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Distance travelled by military recruits during basic training is a significant risk factor for lower limb overuse injury
  1. Richard S. Whittle1,2
  1. 1Department of Aerospace Engineering, Texas A&M University, College Station, Texas, USA
  2. 2British Army, London, UK
  1. Correspondence to Richard S. Whittle, Department of Aerospace Engineering, Texas A&M University, College Station, TX 77843, USA; rswhittle{at}


Introduction Military initial training results in a high incidence of lower limb overuse injuries (stress fractures and medial tibial stress syndrome). This study aimed to determine whether the distance travelled by recruits, both on and off duty, was a risk factor for overuse injury.

Methods 14 male airborne infantry recruits from three training platoons carried global positioning system receivers throughout the first 19 weeks of basic military training. Total distance travelled each day was recorded. This was compared with time of clinical manifestation of 52 lower limb overuse injuries (stress fractures and medial tibial stress syndrome) collected from the 276 airborne infantry recruits in the period immediately preceding the study.

Results Recruits travelled significantly farther than the UK average male population in 17 of 18 measured weeks. Pearson correlation between distance travelled per week and injuries was not significant (p=0.4448); however, correlation between distance travelled per week and injuries two weeks later was significant (p=0.0263). A generalised linear model found distance travelled as a significant covariate (p=0.0144) to the expected number of injuries two weeks later.

Conclusion Recruits travel long distances during basic training, particularly in the first few weeks when they are not yet conditioned. This distance travelled is likely a contributing risk factor to the high incidence of overuse injuries seen during training, and strategies to reduce this distance should be explored.

  • musculoskeletal disorders
  • sports medicine
  • preventive medicine

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  • Contributors RSW was the sole author of this work. RSW conceived and designed the research, collected the data, analysed the data and interpreted the results, prepared the figures, drafted the manuscript, and edited and revised the manuscript. RSW approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The opinions expressed in this document are solely those of the authors and do not represent an endorsement by or the views of The Parachute Regiment, School of Infantry, British Army, Ministry of Defence or the British Government.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was conducted in accordance with the Declaration of Helsinki for Medical Research Involving Human Subjects (revision October 2013) and was ethically reviewed and approved by the Defence Medical Services at ITC and the Lower Limbs Injury Group at the Defence Medical Rehabilitation Centre, Headley Court. Personal data used were treated in accordance with the UK Data Protection Act 1998. The research was considered exempt from full Ministry of Defence Research Ethics Committee (MODREC) approval since personnel were carrying out routine operational training techniques and standard operating procedures with no elevated risk or stress to participants.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. The file containing these data is saved securely and can only be released with the permission of the School of Infantry and the Ministry of Defence.