A prospective study of the effect of a shock absorbing orthotic device on the incidence of stress fractures in military recruits
ABSTRACT In a prospective study of stress fractures the hypothesis that a shock-absorbing orthotic device worn within military boots could lessen the incidence of stress fractures was tested. The incidence of metatarsal, tibial, and femoral stress fractures was lower in the orthotic group, but only the latter difference was statistically significant. The time of onset and the location of stress fractures between orthotic and nonorthotic users did not differ. These findings suggest that the incidence of femoral stress fractures, which are the most dangerous type of stress fracture because of their high risk of developing into displaced fractures, can be reduced by an orthotic device.
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- "These lesions are thought to be generated by large Ground Reaction Forces (GRF) during the Heel Strike (HS) phase of locomotion . Shock absorption techniques have failed to decrease stress fracture incidence in the calcaneus indicating other sources may be responsible for critical loads experienced by the calcaneus  . "
Conference Paper: Calcaneus Stress Fractures: a Finite Element Analysis[Show abstract] [Hide abstract]
ABSTRACT: Shock absorption strategies targeted at reducing ground reaction forces during impact have been unsuccessful in decreasing stress fracture development in the calcaneus. We hypothesize that the critical loads on the calcaneus are instead due to muscles forces. We performed a finite element analysis to estimate the time-evolution of stresses in the calcaneus during single support phase of a self-paced walk. Local stresses were found to be higher than the yield stress and located at the interface between the calcaneus and the Achilles' tendon. This supports the hypothesis that stress fractures are likely to be the effect of muscles forces rather than the impact of the foot to the ground.41st Annual Northeast Bioengineering Conference (NEBEC), Troy, NY; 04/2015
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- "These studies tend to support the use of cushioning in the prevention of injuries to the foot, with a variable effect on tibial injuries. For instance, a randomized prospective study by Milgrom and colleagues  of 390 military recruits showed a lower incidence of metatarsal stress fractures during military training with modified basketball shoes compared with standard-issue boots. The study did not show the same reduction in tibial stress fractures. "
ABSTRACT: This article is an introduction to the fundamentals of stress fracture management. Extrinsic and intrinsic factors, that may play a role in the development of stress fractures, are discussed and incorporated as possible treatment options. Different treatment modalities including ultrasound and electromagnetic fields are addressed, with an emphasis on literature support.Clinics in sports medicine 02/2006; 25(1):29-36, vii. DOI:10.1016/j.csm.2005.08.013 · 2.58 Impact Factor
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- "Traditionally, it is thought that inadequate cushioning in footwear leads to increased stress throughout an athlete's lower extremities, and thus an increased risk of stress injuries     ; however, more recently, some biomechanists have theorized that increased cushioning may actually interfere with a runner's neuromuscular feedback and increase impact forces   . Shoe manufacturers have published studies that have shown a decrease in injuries with better cushioned shoes in aerobic dancers , and several studies of military recruits have shown a protective effect of increased cushioning in shoe wear     ; however, whether or not this applies to the athletic population is unknown. It has been shown that athletic shoes lose a significant amount of cushioning ability over time and with use . "
ABSTRACT: The foot and ankle are critical components in our ability to ambulate. Injuries to either can significantly interfere with a patient's ability to carry out normal activities. In severe cases, they can be devastating to a patient's independence. Careful examination of the foot and ankle using established mechanical tests, along with understanding of the anatomy of the complex,is needed to confirm the history and to assist in the diagnosis and treatment of foot and ankle injuries. The following points are key to clinical examination of the foot and ankle: . The examination of the foot and ankle needs to be done with the patient in both weight-bearing and non-weight bearing positions. . The examination of the foot and ankle should include an evaluation of the patient's gait. . Reproduction of a patient's symptoms is the key to making a correct diagnosis. . Although anatomic variants may predispose some individuals to injury,in general, if asymptomatic, no treatment should be done.Primary Care Clinics in Office Practice 04/2005; 32(1):105-32. DOI:10.1016/j.pop.2004.11.002 · 0.83 Impact Factor