The Biomechanical Basis for Increased Risk of Overuse Musculoskeletal Injuries in Female Soldiers

2015 ◽  
pp. 187-206 ◽  
Author(s):  
Ran Yanovich ◽  
Yuval Heled ◽  
Julie Hughes
Keyword(s):  
Musculoskeletal Injuries ◽  
Increased Risk ◽  
Female Soldiers

scholarly journals Musculoskeletal Injuries Among Females in the Military: A Scoping Review

2020 ◽  
Author(s):  
Pauline Barbeau ◽  
Alan Michaud ◽  
Candyce Hamel ◽  
Danielle Rice ◽  
Becky Skidmore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Stress Fractures ◽  
Musculoskeletal Injuries ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Increased Risk ◽  
Military Members ◽  
The Military

ABSTRACT Introduction Musculoskeletal injuries (MSKi) are a common challenge for those in military careers. Compared to their male peers, reports indicate that female military members and recruits are at greater risk of suffering MSKi during training and deployment. The objectives of this study were to identify the types and causes of MSKi among female military personnel and to explore the various risk factors associated with MSKi. Materials and Methods A scoping review was conducted over a 4-month time frame of English language, peer-reviewed studies published from 1946 to 2019. Search strategies for major biomedical databases (e.g., MEDLINE; Embase Classic + Embase; and the following EBM Reviews—Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment, and the NHS Economic Evaluation Database) were developed by a senior medical information specialist and included 2,891 titles/abstracts. Study selection and data collection were designed according to the Population, Concept, and Context framework. Studies were included if the study population provided stratified data for females in a military context. Results From a total of 2,287 citations captured from the literature searches, 168 peer-reviewed publications (144 unique studies) were eligible for inclusion. Studies were identified from across 10 countries and published between 1977 and 2019. Study designs were primarily prospective and retrospective cohorts. Most studies assessed both prevalence/incidence and risk factors for MSKi (62.50%), with few studies assessing cause (13.69%). For MSKi of female recruits compared to active female members, the prevalence was higher (19.7%-58.3% vs. 5.5%-56.6%), but the incidence (0.02%-57.7% vs. 13.5%-71.9%) was lower. The incidence of stress fractures was found to be much higher in female recruits than in active members (1.6%-23.9% vs. 2.7%). For anthropometric risk factors, increased body fat was a predictor of MSKi, but not stress fractures. For physiological risk factors for both female military groups, being less physically fit, later menarche, and having no/irregular menses were predictors of MSKi and stress fractures. For biomechanical risk factors, among female recruits, longer tibial length and femoral neck diameter increased the risk of stress fractures, and low foot arch increased risk of an ankle sprain. For female active military members, differences in shoulder rotation and bone strength were associated with risk of MSKi. For biological sex, being female compared to male was associated with an increased risk of MSKi, stress fractures, and general injuries. The consequences of experiencing MSKi for active military included limited duties, time off, and discharge. For recruits, these included missed training days, limited duty days, and release. Conclusions This scoping review provides insight into the current state of the evidence regarding the types and causes of MSKi, as well as the factors that influence MSKi among females in the military. Future research endeavors should focus on randomized controlled trials examining training paradigms to see if women are more susceptible. The data presented in the scoping review could potentially be used to develop training strategies to mitigate some of the identified barriers that negatively impact women from pursuing careers in the military.

scholarly journals OVERUSE INJURY RISK INCREASES WITH YEAR-ROUND SPORT PARTICIPATION IN MIDDLE SCHOOL AGED ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0005
Author(s):  
Kevin M. Biese ◽  
Eric G. Post ◽  
Dan Schaefer ◽  
Stephanie Kliethermes ◽  
Alison Brooks ◽  
...  
Keyword(s):  
High School ◽  
Middle School ◽  
Risk Factor ◽  
Overuse Injury ◽  
Sport Participation ◽  
Musculoskeletal Injuries ◽  
Overuse Injuries ◽  
Baseline Survey ◽  
Previous Injury ◽  
Increased Risk

