Sports Medicine and Injury Prevention

Marines pride themselves on being the toughest of all military branches. According to a “Times Magazine” article that came out earlier this month, the United States Marine Corps basic training is the most “bone crushing” basic training in all the United States Armed Forces.

Data contained in military reports from 2004 to 2010 show Marine Corps Recruit Depot San Diego has broken 688 recruits’ tibias and fibulas, in the past six years. That makes more lower leg breaks than any other U.S. military training facility. Marine Corps Recruit Depot Parris Island follows closely behind with 613 recruits.

The article in the “Times Magazine” also shows the Marine Corps current status, which is on a decline when it comes to stress fractures. The intent of the Marine Corps basic training isn’t to break recruits, but to prepare them for the rigorous physical fitness requirements they will encounter in the fleet and combat.

“We are pin pointing what we can really do to maintain the physical readiness and physical fitness of the recruits while minimizing the number of stress fractures and other injuries,” said Melissa K. Mahoney, Sports Medicine and Injury Prevention Program manager, Marine Corps Recruit Depot San Diego.

She explains the high numbers in 2004 could have been partially related to the development of the Sports Medicine and Injury Prevention Program in 2003. This program started helping identify the mass of injuries were tibias and fibulas breaks.

After the war began a demand for more people to enlist led to the Marine Corps letting in less physically ready people in hopes they could quickly adapt to the physical aspects of being a Marine.
The war also led to an increase in the number of patrons wanting to enlist and fight for their country. The lack of physical readiness these patrons had resulted in a large amount of injuries when they were put under the strenuous activities of basic training.

The initial standard test scores, a physical test poolees conduct to enlist, have increased a significant amount since 2004. This shows recruits are more physically ready for such vigorous physical activity then those were six years ago.

“The run portion of the initial standard test is a great predictor for stress fractures,” said Mahoney. “Studies done over the past twenty-five years show recruits that run slower on the initial standard test typically aren’t as physically prepared for the training that they are going to receive and are going to break a lot quicker”
Since the Corps has the longest basic training, recruits have more time and opportunities to get injured.

According to the “Times Magazine,” in 2009 the Air Force ramped up its physical aspects and the length of their training causing them to an all time high since 2004.

Mahoney explains the average amount of running for the recruits during the 12-week span is 37 miles. Running can weaken the lower leg bones causing them to be more prone to fractures.

“When running, each time your foot strikes the ground there’s a force that generates up to the bone. It’s going to cause breakdown in the bone,” said Mahoney. “Like lifting weights, the muscles tear and it gets bigger and/ or stronger, depending on what it is your doing. Same thing is true with the bones, however if you increase the amount of activity your doing to quickly, then the amount of the force going up toward the bone is more than the remodeling can keep up with so we get weakened bones that develop the stress fractures.”

Knowing running is a large cause of lower leg fractures, recruit training has since been geared more toward completing the mission by still being the toughest and still being smarter about it.

One example on how the Corps and the SMIP program has worked on preventing injuries is by moving the crucible to week eleven. This keeps the recruits from performing any strenuous activities from field week, week 8, until the crucible.

“Having those three weeks without a pack on seems to have given the recruits bodies rest to repair any breakdown that has been accruing, and they’re not breaking as frequently,” said Mahoney.
Trainers are present at every physical training event during basic and Marine Combat Training. This helps micromanage the recruit’s physical fitness well-being. The SMIP program also began to educate the drill instructors on what signs to look for regarding injuries.

According to SMIP’s statistics, Company E, graduated June 17, 1.3 percent of their original recruits were dropped for a fracture or stress fracture.

“The statistics are really good because during the winter we usually see more [breaks] because it’s not the high school graduates that have been more physically active,” said Mahoney.

While the article in the “Times Magazine” may point out the Marine Corps has higher physical standards than other services. It failed to mention that the Marine Corps has been working toward minimal injuries as possible by utilizing the SMIP program. It is improving its training by keeping tough physical standards, but increasing the recovery time between intense physical training.