Welcome!
To use the personalized features of this site, please log in or register.
If you have forgotten your username or password, we can help.
|
 |
Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study
| |
|
Original Article
Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study
Maria H. Niva1, 2, 3, Ville M. Mattila1, 4 , Martti J. Kiuru1, 2, 3 and Harri K. Pihlajamäki1, 5
| (1) |
Centre for Military Medicine, Helsinki, Finland |
| (2) |
Department of Radiology, Central Military Hospital, Helsinki, Finland |
| (3) |
Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland |
| (4) |
Hämeenlinna Central Hospital, Hämeenlinna, Finland |
| (5) |
Department of Orthopaedic Surgery, Central Military Hospital, Helsinki, Finland |
Received: 26 September 2008 Accepted: 7 April 2009 Published online: 21 April 2009
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.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.
This work was performed at Central Military Hospital.
References
| 1. |
Ahovuo JA, Kiuru MJ, Visuri T. Fatigue stress fractures of the sacrum: diagnosis with MR imaging. Eur Radiol. 2004;14:500–505.
|
| |
| 2. |
Almeida SA, Williams KM, Shaffer RA, Brodine SK. Epidemiological patterns of musculoskeletal injuries and physical training.
Med Sci Sports Exerc. 1999;31:1176–1182.
|
| |
| 3. |
Anderson MW, Greenspan A. Stress fractures. Radiology. 1996;199:1–12.
|
| |
| 4. |
Beck TJ, Ruff CB, Shaffer RA, Betsinger K, Trone DW, Brodine SK. Stress fracture in military recruits: gender differences
in muscle and bone susceptibility factors. Bone. 2000;27:437–444.
|
| |
| 5. |
Bennell KL, Malcolm SA, Thomas SA, Reid SJ, Brukner PD, Ebeling PR, Wark JD. Risk factors for stress fractures in track and
field athletes: a twelve-month prospective study. Am J Sports Med. 1996;24:810–818.
|
| |
| 6. |
Bennell KL, Malcolm SA, Thomas SA, Wark JD, Brukner PD. The incidence and distribution of stress fractures in competitive
track and field athletes: a twelve-month prospective study. Am J Sports Med. 1996;24:211–217.
|
| |
| 7. |
Brudvig TJ, Gudger TD, Obermeyer L. Stress fractures in 295 trainees: a one-year study of incidence as related to age, sex,
and race. Mil Med. 1983;148:666–667.
|
| |
| 8. |
Burr DB, Milgrom C. Musculoskeletal Fatigue and Stress Fractures. Boca Raton, FL: CRC Press; 2001.
|
| |
| 9. |
Daffner RH, Pavlov H. Stress fractures: current concepts. AJR Am J Roentgenol. 1992;159:245–252.
|
| |
| 10. |
Fredericson M, Bergman AG, Hoffman KL, Dillingham MS. Tibial stress reaction in runners: correlation of clinical symptoms
and scintigraphy with a new magnetic resonance imaging grading system. Am J Sports Med. 1995;23:472–481.
|
| |
| 11. |
Giladi M, Milgrom C, Simkin A, Danon Y. Stress fractures. Identifiable risk factors. Am J Sports Med. 1991;19:647–652.
|
| |
| 12. |
Jones BH, Cowan DN, Tomlinson JP, Robinson JR, Polly DW, Frykman PN. Epidemiology of injuries associated with physical training
among young men in the army. Med Sci Sports Exerc. 1993;25:197–203.
|
| |
| 13. |
Jones BH, Knapik JJ. Physical training and exercise-related injuries: surveillance, research and injury prevention in military
populations. Sports Med. 1999;27:111–125.
|
| |
| 14. |
Kiuru MJ, Niva M, Reponen A, Pihlajamaki HK. Bone stress injuries in asymptomatic elite recruits: a clinical and magnetic
resonance imaging study. Am J Sports Med. 2005;33:272–276.
|
| |
| 15. |
Kiuru MJ, Pihlajamaki HK, Ahovuo JA. Fatigue stress injuries of the pelvic bones and proximal femur: evaluation with MR imaging.
Eur Radiol. 2003;13:605–611.
|
| |
| 16. |
Kiuru MJ, Pihlajamaki HK, Ahovuo JA. Bone stress injuries. Acta Radiol. 2004;45:317–326.
|
| |
| 17. |
Kiuru MJ, Pihlajamaki HK, Perkio JP, Ahovuo JA. Dynamic contrast-enhanced MR imaging in symptomatic bone stress of the pelvis
and the lower extremity. Acta Radiol. 2001;42:277–285.
|
| |
| 18. |
Korpelainen R, Orava S, Karpakka J, Siira P, Hulkko A. Risk factors for recurrent stress fractures in athletes. Am J Sports Med. 2001;29:304–310.
|
| |
| 19. |
Li GP, Zhang SD, Chen G, Chen H, Wang AM. Radiographic and histologic analyses of stress fracture in rabbit tibias. Am J Sports Med. 1985;13:285–294.
|
| |
| 20. |
Lohman M, Kivisaari A, Vehmas T, Kallio P, Malmivaara A, Kivisaari L. MRI abnormalities of foot and ankle in asymptomatic,
physically active individuals. Skeletal Radiol. 2001;30:61–66.
|
| |
| 21. |
Matheson GO, Clement DB, McKenzie DC, Taunton JE, Lloyd-Smith DR, MacIntyre JG. Stress fractures in athletes: a study of 320
cases. Am J Sports Med. 1987;15:46–58.
|
| |
| 22. |
Mattila VM, Niva M, Kiuru M, Pihlajamaki H. Risk factors for bone stress injuries: a follow-up study of 102,515 person-years.
Med Sci Sports Exerc. 2007;39:1061–1066.
|
| |
| 23. |
Niva MH, Kiuru MJ, Haataja R, Pihlajamaki HK. Fatigue injuries of the femur. J Bone Joint Surg Br. 2005;87:1385–1390.
|
| |
| 24. |
Pihlajamaki HK, Ruohola JP, Kiuru MJ, Visuri TI. Displaced femoral neck fatigue fractures in military recruits. J Bone Joint Surg Am. 2006;88:1989–1997.
|
| |
| 25. |
Pihlajamaki HK, Ruohola JP, Weckstrom M, Kiuru MJ, Visuri TI. Long-term outcome of undisplaced fatigue fractures of the femoral
neck in young male adults. J Bone Joint Surg Br. 2006;88:1574–1579.
|
| |
| 26. |
Salminen ST, Pihlajamaki HK, Visuri TI, Bostman OM. Displaced fatigue fractures of the femoral shaft. Clin Orthop Relat Res. 2003;409:250–259.
|
| |
| 27. |
Shin AY, Morin WD, Gorman JD, Jones SB, Lapinsky AS. The superiority of magnetic resonance imaging in differentiating the
cause of hip pain in endurance athletes. Am J Sports Med. 1996;24:168–176.
|
| |
| 28. |
Sormaala MJ, Niva MH, Kiuru MJ, Mattila VM, Pihlajamaki HK. Bone stress injuries of the talus in military recruits. Bone. 2006;39:199–204.
|
| |
| 29. |
Tuan K, Wu S, Sennett B. Stress fractures in athletes: risk factors, diagnosis, and management. Orthopedics. 2004;27:583–591; quiz 592–593.
|
| |
|
|
|
|
|
|