ReviewSports medicine (Auckland, N.Z.)1999
Risk factors for stress fractures.
Review in Sports medicine (Auckland, N.Z.), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Incidence and Risk Factors for the Development of Stress Fractures in Military Recruits and Qualified Personnel: A Systematic Review.International journal of environmental research and public health · 2025Pooled it
- Biomechanics associated with tibial stress fracture in runners: A systematic review and meta-analysis.Journal of sport and health science · 2023Pooled it
- Acute Effects of Gait Interventions on Tibial Loads During Running: A Systematic Review and Meta-analysis.Sports medicine (Auckland, N.Z.) · 2022Pooled it
- Systematic Review and Meta-Analysis of Candidate Gene Association Studies With Fracture Risk in Physically Active Participants.Frontiers in genetics · 2020Pooled it
- Pooled it
- Severely restricting energy intake for 24 h does not affect markers of bone metabolism at rest or in response to re-feeding.European journal of nutrition · 2020Trial
- Menstrual Disruption with Exercise Is Not Linked to an Energy Availability Threshold.Medicine and science in sports and exercise · 2018Trial
- Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction.American journal of physiology. Endocrinology and metabolism · 2015Trial
- Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes.The American journal of sports medicine · 2013Trial
- Navicular and fifth metatarsal base stress fractures: An illustrated anatomical review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Review
- Association of chronic disease risk and physical activity measured by wearable devices in the All of Us program.Communications medicine · 2026Article
- Navicular Stress Fractures: A Narrative Review of Pathoanatomy, Diagnostic Pitfalls, and Management.Cureus · 2025Review
- Effects of endurance exercise and dietary protein intake on osteokine, bone turnover, and inflammatory markers in endurance runners: A narrative review.Bone reports · 2025Review
- Most elite athletes return to preinjury competitive activity after surgical treatment for medial malleolus stress fractures.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2024Article
- Effective counseling for children's bone health.Journal of the Pediatric Orthopaedic Society of North America · 2024Article
- Stress fractures and overuse injuries in children and adolescents.Journal of the Pediatric Orthopaedic Society of North America · 2024Article
- Changes in the Activity of the Erector Spinae and Gluteus Medius Muscles with the Presence of Simulated Lower Limb Dysmetria.Sensors (Basel, Switzerland) · 2024Article
- Multifocal stress fractures in a patient with rheumatoid arthritis.BMJ case reports · 2024Article
- Impact loading in female runners with single and multiple bone stress injuries during fresh and exerted conditions.Journal of sport and health science · 2023Article
- One-stage total knee arthroplasty for the treatment of acute tibial varus stress fracture secondary to osteoarthritis.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2023Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.
Indexed as
Identifiers
10492029What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.