Montgomery L C, Nelson F R, Norton J P, Deuster P A
Department of Military Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799.
Med Sci Sports Exerc. 1989 Jun;21(3):237-43.
Overuse injuries, and stress fractures in particular, afflict many runners and military recruits. This investigation sought to identify pretraining factors which may predispose to overuse injuries. Orthopedic and running history questionnaires and an orthopedic examination were administered to 505 trainees entering an intensive military training school. A novel method for evaluating ankle dorsiflexion was developed, and alignment measures, in units of centimeters rather than degrees, were obtained. Over 10% of the trainees were removed from the school for overuse-related injuries, and over half of these were tibial stress fractures. The incidence of clinically diagnosed stress fractures was 6.3%. No single orthopedic history question or combination of questions could discriminate between trainees who did or did not subsequently incur overuse injuries. Results from the running history indicated that those running 25 or more miles.wk-1 (mpw) had a significantly (P less than 0.027) lower incidence of stress fractures (3.0%) than those running 4 or fewer mpw over the previous year (11.5%). The orthopedic examination did not identify any predisposing alignment characteristics, perhaps due to the low incidence of overuse injuries. Population means are presented for future use in comparative studies.
过度使用损伤，尤其是应力性骨折，困扰着许多跑步者和新兵。本研究旨在确定可能易患过度使用损伤的训练前因素。对进入一所强化军事训练学校的505名学员进行了骨科和跑步史问卷调查以及骨科检查。开发了一种评估踝关节背屈的新方法，并以厘米为单位而非度数获得了对线测量值。超过10%的学员因过度使用相关损伤而被学校除名，其中一半以上是胫骨应力性骨折。临床诊断的应力性骨折发生率为6.3%。没有任何一个骨科病史问题或问题组合能够区分随后是否发生过度使用损伤的学员。跑步史结果表明，那些每周跑步25英里或更多（mpw）的学员应力性骨折发生率（3.0%）显著低于（P<0.027）前一年每周跑步4英里或更少（mpw）的学员（11.5%）。骨科检查未发现任何易患的对线特征，这可能是由于过度使用损伤的发生率较低。给出了总体均值以供未来在比较研究中使用。
