Stress fractures in women’s soccer: our experience during one year of sports season

Summary. Background. Stress fractures are overuse injuries that are difficult to diagnose and treat. Many female athletes have predisposing factors (endocrine-hormonal and nutritional) that may favor their development. This study follows the observation of an increased number of stress fractures during the first part of the 2023-24 sports season in a high-level women’s soccer team. The aim of this study was to analyze the causes of this type of injury and implement appropriate preventive measures. Methods. This study was conducted between August 2023 and May 2024. Five soccer players who sustained this type of injury were included and compared to the other players of the team. The presence of alterations in the menstrual cycle and of eating disorders as well as the axial characteristics of the lower limb and the workloads they had been subjected to were analyzed in all participants. In injured athletes location of the fracture, mineral bone density, grade of stress injury on MRI, treatment provided and time to return to training and to play were also recorded. Results. Injured athletes showed a significantly lower BMI compared to the rest of the team and all presented with concomitant menstrual dysfunction, reduced mineral bone density and energy availability, and lower limb malalignment. Orthopedic treatment was always associated with the application of orthoses as well as hormonal therapy and eating disorders management. Conclusions. Stress fractures are serious injuries that can have potentially negative consequences on athletes’ careers. Early diagnosis, identification of predisposing factors, and their correction, and appropriate orthopedic treatment are essential for managing these injuries and preventing both onset and recurrence.