Predictors of Stress Fracture Susceptibility in Young Female Recruits

Background: Stress fractures account for substantial morbidity for young women undergoing U.S. Marine Corps basic training. Hypothesis: Certain pretraining characteristics identify women at increased risk of stress fractures during boot camp. Study Design: Cohort study; Level of evidence, 2. Methods...

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Bibliographic Details
Published in:The American journal of sports medicine 2006-01, Vol.34 (1), p.108-115
Main Authors: Shaffer, Richard A., Rauh, Mitchell J., Brodine, Stephanie K., Trone, Daniel W., Macera, Caroline A.
Format: Article
Language:English
Subjects:
Abnormalities
Adolescent
Adult
Anthropometry
Biological and medical sciences
Bones
Care and treatment
Causes of
Cohort Studies
Diseases of the osteoarticular system
Exercise Test
Female
Fractures
Fractures, Stress - prevention & control
Health aspects
Humans
Injuries of the limb. Injuries of the spine
Lower Extremity - injuries
Medical sciences
Military Personnel
Musculoskeletal abnormalities
Physical Fitness
Risk Factors
Sports injuries
Sports medicine
Stress fractures
Surveys and Questionnaires
Traumas. Diseases due to physical agents
United States
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Summary:Background: Stress fractures account for substantial morbidity for young women undergoing U.S. Marine Corps basic training. Hypothesis: Certain pretraining characteristics identify women at increased risk of stress fractures during boot camp. Study Design: Cohort study; Level of evidence, 2. Methods: Data collected included baseline performance on a timed run (a measure of aerobic fitness), anthropometric measurements, and a baseline questionnaire highlighting exercise and menstrual status among 2962 women undergoing basic training at the Marine Corps Recruit Depot, Parris Island, in 1995 and 1996. Results: One hundred fifty-two recruits (5.1%) had 181 confirmed lower extremity stress fractures, with the most common sites being the tibia (25%), metatarsals (22%), pelvis (22%), and femur (20%). Logistic regression models revealed that having low aerobic fitness (a slower time on the timed run) and no menses during the past year were significantly associated with the occurrence of any stress fracture and with pelvic or femoral stress fracture during boot camp. Conclusion: These findings suggest that stress fractures may be reduced if women entering Marine Corps Recruit Depot training participated in pretraining activities designed to improve aerobic fitness. Furthermore, women reporting no menses during the previous year may need additional observation during training. Clinical Relevance: Consistent with previous studies, we found that low aerobic fitness was the only modifiable risk factor associated with stress fractures during boot camp. Keywords: injuries menstrual status military women
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546505278703