Stress fracture injury in young military men and women

David W. Armstrong, John Paul H Rue, John H Wilckens, Frank J. Frassica

Research output: Contribution to journalArticle

Abstract

Approximately 5% of all military recruits incur stress fracture injuries during intense physical training, predominately in the lower extremity. We compared young men and women with stress fracture injury (subjects) to a matched group of uninjured volunteers (controls) during a summer training program at the United States Naval Academy to identify possible risk factors for stress fracture injury. The subject group was composed of 13 female and 18 male plebes with training-induced stress fracture injury verified by plain radiographs and/or nuclear bone scan. The control group was composed of 13 female and 18 male plebes who remained without injury during plebe summer training but who were matched with the 31 injured plebes for the Initial Strength Test (1-mi run time, means: women, 7.9 min; men, 6.4 min) and body mass index (means: women, 23.4; men, 23.8). We found that the subjects lost significant body weight (mean, 2.63 ± 0.54 kg) between Day 1 and the date of their diagnosis of a stress fracture (mean, Day 35) and that they continued to lose weight until the date of their DEXA scan (mean, Day 49). Among female plebes, there was no evidence of the female athlete triad (eating disorders, menstrual dysfunction, or low bone density). Thigh girth was significantly smaller in female subjects than in female controls and trended to be lower in male subjects than in male controls. Total body bone mineral content was significantly lower in the male subjects than in male controls. Bone mineral density of the distal tibia and femoral neck were not significantly different between the groups. DEXA-derived structural geometric properties were not different between subjects and controls. Because, on average, tibias were significantly longer in male subjects than in male controls, the mean bone strength index in male subjects was significantly lower than that of male controls. We conclude that significant, acute weight loss combined with regular daily physical training among young military recruits may be a significant contributing risk factor for stress fracture injuries in young military men and women.

Original languageEnglish (US)
Pages (from-to)806-816
Number of pages11
JournalBone
Volume35
Issue number3
DOIs
StatePublished - Sep 2004

Fingerprint

Stress Fractures
Wounds and Injuries
Bone Density
Tibia
Female Athlete Triad Syndrome
Bone and Bones
Femur Neck
Photon Absorptiometry
Thigh
Weight Loss
Volunteers
Lower Extremity
Body Mass Index
Research Design
Body Weight
Education
Weights and Measures
Control Groups

Keywords

  • Bone mineral density (BMD)
  • Physical training
  • Recruits
  • Structural geometry
  • Weight loss

ASJC Scopus subject areas

  • Physiology
  • Hematology

Cite this

Armstrong, D. W., Rue, J. P. H., Wilckens, J. H., & Frassica, F. J. (2004). Stress fracture injury in young military men and women. Bone, 35(3), 806-816. https://doi.org/10.1016/j.bone.2004.05.014

Stress fracture injury in young military men and women. / Armstrong, David W.; Rue, John Paul H; Wilckens, John H; Frassica, Frank J.

In: Bone, Vol. 35, No. 3, 09.2004, p. 806-816.

Research output: Contribution to journalArticle

Armstrong, DW, Rue, JPH, Wilckens, JH & Frassica, FJ 2004, 'Stress fracture injury in young military men and women', Bone, vol. 35, no. 3, pp. 806-816. https://doi.org/10.1016/j.bone.2004.05.014
Armstrong, David W. ; Rue, John Paul H ; Wilckens, John H ; Frassica, Frank J. / Stress fracture injury in young military men and women. In: Bone. 2004 ; Vol. 35, No. 3. pp. 806-816.
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N2 - Approximately 5% of all military recruits incur stress fracture injuries during intense physical training, predominately in the lower extremity. We compared young men and women with stress fracture injury (subjects) to a matched group of uninjured volunteers (controls) during a summer training program at the United States Naval Academy to identify possible risk factors for stress fracture injury. The subject group was composed of 13 female and 18 male plebes with training-induced stress fracture injury verified by plain radiographs and/or nuclear bone scan. The control group was composed of 13 female and 18 male plebes who remained without injury during plebe summer training but who were matched with the 31 injured plebes for the Initial Strength Test (1-mi run time, means: women, 7.9 min; men, 6.4 min) and body mass index (means: women, 23.4; men, 23.8). We found that the subjects lost significant body weight (mean, 2.63 ± 0.54 kg) between Day 1 and the date of their diagnosis of a stress fracture (mean, Day 35) and that they continued to lose weight until the date of their DEXA scan (mean, Day 49). Among female plebes, there was no evidence of the female athlete triad (eating disorders, menstrual dysfunction, or low bone density). Thigh girth was significantly smaller in female subjects than in female controls and trended to be lower in male subjects than in male controls. Total body bone mineral content was significantly lower in the male subjects than in male controls. Bone mineral density of the distal tibia and femoral neck were not significantly different between the groups. DEXA-derived structural geometric properties were not different between subjects and controls. Because, on average, tibias were significantly longer in male subjects than in male controls, the mean bone strength index in male subjects was significantly lower than that of male controls. We conclude that significant, acute weight loss combined with regular daily physical training among young military recruits may be a significant contributing risk factor for stress fracture injuries in young military men and women.

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