Mapping the Global Research Landscape of Stress Fractures in Athletes.

Abstract

Objective: To systematically evaluate the global research landscape and identify key trends, influential contributors, and emerging themes in studies on stress fractures in athletes using bibliometric methods.

Methods: A comprehensive bibliometric analysis was conducted using the Web of Science Core Collection database. Publications from 1969-2026 were analyzed using the topic search terms "stress fracture" or "fatigue fracture" and "athlete" or "sport" or "runner" or "physical training". Key bibliometric indicators included publication trends, country and institutional productivity, collaboration networks, and keyword co-occurrence. Data visualization and network mapping were performed using the VOSviewer software and Google Sheets.

Results: A total of 2547 publications were identified. The annual research output demonstrated a marked increase beginning in the early 2000s, peaking in 2021, followed by a slight decline in recent years. The United States, Japan, and England were the leading contributors. Keyword co-occurrence analysis revealed three primary research clusters: (1) clinical diagnosis and management of stress fractures, (2) risk factors, epidemiology, and prevention, and (3) biomechanics and mechanisms of stress fractures, particularly in running-related activities. Collaboration networks indicated strong contributions from high-income countries, with relatively limited global research integration.

Conclusion: Research on stress fractures in athletes has expanded substantially over the past several decades, driven by advancements in diagnostic imaging, increased sports participation, and growing awareness of overuse injuries. These factors also led the field to develop more specialized investigations in prevention and biomechanics of injury. Although a recent decline in publication count is observed, this is likely due to indexing delays rather than a true reduction in research activity. Despite recent progress, important gaps remain. Future research should prioritize long-term outcomes, standardized methodologies, and multicenter collaborations. Addressing these gaps will be essential to improving the generalizability of findings and optimizing clinical management strategies for athletic populations.