Lower limb injuries in New Zealand Defence Force personnel: descriptive epidemiology

Abstract

Objective: To describe the epidemiology of lower limb injuries in the New Zealand Defence Force (NZDF). Method: Data from all NZDF lower limb injury claims from an 11‐month period were examined for type, site, and circumstances of injury. Both injury codes and narratives were analysed, allowing each injury event to be classified according to mechanism of injury, object involvement, and activity at the time of injury, as well as type and site. Results: The commonest lower limb musculoskeletal injuries were ankle sprains or strains (35%) and knee sprains or strains (16%). Most commonly, injuries were due to acute over‐exertion (37%), involved no other person (50%), and occurred while running (28%) or playing team sports (25%). The injury rate for recruits was more than five times that of trained personnel. Conclusions: Potential interventions should target ankle sprains primarily, but also knee sprains and fractures. Fractures, while accounting for only 6% of lower limb injuries, should be a priority because of their high medical and time‐lost costs. Interventions must also take into account the high incidence of injuries involving individuals alone and sustained during recruit training. The study also demonstrated that analysis of military injury narratives provides valuable extra information on injury causation and the circumstances of injury, and allows more accurate characterisation of the injury process. Implications: This study will provide the basis for development of an injury prevention strategy for lower limb training injuries in the NZDF.

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

“…In contrast to the findings of Davidson et al [40] who reported acute injuries as the most prevalent, our study found overuse the most commonly reported sub-classification of all military training MSKI as well as the most commonly observed across individual training regiments. Heagerty et al [2] investigating four years injury patterns found incidence of 76.9% (Guards) 75.2 (Line), 82.2% (Para) 80.3% (Gurkha) for overuse injuries when considered as a percentage of total MSKI.…”

Incidence of Ankle Sprains Among Active-Duty Members of the United States Armed Services From 1998 Through 2006

“…[1][2][3][12][13][14] According to several studies, 1-3 the majority of ankle sprains documented within military personnel result from participation in organized and recreational sports, exercise, and physical training. Ankle sprains are not an isolated problem affecting US service members, as authors have documented a high rate of sportrelated, exercise-related, and physical training-related ankle sprains in British Army 3,13 and New Zealand Defense Force 2 populations.…”

“…In addition to athletic injuries, the physical fitness and training-related requirements of military service increase soldiers' risk for musculoskeletal injury in general and injury to the lower extremity and ankle specifically. [1][2][3][4] Ankle sprains are one of the most common injuries sustained by members of the US Armed Services and are among the leading causes of sport-related and physical training-related hospitalizations in the military. 1 In general, ankle sprains are often undertreated and result in chronic pain, muscular weakness, and chronic instability.…”

The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies

“…were excluded from our analysis as they were retrospective in design (19,(247)(248)(249)(250)(251). In studies and did not report specific data relating to sprain diagnosis.…”