Skip to main content
SpringerLink
Log in

The Biomechanical Basis for Increased Risk of Overuse Musculoskeletal Injuries in Female Soldiers

  • Chapter
  • First Online:
The Mechanobiology and Mechanophysiology of Military-Related Injuries

Part of the book series: Studies in Mechanobiology, Tissue Engineering and Biomaterials ((SMTEB,volume 19))

Abstract

An increasing number of women are serving in militaries around the world. Overuse musculoskeletal injuries (OMI) are common with military activities in both sexes but are more common in female soldiers, in part because of differences in whole body and tissue-level biomechanics. Sex-based differences in whole body biomechanics such as stride length, knee valgus, and others may help explain differences in OMI risk. Further, tissue-level sexual dimorphisms in body composition, muscle, and bone, also contribute to the higher risk of OMI in female soldiers. Understanding these biomechanical differences will help militaries tailor preventative measures towards female soldiers at high risk of OMI.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Finestone, A.S., Milgrom, C., Yanovich, R., Evans, R., Constantini, N., Moran, D.S.: Evaluation of the performance of females as light infantry soldiers. Biomed. Res. Int. 2014, 572953 (2014)

    Article  Google Scholar 

  2. Kaufman, K.R., Brodine, S., Shaffer, R.: Military training-related injuries: surveillance, research, and prevention. Am. J. Prev. Med. 18, 54–63 (2000)

    Article  Google Scholar 

  3. Pecina, M., Bojanic, I.: Overuse injuries of the musculoskeletal system. CRC Press, Boca Raton (2003)

    Google Scholar 

  4. Zambraski, E.J., Yancosek, K.E.: Prevention and rehabilitation of musculoskeletal injuries during military operations and training. J. Strength. Cond. Res. 26(Suppl 2), S101–S106 (2012)

    Google Scholar 

  5. Ivkovic, A., Franic, M., Bojanic, I., Pecina, M.: Overuse injuries in female athletes. Croat. Med. J. 48, 767–778 (2007)

    Article  Google Scholar 

  6. Cowan, D., Jones, B., Shaffer, R.: Musculoskeletal injuries in the military training environment. In: Military Preventative Medicine: Mobilization and Deployment, pp. 195–210. Department of the Army, Office of the Surgeon General, Washington DC (2003)

    Google Scholar 

  7. Cloeren, M., Mallon, T.M.: Managing workers’ compensation costs in the military setting: the Army’s story. Clin. Occup. Environ. Med. 4:vii, 323–339 (2004)

    Google Scholar 

  8. Department of the Army: U.S. Technical Bulletin Medical (TB MED) 592, In: Prevention and Control of Musculoskeletal Injuries Associated with Physical Training (2011)

    Google Scholar 

  9. Wilkinson, D.M., Blacker, S.D., Richmond, V.L., et al.: Injuries and injury risk factors among British Army infantry soldiers during predeployment training. Inj. Prev. 17, 381–387 (2011)

    Article  Google Scholar 

  10. Schwartz, O., Libenson, T., Astman, N., Haim, L.: Attrition due to orthopedic reasons during combat training: rates, types of injuries, and comparison between infantry and noninfantry units. Mil. Med. 179, 897–900 (2014)

    Article  Google Scholar 

  11. Bergman, B.P., Miller, S.A.: Equal opportunities, equal risks? Overuse injuries in female military recruits. J. Publ. Health Med. 23, 35–39 (2001)

    Article  Google Scholar 

  12. Jones, B.H., Bovee, M.W., Harris 3rd, J.M., Cowan, D.N.: Intrinsic risk factors for exercise-related injuries among male and female army trainees. Am. J. Sports Med. 21, 705–710 (1993)

    Article  Google Scholar 

  13. Ross, J.: A review of lower limb overuse injuries during basic military training. Part 2: Prevention of overuse injuries. Mil. Med. 158, 415–420 (1993)

