Aristotle (384–322 BC) correctly characterized “Olympic Victors” by stating they are “those who do not squander their powers by early and overtraining.” Stress fractures have received various names when diagnosed in the tibia, including exertional posterior compartment syndrome, fatigue fractures, shin splints, anterior tibial periostitis, and medial tibial stress syndrome.

What then is a stress fracture? Pentecost<sup>27 Pentecost R.L. , et al. Fatigue, insufficiency and pathologic fractures JAMA 1964 ;  187 : 1001-1004

Cliquez ici pour aller à la section Références</sup> describes an “insufficiency” fracture as that produced by normal or physiological stress applied to bone with deficient elastic resistance. In contrast, a “fatigue” (stress) fracture occurs when abnormal stress is applied to a bone with normal elastic resistance.

Stress fractures in amateur and professional athletes are becoming a very common entity worldwide. For example, 9 of the 24 members on the 1994 U.S. National World Cup Soccer team were diagnosed with stress fractures. In the United States today there is an ever increasing number of persons participating in sporting activities. Those competing/training including elite, recreational, youth, and female athletes. It is important to consider each of these groups separately as each has special potential problems that must be addressed. If not properly diagnosed early, these injuries can cause significant lost time from participation or even early retirement. With greater numbers participating in longer hours and higher intensity, the medical professional must understand the proper diagnosis, treatment, and prevention of these injuries.

This article serves as an overview to the general concepts on stress fractures, including history, epidemiology, and cause. The proper diagnosis, confirmatory studies, and treatment regimens are presented. Finally, the timing of the athlete's return to sports and stress fracture prevention are reviewed.