Devas1958stress

Stress fractures of the tibia in athletes or “shin soreness”

Devas 1958

Focus is on radiology of stress fractures, but has a cool table summarizing tibial stress fractures in athletes/recruits from 1938-1958:

Prevalence Table

Crazy note about reproducing the pain associated with a stress fracture:

It’s possible to reproduce the pain in some patients by “springing” the tibia. This has to be done by straining the tibia against a fulcrum (such as the knee of a surgeon) placed against the outer side of the leg at the level of tenderness; when the leg, held at the knee and the ankle, is pressed on to this fulcrum a fracture through the medial cortex of the tibia is opened and pain occurs

:astonished:

They talk about how it’s possible that strong calf muscles could cause the tibia to bend, alluding to the idea that muscle forces may be a mechanism for stress fractures. Referenced by the Bone Bending paper with Trudeau and Weir on it (first author Rice maybe?).

Treatment for stress fracture: Rest.

Many of these older studies are focused on the military and coincide with WWII. This paper associates stress fractures with shin soreness in athletes.

Notable Citations:

  1. Aleman 1929 (with maybe the oldest reference to a stress fracture: “insufficiency fracture” in Tidskrift i Militar Halsovard, pg53-54)