The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa. , 1995, The Journal of clinical endocrinology and metabolism.

[89]  J. Eisman,et al.  Prediction of bone density from vitamin D receptor alleles , 1994, Nature.

[90]  J. Wark,et al.  Risk Factors for Stress Fractures in Track and Field Athletes , 1996, The American journal of sports medicine.

[91]  V. Rickert,et al.  A Prospective, Controlled Study of the Effects of Hormonal Contraception on Bone Mineral Density , 2001, Obstetrics and gynecology.

[92]  G. Miller,et al.  The geometric properties of paired human tibiae. , 1980, Journal of biomechanics.

[93]  O. Friberg,et al.  Leg length asymmetry in stress fractures. A clinical and radiological study. , 1982, The Journal of sports medicine and physical fitness.

[94]  E A Harman,et al.  Lower limb morphology and risk of overuse injury among male infantry trainees. , 1996, Medicine and science in sports and exercise.