STRESS FRACTURES IN FEMALE RECRUITS: INTERVENTION BY REDUCING WEIGHT AND CONFIGURATION OF THE COMBAT GEAR

Introduction: Stress fractures comprise a major problem in female police or army recruits. The incidence of stress fractures is reported ranging from 3 to 10 fold when compared to male recruits taking the same training program. This study consisted of an intervention program aiming at reducing combat gear weight and locating the gear as close as possible to the body center of gravity. Material and Methods: In a prospective study we followed up two companies of female recruits of the Israel Border Police. Both companies were followed for the four months of basic training using a basic data questionnaire inclusive of previous physical activity habits, previous acute and overuse injuries, menstrual history and previous smoking habits. An injury questionnaire was filled on commencement of the course and every two weeks thereafter. The clinical records of medic and doctor visits, as well as the personal medical file, were revised. Roentgenological and scintigraphic imaging were performed during the course, when clinical suspicion of a stress fracture arose. The first company of 71 fighters used the standard combat gear amounting to 12.5 kg. The second company of 64 fighters used combat equipment weighing 9.4 kg, held in a combat girdle close to the body center of gravity, inclusive of a shorter personal combat riffle and personal combat vest. Results: There was no difference in the number of clinic visits between the two companies. Complaints suggesting stress fractures were recorded in the first company from the 3 rd to the 8 th week of training and in the second from the 1 st to 3 rd week. The percentage of fighters sent for Scintigraphy because of clinical suspicion of stress fractures was 22.5% in the first company and 6.25% in the second. The percentage of fighters in whom stress fractures were located by Scintigraphy was 15.5% in the first company and 4.7% in the second. The number of stress fractures in average per fighter was 0.45 fractures in the first company and 0.27 fractures in the second. When calculating only “dangerous” stress fractures (long bones and navicular) there were noted 0.34 fractures per fighter in the first company and 0.20 in the second. Total average training days lost for reason of stress fractures was 2.21 per fighter in the first company and 1.08 in the second. Conclusions: Reducing the weight of the fighting gear and securing it closer to the body center of gravity may have a positive effect in reducing the incidence of stress fractures in female recruits of fighting units during the intense basic training program.