    Google Scholar 

  14. Wolfe, J., Turner, K., Caulfield, M., et al.: Gender and trauma as predictors of military attrition: a study of Marine Corps recruits. Mil. Med. 170, 1037–1043 (2005)

    Article  Google Scholar 

  15. DeHaven, K.E., Lintner, D.M.: Athletic injuries: comparison by age, sport, and gender. Am. J. Sports Med. 14, 218–224 (1986)

    Article  Google Scholar 

  16. Luhmann, S.J., Schoenecker, P.L., Dobbs, M.B., Gordon, J.E.: Adolescent patellofemoral pain: implicating the medial patellofemoral ligament as the main pain generator. J. Child Orthop. 2, 269–277 (2008)

    Google Scholar 

  17. Lankhorst, N.E., Bierma-Zeinstra, S.M., van Middelkoop, M.: Factors associated with patellofemoral pain syndrome: a systematic review. Br. J. Sports Med. 47, 193–206 (2013)

    Article  Google Scholar 

  18. Brushoj, C., Larsen, K., Albrecht-Beste, E., Nielsen, M.B., Loye, F., Holmich, P.: Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits. Am. J. Sports Med. 36, 663–670 (2008)

    Article  Google Scholar 

  19. Wills, A.K., Ramasamy, A., Ewins, D.J., Etherington, J.: The incidence and occupational outcome of overuse anterior knee pain during army recruit training. J. R. Army Med. Corps 150, 264–269 (2004)

    Article  Google Scholar 

  20. Coppack, R.J., Etherington, J., Wills, A.K.: The effects of exercise for the prevention of overuse anterior knee pain: a randomized controlled trial. Am. J. Sports Med. 39, 940–948 (2011)

    Article  Google Scholar 

  21. Taunton, J.E., Ryan, M.B., Clement, D.B., McKenzie, D.C., Lloyd-Smith, D.R., Zumbo, B.D.: A retrospective case-control analysis of 2002 running injuries. Br. J. Sports Med. 36, 95–101 (2002)

    Article  Google Scholar 

  22. Boling, M., Padua, D., Marshall, S., Guskiewicz, K., Pyne, S., Beutler, A.: Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand. J. Med. Sci. Sports 20, 725–730 (2010)

    Article  Google Scholar 

  23. Toth, A.P., Cordasco, F.A.: Anterior cruciate ligament injuries in the female athlete. J. Gend. Specif. Med. 4, 25–34 (2001)

    Google Scholar 

  24. Prodromos, C.C., Han, Y., Rogowski, J., Joyce, B., Shi, K.: A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy 23(1320–5), e6 (2007)

    Google Scholar 

  25. Jones, B.H., Thacker, S.B., Gilchrist, J., Kimsey Jr, C.D., Sosin, D.M.: Prevention of lower extremity stress fractures in athletes and soldiers: a systematic review. Epidemiol. Rev. 24, 228–247 (2002)

    Article  Google Scholar 

  26. Neely, F.G.: Intrinsic risk factors for exercise-related lower limb injuries. Sports Med. 26, 253–263 (1998)

    Article  Google Scholar 

  27. Almeida, S.A., Trone, D.W., Leone, D.M., Shaffer, R.A., Patheal, S.L., Long, K.: Gender differences in musculoskeletal injury rates: a function of symptom reporting? Med. Sci. Sports Exerc. 31, 1807–1812 (1999)

    Article  Google Scholar 

  28. Epstein, Y., Yanovich, R., Moran, D.S., Heled, Y.: Physiological employment standards IV: integration of women in combat units physiological and medical considerations. Eur. J. Appl. Physiol. 113, 2673–2690 (2013)

    Article  Google Scholar 

  29. Verbrugge, L.M.: Gender and health: an update on hypotheses and evidence. J. Health Soc. Behav. 26, 156–182 (1985)

    Article  Google Scholar 

  30. Jones, B.: Injuries among men and women in gender-integrated BCT units: Ft Leonard Wood; 1995. Med. Surveill. Mon. Rep. 2(2–3), 7–8 (1996)

