Musculoskeletal Injury Epidemiology in Military Training

Musculoskeletal injuries represent a major health burden among military personnel, with high incidence during initial entry, operational training and deployment phases. Training regimens characterised by heavy load carriage, repetitive impact loading and sustained physical exertion lead to both acute and overuse injuries, particularly in the lower limbs and lumbar spine. Rates of injury vary by training intensity, sex and prior fitness level, with some studies reporting up to half of recruits sustaining at least one injury during basic courses. The temporal distribution often shows a peak in the early weeks of training, indicating a critical window for risk mitigation. Rehabilitation times differ widely according to diagnosis; stress fractures may require months of restricted duty, whereas soft-tissue strains recover more rapidly. Intrinsic risk factors such as low aerobic capacity, previous injury history and suboptimal body composition interact with extrinsic factors including load magnitude, training surface and equipment fit. Emerging surveillance tools, including standardised injury taxonomies and electronic profiling systems, now permit real-time monitoring of injury trends and severity. These data inform adaptive training protocols and targeted prevention strategies. Globally, militaries are adopting evidence-based modifications to conditioning programmes, screening processes and rehabilitation pathways to reduce injury incidence and preserve operational readiness.

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Musculoskeletal Injury Epidemiology in Military Training publication trend

The graph below shows the total number of articles in musculoskeletal injury epidemiology in military training across all publications each year (not limited to Nature Index journals).

Technical terms

Incidence rate: The number of new injury cases per unit of person-time (e.g. injuries per 1,000 person-days).

Hazard ratio: A measure comparing the likelihood of injury occurrence between two groups over time.

Overuse injury: A musculoskeletal injury developing from repetitive submaximal loading without adequate recovery.

Cox proportional hazards model: A statistical approach estimating the association between risk factors and the timing of injury events.

Intrinsic/extrinsic risk factors: Internal characteristics (e.g. age, fitness) versus external influences (e.g. training load, surface) affecting injury risk.

References

1. A machine learning framework to classify musculoskeletal injury risk groups in military service members. Frontiers in Artificial Intelligence (2024).
2. Changes in Physical Performance Following Operational Military Training: A Meta-Analysis. Sports Medicine - Open (2025).
3. Musculoskeletal injuries in British Army recruits: a prospective study of diagnosis-specific incidence and rehabilitation times. BMC Musculoskeletal Disorders (2015).
4. Risk factors for musculoskeletal injuries in the military: a qualitative systematic review of the literature from the past two decades and a new prioritizing injury model. Military Medical Research (2021).
5. Musculoskeletal injuries in military personnel—Descriptive epidemiology, risk factor identification, and prevention. Journal of Science and Medicine in Sport (2021).
6. Musculoskeletal Injuries and United States Army Readiness. Part II: Management Challenges and Risk Mitigation Initiatives. Military Medicine (2020).