Abstract
Background: Musculoskeletal physical training-related injuries are a major problem
in military populations. Injuries are important in terms of loss of time from work
and training and decreased military readiness. The implications of these injuries
in terms of patient morbidity, attrition rates, and training costs for military personnel
are staggering. This article reviews: (1) pertinent epidemiologic literature on musculoskeletal
injury rates; (2) injury type and location; and (3) risk factors for military populations.
Suggestions for injury surveillance and prevention are also offered.
Methods: Existing military and civilian epidemiologic studies were used to estimate
and compare the size of the injury problem, identify risk factors, and test preventive
measures. Most of the military research data obtained was from Marine and Army recruits,
Army Infantry soldiers, and Naval Special Warfare candidates. Additional studies conducted
in operational forces provided documentation of the injury problem in these populations
as well.
Results: Injury rates during military training are high, ranging from 6 to 12 per
100 male recruits per month during basic training to as high as 30 per 100 per month
for Naval Special Warfare training. Data collected show a wide variation in injury
rates that are dependent largely on the following risk factors: low levels of current
physical fitness, low levels of previous occupational and leisure time physical activity,
previous injury history, high running mileage, high amount of weekly exercise, smoking,
age, and biomechanical factors. (Data are contradictory with respect to age.)
Conclusion: Considering the magnitude of training injuries in military populations,
there is a substantial amount of work that remains to be performed, especially in
the areas of surveillance, prevention, and treatment. Modifiable risk factors have
been identified suggesting that overuse and other training injuries could be decreased
with proper interventions. Outpatient surveillance systems are available to capture
musculoskeletal injury data but need to be refined. Given the size of the problem,
a systematic process of prevention should be initiated starting with routine surveillance
to identify high-risk populations for the purpose of prioritizing research and prevention.
Properly planned interventions should then be implemented with the expectation of
dramatically reduced lost work/training time, attrition, and medical costs, while
increasing military readiness.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Intrinsic risk factors for exercise-related injuries among male and female Army trainees.Am J Sports Med. 1993; 21: 705-710
- High injury rates among female Army trainees.Am J Prev Med. 2000; 18: 141-146
- Cigarette smoking, physical fitness, and injuries in infantry soldiers.Am J Prev Med. 1994; 10: 145-150
- Risk of injury in soldiers.Mil Med. 1987; 152: 60-64
- Physical fitness, age, and injury incidence in infantry soldiers.J Occup Med. 1993; 35: 598-603
- Musculoskeletal and medical morbidity associated with rigorous physical training.Clin J Sports Med. 1993; 3: 229-234
- Changes in the incidence of medical conditions at the Commando Training Center, Royal Marines.J Roy Nav Med Serv. 1990; 76: 105-108
- A comparison of male and female orthopedic pathology in basic training.Mil Med. 1979; 144: 532-536
- Nature and causes of injuries in women resulting from an endurance training program.Am J Sports Med. 1980; 8: 265-269
- Associations among body composition, physical fitness, and injury in men and women Army trainees.in: Marriott B.M Grumstrup-Scott J Body composition and physical performance. National Academy Press, Washington, DC1992: 141-173
- Epidemiology of injuries associated with physical training among young men in the Army.Med Sci Sports Exer. 1993; 25: 197-203
- Epidemiologic patterns of musculoskeletal injuries and physical training.Med Sci Sports Exerc. 1999; 31: 1176-1182
- The relationship of foot structure and range of motion on musculoskeletal overuse injuries.Am J Sports Med. 1999; 27: 585-593
- Epidemiology of illness and injury among U.S. Navy and Marine Corps female training population.Mil Med. 1999; 164: 17-21
- Comparative stress fracture incidence in males and females in an equal training environment.Athletic Training. 1977; 12: 126-130
- Stress fracture—a preventable injury.Mil Med. 1982; 147: 285-287
- Stress factors in 295 trainees.Mil Med. 1983; 148: 666-667
