Sacral Stress Fractures: They See You, But Are You Seeing Them?

Sacral stress fractures can be particularly difficult to recognize and diagnose. Although uncommon, sacral stress fractures should be suspected in athletes, particularly female runners presenting with low back or buttock pain (2Y4,6). Sacral stress fractures are most commonly found in female distance runners, but also have been reported in other sports such as tennis, basketball, gymnastics, volleyball, and track and field (5). Patients typically report buttock pain, but also can report low back pain, groin pain, and muscle spasms. Pain is particularly noticeable with impact loading and change of direction.