Distance travelled by military recruits during basic training is a significant risk factor for lower limb overuse injury

2020 ◽  
pp. bmjmilitary-2020-001445
Author(s):  
Richard S. Whittle
Keyword(s):  
Risk Factor ◽  
Lower Limb ◽  
Overuse Injury ◽  
Military Training ◽  
Stress Fractures ◽  
Overuse Injuries ◽  
Medial Tibial Stress Syndrome ◽  
Basic Training ◽  
Stress Syndrome ◽  
High Incidence

IntroductionMilitary initial training results in a high incidence of lower limb overuse injuries (stress fractures and medial tibial stress syndrome). This study aimed to determine whether the distance travelled by recruits, both on and off duty, was a risk factor for overuse injury.Methods14 male airborne infantry recruits from three training platoons carried global positioning system receivers throughout the first 19 weeks of basic military training. Total distance travelled each day was recorded. This was compared with time of clinical manifestation of 52 lower limb overuse injuries (stress fractures and medial tibial stress syndrome) collected from the 276 airborne infantry recruits in the period immediately preceding the study.ResultsRecruits travelled significantly farther than the UK average male population in 17 of 18 measured weeks. Pearson correlation between distance travelled per week and injuries was not significant (p=0.4448); however, correlation between distance travelled per week and injuries two weeks later was significant (p=0.0263). A generalised linear model found distance travelled as a significant covariate (p=0.0144) to the expected number of injuries two weeks later.ConclusionRecruits travel long distances during basic training, particularly in the first few weeks when they are not yet conditioned. This distance travelled is likely a contributing risk factor to the high incidence of overuse injuries seen during training, and strategies to reduce this distance should be explored.

scholarly journals The Protective Effect of Neuromuscular Training on the Medial Tibial Stress Syndrome in Youth Female Track-and-Field Athletes: A Clinical Trial and Cohort Study

2021 ◽  
pp. 1-9
Author(s):  
Guillermo Mendez-Rebolledo ◽  
Romina Figueroa-Ureta ◽  
Fernanda Moya-Mura ◽  
Eduardo Guzmán-Muñoz ◽  
Rodrigo Ramirez-Campillo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Relative Risk ◽  
Confidence Interval ◽  
Lower Limb ◽  
Track And Field ◽  
Medial Tibial Stress Syndrome ◽  
Injury Incidence ◽  
Jump Height ◽  
Countermovement Jump ◽  
Stress Syndrome

Context: Few reports have analyzed the effects of neuromuscular (NM) training programs on the injury incidence among youth female track-and-field athletes. Objective: To determine the effects of NM training on reducing lower limb injury incidence and to establish its effects on countermovement jump performance, balance, 30-m sprint, and joint position sense in youth female track-and-field athletes. Design: Single-blind, randomized controlled clinical trial. Setting: Sports research laboratory. Participants: Twenty-two female athletes were allocated into 2 groups: Conventional (CONV) training (n = 11; age = 15.3 [2.1] y) and NM training (n = 11; age = 15.0 [2.7] y). Interventions: Interventions were performed during the preseason of 6 weeks. The CONV training included anaerobic, strength, and aerobic training. The NM training consisted of a multicomponent program that integrated jumps, landings, and running with strength, endurance, agility, balance, and CORE training. Main Outcome Measures: A follow-up of the cohorts was carried out through the evaluation of lower limb injuries (main outcome) during a regular season (weeks 7–18). Secondary outcomes were measured before and after the intervention: Y-balance test, active joint repositioning, ground reaction force, and countermovement jump height. Results: The injury incidence rate was 17.89 injuries per 1000 hours athlete-exposure in CONV training, and 6.58 in NM training (relative risk = 0.38; 95% confidence interval,  0.18 to 0.82; P = .044). Particularly, the medial tibial stress syndrome incidence rate was 5.96 injuries per 1000 hours athlete-exposure in CONV training and 0.82 in NM training (relative risk = 0.17; 95% confidence interval, 0.02 to 1.12; P = .012). In addition, a significant training × time interaction was noted, favoring improvements in 30-m sprint and countermovement jump height after NM. Conclusion: The NM training may improve youth female athlete’s physical fitness and reduce their injury relative risk of medial tibial stress syndrome injury.

