What causes stress fractures in athletes?

A stress fracture is a small crack in the bone. It’s an “accumulation injury,” says Dr Michael Terry, an orthopedic surgeon and professor of orthopedic surgery.

With exercise and everyday activities, and even our normal body weight, we are constantly putting stress on our bones. But that isn’t necessarily a bad thing, since stress causes microdamage to our bones that our body naturally repairs, and that continual repair process helps to make the bones stronger.

However, “if you don’t give bones long enough to catch up, instead of getting stronger they’ll break down, and you accumulate enough injury that the bones can break,” says Terry.

The most common cause of stress fractures is overtraining to the point that your bones can’t heal. The chance of developing a stress fracture increases if you suffer from any condition that also affects bone health. Such conditions include amenorrhea, in which women stop menstruating; thyroid and parathyroid diseases; and renal diseases.

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“You can get stress fractures anywhere, in theory, but we see them most in the hips and bones of the feet,” says Terry.

Children and teenagers who are growing are also prone to stress fractures at their growth plates, areas of developing tissue at the ends of bones that are weak links in the bone, Terry says. “As kids are growing up, especially when they’re starting to work out more and they’re getting stronger and heavier, because they have a growth plate, they have the increased susceptibility of having a stress fracture around the growth plate.”

Terry notes that athletes on vegetarian or vegan diets can also be susceptible to stress fractures if they don’t get enough protein or certain nutrients.

“Vegans have to be real careful and supplement their diet so they get enough vitamin D and calcium,” he says. – New York Times