Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study

Abstract

Although bone stress injuries are common in male military trainees, it is not known how common they are in female trainees. It also is unclear whether asymptomatic bone stress injuries heal if intensive training is continued. We prospectively followed 10 female trainees of a military Reserve Officer Course. The subjects underwent clinical and MRI examinations of the pelvis, thighs, and lower legs at the beginning, once during, and at the end of their 3-month course. We identified two to five injuries in every female trainee, all of whom already had the injuries at the beginning of the officer course. None of these injuries increased their severity despite vigorous training. Two-thirds were asymptomatic and low grade. Femoral and tibial shafts were the most common locations. Higher-grade injuries were more likely symptomatic, but regardless of the MRI findings, female trainees expressed only mild to moderate symptoms. Asymptomatic, low-grade bone stress injuries of the femoral and tibial shaft are common in female recruits undergoing heavy physical training. Because these injuries seem to remain constant or even disappear despite continued heavy physical activity, we do not recommend routine screening of asymptomatic trainees. As some bone stress fractures may have severe consequences (eg, in the femoral neck), symptomatic bone stress injuries should be examined and treated.

Bilateral Supracondylar Femoral Stress Fractures in an Adolescent: A Case Report

“…Radiographic findings are found 2 to 8 weeks after symptom onset. At this time point the sensitivities of the radiographs can be as low as 10%, which increases up to 70% on follow up [6] . With the potential that stress fractures will take 8 weeks to become evident on radiological imaging this may not be of great diagnostic use [6,7] .…”

“…At this time point the sensitivities of the radiographs can be as low as 10%, which increases up to 70% on follow up [6] . With the potential that stress fractures will take 8 weeks to become evident on radiological imaging this may not be of great diagnostic use [6,7] . Typical findings include a fine area of periosteal bone elevation, sclerosis and an area of low-density bone may also be seen [8] .…”

Isolated Transverse Fracture of the Body of the Hamate Bone : A Rare Case Report

“…This leads to the acceleration of normal bone remodeling, the production of micro-fractures (caused by insufficient time for the bone to repair), the creation of a bone stress injury (i.e., stress reaction), and eventually, a stress fracture. 11,12 Persons who participate in repetitive, high intensity training, such as athletes and military recruits, are at increased risk of developing stress fractures. Stress fractures, classically been described in military recruits and in sports persons, hence, studied and reported extensively in such populations.…”

Multiple Stress Fractures: A Case Report

“…Niva et al performed a study and reported of bone stress injuries at femur and tibia which were asymptomatic at military recruits during intensive training and did not recommend routine screening of asymptomatic military trainees [7]. A systematic review by Snyder et al showed evidence of shoe insoles to reduce the overall femoral and tibial stress fracture incidence during military training by improving biomechanics, lessening fatigue, and attenuating impact.…”