scholarly journals Risk Factors Associated With Medial Tibial Stress Syndrome In Military Cadets During Basic Training

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 268
Author(s):  
Jonathan R. Malaver ◽  
Jenner R. Cubides ◽  
Rodrigo Argothy ◽  
Daniel D. Cohen
Keyword(s):  
Risk Factors ◽  
Medial Tibial Stress Syndrome ◽  
Basic Training ◽  
Factors Associated ◽  
Stress Syndrome

scholarly journals OVERUSE INJURY RISK INCREASES WITH YEAR-ROUND SPORT PARTICIPATION IN MIDDLE SCHOOL AGED ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0005
Author(s):  
Kevin M. Biese ◽  
Eric G. Post ◽  
Dan Schaefer ◽  
Stephanie Kliethermes ◽  
Alison Brooks ◽  
...  
Keyword(s):  
High School ◽  
Middle School ◽  
Risk Factor ◽  
Overuse Injury ◽  
Sport Participation ◽  
Musculoskeletal Injuries ◽  
Overuse Injuries ◽  
Baseline Survey ◽  
Previous Injury ◽  
Increased Risk

BACKGROUND: Retrospective studies of high school aged athletes have demonstrated that participating in one sport for more than 8 months of the year is a risk factor for overuse musculoskeletal injuries. This research has driven the recommendation that suggests youth athletes should not play a single organized sport for more than 8 months out of the year. However, these recommendations have never been prospectively examined in middle school aged athletes. The purpose of this study is to determine if year-round participation, operationally defined as participating in one sport for more than 8 months of the year, is associated with increased risk of overuse injuries in middle school aged athletes. METHODS: A total of 281 children (female N= 113, 40.2%, age= 12.1±1.2 years; range 10-14 years of age) completed an anonymous online survey with their parents for 39 weeks. A baseline survey was conducted in the first week of September 2017 and then weekly surveys were completed until June 2018. The baseline survey consisted of demographic information, previous injury history, and sport participation volume (months per year in primary sport). The weekly surveys asked participants to report their sleep habits, musculoskeletal injuries, and illnesses. Parents and children were asked to complete the surveys together. Participants were included in the analysis if they completed at least 80% of the total surveys. In the baseline survey, participants identified the previous months for which they played their primary sport. Those who marked more than 8 months out of the past 12 months were classified as “year-round participants.” Logistic regression was used to determine if year-round participation (>8 months/year) was a significant predictor of overuse musculoskeletal injuries during the study period. A second logistic regression model was created using the participant’s total reported months participating in a single sport as a predictor of overuse injuries. RESULTS: 80 (28.5%) participants were identified as participating year-round in a single sport and 49 overuse injuries were reported during the study period. Athletes who participated in a single sport year-round were more than twice as likely to sustain an overuse injury during the study period compared to non-year-round athletes (OR [95%CI]: 2.20[1.10-4.39], p=0.025), even after adjusting for sex, age, and previous injury history. The odds of sustaining an overuse injury increased approximately 17% for every additional month of participating in a single sport (OR [95%CI]: 1.17 [1.04 -1.32], p=0.012) again while controlling for sex, age, and previous injury. CONCLUSION: This is the first prospective study in middle school aged athletes examining year-round participation and overuse musculoskeletal injuries. Middle school aged athletes are at a 2-times increased risk of overuse musculoskeletal injuries when participating in a single sport for more than 8 months of the year compared to middle school aged athletes who participated 8 or less months in a single sport. Sport specialization has been identified as a risk factor for high school aged athletes for overuse injury – and our observations indicate that a similar trend may exist in middle school aged athletes. Recommendations regarding monthly sport participation for adolescents have been supported in the high school aged population and these recommendations may extend to an even younger population.

