The epidemiology of stress fractures in collegiate student-athletes, 2004–2005 through 2013–2014 academic years

Context: Stress fractures are injuries caused by cumulative, repetitive stress that leads to abnormal bone remodeling. Specific populations, including female athletes and endurance athletes, are at higher risk than the general athletic population. Whereas more than 460?000 individuals participate in collegiate athletics in the United States, no large study has been conducted to determine the incidence of stress fractures in collegiate athletes. Objective: To assess the incidence of stress fractures in National Collegiate Athletic Association (NCAA) athletes and investigate rates and patterns overall and by sport. Design: Descriptive epidemiology study. Setting: National Collegiate Athletic Association institutions. Patients or Other Participants: National Collegiate Athletic Association athletes. Main Outcome Measure(s): Data were analyzed from the NCAA Injury Surveillance Program for the academic years 2004–2005 through 2013–2014. We calculated rates and rate ratios (RRs) with 95% confidence intervals (CIs). Results: A total of 671 stress fractures were reported over 11778?145 athlete-exposures (AEs) for an overall injury rate of 5.70 per 100000 AEs. The sports with the highest rates of stress fractures were women's cross-country (28.59/100?000 AEs), women's gymnastics (25.58/100000 AEs), and women's outdoor track (22.26/100000 AEs). Among sex-comparable sports (baseball/softball, basketball, cross-country, ice hockey, lacrosse, soccer, swimming and diving, tennis, indoor track, and outdoor track), stress fracture rates were higher in women (9.13/100000 AEs) than in men (4.44/100000 AEs; RR = 2.06; 95% CI = 1.71, 2.47). Overall, stress fracture rates for these NCAA athletes were higher in the preseason (7.30/100000 AEs) than in the regular season (5.12/100000 AEs; RR = 1.43; 95% CI = 1.22, 1.67). The metatarsals (n = 254, 37.9%), tibia (n = 147, 21.9%), and lower back/lumbar spine/pelvis (n = 81, 12.1%) were the most common locations of injury. Overall, 21.5% (n = 144) of stress fractures were recurrent injuries, and 20.7% (n = 139) were season-ending injuries. Conclusions: Women experienced stress fractures at higher rates than men, more often in the preseason, and predominantly in the foot and lower leg. Researchers should continue to investigate biological and biomechanical risk factors for these injuries as well as prevention interventions.
© Copyright 2017 Journal of Human Sport & Exercise. University of Alicante. All rights reserved.

Subjects: college sport in schools sports medicine injury bone overtraining cross apparatus gymnastics track and field baseball softball basketball icehockey soccer American football swimming diving tennis female male
Notations: biological and medical sciences sport games
Tagging: Stressfraktur Lacrosse
DOI: 10.4085/1062-6050-52.8.01
Published in: Journal of Human Sport & Exercise
Published: 2017
Volume: 12
Issue: 4
Pages: 966-975
Document types: article
Language: English
Level: advanced