Comprehensive evaluation and management of stress fractures in military trainees

Improving the Management of Tibia Stress Fractures

“…Studies indicate that 1%-9% of U.S. military recruits will sustain a stress fracture at 6 weeks of training (Philipson & Parker, 2009;Rosenthal & McMillian, 2006). In contrast, the Israeli Defense Force reports an incidence as high as 31% in its recruit within the fi rst 4 weeks of training (Philipson & Parker, 2009).…”

“…Simply stated, a deconditioned individual (or even a fi t athlete) abruptly increases the frequency, duration, and intensity of an activity too rapidly (Patel, Roth, & Kapil, 2011;Yadav et al, 2008 ). The fi rst report of a stress fracture (named "March" fracture) was diagnosed in the foot of a marching recruit in the Prussian Army of 1855 by Dr. Briethaupt (Rosenthal & McMillian, 2006;Yadav et al, 2008 ). Since that time, the prevalence of stress fractures has been closely followed as an area of concern for persons in the military service.…”

“…A high number of stress fractures occur in military training programs, basic training posts, military training academies, and specialty training units due to the repetitive high-impact training with weight-bearing activities such as running and marching (Rosenthal & McMillian, 2006). However, the condition has been occurring in nonmilitary populations with increasing frequency since the mid-1900s (Jones, Thacker, Gilchrist, Kimsey, & Sosin, 2002.…”

“…However, the condition has been occurring in nonmilitary populations with increasing frequency since the mid-1900s (Jones, Thacker, Gilchrist, Kimsey, & Sosin, 2002. Given the athletic nature of many active duty members and physically active persons, the possibility of a stress fracture should be considered when evaluating patients with exercise-related musculoskeletal complaints (Rosenthal & McMillian, 2006). Since prompt diagnosis and treatment are crucial in the management of stress fractures, clinicians must have a high index of suspicion and be knowledgeable of lower extremity musculoskeletal diagnoses to make the appropriate decision for care.…”

“…aggressive training regimen without proper body conditioning) and intrinsic factors (e.g., bone anatomy, fi tness level, and gender; Philipson & Parker, 2009;Rosenthal & McMillian, 2006).…”