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


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)