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Background Musculoskeletal disorders (MSD) are common among soldiers and constitute the most common reason for discontinuing military service within different military populations worldwide. The aims of this study were to investigate the prevalence of musculoskeletal disorders in two cohorts, 10 years apart, in the Swedish Armed Forces, to explore differences between these cohorts and to determine associated factors with MSD. Method Comparative cross-sectional study. Participants were recruited from the Swedish Armed Forces, i.e. soldiers preparing for international missions in 2002 and 2012. A total of 961 soldiers, 7% women, participated in the study. Data were collected using the Musculoskeletal Screening Protocol (MSP), which includes questions regarding prevalence of MSD in ten anatomical locations (neck, upper back, low back, shoulders, elbow, hand, hip, knee, lower limb and foot). An additional five questions concern perceived self-rated health, i.e. how the respondent perceives their own physical body, mental health, social environment, physical environment and work ability. Results Over a ten-year period, both point prevalence and one-year prevalence of MSD in any body part increased significantly, with point prevalence increasing from 7.1 to 35.2% ( p  < 0.001) and one-year prevalence from 27.9 to 67.9% ( p  < 0.001). The knee was the most common anatomic location for MSD in both cohorts. Across each anatomical location (neck, upper back, low back, shoulders, elbow, hand, hip, knee, lower leg and foot), both point prevalence ( p  < 0.039) and one-year prevalence ( p  < 0.005) increased significantly from 2002 to 2012. Most soldiers reported good to excellent perceived health, i.e. self-perception of their physical body, mental health, physical and social environments, and work ability. The odds of reporting one-year prevalence of MSD in any body part was 5.28 times higher for soldiers in Cohort 2012, 1.91 times higher in age group 31–40 and 2.84 times higher in age group 41 and above. Conclusions The prevalence of MSD increased remarkably over a ten-year period among Swedish soldiers preparing for international missions. With increasing age as one risk factor, systematic monitoring of MSD throughout the soldiers’ careers and implementation of targeted primary-to-tertiary preventive programs are thus important.

Exploring sports-related musculoskeletal injuries and treatment characteristics in middle school sports may help inform patient care decisions such as appropriate medical coverage. To describe injury and treatment characteristics of middle school-aged athletes receiving care from athletic trainers within the Athletic Training Practice-Based Research Network (AT-PBRN). Descriptive study. Middle school. Middle school-aged athletes (n = 1011; male = 503, female = 506, 2 declined to answer) with sports-related musculoskeletal injuries. Electronic patient records were analyzed from the AT-PBRN from 59 athletic trainers across 14 states between 2010 and 2022. Summary statistics (frequency, percentages, median, and interquartile ranges [IQR]) were used to describe injury (age at injury, sex, sport, body part, and diagnosis) and treatment characteristics (type of treatment, number of visits, and number of procedures per visit). Football (17.7%, n = 179), basketball (17.6%, n = 178), and soccer (14.9%, n = 151) reported the highest number of injuries. The ankle (17.2%, n = 174), knee (16.5%, n = 167), and head (14.1%, n = 143) were the most common injury locations. Concussion (13.0%, n = 131), ankle strain/sprain (12.4%, n = 125), and thigh/hip/groin sprain/strain (11.1%, n = 112) were the most reported diagnoses. Therapeutic exercise or activities (27.6%, n = 1068), athletic trainer evaluation or re-evaluation (24.7%, n = 957), and hot/cold packs (19.8%, n = 766) were the most common services, with a median of 2 visits (IQR = 1 to 4) and 2 procedures (IQR = 1 to 2) per visit. Football, basketball, and soccer reported the most musculoskeletal injuries for middle school-aged athletes. Concussions were the most frequent diagnosis, followed by ankle sprains/strains. Our findings are similar to prior investigations at the high school and collegiate levels. Treatments at the middle school level were also similar to those that have been previously reported at the high school level with therapeutic exercise/activity, athletic trainer evaluation or re-evaluation, and hot/cold packs being the most common treatments. This information may be useful for informing patient care decisions at the middle-school level.

