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From the * Behavioral Science & Epidemiology Program, Musculoskeletal Injury Epidemiology, Naval Health Research Center, San Diego, California, the Graduate School of Public Health, San Diego State University, San Diego, California, the Graduate Program in Orthopaedic & Sports Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, GEO-CENTERS INC, Newton Centre, Massachusetts, and the || University of California, San Diego/San Diego State University, Joint Doctoral Program in Public Health Epidemiology, San Diego, California
¶ Address correspondence to Daniel W. Trone, MA, Behavioral Science & Epidemiology Program, Musculoskeletal Injury Epidemiology, Naval Health Research Center, PO Box 85122, San Diego, CA 92186-5122 (e-mail: trone{at}nhrc.navy.mil).
Background: Stress fractures account for substantial morbidity for young women undergoing U.S. Marine Corps basic training.
Hypothesis: Certain pretraining characteristics identify women at increased risk of stress fractures during boot camp.
Study Design: Cohort study; Level of evidence, 2.
Methods: Data collected included baseline performance on a timed run (a measure of aerobic fitness), anthropometric measurements, and a baseline questionnaire highlighting exercise and menstrual status among 2962 women undergoing basic training at the Marine Corps Recruit Depot, Parris Island, in 1995 and 1996.
Results: One hundred fifty-two recruits (5.1%) had 181 confirmed lower extremity stress fractures, with the most common sites being the tibia (25%), metatarsals (22%), pelvis (22%), and femur (20%). Logistic regression models revealed that having low aerobic fitness (a slower time on the timed run) and no menses during the past year were significantly associated with the occurrence of any stress fracture and with pelvic or femoral stress fracture during boot camp.
Conclusion: These findings suggest that stress fractures may be reduced if women entering Marine Corps Recruit Depot training participated in pretraining activities designed to improve aerobic fitness. Furthermore, women reporting no menses during the previous year may need additional observation during training.
Clinical Relevance: Consistent with previous studies, we found that low aerobic fitness was the only modifiable risk factor associated with stress fractures during boot camp.
Key Words: injuries • menstrual status • military • women
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