Management of Bone Stress Injuries: A Holistic Approach.

Timothy L Miller, Christopher C Kaeding

Journal: Clinics in sports medicine 2026;45(3):567-582

PMID: 42209061

Abstract

Stress fractures are fatigue fractures of bone that result from an overuse mechanism. These injuries present most commonly in the legs and feet of distance runners and military personnel but can also occur in the upper extremity and the spine depending on the causative activity. Nutritional, hormonal, and biomechanical factors influence the development of bone stress injuries, and no two bone stress injuries behave identically. A thorough history, detailed physical examination, and proper imaging are required to diagnose and classify these injuries. Management of stress injuries requires nutritional and emotional support, rest from the causative activity, and occasionally surgical intervention.

Address: The Ohio State University Wexner Medical Center Jameson Crane Sports Medicine Institute; Department of Athletics, The Ohio State University, The Ohio State University Wexner Medical Center Endurance Medicine Program; U.S. Olympic Team. Electronic address: [email protected].; Department of Orthopaedics, Jameson Crane Sports Medicine Institute, The Ohio State University Wexner Medical Center Division of Sports Medicine; Department of Athletics, The Ohio State University.

DOI: 10.1016/j.csm.2025.10.005

MeSH Terms: Humans, Fractures, Stress, Cumulative Trauma Disorders, Athletic Injuries