STRESS FRACTURES IN ATHLETES: FROM PATHOPHYSIOLOGICAL MECHANISMS TO EVIDENCE-BASED DIAGNOSTIC AND THERAPEUTIC STRATEGIES

Wiktoria Sobieraj; Julia Pająk; Olga Sławatyniec; Anna Kamosińska

doi:10.31435/ijitss.1(49).2026.5289

Authors

Wiktoria Sobieraj MD, Lower Silesian Center for Oncology, Pulmonology and Hematology, Wrocław, Poland https://orcid.org/0009-0007-5412-6302
Julia Pająk MD, 4th Military Clinical Hospital with Polyclinic, Wrocław, Poland https://orcid.org/0009-0007-0882-9365
Olga Sławatyniec MD, 4th Military Clinical Hospital with Polyclinic, Wrocław, Poland https://orcid.org/0009-0007-0373-1588
Anna Kamosińska MD, 4th Military Clinical Hospital with Polyclinic, Wrocław, Poland https://orcid.org/0009-0005-0718-2112

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.5289

Keywords:

Stress Fractures, Athletes, Etiopathogenesis, Diagnosis, Management

Abstract

Background: Stress fractures (SFs) occur due to repetitive submaximal loading exceeding the bone’s intrinsic repair capacity. SFs constitute a significant challenge among endurance athletes and substantially compromise athletic performance and disrupt training continuity, requiring a comprehensive and multidisciplinary therapeutic approach.

Objective: This review synthesises current evidence on the etiology, pathophysiology, diagnosis, and management of SFs in athletes.

Methods: A literature review was conducted to evaluate diagnostic standards and therapeutic strategies for bone stress injuries.

Results: SFs develop along a pathological continuum. Risk factors include abrupt training load transitions and metabolic disturbances like the Female Athlete Triad. While X-rays lack early sensitivity, MRI is the gold standard for diagnosis. Management is risk-stratified: low-risk fractures are typically managed conservatively, whereas high-risk fractures often require surgery or prolonged immobilisation.

Conclusion: Systematic workload management and early, risk-based intervention are essential for effective recovery and the prevention of training interruptions.

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