Background Musculoskeletal injuries (MSKIs) are common in military trainees and present a considerable threat to occupational fitness, deployability, and overall military readiness. Despite the negative effects of MSKIs on military readiness, comprehensive evaluations of the key known and possible risk factors for MSKIs are lacking. The U.S. Army Research Institute of Environmental Medicine (ARIEM) is initiating a large-scale research effort, the ARIEM Reduction in Musculoskeletal Injury (ARMI) Study, to better understand the interrelationships among a wide range of potential MSKI risk factors in U.S. Army trainees in order to identify those risk factors that most contribute to MSKI and may be best targeted for effective mitigation strategies. Methods This prospective study aims to enroll approximately 4000 (2000 male and 2000 female) U.S. Army trainees undergoing Basic Combat Training (BCT). Comprehensive in-person assessments will be completed at both the beginning and end of BCT. Participants will be asked to complete surveys of personal background information, medical history, physical activity, sleep behaviors, and personality traits. Physical measurements will be performed to assess anthropometrics, tibial microarchitecture and whole body bone mineral density, muscle cross-sectional area, body composition, and muscle function. Blood sampling will be also be conducted to assess musculoskeletal, genetic, and nutritional biomarkers of risk. In addition, participants will complete weekly surveys during BCT that examine MSKI events, lost training time, and discrete risk factors for injury. Participants’ medical records will be tracked for the 2 years following graduation from training to identify MSKI events and related information. Research hypotheses focus on the development of a multivariate prediction model for MSKI. Discussion Results from this study are expected to inform current understanding of known and potential risk factors for MSKIs that can be incorporated into solutions that optimize Soldier health and enhance military readiness.

Background Orthopedic injuries can negatively impact both the physical and mental health of patients. Ensuring patient satisfaction with their recovery is crucial for meeting patient-centered goals and enhancing overall health outcomes. Objective We aimed to investigate whether satisfaction with recovery can be predicted based on demographic information and baseline characteristics in people with non-catastrophic musculoskeletal trauma. Methods Participants with acute musculoskeletal injuries were recruited. The Satisfaction and Recovery Index (SRI) was used to assess the patient’s satisfaction with their recovery. A multivariable linear regression model was created to determine factors that are associated with SRI scores. Results A total of 100 patients participated, with a mean age of 32 years and 82% male. The majority had a high school education or lower, were employed, and sustained left-side injuries. Injuries were most often fractures/dislocations caused by motor vehicle collisions. The results of the multivariable linear regression analysis indicated no significant factors predicting satisfaction with recovery. Conclusions The studied demographic variables and baseline characteristics are not associated with the level of satisfaction with recovery among patients with non-catastrophic musculoskeletal trauma. Clinicians can use these findings to rule out these variables as contributors to low (or high) satisfaction with recovery. Future studies must assess the contribution of other probable and relevant psychological and social characteristics. Highlights Thirteen demographic variables that were studied (age, number of people the patient lives with, time since injury, sex, marital status, injured side, dominant side, education level, job, injury type, injured body part, and injury mechanism) cannot predict higher or lower satisfaction with recovery in people with non-catastrophic musculoskeletal trauma. Clinicians can rule out these demographic factors and baseline characteristics as contributors to satisfaction with recovery. Other probable predictors should be considered to understand what factors can contribute to the patient’s satisfaction with their recovery. Plain language study Chronic pain that persists after an orthopedic injury can have a significant negative impact on a patient's mental health. It is also linked to poor quality of life, delayed return to work, and a high socio-economic burden. Preventing these issues early in the recovery process and ensuring patients’ satisfaction with recovery is essential to avoid chronicity and to help them resume baseline levels of activity and work status. In this study, we examined the demographic characteristics of patients to determine if they can predict the level of satisfaction with recovery after orthopedic trauma and the results suggest that these factors are not associated with patients’ level of satisfaction with their recovery. This pivotal finding shifts the focus to other potential contributors, such as psychological ones, in understanding patient recovery experiences. By recognizing that these factors do not play a significant role in patient satisfaction, healthcare providers are encouraged to delve deeper into the psychological and social dimensions that might influence patients’ satisfaction with recovery