BACKGROUND: Retrospective studies of high school aged athletes have demonstrated that participating in one sport for more than 8 months of the year is a risk factor for overuse musculoskeletal injuries. This research has driven the recommendation that suggests youth athletes should not play a single organized sport for more than 8 months out of the year. However, these recommendations have never been prospectively examined in middle school aged athletes. The purpose of this study is to determine if year-round participation, operationally defined as participating in one sport for more than 8 months of the year, is associated with increased risk of overuse injuries in middle school aged athletes. METHODS: A total of 281 children (female N= 113, 40.2%, age= 12.1±1.2 years; range 10-14 years of age) completed an anonymous online survey with their parents for 39 weeks. A baseline survey was conducted in the first week of September 2017 and then weekly surveys were completed until June 2018. The baseline survey consisted of demographic information, previous injury history, and sport participation volume (months per year in primary sport). The weekly surveys asked participants to report their sleep habits, musculoskeletal injuries, and illnesses. Parents and children were asked to complete the surveys together. Participants were included in the analysis if they completed at least 80% of the total surveys. In the baseline survey, participants identified the previous months for which they played their primary sport. Those who marked more than 8 months out of the past 12 months were classified as “year-round participants.” Logistic regression was used to determine if year-round participation (>8 months/year) was a significant predictor of overuse musculoskeletal injuries during the study period. A second logistic regression model was created using the participant’s total reported months participating in a single sport as a predictor of overuse injuries. RESULTS: 80 (28.5%) participants were identified as participating year-round in a single sport and 49 overuse injuries were reported during the study period. Athletes who participated in a single sport year-round were more than twice as likely to sustain an overuse injury during the study period compared to non-year-round athletes (OR [95%CI]: 2.20[1.10-4.39], p=0.025), even after adjusting for sex, age, and previous injury history. The odds of sustaining an overuse injury increased approximately 17% for every additional month of participating in a single sport (OR [95%CI]: 1.17 [1.04 -1.32], p=0.012) again while controlling for sex, age, and previous injury. CONCLUSION: This is the first prospective study in middle school aged athletes examining year-round participation and overuse musculoskeletal injuries. Middle school aged athletes are at a 2-times increased risk of overuse musculoskeletal injuries when participating in a single sport for more than 8 months of the year compared to middle school aged athletes who participated 8 or less months in a single sport. Sport specialization has been identified as a risk factor for high school aged athletes for overuse injury – and our observations indicate that a similar trend may exist in middle school aged athletes. Recommendations regarding monthly sport participation for adolescents have been supported in the high school aged population and these recommendations may extend to an even younger population.

scholarly journals Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1461-e1471 ◽  
Author(s):  
Joseph M Molloy ◽  
Timothy L Pendergrass ◽  
Ian E Lee ◽  
Michelle C Chervak ◽  
Keith G Hauret ◽  
...  
Keyword(s):  
United States ◽  
Injury Risk ◽  
Mechanical Energy ◽  
Musculoskeletal Injuries ◽  
Injury Surveillance ◽  
Overuse Injuries ◽  
Limit Function ◽  
Injury Rates ◽  
Female Soldiers

