Expected Time to Return to Athletic Participation After Stress Fracture in Division I Collegiate Athletes

Abstract

Background:Few studies have documented expected time to return to athletic participation after stress fractures in elite athletes.Hypothesis:Time to return to athletic participation after stress fractures would vary by site and severity of stress fracture.Study Design:Retrospective cohort study.Level of Evidence:Level 3.Methods:All stress fractures diagnosed in a single Division I collegiate men’s and women’s track and field/cross-country team were recorded over a 3-year period. Site and severity of injury were graded based on Kaeding-Miller classification system for stress fractures. Time to return to full unrestricted athletic participation was recorded for each athlete and correlated with patient sex and site and severity grade of injury.Results:Fifty-seven stress fractures were diagnosed in 38 athletes (mean age, 20.48 years; range, 18-23 years). Ten athletes sustained recurrent or multiple stress fractures. Thirty-seven injuries occurred in women and 20 in men. Thirty-three stress fractures occurred in the tibia, 10 occurred in the second through fourth metatarsals, 3 occurred in the fifth metatarsal, 6 in the tarsal bones (2 navicular), 2 in the femur, and 5 in the pelvis. There were 31 grade II stress fractures, 11 grade III stress fractures, and 2 grade V stress fractures (in the same patient). Mean time to return to unrestricted sport participation was 12.9 ± 5.2 weeks (range, 6-27 weeks). No significant differences in time to return were noted based on injury location or whether stress fracture was grade II or III.Conclusion:The expected time to return to full unrestricted athletic participation after diagnosis of a stress fracture is 12 to 13 weeks for all injury sites.Clinical Relevance:Athletes with grade V (nonunion) stress fractures may require more time to return to sport.

Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review

“…In pre-professional dancers, BSI can represent up to 19% of injuries over an academic year, with tibial stress fractures taking the longest time to return to full dance [ 17 ]. When managed conservatively, tibial BSI may require 6–27 weeks to return to sport depending on severity [ 2 , 25 , 26 ].…”

“…For the lumbar spine, a brace may reduce pain during activities of daily living; however, efficacy is yet to be confirmed [ 39 , 137 ]. Time to return to unrestricted sport for any BSI in collegiate level athletics is reportedly 12–13 weeks on average, depending on the grade and severity, yet may range from 6 to 30 weeks [ 25 , 50 ], and is highly dependent on the location of injury.…”

Increased Contact Time and Strength Deficits in Runners With Exercise-Related Lower Leg Pain

“…Some runners then choose to rest or quit running entirely, which leads to time lost from running, reduced mileage, impaired race performance, decreased fitness, and potential overall health consequences. 3,5 To treat this prevalent running injury, we must understand how runners with ERLLP differ from their healthy counterparts. Unfortunately, the causes of ERLLP are not firmly established, although some risk factors have been identified.…”

Epidemiology of Injuries in National Collegiate Athletic Association Women's Track and Field: 2014–2015 Through 2018–2019

“…Special attention in both future research and clinical practice should also be focused on identification of inflammatory conditions of the foot, given the prevalence of foot injuries in this population and that stress injuries of the foot can be both subtle in presentation and result in long periods of TL. [13][14][15] The most reported injuries during this period were hamstring tears and lateral ligament complex tears (ankle sprains). Authors of previous studies have indicated that hamstring injuries in this population are potentially attributable to the strain imposed during active lengthening.…”