This week we discuss sacral stress fractures in athletes. There are two distinct types of sacral stress fractures: fatigue and insufficiency. Fatigue fractures are typically seen in young athletes and results from abnormal stress on a normal bone, while Insufficiency fractures are typically seen in older adults with normal stress to abnormal bone. These definitions feel like unnecessary distinctions, as there must be some insufficiency present in the sacrum for the sacrum to be the site of a stress fracture in a young athlete, rather than a more typical location further down the extremities. Sacral stress fractures are rare, with there only being 53 identified in 11 years of records examined in this paper. Patients primarily present with diffuse low back/lumbosacral pain which is sudden onset of high pain which is provoke by walking/running, although standing and sitting both aggravate pain as well. Most young athletes with sacral stress fracture are runners and are misdiagnosed prior to MRI confirmation of sacral stress fracture. About half of the runners in this cohort returned to prior levels of running, and few returned to prior level of peformance.

The abstract can be found here: https://pubmed.ncbi.nlm.nih.gov/37542387/

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