- Prevention of lower extremity stress fractures.Am J Pub Health. 1988; 78: 1563-1567
- Stress fractures in the lower extremities of soldiers in basic training.Orthop Rev. 1992; 21: 297-303
- Risk factors associated with stress reactions in female Marines.Mil Med. 1997; 162: 698-702
- Use of simple measures of physical activity to predict stress fractures in young men undergoing a rigorous physical training program.Am J Epidemiol. 1999; 149: 236-242
- Injuries in high school sports.Pediatrics. 1978; 61: 465-469
- Mortality and morbidity from injuries in sports and recreation.Ann Rev Pub Health. 1984; 5: 163-192
- Incidence and nature of sports injuries in Ireland.Am J Sports Med. 1993; 21: 137-143
- The socioeconomic consequences of sports injuries in Randers, Denmark.Scand J Med Sci Sports. 1991; 1: 221-224
- Running-related morbidity.Ann Sport Med. 1982; 1: 30-34
- On the epidemiology of running injuries.Am J Sports Med. 1988; 16: 285-294
- An epidemiologic study of the benefits and risks of running.JAMA. 1982; 248: 3118-3121
- Predicting lower extremity injuries among habitual runners.Arch Intern Med. 1989; 149: 2565-2568
- Relationships between running injuries and running shoes.in: Segasser B Pfoerringer W The shoe in sport. Yearbook Med Publishers, Chicago1989: 256-265
- A survey of running injuries in 1505 competitive and recreational runners.J Sports Med Phys Fitness. 1990; 30: 307-315
- Injuries in recreational adult fitness activities.Am J Sports Med. 1993; 21: 461-467
- The epidemiology of aerobic dance injuries.Am J Sports Med. 1986; 14: 67-72
- Injuries to runners.Am J Sports Med. 1986; 14: 151-155
- Occurrence of running injuries in adults following a supervised training program.Int J Sports Med. 1989; 10: Sl86-Sl90
- Rates and risks for running and exercise injuries.Res Q Exerc Sport. 1987; 58: 221-228
- Non-elite marathon runners.Br J Sports Med. 1989; 23: 177-178
- Benefits and risks of running among women.Int J Sports Med. 1988; 9: 92-98
- The elite marathon runner.Br J Sports Med. 1988; 22: 19-21
- The Ontario cohort study of running-related injuries.Arch Intern Med. 1989; 149: 2561-2564
- Training habits and injury experience in distance runners.Physician Sports Med. 1988; 16: 101-113
- Injuries in runners.Am J Sports Med. 1987; 15: 168-171
- An epidemiological investigation of training and injury patterns in British triathletes.Br J Sports Med. 1994; 28: 191-196
- A physical training program to reduce musculoskeletal injuries in U.S. Marine Corps recruits. Naval Health Research Center, Technical Report No. NHRC97-2B. National Technical Information Service, U.S. Dept of Commerce, 1997
- Incidence of and risk factors for injury and illness among male and female Army basic trainees. U.S. Army Research Institute of Environmental Medicine, Natick, MA1988 (Tech. Rep. T19-98)
- Exercise, training, and injuries.Sports Med. 1994; 18: 202-214
- Foot morphologic characteristics and risk of exercise-related injury.Arch Fam Med. 1993; 2: 773-777
- Lower limb morphology and risk of overuse injury among male infantry trainees.Med Sci Sports Exerc. 1996; 28: 945-952
- Dual-energy x-ray absorptiometry derived structural geometry for stress fracture prediction in male U.S. Marine Corps recruits.J Bone Miner Res. 1996; 11: 645-653
- Effects of frequency and duration of training on attrition and incidence of injury.Med Sci Sports Exerc. 1977; 9: 31-36
- Biomechanical properties of infantry combat boot development. Naval Health Research Center, Techn. Rep. No. NHRC-97–26. National Technical Information Service, U.S. Dept of Commerce, 1997
- Prevention of common overuse injuries by the use of shock absorbing insoles.Am J Sports Med. 1990; 18: 636-641
- Analysis of extrinsic factors associated with 379 injuries occurring during 34,236 military parachute descents.J Royal Army Med Corps. 1991; 137: 115-121
- Parachuting injuries among Army Rangers.Mil Med. 1996; 161: 416-419
- A review of parachuting injuries.Injury. 1990; 21: 314-316
- Injury among female and male Army parachutists.Aviat Space Environ Med. 1997; 68: 1006-1011
- Injuries and illnesses incurred by an elite Army unit during the Operation Just Cause.Mil Med. 1995; 160: 373-380
- Braced for impact.J Trauma. 1998; 45: 575-580
- Get SMARTS! (Sports Medicine Research Team System). Department of the Navy, Washington, DC1995
Article info
Identification
Copyright
© 2000 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
