Musculoskeletal Injuries in British Army Recruits: A Retrospective Study of Incidence and Training Outcome in Different Infantry Regiments Over Five Consecutive Training Years

Abstract

Background: Musculoskeletal training injuries represent a considerable socio economic burden with far reaching implications on organisational effectiveness. Injury data analysis is fundamental to understanding the magnitude of the problem and underpins the subsequent design and delivery of targeted prevention strategies. Aim: To evaluate five years inter-regimental musculoskeletal injury patterns and training outcomes in British infantry recruits. Methods: This was a descriptive retrospective observational study of 4777 MSKI reported from a total of 12501 British Infantry recruits over five consecutive training years (1st April 2012-31th March 2017). The observed cohorts comprised of recruits from the Parachute Regiment (n=1910), Line Infantry (n=7799), Guards (n=1834) and the Gurkha Regiment (n=958). The physiotherapy Department collected the injury data throughout consecutive phase 1 and phase 2 training, the Combat Infantryman Course (CIC). Results: The five year cumulative incidence varied between the individual training regiments; 66.49% (95% CI: 64.39-68.62), 38.17% (95% CI: 35.97-40.42) 33.29% (95% CI: 32.22-34.31) and 22.03% (95% CI: 19.42-24.65) for Parachute, Guards, Line, and Gurkha respectively. Overuse injuries were the most frequently observed subclassification whilst the most common site for all types of injury was the knee. Significant difference was found (p week 13). 42.1% of the total injuries accounted for within the first eight weeks of training. Training outcomes, recruits successfully completing training at the first attempt were found to be significantly different (p<0.01); 37.0% (Parachute), 53.1% (Guards), 64.6% (Line) and 98.42% (Gurkha). Conclusions: The wide range in the incidence of MSKI and training outcomes across the four Infantry training Regiments, suggests that there is a requirement to thoroughly investigate the content and delivery of training within the CIC as well as the impact of the introduction of an integrated injury prevention strategy-Project OMEGA.