    Google Scholar 

  31. Jones, B.H., Harris, J.M., Vinh, T.N., Rubin, C.: Exercise-induced stress fractures and stress reactions of bone: epidemiology, etiology, and classification. Exerc. Sport Sci. Rev. 17, 379–422 (1989)

    Google Scholar 

  32. Kernozek, T.W., Torry, M.R., Van Hoof, H., Cowley, H., Tanner, S.: Gender differences in frontal and sagittal plane biomechanics during drop landings. Med. Sci. Sports Exerc. 37, 1003–1012 (2005). discussion 13

    Google Scholar 

  33. Besier, T.F., Gold, G.E., Delp, S.L., Fredericson, M., Beaupre, G.S.: The influence of femoral internal and external rotation on cartilage stresses within the patellofemoral joint. J. Orthop. Res. 26, 1627–1635 (2008)

    Article  Google Scholar 

  34. Huberti, H.H., Hayes, W.C.: Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J. Bone Joint Surg. Am. 66, 715–724 (1984)

    Google Scholar 

  35. Brattstroem, H.: Shape of the Iintercondylar Groove Normally and in Recurrent Dislocation of Patella. A Clinical and X-Ray-Anatomical Investigation. Acta Orthop. Scand. Suppl. 68(SUPPL 68), 1–148 (1964)

    Article  Google Scholar 

  36. Sheehan, F.T., Derasari, A., Fine, K.M., Brindle, T.J., Alter, K.E.: Q-angle and J-sign: indicative of maltracking subgroups in patellofemoral pain. Clin. Orthop. Relat. Res. 468, 266–275 (2010)

    Article  Google Scholar 

  37. Conley, S., Rosenberg, A., Crowninshield, R.: The female knee: anatomic variations. J. Am. Acad. Orthop. Surg. 15(Suppl 1), S31–S36 (2007)

    Article  Google Scholar 

  38. Aglietti, P., Insall, J.N., Cerulli, G.: Patellar pain and incongruence. I: Measurements of incongruence. Clin. Orthop. Relat. Res. 176, 217–224 (1983)

    Google Scholar 

  39. Kernozek, T.W., Greer, N.L.: Quadriceps angle and rearfoot motion: relationships in walking. Arch. Phys. Med. Rehabil. 74, 407–410 (1993)

    Google Scholar 

  40. Guerra, J.P., Arnold, M.J., Gajdosik, R.L.: Q angle: effects of isometric quadriceps contraction and body position. J. Orthop. Sports Phys. Ther. 19, 200–204 (1994)

    Article  Google Scholar 

  41. Nguyen, A.D., Shultz, S.J.: Sex differences in clinical measures of lower extremity alignment. J. Orthop. Sports Phys. Ther. 37, 389–398 (2007)

    Article  Google Scholar 

  42. Silvers, H.J., Mandelbaum, B.R.: Prevention of anterior cruciate ligament injury in the female athlete. Br. J. Sports Med. 41(Suppl 1), i52–i59 (2007)

    Article  Google Scholar 

  43. Dejour, H., Walch, G., Nove-Josserand, L., Guier, C.: Factors of patellar instability: an anatomic radiographic study. Knee Surg. Sports Traumatol. Arthrosc. 2, 19–26 (1994)

    Article  Google Scholar 

  44. Fisher, B., Nyland, J., Brand, E., Curtin, B.: Medial patellofemoral ligament reconstruction for recurrent patellar dislocation: a systematic review including rehabilitation and return-to-sports efficacy. Arthroscopy 26, 1384–1394 (2010)

    Article  Google Scholar 

  45. Decker, M.J., Torry, M.R., Wyland, D.J., Sterett, W.I.: Richard Steadman J. Gender differences in lower extremity kinematics, kinetics and energy absorption during landing. Clin. Biomech. 18, 662–669 (2003)

