Izard, R. M., Greeves, J. P., & Nightingale, T. E. (2009). The efficacy of single-sex platoon training in reducing tibial injuries during British Army training. ACSM 56th Annual Meeting, Seattle, Washington. Presentation number 710.

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The risk of lower limb overuse injuries is markedly higher in female compared with male recruits during British Army Phase-1 Training. In particular, tibial injuries, including stress fractures and medial tibial stress syndrome, account for a high proportion of medical discharges during training. In April 2006, the British Army introduced the Single-sex Training Initiative to Phase-1 training courses to optimize training and reduce the risk of injury to recruits. This study determined the efficacy of single-sex training in reducing medical discharges due to tibial stress fractures and medial tibial stress syndrome in British Army recruits. All medical discharge cases of tibial stress fractures and medial tibial stress syndrome recorded two years before (April 2004 - March 2006) and following (April 2006 - March 2008) the introduction of the Single-sex Training Initiative were extracted from a database held by the Army Recruiting and Training Division. Stress fracture and medial tibial stress syndrome cases were combined and collectively termed tibial injury. Data were separated into male (N = 75) and female (N = 43) cases.

Following the introduction of the Single-sex training Initiative, medical discharges due to tibial injury were reduced from 17.6 to 10.8 per 1000 for female recruits, but remained constant at 2.4 per 1000 for male recruits. The odds ratio for females to males fell from 7.3 to 4.5. The greatest reduction in the incidence of tibial injury in female recruits occurred in the second year following the introduction when the odds ratio reached 3.1.

Implication. The introduction of single-sex training reduced the incidence of tibial stress fractures and medial tibial stress syndrome that led to medical discharges in female recruits. Single-sex training apparently can provide physical demands that are more commensurate with the capability of female recruits. However, as the risk of tibial injuries still remained higher in women than in men during Phase-1 training, suggesting factors as well as the physical demands of training contribute towards the development of overuse injuries in female recruits. [This study provides one more piece of evidence that training females has different demands and therefore, requires different features to those involved with males.]

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