The Effect of Pretraining Sports Activity on the Incidence of Stress Fractures Among Military Recruits

Prevention of Lower Extremity Stress Fractures in Athletes and Soldiers: A Systematic Review

“…Two separately reported analyses based on data from 295 infantry trainees reported that mean estimated maximal oxygen uptakes for persons with stress fractures were not different from those of persons who did not have stress fractures (138), and the incidence of stress fracture for groups with higher aerobic fitness was not significantly different from that of groups with lower fitness levels (142). The difference between these findings and those of other studies may be partially explained by the use of a non-weightbearing submaximal bicycle test for estimation of aerobic capacity and a much more sensitive definition of stress fracture that included asymptomatic stress fractures.…”

“…A survey of 449 Navy special warfare trainees (table 5) (131) and a study of Finnish army recruits (145) reported similar find- ings. An IDF study found no relation between duration of training or amount of running prior to basic training and stress fracture risk (142). The preponderance of the data from military studies indicates that persons who engage in more physical activity, particularly running, will experience fewer stress fractures when beginning a physically demanding training program.…”

Comprehensive evaluation and management of stress fractures in military trainees

“…Multiple studies reported no correlation between level of prior participation in sports or aerobic fitness levels and the occurrence of stress fractures. 41,47 Although Hoffman et al 45 found no statistically significant difference between stress fracture incidence and prior physical activity levels, the highest incidence of stress fracture was reported in those who did not participate in a conditioning program before military training. Shwayhat et al 9 noted a significant increase in lower extremity overuse injuries in Navy SEAL (Sea, Air, and Land) recruits who ran fewer miles and shorter duration runs before the formal training period.…”

Stress Fractures in Military Men and Bone Quality Related Factors

“…Physical fitness or prior physical activity is suggested as a predictor of stress factor risk in individuals undergoing basic military training by the majority of the studies, according to a recent review [5]. However, some studies [22,52] including a recent prospective study [27] found no association between pretraining participation in sport activities and stress fracture incidence in recruits. All individuals in our study were beyond the basic training; therefore the possible differences in their physical fitness would be less variable than in recruits, as they underwent a similar basic training.…”