Risk factors of acute and overuse musculoskeletal injuries among young conscripts: a population-based cohort study

Abstract

BackgroundMilitary service in Finland is compulsory for all male citizens and annually about 80% of 19-year-old men enter into the service. The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth. On the other hand, activity-induced injuries among young are true public health issue. The purpose of the present prospective cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors.MethodsFour successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months. At the beginning of the service, the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified. Predictive associations between injuries and their risk factors were examined by multivariate Cox’s proportional hazard models.ResultsOf the 1411 participants, 27% sustained an acute injury and 51% suffered from overuse injury. Concerning acute injuries, highest risk for severe injuries were detected among conscripts with low fitness level in both the standing long-jump and push-up tests (hazard rate, HR=5.9; 95% CI: 1.6‒21.3). A history of good degree in school sports was not a protective factor against acute injuries. High waist circumference and, on the other hand, being underweight according to BMI increased the HR for overuse injuries. Brisk leisure time physical activity before military entry was a protective factor against overuse injuries. Poor result in Cooper’s test was a warning signal of elevated risk of overuse injuries.ConclusionWe confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training. The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries. Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees. This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries.

Physical and Performance Characteristics Related to Unintentional Musculoskeletal Injury in Special Forces Operators: A Prospective Analysis

“…Earlier researchers 34,36 who aimed to identify risk factors for musculoskeletal injuries in military populations have commonly found body composition measures such as a high BMI to be risk factors for injury. However, we did not find that body fat percentage was a risk factor for injury and only observed a BMI difference in the spine-injury group.…”

The incidence of military training-related injuries in Chinese new recruits: a systematic review and meta-analysis

“…In contrast, dozens of injury categories are used in different diagnoses in other countries (eg, Norway). Furthermore, the subgroup analyses indicated that the combined incidence rate of acute injury was higher than that of overuse injury, which is inconsistent with results from other countries 4. Acute injuries are generally categorised as acute if there is a sudden onset involving known trauma, while overuse-related injuries have a gradual onset without known trauma67–69 or appear during physical activities in a previously symptomless body part 70.…”

“…Other countries have reported varying incidence rates for military training-related musculoskeletal injuries in recruits. For example, the incidence rate in the British Army during 26 weeks of training was reported to be 48.6%2; the incidence rate in the Finish Army during 6 months of training was reported to be 78%4; the incidence rate in the Norwegian Army during 6–10 weeks of training was reported to be 23.20% 5. Overall, musculoskeletal injuries have been the main study object regarding training-related injuries,1–5 and differences in the incidence rate between countries may be due to differences in the course duration, course content and intensity.…”

Sport injuries treated at a physiotherapy center specialized in sports

“…Repetitive exercises and imbalance between training and recovery may be predictive factors for injuries (1,2). On the other hand, moderate physical activity with no focus on high performance is important to prevent illnesses such as hypertension, diabetes type II, obesity and others (3,4).…”

“…Nonetheless, even recreational practitioners are not immune to sports injuries, especially if not properly guided/supervised (1,2). Previous studies have indicated high incidence of injuries related to recreational sports practices and physical activities (5,6).…”