Name
#18 Impact of Pes Planus on Early Adverse Attrition in Military Service
Speakers
Content Presented On Behalf Of:
DHA
Session Type
Poster
Date
Tuesday, March 3, 2026
Start Time
5:00 PM
End Time
7:00 PM
Location
Prince Georges Expo Hall E
Focus Areas/Topics
Clinical Care
Learning Outcomes
1. Explore the Impact of Pes Planus on Military Readiness:
Investigate how pes planus (ICD-10-CM codes M21.4 and Q66.5) affects musculoskeletal health, injury risk, and physical performance in military populations, particularly under the demands of training and operational tasks.
2. Assess Early Adverse Attrition (EAA) in Pes Planus Waivered Enlistees:
Analyze short-term (1-year) and mid-term (3-year) attrition rates among service members with pes planus waivers, compared to medically qualified (MQ) counterparts, using survival analysis methods.
3. Examine Attrition Trends by Service Branch and Sex:
Evaluate how pes planus-related attrition varies across different military branches and between male and female service members, identifying patterns that may inform targeted interventions.
4. Enhance Medical Standards for Pes Planus in Military Recruitment:
Leverage study findings to refine medical policies and waiver criteria, ensuring a balance between recruitment goals and the long-term health and readiness of service members with pes planus.
Investigate how pes planus (ICD-10-CM codes M21.4 and Q66.5) affects musculoskeletal health, injury risk, and physical performance in military populations, particularly under the demands of training and operational tasks.
2. Assess Early Adverse Attrition (EAA) in Pes Planus Waivered Enlistees:
Analyze short-term (1-year) and mid-term (3-year) attrition rates among service members with pes planus waivers, compared to medically qualified (MQ) counterparts, using survival analysis methods.
3. Examine Attrition Trends by Service Branch and Sex:
Evaluate how pes planus-related attrition varies across different military branches and between male and female service members, identifying patterns that may inform targeted interventions.
4. Enhance Medical Standards for Pes Planus in Military Recruitment:
Leverage study findings to refine medical policies and waiver criteria, ensuring a balance between recruitment goals and the long-term health and readiness of service members with pes planus.
Session Currently Live
Description
Pes planus, commonly referred to as flatfoot, is a condition characterized by the collapse of the medial longitudinal arch of the foot, classified under ICD-10-CM codes M21.4 and Q66.5. This condition is associated with biomechanical alterations that can lead to musculoskeletal pain, reduced mobility, and increased risk of overuse injuries, particularly in physically demanding environments such as military service. Studies have shown that pes planus is prevalent among military populations and is linked to higher rates of foot and ankle injuries, plantar fasciitis, and lower leg overuse injuries, which can significantly impact physical readiness and operational performance (Levy et al., 2006; Shibuya et al., 2011; Nesterovica et al., 2021). Additionally, the use of orthotics and footwear interventions has been explored as a potential strategy to mitigate injury risk and improve functional outcomes during initial military training (Franklyn-Miller et al., 2011; Knapik et al., 2014).
To address these readiness challenges, the Medical Standards Analytics and Research (MSAR) team is conducting a study to evaluate early adverse attrition (EAA) among active duty enlistees accessed between FY 2019-2023 via an approved pes planus medical waiver. The waived cohort, composed of individuals diagnosed with pes planus (M21.4 and Q66.5), is compared to demographically matched medically qualified (MQ) enlistees. EAA is assessed at both 1-year and 3-year intervals using Kaplan-Meier survival analysis, with results stratified by service branch and sex to identify differential attrition patterns. Sub-analysis of disability discharge is conducted using chi-square or analogous non-parametric tests to evaluate significance of associations and relative risk. Findings from this study aim to inform evidence-based modifications to DoD medical standards, ensuring optimal balance between recruitment needs and long-term health outcomes for service members.
Disclaimer:
Material was reviewed by WRAIR. There is no objection to presentation. Opinions or assertions are private views of the authors and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense. Investigators adhered to policies for protection of human subjects as prescribed in AR 70–25.