    Article  Google Scholar 

  46. Pollard, C.D., Sigward, S.M., Ota, S., Langford, K., Powers, C.M.: The influence of in-season injury prevention training on lower-extremity kinematics during landing in female soccer players. Clin. J. Sport Med. 16, 223–227 (2006)

    Article  Google Scholar 

  47. Sigward, S.M., Powers, C.M.: The influence of gender on knee kinematics, kinetics and muscle activation patterns during side-step cutting. Clin. Biomech. 21, 41–48 (2006)

    Article  Google Scholar 

  48. Malinzak, R.A., Colby, S.M., Kirkendall, D.T., Yu, B., Garrett, W.E.: A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin. Biomech. 16, 438–445 (2001)

    Article  Google Scholar 

  49. Lephart, S.M., Ferris, C.M., Riemann, B.L., Myers, J.B., Fu, F.H.: Gender differences in strength and lower extremity kinematics during landing. Clin. Orthop. Relat. Res. 401, 162–169 (2002)

    Google Scholar 

  50. Simpson, K., Redmond, J.E., Cohen, B.S., et al.: Quantification of physical activity performed during US Army Basic Combat Training. US Army Med. Dep. J. 4, 55–65 (2013)

    Google Scholar 

  51. Martin, P.E., Nelson, R.C.: The effect of carried loads on the walking patterns of men and women. Ergonomics 29, 1191–1202 (1986)

    Article  Google Scholar 

  52. Hill, P.F., Chatterji, S., Chambers, D., Keeling, J.D.: Stress fracture of the pubic ramus in female recruits. J. Bone Joint Surg. Br. 78, 383–386 (1996)

    Google Scholar 

  53. Pope, R.P.: Prevention of pelvic stress fractures in female army recruits. Mil. Med. 164, 370–373 (1999)

    Google Scholar 

  54. Bruening, D.A., Frimenko, R.E., Goodyear, C.D., Bowden, D.R., Fullenkamp, A.M.: Sex differences in whole body gait kinematics at preferred speeds. Gait Posture 41(2), 540–545 (2014)

    Google Scholar 

  55. Silder, A., Delp, S.L., Besier, T.: Men and women adopt similar walking mechanics and muscle activation patterns during load carriage. J. Biomech. 46, 2522–2528 (2013)

    Article  Google Scholar 

  56. Ferber, R., Davis, I.M., Williams 3rd, D.S.: Gender differences in lower extremity mechanics during running. Clin. Biomech. 18, 350–357 (2003)

    Article  Google Scholar 

  57. Hewett, T.E., Myer, G.D., Ford, K.R.: Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors. Am. J. Sports Med. 34, 299–311 (2006)

    Article  Google Scholar 

  58. McLean, S.G., Fellin, R.E., Suedekum, N., Calabrese, G., Passerallo, A., Joy, S.: Impact of fatigue on gender-based high-risk landing strategies. Med. Sci. Sports Exerc. 39, 502–514 (2007)

    Article  Google Scholar 

  59. Orishimo, K.F., Liederbach, M., Kremenic, I.J., Hagins, M., Pappas, E.: Comparison of landing biomechanics between male and female dancers and athletes, part 1: Influence of sex on risk of anterior cruciate ligament injury. Am. J. Sports Med. 42, 1082–1088 (2014)

    Article  Google Scholar 

  60. Ford, K.R., Shapiro, R., Myer, G.D., Van Den Bogert, A.J., Hewett, T.E.: Longitudinal sex differences during landing in knee abduction in young athletes. Med. Sci. Sports Exerc. 42, 1923–1931 (2010)

