In an era of continual single-sport specialization and year-round training, overuse injuries including stress injuries of bone, are increasingly common. These injuries can be season- or even career-ending. For many elite and professional athletes, the traditional treatment strategy of immobilization and extended rest from sports participation is often not practical or acceptable. An understanding of modern strategies for evaluating and treating stress fractures is paramount for maintaining athletic participation and optimal athletic performance.

This begins with the ability to categorize and stratify bony stress injuries by both severity and risk of fracture progression. Surgical procedures such as open reduction and internal fixation or intramedullary fixation with possible bone grafting remain the standard of care for chronic or severe stress fractures. However, emerging techniques to augment the biologic environment are a minimally invasive adjunct for stimulating and supporting bone healing in elite-level athletes to optimize bone health, expedite recovery, and decrease the risk of nonunion or catastrophic fracture.

Join the authors of “Emerging Options for Biologic Enhancement of Stress Fracture Healing in Athletes” published in the January 1, 2020 issue of JAAOS as they review risk stratification, biologic healing enhancement, and various treatment strategies for maintaining participation and optimal performance for athletes with stress fractures.