Objectives: This study aimed to critically review the results of recent studies that investigated the epidemiology of noncombat-related musculoskeletal injuries (MSIs) in the Navy. Methods: A systematic search was conducted of three major databases (Pubmed, Embase, and Cochrane) to identify epidemiological studies on MSIs in the Navy. Study selection and risk of bias assessment were conducted. Results: The overall prevalence of MSIs ranged from 12.69% to 48.81%. And the prevalence of head and face injuries, upper extremity injuries, spine injuries, chest injuries, and lower extremity injuries were 0.11%–0.66%, 0.53%–11.47%, 0.75%–12.09%, 0.43%–0.95%, and 0.4%–21.17%, respectively. For the specific MSIs, the incidence ranged from 0.03/1000 person-years to 32.3/1000 person-years in the Navy and Marines. The ankle-foot, lumbopelvic, knee and lower leg, and shoulder were identified as the most frequent location for MSIs. Conclusion: This systematic review summarized that the Navy population had a high prevalence of MSIs. And different risk factors for MSIs varied from different anatomic locations. This systematic review also provided valuable information on MSIs for sports medicine specialists.

Overuse-related musculoskeletal injuries mostly affect athletes, especially if involved in preseason conditioning, and military populations; they may also occur, however, when pathological or biological conditions render the musculoskeletal system inadequate to cope with a mechanical load, even if moderate. Within the MOVIDA (Motor function and Vitamin D: toolkit for risk Assessment and prediction) Project, funded by the Italian Ministry of Defence, a systematic review of the literature was conducted to support the development of a transportable toolkit (instrumentation, protocols and reference/risk thresholds) to help characterize the risk of overuse-related musculoskeletal injury. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach was used to analyze Review papers indexed in PubMed and published in the period 2010 to 2020. The search focused on stress (overuse) fracture or injuries, and muscle fatigue in the lower limbs in association with functional (biomechanical) or biological biomarkers. A total of 225 Review papers were retrieved: 115 were found eligible for full text analysis and led to another 141 research papers derived from a second-level search. A total of 183 papers were finally chosen for analysis: 74 were classified as introductory to the topics, 109 were analyzed in depth. Qualitative and, wherever possible, quantitative syntheses were carried out with respect to the literature review process and quality, injury epidemiology (type and location of injuries, and investigated populations), risk factors, assessment techniques and assessment protocols.

To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury. We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel. Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008–2015 were selected for systematic review. The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts. Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies.

Racehorse and jockey incidents on race-days frequently occur together, yet risk factors for their occurrence have historically been investigated separately. Consideration of both horses and humans in tandem is required for a One Health approach to risk reduction. Our objectives were to therefore identify modifiable risk factors for adverse outcomes that are common or conflicting to both horses and their jockeys in Thoroughbred racing. Australian Single National System records for the 2004/05 to 2018/19 flat racing season were merged with the corresponding Australian Racing Incident Database records. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were estimated for the outcomes of racehorse musculoskeletal injury (MSI), racehorse fatality, jockey falls and jockey injury using Poisson regression. Horse-level, race-level, jockey-level and trainer-level factors associated with each adverse outcome during or post-race were identified using multivariable logistic regression. The incidence of MSI was 21.21 (20.84, 21.59), racehorse fatalities 0.55 (0.50, 0.61), jockey falls was 3.01 (2.80, 3.24), and jockey injuries 1.79 (1.63, 1.97) per 1000 flat race starts. There was a decrease in racehorse MSI and jockey falls over the study period but no change in racehorse fatality or jockey injury incidence. In multivariable analysis, longer race distances and higher caliber races were associated with horse (  < 0.01), but not jockey, incidents. Firmer turf surfaces were associated with greater risk of both horse incidents and jockey falls (  < 0.05). Racehorses that were of older age at their first start, and/or had prior race-day injuries had a greater risk of injury and fatality (  < 0.001,  < 0.01, respectively). The most prominent risk factor for jockey fall or injury was a racehorse incident, although overall contributing to a relatively small proportion; 8.6% (  = 42/489) of jockey falls and 15.3% (  = 24/147) of injuries. Jockeys with fewer career starts were at greater risk of falling, and those with a higher percentage of last place finishing positions were at greater risk of injury (  < 0.001). As there were no conflicting risk factors identified between racehorse and jockey injury, policies aimed at reducing horse injury risk are also expected to benefit their riders.