Low fitness, low body mass and prior injury predict injury risk during military recruit training: a prospective cohort study in the British Army

Abstract

BackgroundInjuries sustained by military recruits during initial training impede training progression and military readiness while increasing financial costs. This study investigated training-related injuries and injury risk factors among British Army infantry recruits.MethodsRecruits starting infantry training at the British Army Infantry Training Centre between September 2008 and March 2010 were eligible to take part. Information regarding lifestyle behaviours and injury history was collected using the Military Pre-training Questionnaire. Sociodemographic, anthropometric, physical fitness and injury (lower limb and lower back) data were obtained from Army databases. Univariable and multivariable Cox regression models were used to explore the association between time to first training injury and potential risk factors.Results58% (95% CI 55% to 60%) of 1810 recruits sustained at least 1 injury during training. Overuse injuries were more common than traumatic injuries (65% and 35%, respectively). The lower leg accounted for 81% of all injuries, and non-specific soft tissue damage was the leading diagnosis (55% of all injuries). Injuries resulted in 122 (118 to 126) training days lost per 1000 person-days. Slower 2.4 km run time, low body mass, past injury and shin pain were independently associated with higher risk of any injury.ConclusionsThere was a high incidence of overuse injuries in British Army recruits undertaking infantry training. Recruits with lower pretraining fitness levels, low body mass and past injuries were at higher risk. Faster 2.4 km run time performance and minimal body mass standards should be considered for physical entry criteria.

Musculoskeletal Injuries in British Army Recruits: A Retrospective Study of Incidence and Training Outcome in Different Infantry Regiments

“…The observed regimental injury pattern in terms of onset and anatomical location is similar to previous investigations within both military [1,5,7,9] and sporting populations [34]. Overuse injury is the most common for all CIC regiments, a characteristic observed in numerous other studies [1,5,8,9,15].…”

“…The Gurkha regiment reports the lowest four year average injury rate (21.67%) whilst the Parachute Regiment reports the highest (66.21%). A Study by Sharma, et al [1] Previously reported an overall injury incidence of 48.6% in all British infantry recruits based on 2006-2008 data, whilst another study [5] in the same institution, based on 2009-2011 data, found an even higher injury incidence of 58%. However, although revealing, these studies did not investigate individual regimental specific injury incidence.…”

“…The British military is not excluded from this observation [1,5]. These injuries are identified as having negative impact on injury rates, training time, resources and manning [1,3,[6][7][8][9][10].…”

“…While it is clear that MSK injuries are detrimental to the British Army [1,5,13,14,18,19], it is not clear what constitutes an effective management strategy [3,20]. A wide variety of demographical injury data has been published.…”

“…A wide variety of demographical injury data has been published. For example, incidences of MSK injuries acquired during military training are reported ranging from 20% [10], 47% [21], 48% [1], 59% [5], to 59.7% [6] depending on location.…”