Abstract Introduction Noncombat injuries (“injuries”) greatly impact soldier health and United States (U.S.) Army readiness; they are the leading cause of outpatient medical encounters (more than two million annually) among active component (AC) soldiers. Noncombat musculoskeletal injuries (“MSKIs”) may account for nearly 60% of soldiers’ limited duty days and 65% of soldiers who cannot deploy for medical reasons. Injuries primarily affect readiness through increased limited duty days, decreased deployability rates, and increased medical separation rates. MSKIs are also responsible for exorbitant medical costs to the U.S. government, including service-connected disability compensation. A significant subset of soldiers develops chronic pain or long-term disability after injury; this may increase their risk for chronic disease or secondary health deficits potentially associated with MSKIs. The authors will review trends in U.S. Army MSKI rates, summarize MSKI readiness-related impacts, and highlight the importance of standardizing surveillance approaches, including injury definitions used in injury surveillance. Materials/Methods This review summarizes current reports and U.S. Department of Defense internal policy documents. MSKIs are defined as musculoskeletal disorders resulting from mechanical energy transfer, including traumatic and overuse injuries, which may cause pain and/or limit function. This review focuses on various U.S. Army populations, based on setting, sex, and age; the review excludes combat or battle injuries. Results More than half of all AC soldiers sustained at least one injury (MSKI or non-MSKI) in 2017. Overuse injuries comprise at least 70% of all injuries among AC soldiers. Female soldiers are at greater risk for MSKI than men. Female soldiers’ aerobic and muscular fitness performances are typically lower than men’s performances, which could account for their higher injury rates. Older soldiers are at greater injury risk than younger soldiers. Soldiers in noncombat arms units tend to have higher incidences of reported MSKIs, more limited duty days, and higher rates of limited duty days for chronic MSKIs than soldiers in combat arms units. MSKIs account for 65% of medically nondeployable AC soldiers. At any time, 4% of AC soldiers cannot deploy because of MSKIs. Once deployed, nonbattle injuries accounted for approximately 30% of all medical evacuations, and were the largest category of soldier evacuations from both recent major combat theaters (Iraq and Afghanistan). More than 85% of service members medically evacuated for MSKIs failed to return to the theater. MSKIs factored into (1) nearly 70% of medical disability discharges across the Army from 2011 through 2016 and (2) more than 90% of disability discharges within enlisted soldiers’ first year of service from 2010 to 2015. MSKI-related, service-connected (SC) disabilities account for 44% of all SC disabilities (more than any other body system) among compensated U.S. Global War on Terrorism veterans. Conclusions MSKIs significantly impact soldier health and U.S. Army readiness. MSKIs also figure prominently in medical disability discharges and long-term, service-connected disability costs. MSKI patterns and trends vary between trainees and soldiers in operational units and among military occupations and types of operational units. Coordinated injury surveillance efforts are needed to provide standardized metrics and accurately measure temporal changes in injury rates.

Excess Stress Fractures, Musculoskeletal Injuries, and Health Care Utilization Among Unfit and Overweight Female Army Trainees

2016 ◽  
Vol 45 (2) ◽  
pp. 311-316 ◽  
Author(s):  
Margot R. Krauss ◽  
Nadia U. Garvin ◽  
Michael R. Boivin ◽  
David N. Cowan
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Stress Fracture ◽  
Body Fat ◽  
Stress Fractures ◽  
Musculoskeletal Injuries ◽  
Care Utilization ◽  
Injury Incidence ◽  
Increased Risk ◽  
Rate Ratios

Background: Musculoskeletal injuries are prevalent among military trainees and certain occupations. Fitness and body mass index (BMI) have been associated with musculoskeletal conditions, including stress fractures. Hypothesis: The incidence of, and excess health care utilization for, stress fracture and non–stress fracture overuse musculoskeletal injuries during the first 6 months of service is higher among unfit female recruits. Those who exceeded body fat limits are at a greater risk of incident stress fractures, injuries, or health care utilization compared with weight-qualified recruits. Study Design: Cohort study; Level of evidence, 3. Methods: All applicants to the United States Army were required to take a preaccession fitness test during the study period (February 2005–September 2006). The test included a 5-minute step test scored as pass or fail. BMI was recorded at application. There were 2 distinct comparisons made in this study: (1) between weight-qualified physically fit and unfit women and (2) between weight-qualified physically fit women and those who exceeded body fat limits. We compared the incidence of, and excess health care utilization for, musculoskeletal injuries, including stress fractures and physical therapy visits, during the first 183 days of military service. Results: Among the weight-qualified women, unfit participants had a higher non–stress fracture injury incidence and related excess health care utilization rate compared with fit women, with rate ratios of 1.32 (95% CI, 1.14-1.53) and 1.18 (95% CI, 1.10-1.27), respectively. Among fit women, compared with the weight-qualified participants, those exceeding body fat limits had higher rate ratios for non–stress fracture injury incidence and related excess health care utilization of 1.27 (95% CI, 1.07-1.50) and 1.20 (95% CI, 1.11-1.31), respectively. Weight-qualified women who were unfit had a higher incidence of stress fractures and related excess health care utilization compared with fit women, with rate ratios of 1.62 (95% CI, 1.19-2.21) and 1.22 (95% CI, 1.10-1.36), respectively. Among fit women exceeding body fat limits, the stress fracture incidence and related excess health care utilization rate ratios were 0.79 (95% CI, 0.49-1.28) and 1.44 (95% CI, 1.20-1.72), respectively, compared with those who were weight qualified. Conclusion: The results indicate a significantly increased risk of musculoskeletal injuries, including stress fractures, among unfit recruits and an increased risk of non–stress fracture musculoskeletal injuries among recruits who exceeded body fat limits. Once injured, female recruits who were weight qualified but unfit and those who were fit but exceeded body fat limits had increased health care utilization. These findings may have implications for military accession and training policies as downsizing of military services will make it more important than ever to optimize the health and performance of individual service members.

