From 2005-2006 through the 2012-2013 school years, the National High School Sports-Related Injury Surveillance System, High School RIO (Reporting Information Online) collected information on injuries among high school athletes. The results showed 51,773 injuries were Location of metatarsal stress fracture painsustained, of which 389 (0.8%) were stress fractures, resulting in an overall stress fracture rate of 1.54 per 100,000 AEs. Stress fracture rates were highest in girls’ cross country (10.62), girls’ gymnastics (7.43), and boys’ cross country (5.42). The lowest numbers of incidents were found in boys’ swimming and diving (0.22), boys’ ice hockey (0.32), and cheerleading (0.75).

Across all sports, the most commonly injured body sites were the lower leg (40.3%), foot (34.9%), and lower back/lumbar/spine/pelvis (15.2%). The foot was the most common site of stress fracture in the majority of sports, including girls’ lacrosse (72.7%), boys’ basketball (70.8%), cheerleading (50.0%), girls’ volleyball (45.0%), girls’ soccer (43.2%), football (34.4%), boys’ lacrosse (33.3%), and boys’ soccer (31.3%). The lower leg was the most common site of stress fracture in boys’ and girls’ track and field (60.9% and 78.0%), boys’ and girls’ cross country (71.4% and 66.7%), girls’ field hockey (53.8%), and girls’ basketball (46.0%).

Overall, a large proportion, 65.3%, of stress fractures required a prolonged recovery. 32.8% required more than 3 weeks before return to play, 18.1% were medically disqualified, and 14.1% had an end to the season before return to play. Only 34.7% of athletes who sustained stress fractures returned to play within 3 weeks of injury. 18.1% were reported to be recurrent rather than new injuries.

-Source: The American Journal of Sports Medicine, Published online before print December 5, 2014