Musculoskeletal injuries caused by acute (sudden) incidents as well as chronic repeated stresses to the body (overuse), have been described as the single biggest health problem of the U.S. military because:
- Almost 50% of military experience 1 or more injury each year.
- They result in over 2,000,000 medical encounters annually across military Services.
- They require 90-120 or more days of restricted work or lost duty time, in addition to the cost of treatment.
- Most are overuse strains, sprains, and stress fractures; most to lower extremities (ankle/foot, knee/lower leg).
- More than half of these injuries are exercise or sports-related, especially running.
- Back and shoulder injuries are also common, more often associated with lifting and carrying activities. Technical references.
Injury: The damage or interruption to normal body tissue function resulting from an energy transfer that exceeds the threshold of tissue tolerance either in a single sudden event (acute trauma) or gradually from repetitive events (cumulative micro-trauma). Cause is too much energy [mechanical, environmental (heat/cold/altitude), poisons (drugs/toxins/chemicals), radiation, or electrical], OR lack of energy (e.g., absence of heat or oxygen) from unintentional (unplanned) or intentional (planned, violence-related) events; animate (human/animal/insect) or inanimate (objects/fires) sources. Injuries do not include genetic, degenerative, mental, and pathogenic disease or conditions. Per A Taxonomy of Injuries for Public Health Monitoring & Reporting.
Injury Causes and Risk Factors
Factors affecting the risk of injury can be associated with the activity, the individual, and the environment.
- Activities associated with high injury rates (e.g. running, parachuting) cannot always be avoided, but the frequency/amount and/or proper use of safe procedures or equipment can reduce some risks.
- Though gender and age cannot be changed, these demographic factors may be associated with higher or lower rates of certain injuries, especially when in conjunction with certain modifiable factors. For example, physical fitness levels, weight and body mass index (BMI), nutrition, and smoking are modifiable behaviors and characteristics that can have impacts on injury risk.
- Environmental factors, such as cold or hot weather or rugged terrain, can increase risks so should be balanced with training and mission performance goals. Technical references.
Not all injuries can be avoided, but many common injuries can be prevented. Reducing injuries is necessary to optimize fitness. Unit leaders should strive to reduce the overall rates at which injuries occur by practicing the following:
- Avoid focusing only on fatalities and severe injuries - more common musculoskeletal overuse injuries such as sprains and stress fractures also cause substantial detriment to readiness.
- Become familiar with rates, types and cause of injuries at the local/unit level.
- Remember that not all interventions are proven to be effective, and those that are may not reduce rates if not appropriately implemented and enforced. Evaluation of intervention strategies can help determine whether solutions are effective. Technical references.