Why is injury prevention important to the military?
Injuries are the leading cause of healthcare utilization in DOD,
across all military Services. Approximately 50% of service members seek care for an injury each year
– yet injuries are largely preventable.
Injuries affect military during initial training, operational training and deployment, and have a direct negative impact on overall troop readiness. Injuries result in reduced individual fitness and health, and in certain cases discharge from military duty. In deployments, well over a third of non-battle related injuries have required evacuations.
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What are the most common types of military injuries?
Over 95% of military injuries are musculoskeletal injuries (MSKIs) which are caused by a mechanical energy transfer.
- Most MSKI (>2/3)
are caused by cumulative microtrauma (known as 'overuse' injuries), from repetitive contact with surfaces such as the ground. These are primarily to lower extremities (ankle/foot, knee/lower leg, and hip/upper thigh, even the pelvis). Excessive running and long road marches with heavy rucks are often activities attributed to these overuse MSKI.
- Lower back and shoulder injuries are also common, often associated with lifting and carrying activities. Certain types of military units (e.g.,
paratroopers) may have different injury patterns, such as higher rates of shoulder injuries compared to non-paratroopers).
What are key risk factors for military MSKI?
Some factors, such as a person's sex and age, may impact risk of certain injuries. These are considered
non-modifiable factors, meaning they cannot be changed. It is still useful to be aware of the influence non-modifiable risk factors have on a person's risk of injury,
especially overuse MSKI.
Some factors can be controlled by the person at risk. Other factors may be external conditions or exposures that the person at risk is subjected or required to experience. External factors may be reduced or controlled by unit leaders following risk management and safety protocols in combination with service members' individuals efforts to reduce their risks.
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Too much physical activity too soon – Many military activities associated with high injury rates cannot be avoided, but the frequency/amount and/or proper use of safe procedures or equipment can reduce some risks. For example,
- Healthy weight and behaviors – Physical fitness levels, weight and body mass index (BMI), nutrition, sleep, and smoking are modifiable behaviors and characteristics that can have impacts on injury risk. Being overweight (high BMI) or underweight (low BMI) can increase risk of injury. Poor nutrition and less than 6 hours of sleep have been linked to higher injury rates in military populations. Smoking inhibits cellular recovery so can increase injury risk in addition to slowing the injury healing process.
- Environmental factors, such as cold or hot weather or rugged terrain
– External stressors on the body such as high heat and humidity or cold temperatures may reduce a person's resilience to injury, so should be balanced with training and mission performance goals.
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Prevention
Reducing injuries optimizes force strength by ensuring more resilient and combat-ready service members fitness in addition to reducing the DOD's medical and financial burden.
Unit leaders should strive to reduce injury rates by practicing the following:
- Avoid focusing only on fatalities and severe acute injuries – the more common MSKIs such as joint pain, stress fractures, muscle strains cause more impacts to readiness.
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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.
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