Reducing Stress Fracture in Physically Active Military Women (1998) / Chapter Skim
Currently Skimming:
1 Pathophysiology and Epidemiology of Stress Fractures in Military Women
1 Pathophysiology and Epidemiology of Stress Fractures in Military Women
Pages 9-28
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 9... ...
Although the term stress fracture implies a break In bone continuity, many injuries labeled as stress fractures are not associated with a fracture line on plain radiography (Iones et al., 19891. The normal reaction of bone to stress is a localized acceleration of bone remodeling that alters the micro-architectural configuration to better withstand the altered loading environment.
|
From page 10... ...
They are then assembled into fibriTs that are arranged such that spaces exist between molecules to accommodate the calcium and phosphate crystals. HORMONAL REGULATION OF BONE METABOLISM AND REMODELING The dynamic processes involved in bone metabolism relate to the events associated with bone formation and bone resorption.
|
From page 11... ...
, thyroid hormone, glucocorticoids, and androgens. Paracrine and autocrine factors involved in bone remodeling include IGF and cytokines such as tumor necrosis factor (INF)
|
From page 14... ...
Dunng physical activity, contact with the ground generates forces within the body. With running, vertical ground reaction force has been shown to vary from 2 to 5 times body weight (Bates et al., 1983; Cavanagh and Lafortune, 1980)
|
From page 15... ...
Normal remodeling the bone's response to cyclic loading due to ground reaction forces is a sequential process of osteoclastic resorption and osteoblastic new bone formation. This process takes place continuously on both periosteal and endo steel surfaces within cortical bone and on the surface oftrabeculae (Parfitt, 1984)
|
From page 16... ...
edema, but plain radiographs that specifically detect new bone formation or complete fractures, wall still be negative. By the time plain radiographs are positive, a fi~-blown stress fracture is present.
|
From page 17... ...
In Army recruits undergoing basic training, five injury types are repeatedly cited as accounting for the majority of all training injuries: stress fractures, overuse injuries of the knee, planter fascitis, achilles tendonitis, and article sprains (Iones et al., 1983; Kowal, 1980, Reinker and Ozburne, 1979~. Similarly, these same types of injuries are cited as accounting for the majority of all injuries in civilian running and jogging
|
From page 18... ...
Most studies on stress fracture occurrence in the military have focused on the basic training period. The small amount of data available suggest that, although injury rates decline after basic training, they are still a problem.
|
From page 19... ...
8.9 3.6 Week 6 of BCT (Company E&F) 5.1 1.4 Shaffer, 1997 Navy and Marines: Navy Seals 8.9 Marine Corps Recruits: San Diego 2.2 Parris Island 5.1 3.5 Navy Training 0.6 0.2 Marine Corps Officer Candidate 9.8 School Winfield etal., 1997 Marines 11.5 7.0 NOTE: BCT, basic combat training; , not determined.
|
From page 20... ...
The data in Table 1-2, although based on small sample sizes, suggest that female trainees are more likely to develop stress fractures in the upper leg and pelvis, while male trainees are more likely to have Tower extremity stress fractures. Pelvic and femur fractures require more time for rehabilitation and may result in more disability and operational costs than stress fractures that occur below the knee.
|
From page 21... ...
Army physical fitness standards applicable to active duty servicemembers, (USAREC Reg 60195)
|
From page 22... ...
Men: 45 Women: 38 Push-ups (within 2 min) Men: 30 Women: 14 NOTE: BCT, basic combat training; AIT, advanced individual training; OSUT, one-station unit training; RTC: recruit training command; MCRD, Marine Corps recruit depot; BMT, basic military training; FTU, fitness training unit; PCP, Physical Conditioning Platoon; CR, cardiorespiratory.
|
From page 23... ...
Guidance on the planning and development of physical fitness training is outlined in the Army's Physical Fitness Training manual (FM 21 -20, ~ 992~. The manual provides guidelines for developing programs that will improve arid maintain physical fitness levels for all Army personnel and includes specific chapters devoted to physical training during initial entry training and to injuries.
|
From page 25... ...
reduce injury risk; · implementation of a comprehensive flexibility training program; · addition of exercise warm-up and cool-down routines; · a more progressive ramp-up of Toad-bearing conditioning hikes; and · modification of the scheduling of different physical training events to maximize training benefit and minimize the risks of overtraining and overuse injuries. Through the implementation of the modified physical training program, stress fractures in mate Marine Corps recruits have been reduced by 50 percent with no decrease in fitness level at graduation.
|
From page 26... ...
Based on these findings, OPSHA recommended adoption of the new program in February 1995. Fitness Levels of Recruits Initial fitness levels have been found to be strongly related to subsequent development of stress fractures during basic training (Canham et al., 1996; Deuster and Jones, 1997; Chaffer, 19971.
|
From page 27... ...
* Predicted from 1-ml run time to allow comparison with physical fitness training scores.
|
From page 28... ...
Systemic hormones that affect bone remodeling include parathyroid hormone, calcitonin, vitamin D, estrogen, progesterone, growthhormone, thyroid hormone, glucocorticoids, and androgens. Stress fractures are diagnosed using a combination of clinical symptoms and results from bone imaging studies.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.