A Review of Musculoskeletal Injuries in the United States Army

Musculoskeletal injuries (MSI) are the leading source of ambulatory encounters among active duty service members (1). In 2016, there were 19,158,557 reported ambulatory visits, and 4,198,896 (21.9%) were classified as MSI (1). The Defense Health Agency (DHA) reports that this is the highest annual total of MSI in the past 13 years, and the rate (approximately 15 outpatient visits per person) was 5.0% higher than the 2014 rate and 40.9% higher than in 2007 (1). It is estimated that MSI result in approximately 25 million lost duty/ training days annually (3,8,23). Moreover, decreased readiness, medical evacuation from theater, and disability in the military can often be the result of MSI (1,2,3,6,8,15,23). Therefore, MSI are an enormous burden to the military services.

According to data from 2006, approximately 75,000 U.S. Army Soldiers were unable to deploy on any given day (4). This was approximately 13% of the Army’s end strength, or the maximum number of Soldiers authorized by Congress. While this includes administrative, legal, and medical reasons, 42.5% of those 75,000 Soldiers (31,900) were non-deployable due to medical reasons, primarily MSI (4). This was equivalent to 5.78% of the Army’s end strength. These numbers become especially noticeable in the Army’s primary operational units, which are also known as brigade combat teams (BCT). In fiscal year 2010, approximately 14.5% of Soldiers in BCT were unable to deploy primarily due to MSI (4).

As surmounting as these numbers already are, it may only be half the story. There is reasonable evidence to suggest that medical conditions, namely MSI, are left unreported by 49 – 58% of Soldiers serving in a BCT setting (24,26). The primary reasons these Soldiers cite for not reporting their injuries are: a) fear of it hindering future career progressions or job opportunities; and, b) wanting to avoid being placed on a profile, which places restrictions on participation in unit-level physical training activities (26). The vast majority of these Soldiers (greater than 80%) admit to self-medicating as a primary means of treatment (24)

This article originally appeared in TSAC Report, the NSCA’s quarterly, online-only publication geared toward the training of tactical athletes, operators, and facilitators. It provides research-based articles, performance drills, and conditioning techniques for operational, tactical athletes. The TSAC Report is only available for NSCA Members. Read more articles from TSAC Report