Stress Fracture Sites Related to Underlying Bone Health in Athletic Females

It has long been recognized that moderate exercise is a positive factor in bone health. However, exercise- related injury to bone may occur, frequently in the form of stress fractures.1–3 In the female athlete, stress frac- tures have been reported in a wide variety of sports, especially running, gymnastics, and track and field.4–6 The most commonly described sites for stress fracture are cortical ones, including the shaft of tubular bones such as the tibia, the metatarsals, and less commonly, the femoral shaft. Stress fractures have also been described in areas of cancellous bone, such as the femoral neck, pelvis, and sacrum. At our center, we began to question whether an association existed between location of stress fracture (i.e., cortical or cancellous) in the female athlete and underlying bone health. This query grew in part from our familiarity with the female athlete triad, a term re- cently coined to describe the association of disordered eating, amenorrhea, and osteoporosis in young athletic women.7–13

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