scholarly journals Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review

2014 ◽  
Vol 7 (1) ◽  
Author(s):  
Geoffrey J Dowling ◽  
George S Murley ◽  
Shannon E Munteanu ◽  
Melinda M Franettovich Smith ◽  
Bradley S Neal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Lower Limb ◽  
Overuse Injury ◽  
Foot Function

Effectiveness of foot orthoses for the prevention of lower limb overuse injuries in naval recruits: a randomised controlled trial

2017 ◽  
Vol 52 (5) ◽  
pp. 298-302 ◽  
Author(s):  
Daniel R Bonanno ◽  
George S Murley ◽  
Shannon E Munteanu ◽  
Karl B Landorf ◽  
Hylton B Menz
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Controlled Trial ◽  
Intervention Group ◽  
Achilles Tendinopathy ◽  
Overuse Injuries ◽  
Control Group ◽  
Medial Tibial Stress Syndrome ◽  
Foot Orthoses ◽  
Randomised Controlled

ObjectivesTo evaluate the effectiveness of prefabricated foot orthoses for the prevention of lower limb overuse injuries in naval recruits.MethodsThis study was a participant-blinded and assessor-blinded, parallel-group randomised controlled trial. Three-hundred and six participants aged 17–50 years who undertook 11 weeks of initial defence training at the Royal Australian Navy Recruit School (Cerberus, Australia) were randomised to a control group (flat insoles, n=153) or an intervention group (contoured, prefabricated foot orthoses, n=153). The combined incidence of medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain during the 11-week training period were compared using incidence rate ratios (IRR). Data were analysed using the intention-to-treat principle.ResultsSixty-seven injuries (21.9%) were recorded. The control and intervention group sustained 40 (26.1%) and 27 (17.6%) injuries, respectively (IRR 0.66, 95% CI 0.39 to 1.11, p=0.098). This corresponds to a 34% reduction in risk of developing medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy or plantar fasciitis/plantar heel for the intervention group compared with the control group. Participants in the prefabricated orthoses group were more likely to report at least one adverse event (20.3% vs 12.4%; relative risk (RR) 1.63, 95% CI 0.96 to 2.76; p=0.068; number needed to harm 13, 95% CI 6 to 253). The most common adverse events were foot blisters (n=20, 6.6%), arch pain (n=10, 3.3%) and shin pain (n=8, 2.6%).ConclusionPrefabricated foot orthoses may be beneficial for reducing the incidence of lower limb injury in naval recruits undertaking defence training.Trial registration numberAustralian New Zealand Clinical Trials Registry: ACTRN12615000024549.

scholarly journals Spatiotemporal Gait Parameters as Predictors of Lower-Limb Overuse Injuries in Military Training

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Shmuel Springer ◽  
Uri Gottlieb ◽  
Mariya Lozin
Keyword(s):  
Lower Limb ◽  
Military Training ◽  
Knee Injuries ◽  
Overuse Injuries ◽  
Time Variability ◽  
First Year ◽  
Lower Limb Injury ◽  
Study Objective ◽  
Gait Parameters ◽  
Limb Injuries

The study objective was to determine whether spatiotemporal gait parameters could predict lower-limb overuse injuries in cohort of combat soldiers during first year of military service. Newly recruited infantry soldiers walked on a treadmill at a 15° incline with a fixed speed of 1.67 m/sec while wearing a standard military vest with a 10 kg load. Stride time variability, stride length variability, step length asymmetry, and the duration of the loading response phase of the gait cycle were measured. Injury data on 76 soldiers who did not report musculoskeletal complaints at initial screening were collected one year after recruitment. Multiple logistic regression analyses were conducted to determine the predictive effect of the gait parameters on lower-limb injuries. Twenty-four soldiers (31.6%) had overuse injuries during the first year after recruitment. Duration of the loading response was a significant predictor of general lower-limb injury (p<0.05), as well as of foot/ankle and knee injuries (p<0.05,p<0.01, resp.). A cutoff value of less than 12.15% for loading response duration predicted knee injuries with 83% sensitivity and 67% specificity. This study demonstrates the utility of spatiotemporal gait evaluation, a simple screening tool before military training, which may help to identify individuals at risk of lower-limb overuse injuries.

