Incidence of injuries and factors related to injuries in combat soldiers

Abstract

IntroductionMusculoskeletal injuries to the lower extremities are major factors contributing to drop out from military tasks. The aim of the present study was to determine the incidence of musculoskeletal injuries and the parameters that differentiate between the soldiers who incurred these injuries and those who did not along 14 weeks of an infantry commanders course.MethodsOne-hundred and sixty-eight participants were recruited from an infantry commanders course. The soldiers were tested before (pre), in the middle (middle) and at the end (last) of the course for anthropometric measurements, proprioceptive ability and dynamic postural balance (DPB), and filled out an ankle stability questionnaire (Cumberland Ankle Instability Tool (CAIT). A physiotherapist followed and recorded all musculoskeletal injuries incurred by the participants during the course.ResultsFifty-eight participants out of the 168 (34.5%) reported some pain/injury. Time effects were found for body mass index, DPB asymmetry, DPB in posterior-medial (P-M) direction and proprioception ability. Injury effects were found for DPB asymmetry, DPB in P-M direction, CAIT and proprioception ability. An interaction was found for proprioception ability. The Cox regression showed that the variables that are mostly effecting injuries were pretesting proprioception ability, DPB asymmetry and CAIT.ConclusionsMore than one out of three participants incurred musculoskeletal injuries, with deficits in proprioception ability, DPB and ankle stability in pretesting as major factors contributing to injuries. Further studies should look at the effect of specific exercises such as proprioception, DPB and ankle stability exercises for prevention and treatment of musculoskeletal injuries among combat soldiers.

Distance travelled by military recruits during basic training is a significant risk factor for lower limb overuse injury

“…Many intrinsic and extrinsic factors have been hypothesised as the cause of overuse injuries, including nutrition,11 fatigue,12 flexibility,11 body mass index,11 13 entry-level fitness,11 14 15 and forces from marching 16–18. A logistic regression model was able to predict musculoskeletal injury, including lower limb overuse injuries, significantly with an accuracy of 34.50% 14.…”

Injury Prevention Exercises for Reduced Incidence of Injuries in Combat Soldiers

“…Previously, the YBT has been used in several military populations (15,38,41,45) and was found to predict future musculoskeletal injuries (45). Nagai et al (23) reported that reduced static balance was found to be a predictor of future injuries among soldiers, and they suggested that instituting injury prevention programs developed to improve balance might reduce the rate of musculoskeletal injury.…”

“…The Y-Balance Test (YBT) for each leg was performed according to the technique of Coughlan et al (7), which was previously published on soldiers (45): After the subject had completed 4 practice trials in each direction on each leg, they were given a 2-minute rest period, then performed 3 test trials in each direction.…”

“…Despite the above, very little is known about the association between injury prevention exercises, somatosensory abilities, and musculoskeletal injuries among combat soldiers (45). In athletes, somatosensory deficits have been found to be related to injuries such as recurrent ankle sprains and knee injuries (33).…”

“…These deficits were observed to distinguish between subjects with and without injuries, with subsequent improvement after intervention programs that reduce the risk for future musculoskeletal injuries (33). In relation to combat soldiers, a study on a similar infantry commanders course reported that at precourse, reduced proprioception ability and DPB asymmetry significantly affected the risk of injury occurrence, yet the influence of prevention exercises was not examined (45).…”