title: Risk Factors for Lower Extremity Tendinopathies in Military Personnel.
abstract: BACKGROUND
  Overuse injuries have a significant impact on United States military service members, but research to date has been limited in its ability to assess occupational and behavioral risk factors.
  
  
  OBJECTIVE
  To prospectively identify risk factors for the development of lower extremity tendinopathy and plantar fasciitis in United States military personnel.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  Baseline data from the Millennium Cohort Study, a long-term observational cohort of military personnel, were utilized. Service members were enrolled in the cohort in 2001, 2004, and 2007. A total of 80,106 active-duty personnel were followed over 1 year for the development of patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis. Regression analyses were used to estimate significant associations between each tendinopathy, plantar fasciitis, and demographic, behavioral, and occupational characteristics.
  
  
  RESULTS
  Using medical records, 450 cases of Achilles tendinitis, 584 cases of patellar tendinopathy, and 1228 cases of plantar fasciitis were identified. Recent deployment was associated with an increased risk for developing plantar fasciitis (adjusted odds ratio [AOR], 1.27; 95% confidence interval [CI], 1.04-1.56). Moderate weekly alcohol consumption was marginally associated with an increased risk for Achilles tendinopathy (AOR, 1.33; 95% CI, 1.00-1.76). Overweight or obese individuals were more likely to develop Achilles tendinopathy and plantar fasciitis.
  
  
  CONCLUSIONS
  Lower extremity tendinopathies and plantar fasciitis are common among military service members, and this study identified several modifiable risk factors for their occurrence. These potential risk factors could serve as the focus for future preventive and intervention studies.
authors.affiliation: Orthopaedic Surgery, Keller Army Hospital, New York, New York, USA. ; Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
authors.affiliation: New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut, USA.
authors.forename: Jennifer Moriatis
authors.initials: JM
authors.lastname: Wolf
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Amber D
authors.initials: AD
authors.lastname: Seelig
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Isabel G
authors.initials: IG
authors.lastname: Jacobson
authors.affiliation: Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Besa
authors.initials: B
authors.lastname: Smith
authors.affiliation: Naval Hospital Camp Pendleton, Camp Pendleton, California, USA.
authors.forename: Margaret A K
authors.initials: MA
authors.lastname: Ryan
authors.affiliation: Analytic Services Inc, Arlington, Virginia, USA.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Gackstetter
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
keywords: Achilles tendinopathy; military deployment; patellar tendinopathy; plantar fasciitis