HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Milgrom, C. Articles by Finestone, A. Search for Related Content PubMed PubMed Citation Articles by Milgrom, C. Articles by Finestone, A. Related Collections Fracture

Using Bone’s Adaptation Ability to Lower the Incidence of Stress Fractures

Charles Milgrom, MD^*,, Ariel Simkin, MD^*, Arieh Eldad, BG, MC, IDF, Meir Nyska, MD^* and Aharon Finestone, MAJ, MC, IDF

^* Department of Orthopedics, Hadassah University Hospital, Hebrew University Medical School, Ein Kerem, Jerusalem
Israeli Defence Forces, Medical Corps, Israel Military, Tel Aviv, Israel

Address correspondence and reprint requests to Charles Milgrom, MD, Department of Orthopaedics, Hadassah University Hospital, Ein Kerem. POB 12000 Jerusalem, Israel

In three prospective epidemiologic studies of the effect of pre-military-induction sport activities on the incidence of lower extremity stress fractures during infantry basic training, recruits who played ball sports (principally basketball) regularly for at least 2 years before basic training had a significantly lower incidence of stress fractures (13.2%, 16.7%, and 3.6% in the three studies, respectively) than recruits who did not play ball sports (28.9%, 27%, and 18.8%, respectively). Preinduction running was not related to the incidence of stress fracture. To assess the tibial strain environment during these sport activities, we made in vivo strain measurements on three male volunteers from the research team. Peak tibial compression and tension strain and strain rates during basketball reached levels 2 to 5.5 times higher than during walking and about 10% to 50% higher than during running. The high bone strain and strain rates that occurred in recruits while playing basketball in the years before military induction may have increased their bone stiffness, according to Wolff’s Law. The stiffer bone could tolerate higher stresses better, resulting in lower strains for a given activity and a lower incidence of stress fractures during basic training.

This article has been cited by other articles:

				M. Franklyn, B. Oakes, B. Field, P. Wells, and D. Morgan Section Modulus Is the Optimum Geometric Predictor for Stress Fractures and Medial Tibial Stress Syndrome in Both Male and Female Athletes Am. J. Sports Med., June 1, 2008; 36(6): 1179 - 1189. [Abstract] [Full Text] [PDF]

				M. Fredericson, K. Chew, J. Ngo, T. Cleek, J. Kiratli, and K. Cobb Regional bone mineral density in male athletes: a comparison of soccer players, runners and controls Br. J. Sports Med., October 1, 2007; 41(10): 664 - 668. [Abstract] [Full Text] [PDF]

				S. J Warden, M. W Creaby, A. L Bryant, and K. M Crossley Stress fracture risk factors in female football players and their clinical implications Br. J. Sports Med., August 1, 2007; 41(suppl_1): i38 - i43. [Abstract] [Full Text] [PDF]

				K. E. Varner, S. A. Younas, D. M. Lintner, and J. V. Marymont Chronic Anterior Midtibial Stress Fractures in Athletes Treated With Reamed Intramedullary Nailing Am. J. Sports Med., July 1, 2005; 33(7): 1071 - 1076. [Abstract] [Full Text] [PDF]