PREVALENCE OF MUSCULOSKELETAL INJURIES IN PARTICIPANTS ENROLLED IN ZUMBA-BASED TRAINING

2020 ◽  
Vol 23 (03) ◽  
pp. 2050013
Author(s):  
Swara Sawant ◽  
Sona Kolke
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Odds Ratio ◽  
Musculoskeletal Injuries ◽  
Self Management ◽  
Lower Back ◽  
Increased Risk ◽  
Binomial Regression ◽  
Recurrent Injuries ◽  
Self Administered Questionnaire

Purpose: Our study aimed to find the location and pattern of musculoskeletal injuries in participants enrolled in Zumba-based training and to analyze the contributing risk factors for injuries through a self-administered questionnaire. Methods: A total of 50 participants were recruited in an offline and online-based study using a self-administered questionnaire based on seven demographic-based questions, eight injury-related questions and five questions based on the risk factors related to Zumba-based training. Binomial logistic regression analysis was used to predict the odds-ratio and factors contributing to the risk of injuries. Results: Twenty-nine out of 50 participants (58%) had single or multiple musculoskeletal injuries with the most common sites of injury being in the order of: leg (23%), knee (18%) and ankle, foot and the lower back (15%). Amongst the injured subjects, 10 (34.4%) had sought medical help and 11 (37.9%) had resorted to self-management. The binomial regression analysis showed the presence of recurrent injuries and the flooring of the class to be significantly associated with the risk of injuries. Conclusion: There was a 58% prevalence of musculoskeletal injuries in the subjects enrolled in Zumba-based training. The factors which are found to be an increased risk for musculoskeletal injuries were recurrent injuries and flooring of the class.

scholarly journals Description of Musculoskeletal Injuries Occurring in Female Soldiers Deployed to Afghanistan

2015 ◽  
Vol 180 (3) ◽  
pp. 269-275 ◽  
Author(s):  
Tanja C. Roy ◽  
Sara R. Piva ◽  
Bryan C. Christiansen ◽  
Jonathan D. Lesher ◽  
Peter M. Doyle ◽  
...  
Keyword(s):  
Musculoskeletal Injuries ◽  
Female Soldiers

Clinical Features and isokinetic Parameters in Assessing Injury Risk in elite Football Players

2019 ◽  
Vol 40 (14) ◽  
pp. 903-908
Author(s):  
Rogério F. Liporaci ◽  
Marcelo Saad ◽  
Debora Bevilaqua Grossi ◽  
Marcelo Riberto
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Injury Risk ◽  
Functional Performance ◽  
Exercise Program ◽  
Musculoskeletal Injuries ◽  
Football Players ◽  
Muscle Injuries ◽  
Increased Risk ◽  
Individual Training

AbstractFootball players frequently face the occurrence of non-contact injuries. Although there are likely multiple factors that contribute to increased risk of non-contact injury, it remains a challenge to correlate all these factors. However, it is not clear how much of individual training abilities may interfere in these events. As such, the primary aim of the present study was to determine whether the reduction of functional performance of the thigh in the isokinetic knee tests, anthropometric and morbid history can establish risk factors for lower-limb musculoskeletal injuries throughout the season. The incidence of injuries and odds ratios were calculated for suspected risk factors. Hamstring/Quadriceps conventional ratio outside of the safety range (55–64%) may be involved in the occurrence of non-contact muscle injuries and the risk for any musculoskeletal injuries in the lower extremities is 16 times higher when extensor peak of torque exceeds 10% and 12 times higher when flexor peak of torque difference was greater than 10%. This kind of evaluation can result in intervention programs that may decrease the risk of lower-limb musculoskeletal injuries. Based on these results we can establish a specific and individualized exercise program for each athlete and thus protect them during the season.

