Stress Injury to Bone in the Female Athlete

Nattiv, Aurelia; Armsey, Thomas D.

doi:10.1016/s0278-5919(05)70017-x

Cited by 93 publications

(36 citation statements)

References 108 publications

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“…The literature suggests that increasing the training parameters of exercise (intensity, frequency, and duration) will impart greater risks for injury. 15,42 There is general support for progressive forms of training-a gradual buildup in the frequency, duration, and intensity of exercise, especially early in training. 8,12,41,43 We suggest that a consistent alternateday running schedule, with 2 days of rest from both marching and running, be included each week.…”

Section: Discussionmentioning

confidence: 99%

Effect of rest from running on overuse injuries in Army basic training

Popovich

Gardner

Potter

et al. 2000

American Journal of Preventive Medicine

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Section: Discussionmentioning

confidence: 99%

Effect of rest from running on overuse injuries in Army basic training

Popovich

Gardner

Potter

et al. 2000

American Journal of Preventive Medicine

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“…3,16,25,28 In the past decade, awareness of the female athlete triad and its relationship to musculoskeletal injuries, particularly stress fractures, has been widely reported. 4,6,18,37 Diagnosis of stress fractures begins with a heightened clinical awareness and commonly includes the use of imaging studies. Clinical diagnosis of a stress fracture can be complicated by the lack of a widely accepted physical examination test and the potential for nonmusculoskeletal conditions to masquerade as overuse conditions.…”

mentioning

confidence: 99%

Diagnosis of Medial Knee Pain: Atypical Stress Fracture About the Knee Joint

Rosenthal¹,

Moore²,

DeBerardino³

2006

J Orthop Sports Phys Ther

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Study Design: Resident's case problem. Background: A 19-year-old female, currently enrolled in a military training program, sought medical care for a twisting injury to her right knee. The patient reported her symptoms as similar to an injury she incurred 1 year previously while enrolled in the same military program. The patient's past medical history included a nondepressed fracture of the medial tibial plateau and complete tear of the deep fibers of the medial collateral ligament. Diagnosis: Physical exam revealed nonlocalized anterior and medial knee pain without evidence of internal derangement. Initial knee and tibia radiographs were unremarkable. Referral for orthopedic physician evaluation resulted in concurrence with the therapist's diagnosis and plan of care, and the patient was allowed to continue with limited physical training demands. Despite periods of rest, the patient's symptoms progressively worsened upon attempts to resume running. The examining therapist referred the patient for magnetic resonance imaging (MRI) due to the patient's worsening symptoms, normal radiographs, and concern for a proximal tibia stress fracture. MRI revealed a severe proximal tibial metaphysis stress fracture. Discussion: Stress fractures are commonly encountered injuries in individuals subjected to increased physical training demands. Early evaluation may not yield well-localized findings and may mimic other conditions. Nonmusculoskeletal conditions should be considered in the management of patients with stress fractures. This resident's case problem illustrates the importance of serial physical examinations and collaboration with other healthcare practitioners in the comprehensive assessment and management of a patient with a severe stress fracture.

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“…Menstrual disturbances in female athletes are usually indicative of lower basal estrogen concentrations compared to female athletes without menstrual disturbances (43). It is hypothesized that estrogen deficiencies change the mechanical stimulus threshold for bone remodeling, which makes the bone less likely to adapt to increased loading (44,45). This leads to a reduction in BMD (46) which increases the risk of stress fractures, as discussed previously.…”

Section: Intrinsic Risk Factorsmentioning

confidence: 99%

Experimental validation of finite element predicted bone strain in the human metatarsal

Fung

Loundagin

Edwards

2017

Journal of Biomechanics

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The objective of this study was to verify and validate a finite element modeling routine for the human metatarsal, which is a common location for stress fractures. Experimental strain measurements on 33 human cadaveric metatarsals subject to cantilever bending were compared with strain predictions from finite element (FE) models generated from computed tomography images. For the material property assignment of the FE models, a published density-elasticity relationship was compared with density-elasticity equations developed using optimization techniques. The correlations between the measured and predicted and predicted strains were very high (r 2 ≥0.94) for all of the density-elasticity equations. However, the utilization of an optimized density-elasticity equation improved the accuracy of the finite element models, reducing the maximum error between measured and predicted strains by 10% to 20%. The finite element modeling routine could be used for investigating potential interventions to minimize metatarsal strains and the occurrence of metatarsal stress fractures.iii

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Stress Injury to Bone in the Female Athlete

Cited by 93 publications

References 108 publications

Effect of rest from running on overuse injuries in Army basic training

Effect of rest from running on overuse injuries in Army basic training

Diagnosis of Medial Knee Pain: Atypical Stress Fracture About the Knee Joint

Experimental validation of finite element predicted bone strain in the human metatarsal

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