Management of Bone Stress Injuries: A Holistic Approach.

Stress fractures are fatigue fractures of bone that result from an overuse mechanism. These injuries present most commonly in the legs and feet of distance runners and military personnel but can also occur in the upper extremity and the spine depending on the causative activity. Nutritional, hormonal, and biomechanical factors influence the development of bone stress injuries, and no two bone stress injuries behave identically. A thorough history, detailed physical examination, and proper imaging are required to diagnose and classify these injuries. Management of stress injuries requires nutritional and emotional support, rest from the causative activity, and occasionally surgical intervention.