Stress fractures and overuse injuries in children and adolescents.

UNLABELLED: There is an intricate connection between physical activity, bone health, and the susceptibility to stress fractures and overuse injuries. Physical activity has a positive impact on bone strength while a sedentary lifestyle can lead to a heightened risk for injury. The rise of early sports specialization has led to a substantial increase in overuse injuries, particularly in individual sports.Bone Stress Injuries (BSI) represent a category of overuse injuries closely linked to single sport specialization. BSI involves a spectrum of altered bone mechanics, ranging from edema of periosteum, endosteum, and bone; potentially leading to partial or full cortical breaks. This condition is prevalent in high-level athletes and encompasses stress reactions and fractures, resulting from an imbalance between injury creation and repair. Up to 20% of adolescents are affected, with the tibia being the most common location, predominantly occurring in athletes aged 15 to 25. A holistic approach integrating both physical and nutritional aspects is warranted to ensure sustained musculoskeletal health across diverse pediatric and adolescent groups and athletic endeavors.

KEY CONCEPTS: (1)Early and single sports specialization has a substantial impact on overuse injuries.(2)Bone stress injuries are common in high-level athletes resulting from an imbalance between creation and repair of injury.(3)Relative energy deficiency in sports (REDS) is related to a higher risk for recurrent Bone Stress Injuries.(4)Athletes that are lacking vitamin D are found to have an increased risk for stress fractures.