    Article  Google Scholar 

  61. Rogol, A.D., Roemmich, J.N., Clark, P.A.: Growth at puberty. J. Adolesc. Health 31, 192–200 (2002)

    Article  Google Scholar 

  62. Baxter-Jones, A.D., Faulkner, R.A., Forwood, M.R., Mirwald, R.L., Bailey, D.A.: Bone mineral accrual from 8 to 30 years of age: an estimation of peak bone mass. J. Bone Miner. Res. 26, 1729–1739 (2011)

    Article  Google Scholar 

  63. Forwood, M.R., Bailey, D.A., Beck, T.J., Mirwald, R.L., Baxter-Jones, A.D., Uusi-Rasi, K.: Sexual dimorphism of the femoral neck during the adolescent growth spurt: a structural analysis. Bone 35, 973–981 (2004)

    Article  Google Scholar 

  64. Malina, R.M., Bouchard, C. (eds.): Growth, Maturation, and Physical Activity. Human Kinetics, Champaign (1991)

    Google Scholar 

  65. Wells, C., Plowman, S.: Sexual differences in athletic performance: biological or behavioral? Physician Sports Med. 11, 52–63 (1983)

    Google Scholar 

  66. Jackson, A.S., Stanforth, P.R., Gagnon, J., et al.: The effect of sex, age and race on estimating percentage body fat from body mass index: The Heritage Family Study. Int. J. Obes. Relat. Metab. Disord. 26, 789–796 (2002)

    Article  Google Scholar 

  67. Gallagher, D., Visser, M., Sepulveda, D., Pierson, R.N., Harris, T., Heymsfield, S.B.: How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am. J. Epidemiol. 143, 228–239 (1996)

    Article  Google Scholar 

  68. White, U.A., Tchoukalova, Y.D.: Sex dimorphism and depot differences in adipose tissue function. Biochim. Biophys. Acta 1842, 377–392 (2014)

    Article  Google Scholar 

  69. Ricciardi, R., Deuster, P.A., Talbot, L.A.: Effects of gender and body adiposity on physiological responses to physical work while wearing body armor. Mil. Med. 172, 743–748 (2007)

    Article  Google Scholar 

  70. Patton, J.F., Daniels, W.L., Vogel, J.A.: Aerobic power and body fat of men and women during army basic training. Aviat. Space Environ. Med. 51, 492–496 (1980)

    Google Scholar 

  71. Miller, A.E., MacDougall, J.D., Tarnopolsky, M.A., Sale, D.G.: Gender differences in strength and muscle fiber characteristics. Eur. J. Appl. Physiol. Occup. Physiol. 66, 254–262 (1993)

    Article  Google Scholar 

  72. Vanderburgh, P.M., Kusano, M., Sharp, M., Nindl, B.: Gender differences in muscular strength: an allometric model approach. Biomed. Sci. Instrum. 33, 100–105 (1997)

    Google Scholar 

  73. Knapik, J.J., Sharp, M.A., Canham-Chervak, M., Hauret, K., Patton, J.F., Jones, B.H.: Risk factors for training-related injuries among men and women in basic combat training. Med. Sci. Sports Exerc. 33, 946–954 (2001)

    Article  Google Scholar 

  74. Yanovich, R., Evans, R., Israeli, E., et al.: Differences in physical fitness of male and female recruits in gender-integrated army basic training. Med. Sci. Sports Exerc. 40, S654–S659 (2008)

    Article  Google Scholar 

  75. Beckett, M.B., Hodgdon, J.A.: Lifting and carrying capacities relative to physical fitness measures. Report No. 87-26. Naval Health Medical Research and Development Command. Department of the Navy, Bethesda, Maryland

    Google Scholar 

  76. Janssen, I., Heymsfield, S.B., Wang, Z.M., Ross, R.: Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr. J. Appl. Physiol. 2000(89), 81–88 (1985)

    Google Scholar 

  77. Margolis, L.M., Pasiakos, S.M., Karl, J.P., et al.: Differential effects of military training on fat-free mass and plasma amino acid adaptations in men and women. Nutrients 4, 2035–2046 (2012)

