FOOT PROBLEMS LINKED TO STRESS FRACTURES

Runners who have high arches or flat feet are more likely than others to suffer painful bone injuries of the leg or foot called stress fractures, a Mayo Clinic study shows. On the other hand, people with these or other foot abnormalities don't appear to be at increased risk of running-related knee injuries, according to the study of Navy SEALs.

Those findings contradict some previous research that suggested common problems in runners' knees (including kneecap pain and pain on the side of the knee) could be traced to abnormal foot structure. The results seem likely to be reliable because the participants--449 Navy SEAL trainees--were young, healthy, in good shape, lived together under uniform conditions, and were monitored for injuries during an intensive training program that often included running up to 10 miles a day.

Mayo researchers carried out detailed studies of participants' foot and ankle structure, including measuring the height of their arches, the flexibility of their ankle joints, and the area of the mid-foot (the sole under the arch) that contacted the ground during walking--both barefoot and in combat boots. Then they kept track of the frequency of several common overuse injuries, including stress fractures of bones of the foot or leg, aching around the kneecap, pain on the side of the knee, Achilles tendinitis (inflammation of the tendon just above the heel) and "shin splints."

A total of 149 participants--33 percent--suffered at least one of these injuries during training. Stress fractures were the most common problem and were more frequent in trainees with either low or high arches. People with tight calf muscles were at increased risk of Achilles tendinitis. But "there was no relation between foot structure and knee injuries," said Kenton R. Kaufman, director of Mayo's biomechanics laboratory and the study's principal author.

Studies in civilian runners have found that between 14 percent and 48 percent seek medical attention or reduce mileage because of overuse injuries--a proportion similar to that seen in the trainees. "This really does apply to civilians, not just people who are training to become Navy SEALs," Kaufman said. Unfortunately for avid runners, the treatment for most such injuries is rest.

The study appears in the September-October issue of The American Journal of Sports Medicine.

--Susan Okie

BLOOD PRESSURE TESTS AT HOME OFTEN IN ERROR

People who test their blood pressure at home do not always report the results accurately to their doctors, a situation that can interfere with proper care, a Pittsburgh study shows.

Researchers asked patients with high blood pressure to take their pressure three times a day, using an electronic home test kit, and write down the results. Without their knowledge, home monitors also recorded the blood pressure electronically and the two sets of numbers were later compared.

About two-thirds of the written measurements were identical to the measurements stored electronically. But nearly 20 percent of the written blood pressures differed by more than 10 millimeters of mercury (the standard unit of blood pressure measurement) from the electronic recordings.

Reporting of uncontrolled blood pressure, or hypertension, was more likely to be inaccurate--a finding that researchers called especially worrisome. "False reporting of uncontrolled pressures may misguide physicians in the optimal medical treatment of their patients with hypertension, which could result in worse patient outcomes," they said.

The study included 29 hypertension patients, 15 women and 14 men, randomly selected from the database of a managed care health plan in Pittsburgh. They averaged 56 years in age.

Blood pressure is commonly measured in two numbers. The higher number refers to systolic pressure--when the heart contracts. The lower number refers to the diastolic pressure between beats. Both numbers appear in the usual notation for blood pressure: for example, "130 over 85."

In the study, 9 percent of the electronic readings showing an uncontrolled systolic pressure were reported by the participants as under control, as were 21 percent of the uncontrolled diastolic pressures.

Since patients who agreed to participate in the study may be more likely to report blood pressure correctly, researchers said, the actual incidence of erroneous reporting in the public at large may be even higher than the study indicates.

An estimated 50 million Americans have hypertension. Nearly half are not being treated, and in many of those are being treated still have not brought their blood pressure under control.

The study was done by researchers from the University of Pittsburgh and Health-America of Pennsylvania Inc., a managed care organization. The results appeared last month in Archives of Internal Medicine.

--Don Colburn

ONE-DAY HOSPITAL STAY LESS SATISFYING FOR MOMS

Women who spent only a day in the hospital after a routine delivery of a baby were less satisfied than those who had two days in the hospital, a survey of 499 mothers in Minnesota found.

Seventy-five percent of the women who were in the hospital for one day thought their stay was too short, while 37 percent of the women who stayed two days thought the same, according to the study.

The researchers found no major difference in complications reported by the women or their children, although the babies who left the hospital earlier had a slightly higher rate of jaundice.

The women surveyed were all members of HealthPartners, a Minnesota health plan. The study was reported in the November/December issue of Effective Clinical Practice, a journal of the American College of Physicians-American Society of Internal Medicine.

--Lexie Verdon