A Multiple Intervention Strategy for Reducing Femoral Neck Stress Injuries and Other Serious Overuse Injuries in U.S. Army Basic Combat Training

Abstract

We hypothesized that the use of evidence based injury prevention strategies would lead to a reduction in the incidence of femoral neck stress injuries (FNSIs) and other serious overuse injuries in U.S. Army Basic Combat Training (BCT). An injury prevention strategy began in late 2008 that included: (1) leadership education, (2) leadership enforcement of proven methods, and (3) injury surveillance and reporting. Data on FNSI and removal from training for injury were analyzed based on the fiscal year 2006 through 2010 (n = 210,002). For men, FNSI were reduced from 13 to 20 cases/10,000 recruits per year (2006-2008) to 8 cases/10,000 recruits in 2010 (p < 0.01); for women, FNSI were reduced from 35 to 41 cases/10,000 recruits per year (2006-2008) to 18 cases/10,000 recruits per year in 2010 (p < 0.01). For men, removals from training for injury were reduced from 0.8 to 1.1 cases/100 recruits per year (2006-2008) to 0.5 cases/100 recruits in 2010 (p < 0.01); for women removal from training for injury was reduced from 2.3 to 2.4 cases/100 recruits (2006-2008) to 1.0 case/100 recruits per years in 2010 (p < 0.01). The time course of the changes suggests that following specific injury prevention methods was effective in reducing injuries.

A Multicenter Randomized, Double-Blind, Split-Side, Comparative Study of Moisturizer Containing MAS064D and 1% Hydrocortisone Cream in the Treatment of Infantile Seborrheic Dermatitis

“…Nor does it reflect the financial savings made by reducing the total annual overall injury rate. Encouragingly, savings due to MD alone from OMEGA compare with previously published in year savings, notably the $5.3 m in US Army Basic Combat Training [31], the $4.5 m reported in US Marines [13] and the projected 10% annual saving ($2.5 million) in US Air Force Training [52].…”

“…In keeping with the observations from previous studies a multiple interventional approach was applied to the strategic design and delivery of Project OMEGA [8,9,13,[29][30][31][32]. Initial planning and design has been previously described [8,9,[28][29][30], however, further detail of the programme will be discussed in future papers.…”

“…Leadership support: Leadership education and prevention enforcement were essential components [8,13,30,31]. Specifically, the collegiate culture of ITC, embodied by the Commanding Officers Directive [27], provided the essential firm base from which OMEGA could be delivered.…”

“…This consideration alone is particularly important to supporting the physical development and health of the maturing skeletal system in adolescent recruits. Standardisation of content and training delivery was established with increased emphasis on multi-axial, neuromuscular and proprioceptive and agility exercises [9,13,[29][30][31] and in keeping with previous recommendations, strategies were introduced to limit the likelihood of overtraining [13,34]. Notably, recruits were advised against undertaking extra physical training in their own time whilst a 64% reduction in running mileage, compared to the first seven weeks of the previous programme, reduced high impact axial loading and provided more opportunity for targeted neuromuscular conditioning and active recovery sessions.…”

Young man with sudden severe hip pain secondary to femoral neck stress fracture

“…An average convalescence has been described as 116 days12 or three times longer than that for other lower extremity stress fractures 15. In a study of 220 stress fractures in military recruits, femoral stress fractures healed the slowest, needing a mean time of 21.1 weeks for rehabilitation 1.…”