    Article  Google Scholar 

  78. Knapik, J.J., Wright, J.E., Kowal, D.M., Vogel, J.A.: The influence of U.S. Army Basic Initial Entry Training on the muscular strength of men and women. Aviat. Space Environ. Med. 51, 1086–1090 (1980)

    Google Scholar 

  79. Cummings, S.R., Melton, L.J.: Epidemiology and outcomes of osteoporotic fractures. Lancet 359, 1761–1767 (2002)

    Article  Google Scholar 

  80. Whiting, S.J., Vatanparast, H., Baxter-Jones, A., Faulkner, R.A., Mirwald, R., Bailey, D.A.: Factors that affect bone mineral accrual in the adolescent growth spurt. J. Nutr. 134, 696S–700S (2004)

    Google Scholar 

  81. Jackowski, S.A., Lanovaz, J.L., Van Oort, C., Baxter-Jones, A.D.: Does lean tissue mass accrual during adolescence influence bone structural strength at the proximal femur in young adulthood? Osteoporos. Int. 25, 1297–1304 (2014)

    Article  Google Scholar 

  82. Evans, R.K., Negus, C., Antczak, A.J., Yanovich, R., Israeli, E., Moran, D.S.: Sex differences in parameters of bone strength in new recruits: beyond bone density. Med. Sci. Sports Exerc. 40, S645–S653 (2008)

    Article  Google Scholar 

  83. Beck, T.J., Ruff, C.B., Shaffer, R.A., Betsinger, K., Trone, D.W., Brodine, S.K.: Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors. Bone 27, 437–444 (2000)

    Article  Google Scholar 

  84. Arendt, E., Dick, R.: Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am. J. Sports Med. 23, 694–701 (1995)

    Article  Google Scholar 

  85. Owens, B.D., Mountcastle, S.B., Dunn, W.R., DeBerardino, T.M., Taylor, D.C.: Incidence of anterior cruciate ligament injury among active duty U.S. military servicemen and servicewomen. Mil. Med. 172, 90–91 (2007)

    Article  Google Scholar 

  86. Renstrom, P., Ljungqvist, A., Arendt, E., et al.: Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br. J. Sports Med. 42, 394–412 (2008)

    Article  Google Scholar 

  87. Sutton, K.M., Bullock, J.M.: Anterior cruciate ligament rupture: differences between males and females. J. Am. Acad. Orthop. Surg. 21, 41–50 (2013)

    Article  Google Scholar 

  88. Giugliano, D.N., Solomon, J.L.: ACL tears in female athletes. Phys. Med. Rehabil. Clin. N. Am. 18, 417–438, viii (2007)

    Google Scholar 

  89. Lipps, D.B., Oh, Y.K., Ashton-Miller, J.A., Wojtys, E.M.: Morphologic characteristics help explain the gender difference in peak anterior cruciate ligament strain during a simulated pivot landing. Am. J. Sports Med. 40, 32–40 (2012)

    Article  Google Scholar 

  90. Chandrashekar, N., Mansouri, H., Slauterbeck, J., Hashemi, J.: Sex-based differences in the tensile properties of the human anterior cruciate ligament. J. Biomech. 39, 2943–2950 (2006)

    Article  Google Scholar 

  91. Kjaer, M., Langberg, H., Heinemeier, K., et al.: From mechanical loading to collagen synthesis, structural changes and function in human tendon. Scand. J. Med. Sci. Sports 19, 500–510 (2009)

    Article  Google Scholar 

  92. Kubo, K., Kanehisa, H., Fukunaga, T.: Gender differences in the viscoelastic properties of tendon structures. Eur. J. Appl. Physiol. 88, 520–526 (2003)

    Article  Google Scholar 

  93. Miller, B.F., Hansen, M., Olesen, J.L., et al.: Tendon collagen synthesis at rest and after exercise in women. J. Appl. Physiol. 2007(102), 541–546 (1985)

