Physical and psychological stressors linked with stress fractures in recruit training

D. S. Moran*, R. Evans, Y. Arbel, O. Luria, A. Hadid, R. Yanovich, C. Milgrom, A. S. Finestone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


This study aimed to measure ambulation in infantry army basic training, and to evaluate if covering more distance can explain stress fractures in a stressor-stress model. Forty-four male combat recruits (18.7±0.7 years) participated in a 6-month rigorous high intensity combat training program. Baseline data included anthropometric measurements, VO2max, and psychological questionnaires. Actual distance covered was measured using a pedometer over an 11-week training period. Psychological questionnaires were repeated after 2 months. Sixteen recruits were diagnosed with stress fractures by imaging (SFi=36.4%). Statistical analysis included comparing measured variables between SFi and those without stress fractures (NSF). The recruits covered 796±157km, twofold the distance planned of 378km (P<0.001). The SFi group covered a distance 16.4% greater than that of the NSF group (866±136 and 744±161km, respectively, P<0.01), and also demonstrated greater psychological stress. These data reveal the importance of adherence to or enforcement of military training programs. In the light of these data, the Israeli Defense Forces program needs reappraisal. A stressor-stress response might explain the susceptibility of certain recruits for injury. Using advanced technology, monitoring ambulation may prevent stress fracture development by limiting subjects exceeding a certain level. Psychological profile may also play a role in predicting stress fracture development.

Original languageEnglish
Pages (from-to)443-450
Number of pages8
JournalScandinavian Journal of Medicine and Science in Sports
Issue number4
StatePublished - Aug 2013
Externally publishedYes


  • Bone
  • Military basic training
  • Psychological stress
  • Risk factors


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