scholarly journals Incidence and Time to Return to Training for Stress Fractures during Military Basic Training

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Alexander M. Wood ◽  
Richard Hales ◽  
Andre Keenan ◽  
Alexandra Moss ◽  
Michael Chapman ◽  
...  
Keyword(s):  
Stress Fracture ◽  
Military Training ◽  
Return To Sport ◽  
Stress Fractures ◽  
Basic Training ◽  
Military Population ◽  
Epidemiological Database ◽  
Recovery Times ◽  
Time Required ◽  
Rehabilitation Time

Currently, little is known about the length of time required to rehabilitate patients from stress fractures and their return to preinjury level of physical activity. Previous studies have looked at the return to sport in athletes, in a general population, where rehabilitation is not as controlled as within a captive military population. In this study, a longitudinal prospective epidemiological database was assessed to determine the incidence of stress fractures and the time taken to rehabilitate recruits to preinjury stage of training. Findings demonstrated a background prevalence of 5% stress fractures in Royal Marine training; femoral and tibial stress fractures take 21.1 weeks to return to training with metatarsal stress fractures being the most common injury taking 12.2 weeks. Rehabilitation from stress fractures accounts for 814 weeks of recruit rehabilitation time per annum. Stress fracture incidence is still common in military training; despite this stress fracture recovery times remain constant and represent a significant interruption in training. It takes on average 5 weeks after exercise specific training has restarted to reenter training at a preinjury level, regardless of which bone has a stress fracture. Further research into their prevention, treatment, and rehabilitation is required to help reduce these burdens.

Medial Tibial Stress Syndrome (Tibial Fasciitis)

2007 ◽  
Vol 97 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Richard T. Bouché ◽  
Cherie H. Johnson
Keyword(s):  
Strain Gauges ◽  
Overuse Injuries ◽  
Medial Tibial Stress Syndrome ◽  
Flexor Digitorum Longus ◽  
Posterior Tibial ◽  
Stress Syndrome ◽  
Fresh Cadaver ◽  
Flexor Digitorum ◽  
Linear Manner

Although medial tibial stress syndrome is one of the most common lower-extremity overuse injuries, its pathomechanics remain controversial. Two popular theories have been proposed to account for this condition: tibial bending and fascial traction. This article evaluates the role of fascial traction in medial tibial stress pathomechanics. We hypothesized that with contraction of the deep leg flexors tension would be imparted to the tibial fascial attachment at the medial tibial crest. We also speculated that circumferential straps would dampen tension directed to the medial tibial crest. The amount of strain present in the tibial fascia adjacent to its distal medial tibial crest insertion during loading of the leg was investigated as a descriptive laboratory pilot study using three fresh cadaver specimens. Strain in the distal tibial fascia was measured using strain gauges placed in the fascia at its medial tibial crest insertion. As tension on the posterior tibial, flexor digitorum longus, and soleus tendons increased, strain in the tibial fascia increased in a consistent linear manner (P &lt; .0001). We conclude that fascial tension may play a role in the pathomechanics of medial tibial stress syndrome. The tenting effect of the posterior tibial, flexor digitorum longus, and soleus tendons caused by muscle contraction exerts a force on the distal tibial fascia that is directed to its tibial crest insertion. Circumferential straps provided no dampening effect on tension directed to the medial tibial crest. (J Am Podiatr Med Assoc 97(1): 31–36, 2007)

scholarly journals Dynamic foot function as a risk factor for lower limb overuse injury: A systematic review

2014 ◽  
Vol 18 ◽  
pp. e110 ◽  
Author(s):  
G. Dowling ◽  
G. Murley ◽  
M. Franettovich Smith ◽  
S. Munteanu ◽  
N. Collins
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Lower Limb ◽  
Overuse Injury ◽  
Foot Function
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