Introduction: Bone stress injuries are overuse injuries that develop in response to repetitive
loading of normally healthy bones. When the accumulation of microdamage during targeted
remodelling exceeds the removal of this damage, bone stress injuries can occur. They often
occur in active individuals, such as athletes. Early diagnosis and identification of risk factors
are crucial as their treatment can help prevent re-injury. Purpose: The aim of this literature
review is to analyse the epidemiological characteristics of bone stress injuries and identify
the main risk factors that contribute to their occurrence. Methods: The literature search was
conducted in the PubMed database using the keywords bone stress injury, stress fracture,
risk factors, athletes, epidemiology. Results: Eight studies involving professional, high
school, university, and recreational athletes were analysed. An incidence of between 4,0 %
and 52,4 % was reported, with the tibia, femur, sacrum and metatarsals being the most
common sites of injury. Previous bone injuries, low bone mineral density, late menarche and
amenorrhea in women, low cadence, and training errors have been identified as possible risk
factors for the development of bone injuries. A few studies have also found a link between
low body mass index, low lean body mass and low fat body mass, leg length discrepancy,
disordered eating patterns, lack of sleep and high stress levels and a higher rate of bone
injury. Discussion and conclusion: Bone stress injuries are one of the most common
musculoskeletal injuries in athletes. Previous bone stress injury is a strong predictive factor
for the occurence of bone stress injuries, while strength training could be an important
protective factor. Therefore comprehensive management and identification of risk factors
are crucial for a better understanding of bone stress injuries and thus for earlier diagnosis,
more succesful rehabilitation and efficient prevention
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