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Open Access J Sports Med. 2015 Mar 27;6:87-95. doi: 10.2147/OAJSM.S39512. eCollection 2015.

Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners.

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College of Health Science, Misericordia University, Dallas, PA, USA.
Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN, USA.


Stress fractures account for between 1% and 20% of athletic injuries, with 80% of stress fractures in the lower extremity. Stress fractures of the lower extremity are common injuries among individuals who participate in endurance, high load-bearing activities such as running, military and aerobic exercise and therefore require practitioner expertise in diagnosis and management. Accurate diagnosis for stress fractures is dependent on the anatomical area. Anatomical regions such as the pelvis, sacrum, and metatarsals offer challenges due to difficulty differentiating pathologies with common symptoms. Special tests and treatment regimes, however, are similar among most stress fractures with resolution between 4 weeks to a year. The most difficult aspect of stress fracture treatment entails mitigating internal and external risk factors. Practitioners should address ongoing risk factors to minimize recurrence.


medial tibial stress syndrome; nonunion stress fracture; stress injury

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