Military-issue footwear causing musculoskeletal injuries

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MilitaryBootsDrilling in the wrong footwear is causing musculoskeletal (MSK) injuries, resulting in troops being invalided out, according to a small UK study.

Marching around a parade yard with boots shiny enough to see your face in – as a sergeant major barks in your ear – is a classic scene from military life. But the Daily Mail reports that a study warns that ‘square-bashing’ could be a thing of the past as it is damaging soldiers’ health.

Experts claim soldiers should be wearing trainers instead of combat boots.

The report says the UK’s Ministry of Defence is carrying out its own inquiry into the issue, the principal cause of medical discharge in the Army for the past five years.

Up to two thousand soldiers leave annually because they are no longer fighting fit, many badly injured in Iraq and Afghanistan. It has been found that almost half of British Army recruits suffer MSK injuries during the 26-week initial training programme. Now a study led by Dr Alex Rawcliffe of Napier University, Edinburgh, has warned standard-issue combat and ammo boots are responsible. He said: ‘The stiffer landing patterns/strategies of foot-drill may predispose recruits to bone strains within the single-load failure threshold, typically resulting in bone micro-damage and subsequent stress fracture.’

Rawcliffe’s report said the “unique landing techniques of foot-drill combined with the lack of shock-absorbing capabilities of standard-issue footwear,” were to blame. Currently troops are issued Hi-Tec Silver Shadow training shoes, which are a better fit for drilling in, along with combat and ammo boots. The study recommends that “recruits wear a form of shock-absorbing footwear similar to that of the training shoe, to reduce the cyclic high-impact loading forces of foot-drill, that may contribute to an increased risk of lower-limb MSK injury”.

The report says women are particularly at risk – with a US study showing that the discharge rates for musculoskeletal conditions have been as high as 140 per 10,000 Army women per year, compared with 81 per 10,000 Army men per year.

A report following an independent UK MoD inquiry into MSK injuries is due in 2019. A spokesperson for the MoD, which was not involved in the trials, said: “The health and wellbeing of our personnel is of paramount importance, and we equip and train them to the high standard required for a successful Army career.”

Abstract
High rates of occupational training-related lower-limb musculoskeletal [MSK] overuse injuries are reported for British Army recruits during basic training. Foot-drill is a repetitive impact loading occupational activity and involves striking the ground violently with an extended-knee [straight-leg] landing. Foot-drill produces vertical ground reaction forces [vGRF] equal to and/or greater than those reported for high-level plyometric exercises/activities. Shock absorbing footwear aid in the attenuation of the magnitude of vGRF, resulting in a reduced risk of lower-limb MSK overuse injury when running. The potential shock absorbing characteristics of standard issue British Army footwear on the magnitude of vGRF and temporal parameters of foot-drill are scant. Therefore, this study sought to determine the magnitude of, and examine changes in vGRF and temporal parameters of foot-drill across three types of British Army footwear. Sampled at 1000hz, the mean of eight-trials from fifteen recreationally active males were collected from four foot-drills; stand-at-ease [SaE], stand-at-attention [SaA], quick-march [QM] and halt. Analysis of a normal walk was included to act as a comparison with quick-march

Authors
Alex J Rawcliffe, Scott M Graham, Richard J Simpson, Gavin L Moir , Russell JJ Martindale, Stelios G Psycharakis, Chris Connaboy

Daily Mail report
Journal of Strength and Conditioning Research abstract


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