scholarly journals The Risk Factors for Musculoskeletal Injuries in Thoroughbred Racehorses in Queensland, Australia: How These Vary for Two-Year-Old and Older Horses and with Type of Injury

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 270
Author(s):  
Kylie L. Crawford ◽  
Anna Finnane ◽  
Clive J. C. Phillips ◽  
Ristan M. Greer ◽  
Solomon M. Woldeyohannes ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Speed ◽  
Conditional Logistic Regression ◽  
Musculoskeletal Injuries ◽  
Slow Pace ◽  
Total Distance ◽  
Thoroughbred Racehorses ◽  
Increased Risk ◽  
Type Of Injury ◽  
The Impact

Musculoskeletal injuries (MSI) continue to affect Thoroughbred racehorses internationally. There is a strong interest in developing training and management strategies to reduce their impact, however, studies of risk factors report inconsistent findings. Furthermore, many injuries and fatalities occur during training rather than during racing, yet most studies report racing data only. By combining racing and training data a larger exposure to risk factors and a larger number of musculoskeletal injuries are captured and the true effect of risk factors may be more accurately represented. Furthermore, modifications to reduce the impact of MSI are more readily implemented at the training level. Our study aimed to: (1) determine the risk factors for musculoskeletal injuries and whether these are different for two-year-old and older horses and (2) determine whether risk factors vary with type of injury. This was performed by repeating analyses by age category and injury type. Data from 202 cases and 202 matched controls were collected through weekly interviews with trainers and analysed using conditional logistic regression. Increasing dam parity significantly reduced the odds of injury in horses of all age groups because of the effect in two-year-old horses (odds ratio (OR) 0.08; 95% confidence interval (CI) 0.02, 0.36; p < 0.001). Increasing total preparation length is associated with higher odds of injury in horses of all ages (OR 5.56; 95% CI 1.59, 19.46; p = 0.01), but particularly in two-year-old horses (OR 8.05; 95% CI 1.92, 33.76; p = 0.004). Increasing number of days exercised at a slow pace decreased the odds of injury in horses of all ages (OR 0.09; 95% CI 0.03, 0.28; p < 0.001). The distance travelled at three-quarter pace and above (faster than 13 m/s; 15 s/furlong; 800 m/min; 48 km/h) and the total distance travelled at a gallop (faster than 15 m/s; 13 s/furlong; 900 m/min; 55 km/h) in the past four weeks significantly affected the odds of injury. There was a non-linear association between high-speed exercise and injury whereby the odds of injury initially increased and subsequently decreased as accumulated high-speed exercise distance increased. None of the racing career and performance indices affected the odds of injury. We identified horses in this population that have particularly high odds of injury. Two-year-old horses from primiparous mares are at increased odds of injury, particularly dorsal metacarpal disease. Two-year-old horses that have had a total preparation length of between 10 and 14 weeks also have increased odds of injury. Horses of all ages that travelled a total distance of 2.4–3.8 km (12–19 furlongs) at a gallop in the last four weeks and horses three years and older that travelled 3.0–4.8 km (15–24 furlongs) at three-quarter pace and above also have increased odds of injury. We recommend that these horses should be monitored closely for impending signs of injury. Increasing the number of days worked at a slow pace may be more effective for preventing injury, if horses are perceived at a higher risk, than resting the horse altogether. Early identification of horses at increased risk and appropriate intervention could substantially reduce the impact of musculoskeletal injuries in Thoroughbred racehorses.

scholarly journals Heavy Loads and Lifting are Risk Factors for Musculoskeletal Injuries in Deployed Female Soldiers

2016 ◽  
Vol 181 (11) ◽  
pp. e1476-e1483 ◽  
Author(s):  
Tanja C. Roy ◽  
Sara R. Piva ◽  
Bryan C. Christiansen ◽  
Jonathan D. Lesher ◽  
Peter M. Doyle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Musculoskeletal Injuries ◽  
Heavy Loads ◽  
Female Soldiers
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