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J Athl Train. 2000 Oct-Dec; 35(4): 453–457.
PMCID: PMC1323374

Sacral Stress Fracture in a Female Collegiate Distance Runner: A Case Report

David Klossner, PhD, ATC



To present the case of a 19-year-old collegiate distance runner diagnosed with a unilateral sacral stress fracture.


Low back and sacroiliac joint pain are common in female athletes but are often difficult to differentiate. Although sacral stress fractures in young female athletes are rarely reported, they are a potential cause of low back pain.

Differential Diagnosis:

Acute lumbosacral strain, disc disease, gluteus maximus strain, idiopathic low back pain, low back strain, sacroiliac joint sprain, or congenital anomaly.


Six weeks of active rest and nutritional counseling followed by an incremental 8-week running program. The athlete returned to symptom-free competitive running within 4 months.


This young athlete presented with a unilateral sacral stress fracture with components of the female athlete triad and a vigorous exercise regime.


Sacral stress fractures are rare in the young female athletic population. Because stress fractures in female runners have various etiologies, a thorough patient history and diagnostic imaging are necessary in the evaluation. Athletes can return to their normal activity once a successful management strategy has addressed all components of the female athlete triad while providing adequate rest. Prevention strategies, such as screening for the components of the female athlete triad, may help to decrease injuries and promote healthier lifestyles among this population.

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Selected References

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