misalignment or ligament laxity. In the case of ATD6-56, improper loading was likely the causal factor. Frequent squatting and kneeling can lead to this condition, but if the right knee bone ATD6-22 (that has no such trauma) belongs to the same individual, then this is unlikely to be the reason. If so, the lesion was caused by a local trauma, such as strain on the soft tissue around the joint due to high intensity activity, or a fracture of the left femur and/or tibia (that is unconfirmable since neither bone is associated with this individual). The right fourth metatarsal ATD6-124 has a length x width lesion on the medial (toward the midline of the bone) side consistent with a march fracture. This condition is most often encountered by soldiers, long distance runners, and potentially flatfooted people whose foot bones failed under repeated, high intensity activity. Later Neanderthals would evolve a much more robust lower skeleton possibly to withstand such taxing movement across uneven terrain. Although only one other example of the condition has been identified (at Sima de los Huesos) among archaic humans, march fractures were probably a common injury for them given that the healed fracture leaves no visible mark, as well as their presumed high intensity lifestyle. Culture Technology H. antecessor was producing simple stone tools at Gran Dolina. This industry is found elsewhere in Early Pleistocene Spain—notably in Barranc de la Boella and the nearby Galería—distinguished by the preparation and sharpening of cores before flaking, the presence of (crude) bifaces, and some degree of standardisation of tool types. This bears some resemblance to the much more complex Acheulean industry, characteristic of African and later European sites. The earliest evidence of typical Acheulean toolsets comes from Africa 1.75 million years ago, but the typical Acheulean toolset pops up in Western Europe nearly a million years later. It is debated if these early European sites evolved into the European Acheulean industry independently from African counterparts, or if the Acheulean was brought up from Africa and diffused across Europe. In 2020 French anthropologist Marie-Hélène Moncel argued the appearance of typical Achuelean bifaces 700,000 years ago in Europe was too sudden to be the result of completely independent evolution from local technologies, so there must have been influence from Africa. Wearing on the TD6 stone tools is consistent with repeated abrasion against flesh, so they were probably used as butchering implements.