The objective of the study was to examine the risk factors and prognostic indicators for medial tibial stress syndrome (MTSS). In total, 35 subjects were included in the study. For the risk factor analysis, the following parameters were investigated: hip internal and external ranges of motion, knee flexion and extension, dorsal and plantar ankle flexion, hallux flexion and extension, subtalar eversion and inversion, maximal calf girth, lean calf girth, standing foot angle and navicular drop test. After multivariate regression decreased hip internal range of motion, increased ankle plantar flexion and positive navicular drop were associated with MTSS. A higher body mass index was associated with a longer duration to full recovery. For other prognostic indicators, no relationship was found.

Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from the Dutch Armed Forces are reviewed, with an emphasis on the most prevalent conditions of medial tibial stress syndrome and chronic exertional compartment syndrome. The conclusion is that exercise related leg pain in the military is an occupational problem that deserves further study.

This study, using 12 train drivers on a high speed track and 11 drivers on a mountain track, tried to differentiate between the physical, emotional, mental, and subjective workload components imposed on the drivers during work. With the simultaneous recording and on-line analysis of heart rate and physical activity, the emotional component in terms of the so-called additional heart rate was separated from the physical component. Mental workload was calculated by the heart rate variability and by shifts in the T-wave amplitude of the ECG. Speed of the train, mode of driving, and stress of the situation were rated by two observers who accompanied the drivers in the cabin. During speeds up to 100 km/h as compared to standstills no heart rate changes occurred, but with speeds from 100 km/h up to 200 km/h heart rate decreased indicating a monotony effect. However, heart rate variability, and T-wave amplitude indicated higher mental load during driving in most speed categories. Starting the train and coming to a halt showed greater emotional workload as compared to moving. Observer ratings of stress and subjective ratings of stress by the drivers revealed several discrepancies. Discrepancies were also seen between workload as indicated by the physiological parameters, and corresponding stress ratings by the observers or by the drivers.

Background Musculoskeletal injuries (MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training, operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available. Methods A systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed (using the “snowball method”). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made. Results In total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the “order of importance” and including concepts that are modifiable/non-modifiable, as well as extrinsic/intrinsic risk factors. Conclusions This is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.