    Google Scholar 

  94. Sharp, M.A.: Physical fitness and occupational performance of women in the U.S. Army. Work 4, 80–92 (1994)

    MathSciNet  Google Scholar 

  95. Laubach, L.L.: Comparative muscular strength of men and women: a review of the literature. Aviat. Space Environ. Med. 47, 534–542 (1976)

    Google Scholar 

  96. Cowan, D.N., Bedno, S.A., Urban, N., Lee, D.S., Niebuhr, D.W.: Step test performance and risk of stress fractures among female army trainees. Am. J. Prev. Med. 42, 620–624 (2012)

    Article  Google Scholar 

  97. Jones, B.H., Shaffer, R.A., Snedecor, M.R.: Injuries treated in outpatient clinics: surverys and research data. Mil. Med. 164, 1–89 (1999)

    Google Scholar 

  98. Warden, S.J., Hurst, J.A., Sanders, M.S., Turner, C.H., Burr, D.B., Li, J.: Bone adaptation to a mechanical loading program significantly increases skeletal fatigue resistance. J. Bone Miner. Res. 20, 809–816 (2005)

    Article  Google Scholar 

  99. Hubal, M.J., Gordish-Dressman, H., Thompson, P.D., et al.: Variability in muscle size and strength gain after unilateral resistance training. Med. Sci. Sports Exerc. 37, 964–972 (2005)

    Article  Google Scholar 

  100. Knapik, J.J., Darakjy, S., Hauret, K.G., et al.: Increasing the physical fitness of low-fit recruits before basic combat training: an evaluation of fitness, injuries, and training outcomes. Mil. Med. 171, 45–54 (2006)

    Article  Google Scholar 

  101. Lee, L., Kumar, S., Kok, W.L., Lim, C.L.: Effects of a pre-training conditioning programme on basic military training attrition rates. Ann. Acad. Med. Singap. 26, 3–7 (1997)

    Google Scholar 

  102. Lunt, H.: A pre-joining fitness test improves pass rates of Royal Navy recruits. Occup. Med. (Lond.) 57, 377–379 (2007)

    Article  Google Scholar 

  103. Geary, K.G., Irvine, D., Croft, A.M.: Does military service damage females? An analysis of medical discharge data in the British armed forces. Occup. Med. (Lond.) 52, 85–90 (2002)

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Dr. Rebecca Fellin for her helpful comments on this chapter and Katelyn Guerriere for her aid in recreating the figures in this chapter. This work is supported in part by an appointment to the Postgraduate Research Participation Program funded by USARIEM & administered by Oak Ridge Institute for Science and Engineering (JMH).

Disclaimer

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the U.S. Army or the Department of Defense.

Author information

Authors and Affiliations

  1. Institute of Military Physiology, The Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel

    Ran Yanovich & Yuval Heled

  2. Military Performance Division, United States Army Research Institute of Environmental Medicine, 15 Kansas Street, BLDG 42, Natick, MA, 01760, USA

    Julie Hughes

Authors
  1. Ran Yanovich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuval Heled
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julie Hughes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julie Hughes .

Editor information

Editors and Affiliations

  1. Tel Aviv University, Tel Aviv-Yafo, Israel

    Amit Gefen

  2. Tel Aviv University, Tel Aviv-Yafo, Israel

    Yoram Epstein

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Yanovich, R., Heled, Y., Hughes, J. (2015). The Biomechanical Basis for Increased Risk of Overuse Musculoskeletal Injuries in Female Soldiers. In: Gefen, A., Epstein, Y. (eds) The Mechanobiology and Mechanophysiology of Military-Related Injuries. Studies in Mechanobiology, Tissue Engineering and Biomaterials, vol 19. Springer, Cham. https://doi.org/10.1007/8415_2015_188

Download citation

  • DOI: https://doi.org/10.1007/8415_2015_188

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33010-5

  • Online ISBN: 978-3-319-33012-9

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics

Search

Navigation