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

Publication ,  Journal Article
Molloy, JM; Pendergrass, TL; Lee, IE; Chervak, MC; Hauret, KG; Rhon, DI
Published in: Mil Med
September 18, 2020

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.

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Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

September 18, 2020

Volume

185

Issue

9-10

Start / End Page

e1461 / e1471

Location

England

Related Subject Headings

  • United States
  • Strategic, Defence & Security Studies
  • Musculoskeletal System
  • Musculoskeletal Diseases
  • Military Personnel
  • Male
  • Iraq
  • Humans
  • Female
  • Afghanistan
 

Citation

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Molloy, J. M., Pendergrass, T. L., Lee, I. E., Chervak, M. C., Hauret, K. G., & Rhon, D. I. (2020). Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact. Mil Med, 185(9–10), e1461–e1471. https://doi.org/10.1093/milmed/usaa027
Molloy, Joseph M., Timothy L. Pendergrass, Ian E. Lee, Michelle C. Chervak, Keith G. Hauret, and Daniel I. Rhon. “Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact.Mil Med 185, no. 9–10 (September 18, 2020): e1461–71. https://doi.org/10.1093/milmed/usaa027.
Molloy JM, Pendergrass TL, Lee IE, Chervak MC, Hauret KG, Rhon DI. Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact. Mil Med. 2020 Sep 18;185(9–10):e1461–71.
Molloy, Joseph M., et al. “Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact.Mil Med, vol. 185, no. 9–10, Sept. 2020, pp. e1461–71. Pubmed, doi:10.1093/milmed/usaa027.
Molloy JM, Pendergrass TL, Lee IE, Chervak MC, Hauret KG, Rhon DI. Musculoskeletal Injuries and United States Army Readiness Part I: Overview of Injuries and their Strategic Impact. Mil Med. 2020 Sep 18;185(9–10):e1461–e1471.

Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

September 18, 2020

Volume

185

Issue

9-10

Start / End Page

e1461 / e1471

Location

England

Related Subject Headings

  • United States
  • Strategic, Defence & Security Studies
  • Musculoskeletal System
  • Musculoskeletal Diseases
  • Military Personnel
  • Male
  • Iraq
  • Humans
  • Female
  • Afghanistan