Article

A prospective study of the effect of a shock absorbing orthotic device on the incidence of stress fractures in military recruits

Foot & ankle 11/1985; 6(2):101-4. DOI: 10.1177/107110078500600209
Source: PubMed

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 [2]. 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 [1] [3]. "
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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 [21] 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. "
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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 [7] [11] [16] [18] [19]; however, more recently, some biomechanists have theorized that increased cushioning may actually interfere with a runner's neuromuscular feedback and increase impact forces [20] [21] [22]. Shoe manufacturers have published studies that have shown a decrease in injuries with better cushioned shoes in aerobic dancers [11], and several studies of military recruits have shown a protective effect of increased cushioning in shoe wear [23] [24] [25] [26] [27]; 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 [18]. "
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