Sex Differences in Training Loads during British Army Basic Training

Abstract

Sex differences in training loads could contribute to the greater injury risk for women during basic training. Daily RPE appears a practical option for measuring internal training load during military training.

Understanding the musculoskeletal injury risk of women in combat: the effect of infantry training and sex on musculoskeletal injury incidence during British Army basic training

“…Women are typically at a twofold to threefold higher risk for musculoskeletal injury than men during basic military training 6 11–14. Women entering military training have lower aerobic fitness, upper-body strength, lower-body strength, and muscle mass, compared with men,3 10 31 which contribute to a higher physiological stress during military training3 32 and increase the risk of musculoskeletal injury 6 14. These proposed sex differences in physical performance and body size did not translate to a sex difference in the incidence of stress fractures during standard entrant training, likely because of the low rates of stress fracture in both men and women.…”

“…Previous studies have reported the incidence or prevalence of musculoskeletal injury in British Army basic military training,6–9 but we provide new data comparing infantry training with standard entry training using defence medical records. The physiological stress during infantry training4 is greater than standard entry training,1–3 and we therefore hypothesised that infantry training would result in a higher incidence of musculoskeletal injury. The lower incidence of upper limb injury and the similar incidence of lower limb injury could be due to higher physical fitness of infantry recruits 9.…”

“…These proposed sex differences in physical performance and body size did not translate to a sex difference in the incidence of stress fractures during standard entrant training, likely because of the low rates of stress fracture in both men and women. The higher physiological stress for women in military training is most evident during field exercises3 5 and load carriage,32 which are limited during standard entry training and are more typical of infantry and officer training. To better understand the risk for musculoskeletal injury of women during more arduous and prolonged infantry-based training, we examined the incidence of injury during officer training.…”

“…Standard entry recruits (non-infantry soldiers) complete the 14-week Common Military Syllabus (CMS), infantry recruits complete the 26-week Combined Infantry Course (CIC), and officer cadets complete the 44-week Commissioning Course (CC). British Army basic training is physically arduous1–5 and results in a high incidence of musculoskeletal injury (46%–58%) 6–10. The risk of musculoskeletal injury is typically two to three times higher in women than in men during British Army basic training6 and other basic military training courses11–14 due in part to the lower body mass and aerobic fitness of women 6 14.…”

Skeletal responses to an all-female unassisted Antarctic traverse

“…An increase in trabecular vBMD is recognised as an early adaptation to mechanical loading [15,[36][37][38][39], whereas a reduction in cortical vBMD could be due to the unmineralised nature of new bone [10,15]. Basic military training is characterised by large increases in physical [40][41][42] and locomotor activity [40,43], and therefore the mechanical loading for the tibia is considered to be high [15,38,44,45]. Alpine skiing, the closest model of exercise to polar exploration, appears to increase trabecular vBMD of the tibia [35], but the mechanical loading profile of the expedition was not studied and each participant had undergone two years of prior training.…”