Injuries Associated with the 580 km University Student Grand Voluntary Road March: Focus on Foot Injuries

Abstract

College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 ± 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries.

Importance of Sock Type in the Development of Foot Lesions on Low-Difficulty, Short Hikes

“…Numerous studies have analyzed lesions and illnesses developed by hikers on long distance, endurance, and difficult walks. Boulware et al studied the development of lesions and injuries after three days of mountain hiking [43], Choi et al after 21 consecutive days of walking [17], Anderson et al on long distance hikes [6], and Travis et al on short walks on volcanic terrain [44]. However, no studies have addressed one-day or low-difficulty, short hikes, the type most recommended for improving physical health and reducing stress [45,46].…”

“…However, no studies have addressed one-day or low-difficulty, short hikes, the type most recommended for improving physical health and reducing stress [45,46]. Data for the present study were collected by physical examination rather than through questionnaires filled in by hikers after completing a walk, as in some of the works identified [6,11,17,43,44,47].…”

“…However, nail lesions were detected after participants had hiked 14.5 km. This shortens the distance of 580 km in which Choi et al detected the loss of the nail plate as the only nail lesion [17].…”

“…Body mass index was also a direct predictive factor in foot lesions. Although no studies analyzing BMI as a predictive factor were identified, backpack weight has been determined as a risk factor in blister development [17]. Non-technical socks were revealed as a powerful predictive factor of dermal and muscle lesions in hikers.…”

“…Lower limb muscle injuries [16] and injuries due to backpack use and weight are also frequent [6]. Development of nail lesions after long-distance walks has also been previously described [17].…”