Page 142 - Journal of Special Operations Medicine - Winter 2014

Table 1 Injuries and Symptoms Among Soldiers During a 20-km Maximal Effort Road March
During March* Totals
Soldier Continued Soldier Did Not 1-15 Days
Study Injury/Symptoms March, No. Continue March, No. Post March, No. † No. %
Study 1 3 Foot blisters 13 0 19 32 35
Foot hotspots ‡ 3 0 0 3 3
Back pain/strain 5 7 9 21 23
Metatarsalgia 1 1 9 11 12
Leg strain/pain 0 0 7 7 8
Sprains (foot/knee/ankle) 1 1 4 6 7
Knee pain 0 0 4 4 4
Foot contusion 0 1 1 2 2
Other 1 2 2 5 5

Study 2 4 Foot blisters 43 3 3 49 50
Foot hotspots ‡ 1 0 0 1 1
Metatarsalgia 6 2 9 17 17
Ankle and knee sprains 5 0 0 5 5
Back strain 3 1 0 4 4
Knee pain 3 1 3 7 7
Hip and thigh pain 2 1 0 3 3
Ingrown toenail 0 3 0 3 3
Foot swelling 1 1 0 2 2
Hip abrasion 2 0 0 2 2
Stress fracture 0 1 0 1 1
Black toe 1 0 0 1 1
Leg numbness 1 0 0 1 1
Groin strain 0 0 1 1 1
Foot pain 2 0 0 2 2
Other 1 1 0 2 2
Notes: *From medic and physician reports.
† From medical records of Soldiers up to 15 days after the march.
‡ Hotspots are erythemic areas from frictional rubbing and are blister precursors.

march during which they were asked to move as rap- injuries and symptoms experienced by Soldiers during
idly as possible to complete a mission. Medics and a foot marching.
physician were present on the march course to record
and treat injuries, and Soldier medical records were
screened for march-related injuries several days after Foot Blisters
the foot march. Study 2 shows injuries experienced by A previous edition of this column covered the causes
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218 male US infantry Soldiers who carried an average and prevention of foot blisters. Briefly, blisters are
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of about 104 lb during a 161-km road march conducted caused by friction and moisture, and if either or both
over 5 consecutive days (about 32km each day). Injuries of these can be reduced, the likelihood of blisters can be
were recorded at fixed medical facilities along the march reduced. Proper boot sizing, foot conditioning by foot-
route and for several days after the mission. These data march training, using socks with material that moves
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indicate that foot blisters, back pain, metatarsalgia moisture away from the foot (e.g., polyester, acrylic),
(pain under the foot metatarsals), back pain, and knee and use of antiperspirants on the foot will likely reduce
pain are among the most common load-carriage–related blister incidence.

132 Journal of Special Operations Medicine Volume 14, Edition 4/Winter 2014